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The ZJU index, an innovative metabolic marker, combines triglycerides, fasting plasma glucose, body mass index, and the ratio of alanine aminotransferase to aspartate aminotransferase. This study examines how ZJU index variations correlate with all-cause mortality risk in US adults with metabolic syndrome (MetS). Data were obtained from 6020 individuals with MetS, extracted from the 2005-2018 National Health and Nutrition Examination Survey dataset, and linked to the National Death Index. Using multivariable Cox regression and restricted cubic splines, the impact of the ZJU index on all-cause mortality was evaluated. To identify the inflection points, piecewise Cox proportional hazards modeling was applied. Additionally, subgroup analyses and interaction assessments aimed to evaluate the consistency and reliability of the ZJU index. After multivariable adjustment, a U-shaped nonlinear relationship was identified, associating the ZJU value with all-cause deaths in MetS patients. Specifically, below a ZJU index threshold of 46.25, lower values were inversely correlated with mortality (hazard ratio 0.95, 95% CI 0.91-0.99). Above this threshold, there was a positive connection (hazard ratio 1.04, 95% CI 1.00-1.08) with death. Maintaining the ZJU index within an optimal range may reduce mortality risk in MetS patients.
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http://dx.doi.org/10.1097/MD.0000000000044203 | DOI Listing |
Diabetes Metab
September 2025
Paris Diabetology Federation, Paris, France; Institut Necker Enfants Malades, INSERM U1151, CNRS UMR 8253, IMMEDIAB Laboratory, Université Paris Cité, Paris, France; Department of Diabetology and Endocrinology, Bichat Hospital, AP-HP, Paris, France.
Aim: - To investigate the incidences of death and lower limb amputation (LLA) among patients hospitalized with a first diabetic foot ulcer and to identify the associated risk factors.
Methods: - We leveraged medical records from 08/2017 to 10/2023 in the clinical data warehouse of the Greater Paris Hospitals. The primary outcome was the cumulative incidence of death estimated at 12 months.
Environ Res
September 2025
Advanced Institute of Information Technology, Peking University, Hangzhou 311215, China; National Institute of Health Data Science, Peking University, Beijing 100191, China; Renal Division, Department of Medicine, Peking University First Hospital; Peking University Institute of Nephrology, Beijing 1
Objective: The impact of desert-originated dust has been underestimated in fine particulate matters (PM)-related disease burden studies. This study aimed to assess the association of long-term dust PM exposure and all-cause mortality among older adults in China.
Methods: A cohort study using electronic health records (2010-2020) across Weinan, a city in northwest China, which experiences persistently high PM levels and frequent sand and dust storms, included 1,553,724 adults aged ≥45 years.
Lancet HIV
September 2025
Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK; Botswana Harvard Health Partnership, Gaborone, Botswana.
Background: HIV-associated cryptococcal meningitis case fatality remains greater than 25%. Co-prevalent infections might contribute to poor outcomes. We aimed to ascertain the prevalence and the clinical significance of Epstein-Barr virus (EBV) and cytomegalovirus co-infections in patients with cryptococcal meningitis to guide potential therapeutic interventions.
View Article and Find Full Text PDFInjury
September 2025
Washington University School of Medicine, Department of Orthopaedic Surgery, St. Louis, MO, USA. Electronic address:
Introduction: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are increasingly prescribed for Type 2 diabetes and obesity due to their cardiometabolic benefits. However, their effects on fracture healing remain controversial. This study investigates perioperative GLP-1 RA use and outcomes following surgical treatment of lower extremity (LE) fractures.
View Article and Find Full Text PDFJPEN J Parenter Enteral Nutr
September 2025
Division of Gastroenterology, Department of Medicine, Toronto General Hospital, University of Toronto, University Health Network, Toronto, Ontario, Canada.
Background: Intravenous lipid emulsions are a key component of parenteral nutrition, and their fatty acid compositions may influence immune responses and clinical outcomes.
Methods: This retrospective cohort study conducted from January 2020 to December 2022 compared clinical outcomes of hospitalized non-critical care patients receiving parenteral nutrition with either mixed oil or soybean oil lipid emulsions for at least 48 h. The primary outcome was a composite of the presence of pneumonia, urinary tract infection, or an intra-abdominal collection diagnosed within 14 days of initiating parenteral nutrition.