This study investigated the association of hypertension with cognitive impairment and determined whether better adherence to plant-based diet(PBD)patterns may modify the association.We analyzed 4485 elderly individual...This study investigated the association of hypertension with cognitive impairment and determined whether better adherence to plant-based diet(PBD)patterns may modify the association.We analyzed 4485 elderly individuals with normal cognition at baseline from the Chinese Longitudinal Healthy Longevity Survey(2011−2018).Cognitive function was assessed by the Mini-mental State Examination(MMSE),and cognitive impairment was defined as an MMSE score below 18 points.Diet patterns were assessed using the overall plant-based diet index(PDI),healthful plant-based diet index(hPDI),and unhealthful plant-based diet index(uPDI)derived from a simplified food frequency questionnaire(FFQ).Blood pressure was measured through physical examination.Cox proportional hazard regression and restricted cubic spline were performed.Participants with hypertension had an increased risk of cognitive impairment compared with normal group.The associations between hypertension and cognitive impairment were more pronounced among participants with lower PDI than those with higher PDI,among participants with lower hPDI than those with higher hPDI,and among participants with higher uPDI than those with lower uPDI.A healthful PBD pattern may attenuate hypertension-induced cognitive impairment,while an unhealthful PBD pattern may exacerbate hypertensioninduced cognitive impairment in elderly.Adherence to healthful PBD pattern could be used to prevent or mitigate adverse neurological effects in the hypertensive population.展开更多
Hepatitis B virus(HBV)(sub)genotypes A1,D3 and E circulate in sub-Saharan Africa,the region with one of the highest incidences of HBV-associated hepatocellular carcinoma globally.Although genotype E was identified mor...Hepatitis B virus(HBV)(sub)genotypes A1,D3 and E circulate in sub-Saharan Africa,the region with one of the highest incidences of HBV-associated hepatocellular carcinoma globally.Although genotype E was identified more than 20 years ago,and is the most widespread genotype in Africa,it has not been extensively studied.The current knowledge status and gaps in its origin and evolution,natural history of infection,disease progression,response to antiviral therapy and vaccination are discussed.Genotype E is an African genotype,with unique molecular characteristics that is found mainly in Western and Central Africa and rarely outside Africa except in individuals of African descent.The low prevalence of this genotype in the African descendant populations in the New World,phylogeographic analyses,the low genetic diversity and evidence of remnants of genotype E in ancient HBV samples suggests the relatively recent reintroduction into the population.There is scarcity of information on the clinical and virological characteristics of genotype E-infected patients,disease progression and outcomes and efficacy of anti-HBV drugs.Individuals infected with genotype E have been characterised with high hepatitis B e antigen-positivity and high viral load with a lower end of treatment response to interferon-alpha.A minority of genotype E-infected participants have been included in studies in which treatment response was monitored.Of concern is that current guidelines do not consider patients infected with genotype E.Thus,there is an urgent need for further large-scale investigations into genotype E,the neglected genotype of HBV.展开更多
基金supported by the National Key R&D Program of China(2018YFC2000400)the National Natural Sciences Foundation of China(72061137004)+1 种基金the National Institute on Aging of National Institutes of Health(P01AG031719)Duke/DukeNUS(grant RECA(Pilot)/2019/0051 to Y.Z.).
文摘This study investigated the association of hypertension with cognitive impairment and determined whether better adherence to plant-based diet(PBD)patterns may modify the association.We analyzed 4485 elderly individuals with normal cognition at baseline from the Chinese Longitudinal Healthy Longevity Survey(2011−2018).Cognitive function was assessed by the Mini-mental State Examination(MMSE),and cognitive impairment was defined as an MMSE score below 18 points.Diet patterns were assessed using the overall plant-based diet index(PDI),healthful plant-based diet index(hPDI),and unhealthful plant-based diet index(uPDI)derived from a simplified food frequency questionnaire(FFQ).Blood pressure was measured through physical examination.Cox proportional hazard regression and restricted cubic spline were performed.Participants with hypertension had an increased risk of cognitive impairment compared with normal group.The associations between hypertension and cognitive impairment were more pronounced among participants with lower PDI than those with higher PDI,among participants with lower hPDI than those with higher hPDI,and among participants with higher uPDI than those with lower uPDI.A healthful PBD pattern may attenuate hypertension-induced cognitive impairment,while an unhealthful PBD pattern may exacerbate hypertensioninduced cognitive impairment in elderly.Adherence to healthful PBD pattern could be used to prevent or mitigate adverse neurological effects in the hypertensive population.
基金Supported by National Research Foundation(NRF)of South Africa,No.GUN#93516Deutsche Forschungsgemeinschaft(DFG,English:German Research Foundation)Cancer Association of South Africa(CANSA).
文摘Hepatitis B virus(HBV)(sub)genotypes A1,D3 and E circulate in sub-Saharan Africa,the region with one of the highest incidences of HBV-associated hepatocellular carcinoma globally.Although genotype E was identified more than 20 years ago,and is the most widespread genotype in Africa,it has not been extensively studied.The current knowledge status and gaps in its origin and evolution,natural history of infection,disease progression,response to antiviral therapy and vaccination are discussed.Genotype E is an African genotype,with unique molecular characteristics that is found mainly in Western and Central Africa and rarely outside Africa except in individuals of African descent.The low prevalence of this genotype in the African descendant populations in the New World,phylogeographic analyses,the low genetic diversity and evidence of remnants of genotype E in ancient HBV samples suggests the relatively recent reintroduction into the population.There is scarcity of information on the clinical and virological characteristics of genotype E-infected patients,disease progression and outcomes and efficacy of anti-HBV drugs.Individuals infected with genotype E have been characterised with high hepatitis B e antigen-positivity and high viral load with a lower end of treatment response to interferon-alpha.A minority of genotype E-infected participants have been included in studies in which treatment response was monitored.Of concern is that current guidelines do not consider patients infected with genotype E.Thus,there is an urgent need for further large-scale investigations into genotype E,the neglected genotype of HBV.
