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Majidpour M, Saravani R, Sargazi S, Sargazi S, Harati‐Sadegh M, Khorrami S, Sarhadi M, Alidadi A. A Study on Associations of Long Noncoding RNA HOTAIR Polymorphisms With Genetic Susceptibility to Chronic Kidney Disease. J Clin Lab Anal 2024; 38:e25086. [PMID: 38958113 PMCID: PMC11252834 DOI: 10.1002/jcla.25086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2024] [Revised: 05/22/2024] [Accepted: 06/09/2024] [Indexed: 07/04/2024] Open
Abstract
BACKGROUND The importance of long noncoding RNAs (lncRNAs) in various biological processes has been increasingly recognized in recent years. This study investigated how gene polymorphism in HOX transcript antisense RNA (HOTAIR) lncRNA affects the predisposition to chronic kidney disease (CKD). METHODS This study comprised 150 patients with CKD and 150 healthy controls. A PCR-RFLP and ARMS-PCR techniques were used for genotyping the five target polymorphisms. RESULTS According to our findings, rs4759314 confers strong protection against CKD in allelic, dominant, and codominant heterozygote genetic patterns. Furthermore, rs3816153 decreased CKD risk by 78% when TT versus GG, 55% when GG+GT versus TT, and 74% when GT versus TT+GG. In contrast, the CC+CT genotype [odds ratio (OR) = 1.66, 95% confidence intervals (CIs) = 1.05-2.63] and the T allele (OR = 1.50, 95% CI = 1.06-2.11) of rs12826786, as well as the TT genotype (OR = 2.52, 95% CI = 1.06-5.98) of rs3816153 markedly increased the risk of CKD in the Iranian population. Although no linkage disequilibrium was found between the studied variants, the Crs12826786Trs920778Grs1899663Grs4759314Grs3816153 haplotype was associated with a decreased risk of CKD by 86% (OR = 0.14, 95% CI = 0.03-0.66). CONCLUSION The rs920778 was not correlated with CKD risk, whereas the HOTAIR rs4759314, rs12826786, rs1899663, and rs3816153 polymorphisms affected the risk of CKD in our population. It seems essential to conduct repeated studies across various ethnic groups to explore the link between HOTAIR variants and their impact on the disease outcome.
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Affiliation(s)
- Mahdi Majidpour
- Clinical Immunology Research CenterZahedan University of Medical SciencesZahedanIran
| | - Ramin Saravani
- Cellular and Molecular Research CenterResearch Institute of Cellular and Molecular Sciences in Infectious Diseases, Zahedan University of Medical SciencesZahedanIran
- Department of Clinical Biochemistry, School of MedicineZahedan University of Medical SciencesZahedanIran
| | - Saman Sargazi
- Cellular and Molecular Research CenterResearch Institute of Cellular and Molecular Sciences in Infectious Diseases, Zahedan University of Medical SciencesZahedanIran
- Department of Clinical Biochemistry, School of MedicineZahedan University of Medical SciencesZahedanIran
| | - Sara Sargazi
- Cellular and Molecular Research CenterResearch Institute of Cellular and Molecular Sciences in Infectious Diseases, Zahedan University of Medical SciencesZahedanIran
| | - Mahdiyeh Harati‐Sadegh
- Genetics of Non‐Communicable Disease Research CenterZahedan University of Medical SciencesZahedanIran
| | - Shadi Khorrami
- Metabolic Syndrome Research CenterMashhad University of Medical SciencesMashhadIran
| | - Mohammad Sarhadi
- Cellular and Molecular Research CenterResearch Institute of Cellular and Molecular Sciences in Infectious Diseases, Zahedan University of Medical SciencesZahedanIran
| | - Ali Alidadi
- Department of Nephrology, Faculty of MedicineZahedan University of Medical SciencesZahedanIran
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Yu B, Tang W, Fan Y, Ma C, Ye T, Cai C, Xie Y, Shi Y, Baima K, Yang T, Wang Y, Jia P, Yang S. Associations between residential greenness and obesity phenotypes among adults in Southwest China. Health Place 2024; 87:103236. [PMID: 38593578 DOI: 10.1016/j.healthplace.2024.103236] [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: 09/01/2023] [Revised: 02/27/2024] [Accepted: 03/21/2024] [Indexed: 04/11/2024]
Abstract
BACKGROUND Although exposure to greenness has generally benefited human metabolic health, the association between greenness exposure and metabolic obesity remains poorly studied. We aimed to investigate the associations between residential greenness and obesity phenotypes and the mediation effects of air pollutants and physical activity (PA) level on the associations. METHODS We used the baseline of the China Multi-Ethnic Cohort (CMEC) study, which enrolled 87,613 adults. Obesity phenotypes were defined based on obesity and metabolic status, including metabolically unhealthy obesity (MUO), non-obesity (MUNO), metabolically healthy obesity (MHO), and non-obesity (MHNO). Greenness exposure was measured as the 3-year mean values of the normalized difference vegetation index (NDVI) and enhanced vegetation index (EVI) within the 500-m buffer zones around the participants' residence. Multivariable logistic regression was used to estimate the associations between greenness and obesity phenotypes. Stratified analyses by age, sex, educational level, and urbanicity were performed to identify how the effect varies across different subgroups. Causal mediation analysis was used to examine the mediation effects of air pollutants and PA level. RESULTS Compared with MHNO, each interquartile range (IQR) increase in greenness exposure was associated with reduced risks of MHO (ORNDVI [95% CI] = 0.87 [0.81, 0.93]; OREVI = 0.91 [0.86, 0.97]), MUO (ORNDVI = 0.83 [0.78, 0.88]; OREVI = 0.86 [0.81, 0.91]), and MUNO (ORNDVI = 0.88 [0.84, 0.91]; OREVI = 0.89 [0.86, 0.92]). For each IQR increase in both NDVI and EVI, the risks of MHO, MUO, and MUNO were reduced more in men, participants over 60 years, those with a higher level of education, and those living in urban areas, compared to their counterparts. Concentrations of particulate matter (PM) and PA level partially mediated the associations between greenness exposure and obesity phenotypes. CONCLUSIONS Exposure to residential greenness was associated with decreased risks of MHO, MUO, and MUNO, which was mediated by concentrations of PM and PA level, and modified by sex, age, educational level, and urbanicity.
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Affiliation(s)
- Bin Yu
- Institute for Disaster Management and Reconstruction, Sichuan University-The Hong Kong Polytechnic University, Chengdu, China; West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Wenge Tang
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
| | - Yunzhe Fan
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Chunlan Ma
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Tingting Ye
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Changwei Cai
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Yiming Xie
- Jianyang Center for Disease Control and Prevention, Jianyang, China
| | - Yuanyuan Shi
- School of Resource and Environmental Sciences, Wuhan University, Wuhan, China; International Institute of Spatial Lifecourse Health (ISLE), Wuhan University, Wuhan, China
| | - Kangzhuo Baima
- High Altitude Health Science Research Center of Tibet University, Lhasa, Tibet, China
| | - Tingting Yang
- School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, China
| | - Yanjiao Wang
- School of Public Health, Kunming Medical University, Kunming, China
| | - Peng Jia
- School of Resource and Environmental Sciences, Wuhan University, Wuhan, China; International Institute of Spatial Lifecourse Health (ISLE), Wuhan University, Wuhan, China; Hubei Luojia Laboratory, Wuhan, China; School of Public Health, Wuhan University, Wuhan, China.
| | - Shujuan Yang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China; International Institute of Spatial Lifecourse Health (ISLE), Wuhan University, Wuhan, China.
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Raoofi S, Pashazadeh Kan F, Rafiei S, Hoseinipalangi Z, Rezaei S, Ahmadi S, Masoumi M, Noorani Mejareh Z, Roohravan Benis M, Sharifi A, Shabaninejad H, Kiaee ZM, Ghashghaee A. Hemodialysis and peritoneal dialysis-health-related quality of life: systematic review plus meta-analysis. BMJ Support Palliat Care 2023; 13:365-373. [PMID: 34301643 DOI: 10.1136/bmjspcare-2021-003182] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 07/08/2021] [Indexed: 01/11/2023]
Abstract
BACKGROUND Patients with end-stage renal disease undergoing haemodialysis experience a variety of stressors leading to decreased level of quality of life (QoL). Thus, in this study, we aimed to review the current literature and identify factors affecting the health-related QoL (HRQoL) in these patients. METHODS A total of 147 studies were extracted from databases of Web of Science, PubMed, Scopus, Google Scholar, and Embase published between January 2000 and December 2020. Data were analysed using R software and results were reported with reference to Preferred Reporting Items for Systematic Reviews and Meta-Analyses standards. RESULTS A total of 623 728 patients undergoing dialysis participated in 147 studies in which QoL was assessed by means of two valid questionnaires, including Short-Form 36 (SF-36) and Kidney Disease Quality of Life (KDQOL)-short form V.1.3. Total HRQoL score for patients undergoing dialysis measured by KDQOL was 64.25 (95% CI 55.67 to 72.82). Based on SF-36, the mean score of mental health items was higher than the mean score of physical health condition. Furthermore, meta-regression based on the geographical place of residence revealed that the highest QoL in patients was observed in Japan, 66.96 (95% CI 63.65 to 70.28) and Brazil, 58.03 (95% CI 53.45 to 62.6). CONCLUSION Studies conducted on HRQoL among patients undergoing dialysis recommend useful strategies to clinicians, letting them assess patients' QoL in terms of a wide range of physical, mental and environmental aspects.
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Affiliation(s)
- Samira Raoofi
- Student Research Committee, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
| | - Fatemeh Pashazadeh Kan
- Health Management and Economics Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Sima Rafiei
- Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran (the Islamic Republic of)
| | - Zahra Hoseinipalangi
- Student Research Committee, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
| | - Sepide Rezaei
- Student Research Committee, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
| | - Saba Ahmadi
- Student Research Committee, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
| | - Maryam Masoumi
- Clinical Research and Development Center, Qom University of Medical Sciences, Qom, Iran
| | - Zahra Noorani Mejareh
- Student Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mahshid Roohravan Benis
- Student Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Alireza Sharifi
- Student Research Committee, Qom University of Medical Sciences, Qom, Tehran, Iran (the Islamic Republic of)
| | - Hosein Shabaninejad
- Population Health Sciences Institute (PHSI), Newcastle University, Newcastle, UK
| | | | - Ahmad Ghashghaee
- Student Research Center, Qazvin university of medical sciences, Qazvin, Iran
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Zhao L, Zou Y, Wu Y, Cai L, Zhao Y, Wang Y, Xiao X, Yang Q, Yang J, Ren H, Tong N, Liu F. Metabolic phenotypes and risk of end-stage kidney disease in patients with type 2 diabetes. Front Endocrinol (Lausanne) 2023; 14:1103251. [PMID: 37234807 PMCID: PMC10206309 DOI: 10.3389/fendo.2023.1103251] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 04/13/2023] [Indexed: 05/28/2023] Open
Abstract
Background Obesity often initiates or coexists with metabolic abnormalities. This study aimed to investigate the pathological characteristics and the independent or mutual relations of obesity and metabolic abnormalities with end-stage kidney disease (ESKD) in patients with type 2 diabetes (T2D) and associated diabetic kidney disease (DKD). Methods A total of 495 Chinese patients with T2D and biopsy-confirmed DKD between 2003 and 2020 were enrolled in this retrospective study. The metabolic phenotypes were based on the body weight index (BMI)-based categories (obesity, BMI ≥ 25.0 kg/m2) and metabolic status (metabolically unhealthy status, ≥ 1 criterion National Cholesterol Education Program Adult Treatment Panel III (NCEP/ATP III) excluding waist circumference and hyperglycemia) and were categorized into four types: metabolically healthy non-obesity (MHNO), metabolically healthy obesity (MHO), metabolically unhealthy non-obesity (MUNO), and metabolically unhealthy obesity (MUO). The pathological findings were defined by the Renal Pathology Society classification. Cox proportional hazards models were used to estimate hazard ratios (HRs) for ESKD. Results There are 56 (11.3%) MHNO patients, 28 (5.7%) MHO patients, 176 (35.6%) MUNO patients, and 235 (47.5%) MUO patients. The high prevalence of the Kimmelstiel-Wilson nodule and severe mesangial expansion were associated with obesity, whereas severe IFTA was related to metabolically unhealthy status. In the multivariate analysis, the adjusted HR (aHR) was 2.09 [95% confidence interval (CI) 0.99-4.88] in the MHO group, 2.16 (95% CI 1.20-3.88) in the MUNO group, and 2.31 (95% CI 1.27-4.20) in the MUO group compared with the MHNO group. Furthermore, the presence of obesity was insignificantly associated with ESKD compared with non-obese patients (aHR 1.22, 95% CI 0.88-1.68), while the metabolically unhealthy status was significantly associated with ESKD compared to the metabolically healthy status in the multivariate analysis (aHR 1.69, 95% CI 1.10-2.60). Conclusion Obesity itself was insignificantly associated with ESKD; however, adding a metabolically unhealthy status to obesity increased the risk for progression to ESKD in T2D and biopsy-proven DKD.
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Affiliation(s)
- Lijun Zhao
- Department of General Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital of Sichuan University, Chengdu, Sichuan, China
- Department of Nephrology, Laboratory of Diabetic Kidney Disease, Centre of Diabetes and Metabolism Research, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Yutong Zou
- Department of Nephrology, Laboratory of Diabetic Kidney Disease, Centre of Diabetes and Metabolism Research, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Yucheng Wu
- Department of Nephrology, Laboratory of Diabetic Kidney Disease, Centre of Diabetes and Metabolism Research, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Linli Cai
- Department of Nephrology, Laboratory of Diabetic Kidney Disease, Centre of Diabetes and Metabolism Research, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Yuancheng Zhao
- Department of Nephrology, Laboratory of Diabetic Kidney Disease, Centre of Diabetes and Metabolism Research, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Yiting Wang
- Department of Nephrology, Laboratory of Diabetic Kidney Disease, Centre of Diabetes and Metabolism Research, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Xiang Xiao
- Department of Nephrology, Laboratory of Diabetic Kidney Disease, Centre of Diabetes and Metabolism Research, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Qing Yang
- Department of Nephrology, Laboratory of Diabetic Kidney Disease, Centre of Diabetes and Metabolism Research, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Jia Yang
- Department of Nephrology, Laboratory of Diabetic Kidney Disease, Centre of Diabetes and Metabolism Research, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Honghong Ren
- Department of Nephrology, Laboratory of Diabetic Kidney Disease, Centre of Diabetes and Metabolism Research, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Nanwei Tong
- Division of Endocrinology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Fang Liu
- Department of Nephrology, Laboratory of Diabetic Kidney Disease, Centre of Diabetes and Metabolism Research, West China Hospital of Sichuan University, Chengdu, Sichuan, China
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Yu M, Zhang S, Wang L, Wu J, Li X, Yuan J. Metabolically Healthy Obesity and Carotid Plaque among Steelworkers in North China: The Role of Inflammation. Nutrients 2022; 14:5123. [PMID: 36501152 PMCID: PMC9740549 DOI: 10.3390/nu14235123] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 11/26/2022] [Accepted: 11/29/2022] [Indexed: 12/03/2022] Open
Abstract
This study aimed to investigate the association between metabolically healthy obesity (MHO) and carotid plaque. In this cross-sectional survey, 3467 steelworkers in North China were surveyed. There are two criteria for defining a carotid plaque: (1) the lesion structure exceeds 50% of the peripheral intima-media thickness value or invades the arterial lumen by at least 0.5 mm; (2) a thickness > 1.5 mm from the intima−lumen interface to the media−adventitia interface. Metabolic health was defined as the nonexistence of one of the metabolic syndrome (MetS) diagnostic criteria for metabolic abnormalities. Obesity was defined as having a BMI ≥ 25 kg/m2. To calculate the odds ratio (OR) for the prevalence carotid plaque, a logistic regression was used for the analysis. The prevalence of carotid plaque in the subjects was 14.3% for metabolically healthy non-obesity (MHNO), 32.4% for MHO, 18.9% for metabolically unhealthy non-obesity (MUNO), and 46.8% for metabolically unhealthy obesity (MUO). The odds ratios for suffering from carotid plaque were 1.27 (95% CI: 0.69 to 2.32) for MHO, 1.83 (95% CI: 1.29 to 2.58) for MUNO, and 1.81 (1.28 to 2.56) for MUO in comparison with MHNO after adjusting for confounders. There was no association between the MHO phenotype and carotid plaque prevalence among steelworkers in North China.
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Affiliation(s)
- Miao Yu
- Department of Epidemiology and Health Statistics, School of Public Health, North China University of Science and Technology, Tangshan 063210, China
| | - Shengkui Zhang
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical, Beijing 100050, China
| | - Lihua Wang
- Department of Epidemiology and Health Statistics, School of Public Health, North China University of Science and Technology, Tangshan 063210, China
| | - Jianhui Wu
- Department of Epidemiology and Health Statistics, School of Public Health, North China University of Science and Technology, Tangshan 063210, China
| | - Xiaoming Li
- Department of Epidemiology and Health Statistics, School of Public Health, North China University of Science and Technology, Tangshan 063210, China
| | - Juxiang Yuan
- Department of Epidemiology and Health Statistics, School of Public Health, North China University of Science and Technology, Tangshan 063210, China
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Busa I, Ordóñez-Mena JM, Yang Y, Wolstenholme J, Petrou S, Taylor CJ, O’Callaghan CA, Fraser SDS, Taal MW, McManus RJ, Hirst JA, Hobbs FDR. Quality of life in older adults with chronic kidney disease and transient changes in renal function: Findings from the Oxford Renal cohort. PLoS One 2022; 17:e0275572. [PMID: 36240168 PMCID: PMC9565742 DOI: 10.1371/journal.pone.0275572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 09/19/2022] [Indexed: 11/07/2022] Open
Abstract
Background Quality of life (QoL) is an important measure of disease burden and general health perception. The relationship between early chronic kidney disease (CKD) and QoL remains poorly understood. The Oxford Renal Study (OxRen) cohort comprises 1063 adults aged ≥60 years from UK primary care practices screened for early CKD, grouped according to existing or screen-detected CKD diagnoses, or biochemistry results indicative of reduced renal function (referred to as transient estimated glomerular filtration rate (eGFR) reduction). Objectives This study aimed to compare QoL in participants known to have CKD at recruitment to those identified as having CKD through a screening programme. Methods Health profile data and multi-attribute utility scores were reported for two generic questionnaires: 5-level EuroQol-5 Dimension (EQ-5D-5L) and ICEpop CAPability measure for Adults (ICECAP-A). QoL was compared between patients with existing and screen-detected CKD; those with transient eGFR reduction served as the reference group in univariable and multivariable linear regression. Results Mean and standard deviation utility scores were not significantly different between the subgroups for EQ-5D-5L (screen-detected:0.785±0.156, n = 480, transient:0.779±0.157, n = 261, existing CKD:0.763±0.171, n = 322, p = 0.216) or ICECAP-A (screen-detected:0.909±0.094, transient:0.904±0.110, existing CKD:0.894±0.115, p = 0.200). Age, smoking status, and number of comorbidities were identified as independent predictors of QoL in this cohort. Conclusion QoL of participants with existing CKD diagnoses was not significantly different from those with screen-detected CKD or transient eGFR reduction and was similar to UK mean scores for the same age, suggesting that patient burden of early CKD is minor. Moreover, CKD-related comorbidities contribute more significantly to disease burden in earlier stages of CKD than renal function per se. Larger prospective studies are required to define the relationship between QoL and CKD progression more precisely. These data also confirm the essentially asymptomatic nature of CKD, implying that routine screening or case finding are required to diagnose it.
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Affiliation(s)
- Isabella Busa
- University of Oxford Medical School, Osler House, John Radcliffe Hospital, Oxford, United Kingdom
- * E-mail:
| | - José M. Ordóñez-Mena
- Nuffield Department of Primary Care Health Science, University of Oxford, Oxford, United Kingdom
- National Institute for Health Research (NIHR) Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | - Yaling Yang
- Nuffield Department of Primary Care Health Science, University of Oxford, Oxford, United Kingdom
- National Institute for Health Research (NIHR) Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | - Jane Wolstenholme
- Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Stavros Petrou
- Nuffield Department of Primary Care Health Science, University of Oxford, Oxford, United Kingdom
| | - Clare J. Taylor
- Nuffield Department of Primary Care Health Science, University of Oxford, Oxford, United Kingdom
| | | | - Simon D. S. Fraser
- School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Maarten W. Taal
- Centre for Kidney Research and Innovation, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Richard J. McManus
- Nuffield Department of Primary Care Health Science, University of Oxford, Oxford, United Kingdom
| | - Jennifer A. Hirst
- Nuffield Department of Primary Care Health Science, University of Oxford, Oxford, United Kingdom
- National Institute for Health Research (NIHR) Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | - F. D. Richard Hobbs
- Nuffield Department of Primary Care Health Science, University of Oxford, Oxford, United Kingdom
- National Institute for Health Research (NIHR) Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
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Walther CP, Benoit JS, Gregg LP, Bansal N, Nambi V, Feldman HI, Shlipak MG, Navaneethan SD. Heart failure-type symptom scores in chronic kidney disease: The importance of body mass index. Int J Obes (Lond) 2022; 46:1910-1917. [PMID: 35978101 PMCID: PMC9710200 DOI: 10.1038/s41366-022-01208-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 08/02/2022] [Accepted: 08/03/2022] [Indexed: 11/08/2022]
Abstract
OBJECTIVES This analysis sought to determine factors (including adiposity-related factors) most associated with HF-type symptoms (fatigue, shortness of breath, and edema) in adults with chronic kidney disease (CKD). BACKGROUND Symptom burden impairs quality of life in CKD, especially symptoms that overlap with HF. These symptoms are common regardless of clinical HF diagnosis, and may be affected by subtle cardiac dysfunction, kidney dysfunction, and other factors. We used machine learning to investigate cross-sectional relationships of clinical variables with symptom scores in a CKD cohort. METHODS Participants in the Chronic Renal Insufficiency Cohort (CRIC) with a baseline modified Kansas City Cardiomyopathy Questionnaire (KCCQ) score were included, regardless of prior HF diagnosis. The primary outcome was Overall Summary Score as a continuous measure. Predictors were 99 clinical variables representing demographic, cardiac, kidney and other health dimensions. A correlation filter was applied. Random forest regression models were fitted. Variable importance scores and adjusted predicted outcomes are presented. RESULTS The cohort included 3426 individuals, 10.3% with prior HF diagnosis. BMI was the most important factor, with BMI 24.3 kg/m2 associated with the least symptoms. Symptoms worsened with higher or lower BMIs, with a potentially clinically relevant 5 point score decline at 35.7 kg/m2 and a 1-point decline at the threshold for low BMI, 18.5 kg/m2. The most important cardiac and kidney factors were heart rate and eGFR, the 4th and 5th most important variables, respectively. Results were similar for secondary analyses. CONCLUSIONS In a CKD cohort, BMI was the most important feature for explaining HF-type symptoms regardless of clinical HF diagnosis, identifying an important focus for symptom directed investigations.
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Affiliation(s)
- Carl P Walther
- Selzman Institute for Kidney Health, Section of Nephrology, Baylor College of Medicine, Houston, TX, USA.
| | - Julia S Benoit
- Texas Institute for Measurement, Evaluation, and Statistics, University of Houston, Houston, TX, USA
| | - L Parker Gregg
- Selzman Institute for Kidney Health, Section of Nephrology, Baylor College of Medicine, Houston, TX, USA
- Section of Nephrology, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA
| | - Nisha Bansal
- Kidney Research Institute and Division of Nephrology, University of Washington, Seattle, WA, USA
| | - Vijay Nambi
- Section of Cardiology, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA
- Section of Cardiovascular Research, Baylor College of Medicine, Houston, TX, USA
| | - Harold I Feldman
- Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA, USA
| | - Michael G Shlipak
- Kidney Health Research Collaborative, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
- General Internal Medicine Division, Medical Service, San Francisco Veterans Affairs Health Care System, San Francisco, CA, USA
| | - Sankar D Navaneethan
- Selzman Institute for Kidney Health, Section of Nephrology, Baylor College of Medicine, Houston, TX, USA
- Section of Nephrology, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA
- Institute of Clinical and Translational Research, Baylor College of Medicine, Houston, TX, USA
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Yu M, Zhang S, Wang L, Feng H, Li X, Wu J, Yuan J. Association of Metabolically Healthy Obesity and Glomerular Filtration Rate among Male Steelworkers in North China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11764. [PMID: 36142036 PMCID: PMC9517549 DOI: 10.3390/ijerph191811764] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 09/13/2022] [Accepted: 09/15/2022] [Indexed: 06/16/2023]
Abstract
This study aims to investigate the association between metabolically healthy obesity (MHO) and the early stages of renal dysfunction and whether systemic inflammation affects the study's outcome. Male steelworkers in northern China were investigated in this cross-sectional survey (n = 6309). A decrease in estimated glomerular filtration rate (eGFR) was used as the primary outcome, which was defined as an eGFR of ≤89 mL/min/1.73 m2. A BMI ≥ 25 kg/m2 was used to determine obesity. In the definition of metabolic health, the absence of metabolic syndrome components is considered metabolically healthy. An assessment of inflammation was carried out using a surrogate marker called high-sensitivity C-reactive protein (hs-CRP). The adjusted odds ratio (OR) and confidence intervals (CIs) were estimated using the multivariable logistic regression model. After adjusting for hs-CRP, MHO (OR = 1.97; 95% CI: 1.21 to 3.21) was significantly associated with decreased eGFR compared to metabolically healthy non-obesity (MHNO). With the MHNO/hs-CRP ≤ 0.01 mg/dL group as a reference, the OR was 2.17 (95% CI: 1.17 to 4.02) for decreased eGFR in the group with MHO/hs-CRP > 0.01 mg/dL. MHO is associated with renal dysfunction at an early stage. To some degree, this risk can be explained by the level of inflammation.
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Affiliation(s)
- Miao Yu
- Department of Epidemiology and Health Statistics, School of Public Health, North China University of Science and Technology, Tangshan 063210, China
| | - Shengkui Zhang
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical, Beijing 100005, China
| | - Lihua Wang
- Department of Epidemiology and Health Statistics, School of Public Health, North China University of Science and Technology, Tangshan 063210, China
| | - Hongman Feng
- Department of Epidemiology and Health Statistics, School of Public Health, North China University of Science and Technology, Tangshan 063210, China
| | - Xiaoming Li
- Department of Epidemiology and Health Statistics, School of Public Health, North China University of Science and Technology, Tangshan 063210, China
| | - Jianhui Wu
- Department of Epidemiology and Health Statistics, School of Public Health, North China University of Science and Technology, Tangshan 063210, China
| | - Juxiang Yuan
- Department of Epidemiology and Health Statistics, School of Public Health, North China University of Science and Technology, Tangshan 063210, China
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9
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Prevalence of Drug Interaction in Severely Obese Individuals and Associated Factors: Baseline Results from a Clinical Trial. Sci Pharm 2020. [DOI: 10.3390/scipharm88040048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The prevalence of obesity is increasing worldwide and is commonly associated with comorbidities. The use of several drugs is often necessary, which leads to Potential Drug Interactions (PDI) that may increase the morbidity and mortality. This study aimed to analyze the prevalence of drug interaction and its association with socio-demographics, health status, and drug use in severely obese individuals. Baseline data from a randomized clinical trial registered at Clinicaltrial.gov (NCT02463435) were used. A total of 150 individuals aged 18–65 years with a body mass index of 35 kg/m2 were included. The outcome variable was the presence of PDI, and the explanatory variables were divided into the following four levels: socio-demographic, lifestyle, health, and medication use. The prevalence of PDI was 50% (n = 75) (95% CI 41–58). The variables associated with drug–drug interactions in the multiple analyses were arterial hypertension (PR 1.83, 95%, CI 1.10–3.04), polypharmacy (PR 3.12, 95%, CI 2.17–4.50), and diabetes mellitus (PR 0.60, 95%, CI 0.45–0.81). The risk factors for the occurrence of drug interaction were the presence of diabetes mellitus, hypertension, and polypharmacy.
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10
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Moreno-Egea A, Romero-Reyes M, Gómez-López MV, Crespo-Montero R. Alteraciones del sueño en pacientes con enfermedad renal crónica avanzada. ENFERMERÍA NEFROLÓGICA 2020. [DOI: 10.37551/s2254-28842020027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Introducción: Los pacientes con Enfermedad Renal Crónica Avanzada, sufren una amplia variedad de síntomas físicos y psicológicos. Al llegar a estadios finales, sufren alteraciones significativas en la salud física, mental, emocional y social, destacándose el impacto en la calidad del sueño.Objetivo: Analizar las principales alteraciones del sueño en pacientes con Enfermedad Renal Crónica Avanzada.Material y Método: Se llevó a cabo un estudio observacional descriptivo transversal en el Servicio de Nefrología del Hospital Universitario Reina Sofía de Córdoba en pacientes con Enfermedad Renal Crónica Avanzada en estadios 4-5. Se estudiaron las alteraciones del sueño mediante el cuestionario Índice de Calidad de Sueño de Pittsburg y su relación con otras variables como la edad, sexo, comorbilidad, Hemoglobina, Creatinina Sérica e Índice de Masa Corporal.Resultados: Se estudiaron 119 pacientes, con una edad media de 67,61±14,89 años; 52 mujeres (43,7%). El valor medio del Índice de Calidad de Sueño fue de 9,66±4 puntos. El 83,2% de los pacientes presentaban alteraciones del sueño (puntuación >5 puntos). Esta puntuación mostró tener una relación significativa con la comorbilidad y la edad. No se encontraron relaciones entre las alteraciones del sueño con el sexo, aclaramiento renal ni Índice de Masa Corporal.Conclusión: Una mayoría de los pacientes con Enfermedad Renal Crónica Avanzada en estadios 4-5 presentan alteraciones del sueño. Estas alteraciones están relacionadas con mayor comorbilidad y edad avanzada, sin que el sexo, el aclaramiento renal o el Índice de Masa Corporal tengan relación con esta alteración, al menos en la muestra estudiada.
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Affiliation(s)
- Ana Moreno-Egea
- Departamento de Enfermería. Facultad de Medicina y Enfermería. Universidad de Córdoba. Córdoba. España
| | - Mónica Romero-Reyes
- Departamento de Enfermería. Facultad de Medicina y Enfermería. Universidad de Córdoba. Córdoba. España
| | | | - Rodolfo Crespo-Montero
- Departamento de Enfermería. Facultad de Medicina y Enfermería. Universidad de Córdoba. Córdoba. España. Servicio de Nefrología. Hospital Universitario Reina Sofía de Córdoba. Córdoba. España. Instituto Maimónides de Investigación Biomédica de Córdoba. Córdoba. España
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11
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Abeywickrama HM, Wimalasiri S, Koyama Y, Uchiyama M, Shimizu U, Kakihara N, Chandrajith R, Nanayakkara N. Quality of Life and Symptom Burden among Chronic Kidney Disease of Uncertain Etiology (CKDu) Patients in Girandurukotte, Sri Lanka. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E4041. [PMID: 32517110 PMCID: PMC7312904 DOI: 10.3390/ijerph17114041] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 05/26/2020] [Accepted: 06/04/2020] [Indexed: 12/20/2022]
Abstract
Symptom burden and health-related quality of life (HRQOL) are important predictors of how a disease affects patients' lives, especially for endemic health problems such as chronic kidney disease of uncertain etiology (CKDu). Our study describes symptom burden, HRQOL, and associated demographic and clinical variables in CKDu patients in the Girandurukotte area, Sri Lanka. A cross-sectional study included 120 CKDu patients attending the renal clinic in the endemic area. The instruments applied were the Kidney Disease Quality of Life-Short Form (KDQOL-SFTM) version 1.3 and CKD Symptom Index-Sri Lanka. Socio-demographic, disease-related, and anthropometric variables were also investigated. The mean age of patients was 61.87 (SD 11.31), while 69.2% were male. The mean glomerular filtration rate was 28.17 (SD 14.03) mL/min/1.73 min2, and 70.8% were anemic. Bone/joint pain was the most experienced symptom while the median number of symptoms reported by patients was 5 (IQR 3-7). The mean symptom burden, physical component summary, mental component summary, and kidney-disease-specific component scores were 12.71 (SD 10.45), 68.63 (SD 19.58), 78.53 (SD 18.78), and 81.57 (SD 5.86), respectively. Age was found to be a significant predictor of HRQOL, while hemoglobin level and being a farmer were significant predictors of symptom burden. Our data indicate that CKDu patients in all stages experience at least one symptom affecting all aspects of HRQOL.
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Affiliation(s)
- Hansani Madushika Abeywickrama
- Graduate School of Health Sciences, School of Health Sciences, Faculty of Medicine, Niigata University, 2-746, Asahimachi, Niigata 951-8518, Japan; (M.U.); (U.S.); (N.K.)
| | - Swarna Wimalasiri
- Department of Food Science and Technology, Faculty of Agriculture, University of Peradeniya, Kandy 20400, Sri Lanka;
| | - Yu Koyama
- Graduate School of Health Sciences, School of Health Sciences, Faculty of Medicine, Niigata University, 2-746, Asahimachi, Niigata 951-8518, Japan; (M.U.); (U.S.); (N.K.)
| | - Mieko Uchiyama
- Graduate School of Health Sciences, School of Health Sciences, Faculty of Medicine, Niigata University, 2-746, Asahimachi, Niigata 951-8518, Japan; (M.U.); (U.S.); (N.K.)
| | - Utako Shimizu
- Graduate School of Health Sciences, School of Health Sciences, Faculty of Medicine, Niigata University, 2-746, Asahimachi, Niigata 951-8518, Japan; (M.U.); (U.S.); (N.K.)
| | - Nahoko Kakihara
- Graduate School of Health Sciences, School of Health Sciences, Faculty of Medicine, Niigata University, 2-746, Asahimachi, Niigata 951-8518, Japan; (M.U.); (U.S.); (N.K.)
| | - Rohana Chandrajith
- Department of Geology, Faculty of Science, University of Peradeniya, Kandy 20400, Sri Lanka;
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12
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Chronic kidney disease attenuates the impact of obesity on quality of life. Sci Rep 2020; 10:2375. [PMID: 32047200 PMCID: PMC7012880 DOI: 10.1038/s41598-020-59382-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 01/27/2020] [Indexed: 12/14/2022] Open
Abstract
The impact of obesity on health-related quality of life (HRQoL) in chronic kidney disease (CKD) population has not been elucidated, despite the impairment of HRQoL in the obese among general population. We hypothesized that the impact of obesity on HRQoL might be confounded by impaired renal function in CKD population, and that CKD would attenuate the impact of obesity on HRQoL. To compare the impact of obesity on HRQoL according to kidney function, 17,001 subjects from Korea National Health and Nutrition Examination Survey (2008–2011) were categorized by estimated glomerular filtration rate (eGFR), as follows: group 1, eGFR ≥ 90 mL/min/1.73 m2; group 2, eGFR of 60–89 mL/min/1.73 m2; group 3, eGFR < 60 mL/min/1.73 m2. The association between obesity parameters (body mass index, waist circumference and, truncal fat mass) and HRQoL parameters (EQ-5D index and EQ-VAS) were cross-sectionally analyzed. Despite robust correlations between obesity parameters and low EQ-5D index or EQ-VAS in general population, no significant association was observed in group 3 population. Impact of obesity on HRQoL in CKD population was only limitedly observed in the mobility domain of EQ-5D, as mobility limitation was associated with increased body mass index or waist circumference regardless of kidney function. Therefore, the impact of obesity on HRQoL seems significantly attenuated in CKD population, suggesting that the risk of obesity should not be over-estimated in patients with CKD, especially with respect to HRQoL.
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13
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Wang M, Li J, Li Y, Yao S, Zhao M, Wang C, Wu S, Xue H. The effects of hypertension and diabetes on new‐onset chronic kidney disease: A prospective cohort study. J Clin Hypertens (Greenwich) 2019; 22:39-46. [PMID: 31873983 DOI: 10.1111/jch.13768] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 11/18/2019] [Accepted: 12/02/2019] [Indexed: 12/16/2022]
Affiliation(s)
- Miao Wang
- Department of Cardiology Chinese People's Liberation Army General Hospital Beijing China
- The School of Medicine Nankai University Tianjin China
| | - Junjuan Li
- Department of Nephrology Kailuan Hospital Hebei United University Tangshan China
| | - Yao Li
- Department of Cardiology Chinese People's Liberation Army General Hospital Beijing China
| | - Siyu Yao
- Department of Cardiology Chinese People's Liberation Army General Hospital Beijing China
| | - Maoxiang Zhao
- Department of Cardiology Chinese People's Liberation Army General Hospital Beijing China
| | - Chi Wang
- Department of Cardiology Chinese People's Liberation Army General Hospital Beijing China
| | - Shouling Wu
- Department of Cardiology Kailuan Hospital Hebei United University Tangshan China
| | - Hao Xue
- Department of Cardiology Chinese People's Liberation Army General Hospital Beijing China
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