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Hasegawa K, Sakurai A, Mizuki M, Kurita H, Tsukahara T, Nomiyama T. Association between the number of teeth and incident pre-diabetes among middle-aged adults with periodontal disease: a retrospective cohort analysis of Japanese claims data. BMJ Open 2023; 13:e075527. [PMID: 37984959 PMCID: PMC10660919 DOI: 10.1136/bmjopen-2023-075527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 10/20/2023] [Indexed: 11/22/2023] Open
Abstract
OBJECTIVES To investigate the association between the number of teeth and the new onset of pre-diabetes. DESIGN Retrospective cohort study. SETTING The National Database of Health Insurance Claims and Specific Health Checkups of Japan, which holds information from both the yearly health check-up programme known as the 'Specific Health Checkup' and health insurance claims data. PARTICIPANTS 1 098 371 normoglycaemic subjects who participated in the Specific Health Checkup programme every year from fiscal year (FY) 2015 to FY 2018 and had dental insurance claims data with a diagnosis of periodontal disease during FY 2016. OUTCOME MEASURES Incidence of pre-diabetes or diabetes observed at the Specific Health Checkup during FY 2018. RESULTS Among the participants, 1 77 908 subjects developed pre-diabetes, and 579 developed diabetes at the check-up during the subsequent follow-up year. Compared with the subjects with 26-28 teeth, those with 20-25, 15-19 or 1-14 teeth were associated with an increased likelihood of developing pre-diabetes or diabetes onset with adjusted ORs of 1.03 (95% CI: 1.02 to 1.05), 1.06 (1.03 to 1.09) and 1.07 (1.04 to 1.11), respectively. No clear modifications were observed for age, sex, body mass index or current smoking. CONCLUSIONS Having fewer teeth was associated with a higher incidence of pre-diabetes. Due to the limitations of this study, however, causality remains undetermined.
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Affiliation(s)
- Kohei Hasegawa
- Department of Preventive Medicine and Public Health, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
| | - Akinari Sakurai
- Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
| | - Masaru Mizuki
- Center for Perinatal, Pediatric, and Environmental Epidemiology, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
| | - Hiroshi Kurita
- Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
- Center for Perinatal, Pediatric, and Environmental Epidemiology, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
| | - Teruomi Tsukahara
- Department of Preventive Medicine and Public Health, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
- Center for Perinatal, Pediatric, and Environmental Epidemiology, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
- Department of Occupational Medicine, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
| | - Tetsuo Nomiyama
- Department of Preventive Medicine and Public Health, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
- Center for Perinatal, Pediatric, and Environmental Epidemiology, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
- Department of Occupational Medicine, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
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Kitazawa A, Fukuda Y. Sex-specific association of body mass index and fatty liver index with prevalence of renal hyperfiltration: a cross sectional study using Japanese health check-up data. BMC Nephrol 2023; 24:85. [PMID: 37013497 PMCID: PMC10071694 DOI: 10.1186/s12882-023-03137-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 03/22/2023] [Indexed: 04/05/2023] Open
Abstract
BACKGROUND The relationship between obesity and nonalcoholic fatty liver disease and renal hyperfiltration is controversial. This study aimed to assess the correlations of body mass index and fatty liver index, respectively, with renal hyperfiltration in non-diabetic subjects, considering age, sex, and body surface area. METHODS This cross-sectional study assessed the Japanese health check-up data (FY2018) of 62,379 non-diabetic individuals from a health insurance database. Renal hyperfiltration is the ≥ 95th percentile of estimated glomerular filtration rate (derived by Chronic Kidney Disease Epidemiology Collaboration formula) by gender and age in healthy subjects. After adjusting for potential confounders, multiple logistic regression models were applied to evaluate the correlation of renal hyperfiltration with body mass index categories and fatty liver index (10 equal parts). RESULTS A negative and positive correlation, respectively, were noted when the body mass index was < 21 and ≥ 30 in women; however, a positive correlation was noted for BMI < 18.5 and ≥ 30 in men. Renal hyperfiltration prevalence increased when fatty liver index increased for both sexes; the cutoff value for fatty liver index was 14.7 for women and 30.4 for men. CONCLUSIONS Body mass index and renal hyperfiltration correlated linearly in women; however, in men, the correlation was U-shaped; therefore, differing by sex. However, fatty liver index correlated linearly with renal hyperfiltration in both sexes. Non-alcoholic fatty liver disease might be associated with renal hyperfiltration; Fatty liver index is a simple marker that can be obtained from health check-ups. Since a high fatty liver index correlated with renal hyperfiltration, it may be beneficial to monitor the renal function in such a population.
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Affiliation(s)
- Atsushi Kitazawa
- Teikyo University Graduate School of Public Health, 2-11-1 Kaga, Itabashi-Ku, Tokyo, Japan.
- Department of Nephrology, Dokkyo Medical University Saitama Medical Center, Saitama, Japan.
| | - Yoshiharu Fukuda
- Teikyo University Graduate School of Public Health, 2-11-1 Kaga, Itabashi-Ku, Tokyo, Japan
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Adeva-Andany MM, Fernández-Fernández C, Funcasta-Calderón R, Ameneiros-Rodríguez E, Adeva-Contreras L, Castro-Quintela E. Insulin Resistance is Associated with Clinical Manifestations of Diabetic Kidney Disease (Glomerular Hyperfiltration, Albuminuria, and Kidney Function Decline). Curr Diabetes Rev 2022; 18:e171121197998. [PMID: 34789129 DOI: 10.2174/1573399818666211117122604] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 09/13/2021] [Accepted: 09/15/2021] [Indexed: 11/22/2022]
Abstract
Clinical features of diabetic kidney disease include glomerular hyperfiltration, albuminuria, and kidney function decline towards End-Stage Kidney Disease (ESKD). There are presently neither specific markers of kidney involvement in patients with diabetes nor strong predictors of rapid progression to ESKD. Serum-creatinine-based equations used to estimate glomerular filtration rate are notoriously unreliable in patients with diabetes. Early kidney function decline, reduced glomerular filtration rate, and proteinuria contribute to identifying diabetic patients at higher risk for rapid kidney function decline. Unlike proteinuria, the elevation of urinary albumin excretion in the range of microalbuminuria is frequently transient in patients with diabetes and does not always predict progression towards ESKD. Although the rate of progression of kidney function decline is usually accelerated in the presence of proteinuria, histological lesions of diabetes and ESKD may occur with normal urinary albumin excretion. No substantial reduction in the rate of ESKD associated with diabetes has been observed during the last decades despite intensified glycemic control and reno-protective strategies, indicating that existing therapies do not target underlying pathogenic mechanisms of kidney function decline. Very long-term effects of sodium-glucose transporters- 2 inhibitors and glucagon-like peptide-1 analogs remain to be defined. In patients with diabetes, glucagon secretion is typically elevated and induces insulin resistance. Insulin resistance is consistently and strongly associated with clinical manifestations of diabetic kidney disease, suggesting that reduced insulin sensitivity participates in the pathogenesis of the disease and may represent a therapeutic objective. Amelioration of insulin sensitivity in patients with diabetes is associated with cardioprotective and kidney-protective effects.
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Affiliation(s)
- María M Adeva-Andany
- Nephrology Division, Hospital General Juan Cardona, c/ Pardo Bazán s/n, 15406 Ferrol, Spain
| | | | | | | | | | - Elvira Castro-Quintela
- Nephrology Division, Hospital General Juan Cardona, c/ Pardo Bazán s/n, 15406 Ferrol, Spain
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Shimada Y, Nakasone Y, Hirabayashi K, Sakuma T, Koike H, Oguchi T, Yamashita K, Uchimido R, Moriya T, Komatsu M, Aizawa T. Development of glomerular hyperfiltration, a multiphasic phenomenon. Am J Physiol Renal Physiol 2020; 319:F1037-F1041. [PMID: 33135477 DOI: 10.1152/ajprenal.00305.2020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The trajectory of glomerular filtration rate (GFR) in relation to glomerular hyperfiltration (GHF) has been unknown. It was evaluated retrospectively in 23,982 GHF-free health examinees who were followed for 2-10 yr (mean: 5.1 yr). GFR was estimated by the serum creatinine concentration, and GHF was defined as age- and sex-specific estimated GFR (eGFR) ≥ 95% of the Japanese general population. The temporal profile of eGFR was plotted in a GHF-centered way, which was fitted to a random coefficient linear mixed model. Of the 23,982 subjects, 797 and 23,185 subjects developed or did not develop GHF, respectively, so that they were termed as the GHF(+) and GHF(-) groups. At baseline, median eGFR was significantly elevated in the GHF(+) group compared with in the GHF(-) group: 94.1 versus 77.3 mL/min/1.73 m2 (P < 0.001). Elevation of basal eGFR lasted for a mean (SD) of 3.3 (1.9) yr in the GHF(+) group; mean eGFR then rose to the GHF range, which was 108.5 mL/min/1.73 m2. The eGFR decline after the peak was steeper in the GHF(+) group than in the GHF(-) group: -0.984 versus -0.497 mL/min/1.73 m2/yr (P < 0.001). Baseline eGFR, but no other variable, well predicted incident GHF, with an area under the receiver operating characteristic curve of 0.87 (95% confidence interval: 0.86-0.88). In conclusion, GHF occurs as a chronic, multiphasic phenomenon: initially with a sustained GFR elevation for years, followed by a GFR surge to the GHF range, which was accompanied by accelerated GFR declining.
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Affiliation(s)
| | | | | | | | - Hideo Koike
- Health Center, Aizawa Hospital, Matsumoto, Japan
| | - Tomomasa Oguchi
- Kidney Disease and Dialysis Center, Aizawa Hospital, Matsumoto, Japan
| | | | - Ryo Uchimido
- Department of Intensive Care Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tatsumi Moriya
- Health Care Center, Kitasato University, Sagamihara, Kanagawa, Japan
| | - Mitsuhisa Komatsu
- Division of Diabetes, Endocrinology and Metabolism, Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan
| | - Toru Aizawa
- Diabetes Center, Aizawa Hospital, Matsumoto, Japan
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Kandasamy Y, Rudd D, Lumbers ER, Smith R. An evaluation of preterm kidney size and function over the first two years of life. Pediatr Nephrol 2020; 35:1477-1482. [PMID: 32297001 PMCID: PMC7316836 DOI: 10.1007/s00467-020-04554-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 03/20/2020] [Accepted: 03/24/2020] [Indexed: 01/09/2023]
Abstract
BACKGROUND We carried out a study to determine the impact of prematurity on kidney development in the first 2 years of life. METHODS In this prospective study, extremely preterm neonates (gestation < 28 weeks) were recruited and underwent assessments at 6, 12, and 24 months of age. A cohort of neonates born term were also recruited and followed up for 24 months. The primary outcomes measured in this study were total kidney volume (TKV) and estimated glomerular filtration rate (eGFR); albuminuria and blood pressure measurements (all provided as mean (standard deviation)) were the secondary outcomes. RESULTS Fifty-three premature and 31 term neonates (control) were recruited. At the age of 24 months (corrected age), infants born preterm had significantly smaller TKV (56.1 (9.4) vs. 64.8 (10.2) mL; P = 0.006). There was no difference in eGFR. These preterm infants were smaller (11.25 (1.53) vs. 12.9 (1.8) kg; P = 0.002) and shorter (83.8 (3.0) vs. 86.3 (3.4) cm; P = 0.02) when compared with the control group. At 6, 12, and 18 months respectively, preterm infants had, relative to their height, significantly smaller kidney volumes (0.54 (0.1) vs. 0.59 (0.1) mL/cm, P = 0.05; 0.61 (0.1) vs.0.71 (0.1) mL/cm, P = 0.003; and 0.67 (0.1) vs.0.76 (0.1) mL/cm, P = 0.006). CONCLUSIONS Relative to body length, TKV in premature infants is smaller. Since length reflects adult body proportions more accurately than BSA, TKV to height ratio may be a more important measure in the child. Despite smaller TKV (and therefore fewer nephrons), infants born prematurely achieve similar eGFRs in the first 24 months of life, probably due to single-nephron hyperfiltration.
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Affiliation(s)
- Yogavijayan Kandasamy
- Department of Neonatology, The Townsville Hospital, 100 Angus Smith Drive, Douglas, Queensland, 4814, Australia.
- Mothers and Babies Research Centre, Hunter Medical Research Institute, HMRI, The University of Newcastle, Newcastle, NSW, 2310, Australia.
- College of Medicine and Dentistry, James Cook University, Douglas, QLD, 4814, Australia.
| | - Donna Rudd
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Douglas, QLD, 4814, Australia
| | - Eugenie R Lumbers
- Mothers and Babies Research Centre, Hunter Medical Research Institute, HMRI, The University of Newcastle, Newcastle, NSW, 2310, Australia
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Newcastle, NSW, 2310, Australia
| | - Roger Smith
- Mothers and Babies Research Centre, Hunter Medical Research Institute, HMRI, The University of Newcastle, Newcastle, NSW, 2310, Australia
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Rodríguez-Poncelas A, Franch-Nadal J, Coll-de Tuero G, Mata-Cases M, Alonso-Fernández M, Mur-Marti T, Ruiz A, Giraldez-García C, Regidor E. High levels of fasting glucose and glycosylated hemoglobin values are associated with hyperfiltration in a Spanish prediabetes cohort. The PREDAPS Study. PLoS One 2019; 14:e0222848. [PMID: 31536578 PMCID: PMC6752878 DOI: 10.1371/journal.pone.0222848] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 09/08/2019] [Indexed: 11/19/2022] Open
Abstract
AIM This study aimed to investigate whether different levels of fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) in prediabetes are associated with hyperfiltration. METHODS A prospective cohort of 2,022 individuals aged 30-74 years took part in the PREDAPS Study. One cohort of 1,184 participants with prediabetes and another cohort of 838 participants with normal FPG and normal HbA1c were followed for 5 years. Hyperfiltration was defined as an estimated glomerular filtration rate (eGFR) above the age- and gender-specific 95th percentile for healthy control participants, while hypofiltration was defined as an eGFR below the 5th percentile. The prevalence of hyperfiltration was compared for different levels of prediabetes: level 1 of prediabetes: FPG <100 mg/dL plus HbA1c 5.7-6.0% or FPG 100-109 mg/dL plus HbA1c < 5.7%; level 2 of prediabetes: FPG <100 mg/dL plus HbA1c 6.1-6.4% or FPG 100-109 mg/dL plus HbA1c 5.7-6.0% or FPG 110-125 mg/dL plus HbA1c <5.7% and level 3 of prediabetes: FPG 100-109 mg/dL plus HbA1c 6.1-6.4% or FPG 110-125 mg/dL plus HbA1c 5.7-6.4%. RESULTS The participants with hyperfiltration were significantly younger, had a higher percentage of active smokers, and lower levels of hemoglobin and less use of ACEIs or ARBs. Only level 3 prediabetes based on FPG 100-109 mg/dL plus HbA1c 6.1-6.4% or FPG 110-125 mg/dL plus HbA1c 5.7-6.4% had a significantly higher odds ratio (OR) of hyperfiltration (OR 1.69 (1.05-2.74); P < 0.001) compared with no prediabetes (FPG < 100 mg/dL and HbA1c < 5.7%) after adjustment for different factors. The odds ratios for different levels of HbA1c alone in prediabetes increased progressively, but not significantly. CONCLUSIONS Level 3 of prediabetes based on FPG 100-109 mg/dL plus HbA1c 6.1-6.4% or FPG 110-125 mg/dL plus HbA1c 5.7-6.4% had a significantly higher OR of hyperfiltration compared with participants without prediabetes.
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Affiliation(s)
- Antonio Rodríguez-Poncelas
- METHARISC Group, USR Girona, IDIAP Gol i Gorina, Girona, Spain
- Grup de Recerca Epidemiològica en Diabetis des de l´Atenció Primària (DAP_CAT) Jordi Gol, Barcelona, Spain
- RedGDPS Foundation, Madrid, Spain
| | - Josep Franch-Nadal
- RedGDPS Foundation, Madrid, Spain
- USR Barcelona ciutat–IDIAP Jordi Gol, Barcelona, Spain
- CIBER Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
- Departament de Medicina, Universitat de Barcelona, Barcelona, Spain
| | - Gabriel Coll-de Tuero
- METHARISC Group, USR Girona, IDIAP Gol i Gorina, Girona, Spain
- Departamento de Ciencias Médicas, Universitat de Girona, Girona, Spain
| | - Manel Mata-Cases
- Grup de Recerca Epidemiològica en Diabetis des de l´Atenció Primària (DAP_CAT) Jordi Gol, Barcelona, Spain
- RedGDPS Foundation, Madrid, Spain
- USR Barcelona ciutat–IDIAP Jordi Gol, Barcelona, Spain
- CIBER Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
| | - Margarita Alonso-Fernández
- RedGDPS Foundation, Madrid, Spain
- Centro de Salud La Ería, Asturias, Spain
- Departamento de Medicina Preventiva y Salud Publica, Universidad de Oviedo, Asturias, Spain
| | - Teresa Mur-Marti
- RedGDPS Foundation, Madrid, Spain
- Mutua Terrassa, Barcelona, Spain
| | - Antonio Ruiz
- RedGDPS Foundation, Madrid, Spain
- Centro de Salud Universitario Pinto, Madrid, Spain
| | | | - Enrique Regidor
- RedGDPS Foundation, Madrid, Spain
- Departamento de Salud Pública y Materno-Infantil, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
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