ArticleFrontiers in public health2025
Cumulative behavioral and metabolic determinants of health are associated with higher inflammation-related indices: insights from a cross-sectional study (NHANES 2005-2018).
Article in Frontiers in public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: This study innovatively investigates the cumulative associations between behavioral determinants of health (BDoH), metabolic determinants of health (MDoH), and systemic inflammation biomarkers in U.S. adults, using a novel cross-sectional framework to quantify their synergistic effects. Methods: Utilizing cross-sectional data from 18,500 participants in the National Health and Nutrition Examination Survey (NHANES 2005-2018 cycle), we developed a composite exposure model integrating BDoH (smoking status, physical activity, dietary quality) and MDoH (obesity metrics, hypertension, diabetes) through standardized questionnaires and clinical measurements. Systemic immune-inflammation index (SII) and systemic inflammatory response index (SIRI) were calculated from peripheral blood cell counts. Multivariable-adjusted logistic regression models examined dose-response relationships, with trend analysis explicitly testing cumulative BDoH-MDoH interactions. Results: The cohort (mean age 44.3 ± 0.3 years; 52.4% male) demonstrated significant positive associations between adverse health determinants and inflammatory indices. Current tobacco use (OR = 1.32, 95%CI = 1.18-1.47), suboptimal diet (HEI < 52: OR = 1.24, 95%CI = 1.11-1.38), obesity (BMI ≥ 30 kg/m Conclusion: This cross-sectional study provides the first evidence that integrated BDoH-MDoH cumulative exposure models uncover distinct and synergistic inflammatory pathways. Both individual and combined behavioral-metabolic risk factors significantly associate with systemic inflammation biomarker elevation, highlighting the necessity of dual-target intervention strategies.
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