1.Liuwei Dihuangwan Promote Mitophagy to Modulate Neuroinflammation and Behavioral Impairments in Rat Model of Autism Spectrum Disorder (ASD)
Pengjue HUANG ; Mingyue JIANG ; Ji WU ; Niya YIN ; Lei OUYANG ; Qinquan ZHU ; Di ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(2):52-60
ObjectiveTo observe the effect of Liuwei Dihuangwan on behavioral impairments in the rat model of autism spectrum disorder (ASD) and explore the mechanism of action. MethodsTwelve SD pregnant rats were intraperitoneally injected with valproic acid (VPA) (10 rats) or normal saline (2 rats), and male offspring were selected to establish the model of ASD and the control rats. Rats were randomly assigned into model, low-dose (0.75 g·kg-1) and high-dose (1.5 g·kg-1) Liuwei Dihuangwan, vitamin D (positive drug, 3.7×10-5 g·kg-1), and blank groups. Each group was administrated with the corresponding concentration of drugs or the same volume of normal saline by gavage for 2 weeks. After the intervention, the three-chamber social test was conducted to evaluate social interaction and social preference. The open field test was carried out to observe spontaneous behavior and anxiety state. Hematoxylin-eosin staining (HE) was used to observe the pathological changes of the prefrontal tissue. Transmission electron microscopy was employed to observe the ultrastructure of mitochondria in prefrontal neurons. Immunofluorescence was used to detect the expression of ionized calcium-binding adapter molecule-1 (Iba-1) in the prefrontal tissue. Enzyme-linked immunosorbent assay (ELISA) was adopted to measure the levels of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6). Western blot was employed to assess the expression differences of phosphorylated adenosine monophosphate-activated protein kinase (p-AMPK), adenosine monophosphate-activated protein kinase (AMPK), phosphorylated Unc-51-like autophagy-activating kinase 1 (p-ULK1), Unc-51-like autophagy-activating kinase 1 (ULK1), and FUN14 domain-containing protein 1 (FUNDC1). ResultsCompared with the blank group, the model group spent less time sniffing stranger 1 and stranger 2 in the three-chamber social test (P<0.01) and showed reductions in the total distance traveled, average speed, distance traveled in the central area, and time spent in the central area in the open field test (P<0.01). In addition, the model group showed extensive apoptosis of neurons, with shrunken nuclei and red-stained cytoplasm, and extensive necrosis of neurons in the prefrontal tissue, mitochondrial swelling, decreased matrix density, disrupted cristae, and autophagic lysosomes in neurons, increases in the rate of Iba-1 positive cells in the prefrontal area (P<0.01) and the levels of TNF-α and IL-6 (P<0.01), and down-regulation in the expression of p-AMPK/AMPK, p-ULK1/ULK1, and FUNDC1 (P<0.01). Compared with the model group, low-dose and high-dose Liuwei Dihuangwan and the vitamin D prolonged the time spent sniffing stranger 1 and stranger 2 in the three-chamber social test (P<0.05, P<0.01), increased the total distance traveled, average speed, distance traveled in the central area, and time spent in the central area in the open field test (P<0.05, P<0.01), restored the morphology of neurons in the prefrontal tissue, decreased the number of apoptotic cells, alleviated the swelling of mitochondria in neurons, increased the matrix density, mitigated the fragmentation and disorder of cristae, and increased the number of autophagosomes. Moreover, the drugs decreased the rate of Iba-1 positive cells in the prefrontal area (P<0.01), lowered the levels of TNF-α and IL-6 (P<0.01), and up-regulated the expression of p-AMPK/AMPK, p-ULK1/ULK1, and FUNDC1 (P<0.01). ConclusionLiuwei Dihuangwan ameliorate autism-like behaviors and reduce neuronal apoptosis and neuroinflammatory damage in the rat model of ASD by promoting mitophagy mediated by the AMPK/ULK1/FUNDC1 pathway.
2.Herbal Textual Research on Inulae Flos in Famous Classical Formulas
Caixia LIU ; Yue HAN ; Yanzhu MA ; Lei GAO ; Sheng WANG ; Yan YANG ; Wenchuan LUO ; Ling JIN ; Jing SHAO ; Zhijia CUI ; Zhilai ZHAN
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(3):210-221
In this paper, by referring to ancient and modern literature, the textual research of Inulae Flos has been conducted to clarify the name, origin, production area, quality evaluation, harvesting, processing and others, so as to provide reference and basis for the development and utilization of famous classical formulas containing this herb. After textual research, it could be verified that the medicinal use of Inulae Flos was first recorded in Shennong Bencaojing of the Han dynasty. In successive dynasties, Xuanfuhua has been taken as the official name, and it also has other alternative names such as Jinfeicao, Daogeng and Jinqianhua. The period before the Song and Yuan dynasties, the main origin of Inulae Flos was the Asteraceae plant Inula japonica, and from the Ming and Qing dynasties to the present, I. japonica and I. britannica are the primary source. In addition to the dominant basal species, there are also regional species such as I. linariifolia, I. helianthus-aquatili, and I. hupehensis. The earliest recorded production areas in ancient times were Henan, Hubei and other places, and the literature records that it has been distributed throughout the country since modern times. The medicinal part is its flower, the harvesting and processing method recorded in the past dynasties is mainly harvested in the fifth and ninth lunar months, and dried in the sun, and the modern harvesting is mostly harvested in summer and autumn when the flowers bloom, in order to remove impurities, dry in the shade or dry in the sun. In addition, the roots, whole herbs and aerial parts are used as medicinal materials. In ancient times, there were no records about the quality of Inulae Flos, and in modern times, it is generally believed that the quality of complete flower structure, small receptacles, large blooms, yellow petals, long filaments, many fluffs, no fragments, and no branches is better. Ancient processing methods primarily involved cleaning, steaming, and sun-drying, supplemented by techniques such as boiling, roasting, burning, simmering, stir-frying, and honey-processing. Modern processing focuses mainly on cleaning the stems and leaves before use. Regarding the medicinal properties, ancient texts describe it as salty and sweet in taste, slightly warm in nature, and mildly toxic. Modern studies characterize it as bitter, pungent, and salty in taste, with a slightly warm nature. Its therapeutic effects remain consistent across eras, including descending Qi, resolving phlegm, promoting diuresis, and stopping vomiting. Based on the research results, it is recommended that when developing famous classical formulas containing Inulae Flos, either I. japonica or I. britannica should be used as the medicinal source. Processing methods should follow formula requirements, where no processing instructions are specified, the raw products may be used after cleaning.
3.Herbal Textual Research on Inulae Flos in Famous Classical Formulas
Caixia LIU ; Yue HAN ; Yanzhu MA ; Lei GAO ; Sheng WANG ; Yan YANG ; Wenchuan LUO ; Ling JIN ; Jing SHAO ; Zhijia CUI ; Zhilai ZHAN
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(3):210-221
In this paper, by referring to ancient and modern literature, the textual research of Inulae Flos has been conducted to clarify the name, origin, production area, quality evaluation, harvesting, processing and others, so as to provide reference and basis for the development and utilization of famous classical formulas containing this herb. After textual research, it could be verified that the medicinal use of Inulae Flos was first recorded in Shennong Bencaojing of the Han dynasty. In successive dynasties, Xuanfuhua has been taken as the official name, and it also has other alternative names such as Jinfeicao, Daogeng and Jinqianhua. The period before the Song and Yuan dynasties, the main origin of Inulae Flos was the Asteraceae plant Inula japonica, and from the Ming and Qing dynasties to the present, I. japonica and I. britannica are the primary source. In addition to the dominant basal species, there are also regional species such as I. linariifolia, I. helianthus-aquatili, and I. hupehensis. The earliest recorded production areas in ancient times were Henan, Hubei and other places, and the literature records that it has been distributed throughout the country since modern times. The medicinal part is its flower, the harvesting and processing method recorded in the past dynasties is mainly harvested in the fifth and ninth lunar months, and dried in the sun, and the modern harvesting is mostly harvested in summer and autumn when the flowers bloom, in order to remove impurities, dry in the shade or dry in the sun. In addition, the roots, whole herbs and aerial parts are used as medicinal materials. In ancient times, there were no records about the quality of Inulae Flos, and in modern times, it is generally believed that the quality of complete flower structure, small receptacles, large blooms, yellow petals, long filaments, many fluffs, no fragments, and no branches is better. Ancient processing methods primarily involved cleaning, steaming, and sun-drying, supplemented by techniques such as boiling, roasting, burning, simmering, stir-frying, and honey-processing. Modern processing focuses mainly on cleaning the stems and leaves before use. Regarding the medicinal properties, ancient texts describe it as salty and sweet in taste, slightly warm in nature, and mildly toxic. Modern studies characterize it as bitter, pungent, and salty in taste, with a slightly warm nature. Its therapeutic effects remain consistent across eras, including descending Qi, resolving phlegm, promoting diuresis, and stopping vomiting. Based on the research results, it is recommended that when developing famous classical formulas containing Inulae Flos, either I. japonica or I. britannica should be used as the medicinal source. Processing methods should follow formula requirements, where no processing instructions are specified, the raw products may be used after cleaning.
4.Herbal Textual Research on Zijingpi in Famous Classical Formulas
Shuyi YANG ; Linmin FENG ; Wuwei MENG ; Zhilai ZHAN ; Lei ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(13):212-224
By consulting herbal texts, medical records, formula collections, and other relevant literature from various historical periods, as well as modern and contemporary research materials, different aspects of the historical evolution of Zijingpi, including its name, origin, scientific name verification, medicinal part, genuine producing areas, harvesting, processing, and preparation, properties and flavors, and primary indications, were systematically reviewed and verified, providing a basis for the development of famous classical formula preparations containing this medicinal material. According to the textual research, Cercis chinensis was first recorded under the name "Zijingmu" in the Rihuazi Bencao from the Five Dynasties period. From the Song Dynasty to the Qing Dynasty, it was known by various names such as "Zijing", "Zijingpi", and "Zijingmupi". In modern and contemporary times, it has been officially named "Zijingpi", with aliases such as "Mantiaohong", "Zihuashu", and "Qingminghua". Historically, the mainstream source of Zijingpi was the dried bark of Cercis chinensis Bunge, a species of the legume family. However, there were also instances of confusion with the Lythraceae plant Lagerstroemia indica L. The producing areas of Zijingpi have no special geographical limitation, and the plant is currently distributed throughout most parts of China. There were no special requirements for harvesting time in ancient times, while modern records indicate harvesting time in spring, summer, and autumn. Ancient processing methods were rarely recorded, with only mentions of stir-frying Zijingpi. Modern practice mostly uses the raw material medicinally. Modern standards prefer it to be "dry, long strips, and thick". The functions of Zijingpi, mainly to promote blood circulation, relieve strangury, and detoxify, have remained consistent from ancient to modern times. Based on the textual research findings, it is recommended that when developing and exploiting the famous classical formulas containing Zijingpi, the bark of C. chinensis should be selected as the source. The processing method should be chosen according to the formula requirements, and if no specific requirements are indicated, it is suggested to use the raw material medicinally.
5.Pollution status and health risk assessment of PM2.5-bound polycyclic hydrocarbons in Yanta District of Xi’an from 2023 to 2024
Minjuan WANG ; Di ZHAO ; Sicen LIU ; Nan ZHANG ; Lei CAO ; Ticao ZHOU
Journal of Environmental and Occupational Medicine 2026;43(6):730-738
Background Polycyclic aromatic hydrocarbons (PAHs) readily adsorb onto the surface of fine particulate matter (PM2.5) and are representative components of organic pollutants in the atmosphere. PAHs are known for their significant carcinogenic, teratogenic, and mutagenic toxicity, and long-term exposure to PAHs has adverse effects on human health. Objective To investigate the concentration, composition, and pollution sources of 16 priority PAHs in PM2. 5 of Yanta District, Xi'an, and to evaluate the associated health risks. Methods PM2.5 samples were collected from March 2023 to February 2024. The concentrations of 16 PAHs (ΣPAHs) were determined by high performance liquid chromatography (HPLC). Diagnostic ratios (DR) and positive matrix factorization (PMF) were used to identify the sources of PAHs. Pearson correlation analysis was applied to examine the relationship between PAHs concentrations and meteorological factors. Furthermore, the toxicity of individual PAHs was converted into benzo[a]-pyrene (BaP) toxicity equivalents to calculate the toxicity of total PAHs. An incremental lifetime carcinogenic risk (ILCR) model was established to evaluate the health risks of PAHs inhalation across different demographic groups. Results The average concentration of ΣPAHs in PM2.5 of Yanta District, Xi'an followed a seasonal descending order: winter (15.71 ng·m−3) > spring (5.55 ng·m−3) > autumn (4.34 ng·m−3) > summer (1.47 ng·m−3). The relative abundances of PAHs in PM2.5 varied significantly by ring number, 4-ring PAHs accounted for the largest proportion, followed by 5-ring, 3-ring and 6-ring PAHs, while 2-ring PAHs were the least abundant. This ring distribution pattern remained consistent across seasons. The contribution rates of different emission sources to ΣPAHs concentration exhibited seasonal variations. Source apportionment revealed that industrial and traffic emissions were major contributors in spring; traffic emissions dominated in summer and autumn; and coal, natural gas, and biomass combustion were the predominant sources in winter. Correlation analysis showed that ΣPAHs concentration was highly positively correlated with atmospheric pressure and negatively correlated with temperature, but not significantly correlated with precipitation, wind speed, solar radiation, and relative humidity. The ILCR model indicated significant seasonal differences (winter > spring > autumn > summer) in inhalation health risks between adults and children, primarily due to variations in inhalation rates and body weight. Adults faced higher health risks than children across all seasons. Conclusion PAHs pollution in PM2.5 of Yanta District, Xi 'an is primarily driven by traffic emissions and the combustion of coal, natural gas, and biomass. PAHs concentrations are significantly influenced by meteorological factors, particularly air pressure, and temperature. Inhalation exposure poses distinct health risks to adults in winter. To effectively reduce ΣPAHs concentrations and mitigate air pollution, emission controls on winter coal combustion should be prioritized.
6.Liuwei Dihuangwan Reduces Valproic Acid-induced ASD-like Behaviors in Rats by Modulating mTOR-mediated Synaptic Plasticity in Prefrontal Cortex-hippocampus Circuit
Ji WU ; Niya YIN ; Lei OUYANG ; Siyu HE ; Fangyu PEI ; Ying XIE ; Fan LI ; Qian LEI ; Sha ZHAO ; Di ZHANG ; Qinquan ZHU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(22):1-11
ObjectiveTo investigate the effects of Liuwei Dihuangwan on mammalian target of rapamycin (mTOR)-mediated synaptic plasticity in the prefrontal cortex-hippocampus circuit in the rat model of valproic acid (VPA)-induced autism spectrum disorder (ASD) and to explore its potential mechanism for reducing behavioral abnormalities in ASD rats. MethodsThirteen SD pregnant rats were randomized into the VPA group (10 rats) and the control group (3 rats). On gestational day 13, the VPA group was intraperitoneally injected with VPA solution (600 mg·kg-1), while the control group was injected with an equal volume of normal saline. Male pups of 21 days old from both groups underwent behavioral tests to screen the ASD model rats (32 rats). These rats were then randomly assigned to the model (distilled water), vitamin D (1 480 U·kg-1), low-dose (0.75 g·kg-1) Liuwei Dihuangwan, and high-dose (1.5 g·kg-1) Liuwei Dihuangwan groups, and normal male pups were selected as the blank group (distilled water), with 8 rats in each group. Each group was treated with the corresponding drug or an equal volume of distilled water via gavage daily. After drug administration, behavioral tests were conducted again, followed by anesthesia and tissue collection. Nissl staining was carried out to observe the morphological changes of neurons in the prefrontal cortex and hippocampus. Transmission electron microscopy was used to observe changes in hippocampal synaptic structure. Immunohistochemistry and Western blot were employed to determine the expression of mTOR, phosphatidylinositol 3-kinase (PI3K), and protein kinase B (Akt) in the prefrontal cortex, as well as synaptophysin-1 (SYP-1), postsynaptic density 95 (PSD95), and N-methyl-D-aspartate receptors (NMDARs) in the hippocampus. ResultsCompared with the control group, the model group exhibited severe growth retardation and developmental deformities, with abnormal behavioral performance and pathological damage to neurons and synapses in the prefrontal cortex and hippocampus. Compared with the model group, all treatment groups showed reduced behavioral abnormalities and pathological damage to neurons and synapses in the prefrontal cortex and hippocampus, with the most significant effects in the high-dose Liuwei Dihuangwan group. Immunohistochemistry and Western blotting results showed that compared with the control group, the model group exhibited significantly increased protein levels and phosphorylation ratios of p-mTOR, p-Akt, and p-PI3K in the prefrontal cortex (P<0.05, P<0.01), and decreased protein levels of SYP-1 and PSD95 and increased protein level of NMDARs in the hippocampus (P<0.01). Compared with those in the model group, the protein levels of p-mTOR, p-Akt, and p-PI3K in the prefrontal cortex decreased in the vitamin D and high-dose Liuwei Dihuangwan groups (P<0.05), and the p-mTOR/mTOR, p-Akt/Akt, and p-PI3K/PI3K ratios in the prefrontal cortex declined in the vitamin D group (P<0.05). The high-dose Liuwei Dihuangwan group showed a reduction in p-PI3K/PI3K ratio (P<0.05). The protein level of SYP-1 and PSD95 in the hippocampus increased in the vitamin D, low-dose Liuwei Dihuangwan, and high-dose Liuwei Dihuangwan groups (P<0.05, P<0.01), while the protein level of NMDARs decreased in the vitamin D and high-dose Liuwei Dihuangwan groups (P<0.01). ConclusionLiuwei Dihuangwan significantly reduces VPA-induced ASD-like behaviors and enhances the regeneration and repair of neurons in the prefrontal cortex and synaptic structures in the hippocampus by downregulating of PI3K/Akt/mTOR expression in the prefrontal cortex, upregulating SYP-1 and PSD95 expression in the hippocampus, and inhibiting NMDARs expression.
7.The neurophysiological mechanisms of exercise-induced improvements in cognitive function.
Jian-Xiu LIU ; Bai-Le WU ; Di-Zhi WANG ; Xing-Tian LI ; Yan-Wei YOU ; Lei-Zi MIN ; Xin-Dong MA
Acta Physiologica Sinica 2025;77(3):504-522
The neurophysiological mechanisms by which exercise improves cognitive function have not been fully elucidated. A comprehensive and systematic review of current domestic and international neurophysiological evidence on exercise improving cognitive function was conducted from multiple perspectives. At the molecular level, exercise promotes nerve cell regeneration and synaptogenesis and maintains cellular development and homeostasis through the modulation of a variety of neurotrophic factors, receptor activity, neuropeptides, and monoamine neurotransmitters, and by decreasing the levels of inflammatory factors and other modulators of neuroplasticity. At the cellular level, exercise enhances neural activation and control and improves brain structure through nerve regeneration, synaptogenesis, improved glial cell function and angiogenesis. At the structural level of the brain, exercise promotes cognitive function by affecting white and gray matter volumes, neural activation and brain region connectivity, as well as increasing cerebral blood flow. This review elucidates how exercise improves the internal environment at the molecular level, promotes cell regeneration and functional differentiation, and enhances the brain structure and neural efficiency. It provides a comprehensive, multi-dimensional explanation of the neurophysiological mechanisms through which exercise promotes cognitive function.
Animals
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Humans
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Brain/physiology*
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Cognition/physiology*
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Exercise/physiology*
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Nerve Regeneration/physiology*
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Neuronal Plasticity/physiology*
8.Identification and functional analysis of β-amyrin synthase gene in Dipsacus asper.
Huan LEI ; Hua HE ; Jiao XU ; Chang-Gui YANG ; Wei-Ke JIANG ; Tao ZHOU ; Lan-Ping GUO
China Journal of Chinese Materia Medica 2025;50(4):1043-1050
Dipsaci Radix is a commonly used Chinese herbal medicine in China, with triterpenoid saponins as the main active components. β-Amyrin synthase, a member of the oxidosqualene cyclase superfamily, plays a crucial role in the biosynthesis of oleanane-type triterpenoid saponins. Asperosaponin Ⅵ is an oleanane-type triterpenoid saponin. To explore the β-amyrin synthase genes involved in the biosynthesis of asperosaponin Ⅵ in Dipsacus asper, this study screened the candidate genes from the transcriptome data of D. asper. Two β-amyrin synthase genes, Da OSC1 and Da OSC2, were identified by phylogenetic analysis and correlation analysis. The coding sequences of Da OSC1 and Da OSC2 were 2 286 bp and 2 295 bp in length, encoding 761 and 764 amino acids,respectively. Multiple sequence alignments showed that Da OSC1 and Da OSC2 had three conserved motifs( DCTAE, QW, and MWCYCR) unique to the oxidosqualene cyclase family. Real-time quantitative PCR results showed that Da OSC1 and Da OSC2 had the highest expression levels in the roots. Compared with normal growth conditions, the low-temperature treatment significantly upregulated the expression of Da OSC1 and Da OSC2. Agrobacterium-mediated transient expression of Da OSC1 and Da OSC2 in Nicotiana benthamiana resulted in the production of β-amyrin, which suggested that Da OSC1 and Da OSC2 were able to catalyze the synthesis of β-amyrin. This study clarified the catalytic functions of two β-amyrin synthases in D. asper, analyzed their expression patterns in different tissue and at low temperatures. The findings provide a foundation for further studying the biosynthetic pathway and regulatory mechanism of asperosaponin Ⅵ in D. asper.
Intramolecular Transferases/chemistry*
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Phylogeny
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Plant Proteins/chemistry*
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Gene Expression Regulation, Plant
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Dipsacaceae/classification*
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Saponins/metabolism*
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Oleanolic Acid/metabolism*
9.Detection and sequence analysis of broad bean wilt virus 2 on Rehmannia glutinosa.
Xiao-Long DENG ; Jie YAO ; Lang QIN ; Shi-Wen DING ; Tie-Lin WANG ; Kun ZHANG ; Lei CHENG ; Zhen HE
China Journal of Chinese Materia Medica 2025;50(7):1741-1747
To clarify the occurrence and distribution of broad bean wilt virus 2(BBWV2) on Rehmannia glutinosa, this study collected 87 R. glutinosa samples with typical symptoms of viral disease such as chlorosis and crumple from Wenxian county and Wuzhi county in Jiaozuo city, Henan province and Qiaocheng district in Bozhou city, Anhui province. The BBWV2 CP target band was amplified from 37 R. glutinosa samples by RT-PCR technology. The total detection rate reached 42.5%, among which 43.0% was detected in samples from Henan province. The detection rate in samples from Anhui province was 37.5%. 37 BBWV2 CP sequences were obtained by cloning and sequencing of BBWV2 positive samples(data has been submitted to GenBank, accession numbers: PP407959-PP407995), and the sequence analysis of these CP sequences with 91 other BBWV2 isolates in GenBank showed a high genetic diversity with a consistency rate of 70.8%-100%. Meanwhile, phylogenetic analysis showed that BBWV2 could be divided into three groups according to CP sequences, among which the BBWV2 in R. glutinosa isolates obtained in this study were all located in group 3. This study identified the differences in the occurrence, distribution, and genetic diversity of BBWV2 in R. glutinosa from Henan province and Anhui province and provided a theoretical basis for the prevention and control of BBWV2.
Rehmannia/virology*
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Phylogeny
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Plant Diseases/virology*
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China
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Molecular Sequence Data
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Fabavirus/classification*
10.Association of Body Mass Index with All-Cause Mortality and Cause-Specific Mortality in Rural China: 10-Year Follow-up of a Population-Based Multicenter Prospective Study.
Juan Juan HUANG ; Yuan Zhi DI ; Ling Yu SHEN ; Jian Guo LIANG ; Jiang DU ; Xue Fang CAO ; Wei Tao DUAN ; Ai Wei HE ; Jun LIANG ; Li Mei ZHU ; Zi Sen LIU ; Fang LIU ; Shu Min YANG ; Zu Hui XU ; Cheng CHEN ; Bin ZHANG ; Jiao Xia YAN ; Yan Chun LIANG ; Rong LIU ; Tao ZHU ; Hong Zhi LI ; Fei SHEN ; Bo Xuan FENG ; Yi Jun HE ; Zi Han LI ; Ya Qi ZHAO ; Tong Lei GUO ; Li Qiong BAI ; Wei LU ; Qi JIN ; Lei GAO ; He Nan XIN
Biomedical and Environmental Sciences 2025;38(10):1179-1193
OBJECTIVE:
This study aimed to explore the association between body mass index (BMI) and mortality based on the 10-year population-based multicenter prospective study.
METHODS:
A general population-based multicenter prospective study was conducted at four sites in rural China between 2013 and 2023. Multivariate Cox proportional hazards models and restricted cubic spline analyses were used to assess the association between BMI and mortality. Stratified analyses were performed based on the individual characteristics of the participants.
RESULTS:
Overall, 19,107 participants with a sum of 163,095 person-years were included and 1,910 participants died. The underweight (< 18.5 kg/m 2) presented an increase in all-cause mortality (adjusted hazards ratio [ aHR] = 2.00, 95% confidence interval [ CI]: 1.66-2.41), while overweight (≥ 24.0 to < 28.0 kg/m 2) and obesity (≥ 28.0 kg/m 2) presented a decrease with an aHR of 0.61 (95% CI: 0.52-0.73) and 0.51 (95% CI: 0.37-0.70), respectively. Overweight ( aHR = 0.76, 95% CI: 0.67-0.86) and mild obesity ( aHR = 0.72, 95% CI: 0.59-0.87) had a positive impact on mortality in people older than 60 years. All-cause mortality decreased rapidly until reaching a BMI of 25.7 kg/m 2 ( aHR = 0.95, 95% CI: 0.92-0.98) and increased slightly above that value, indicating a U-shaped association. The beneficial impact of being overweight on mortality was robust in most subgroups and sensitivity analyses.
CONCLUSION
This study provides additional evidence that overweight and mild obesity may be inversely related to the risk of death in individuals older than 60 years. Therefore, it is essential to consider age differences when formulating health and weight management strategies.
Humans
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Body Mass Index
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China/epidemiology*
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Male
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Female
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Middle Aged
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Prospective Studies
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Rural Population/statistics & numerical data*
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Aged
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Follow-Up Studies
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Adult
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Mortality
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Cause of Death
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Obesity/mortality*
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Overweight/mortality*

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