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Wan KS, Hairi NN, Mustapha F, Mohd Yusoff MF, Mat Rifin H, Ismail M, Moy FM, Ahmad NA. Prevalence of diabetic kidney disease and the associated factors among patients with type 2 diabetes in a multi-ethnic Asian country. Sci Rep 2024; 14:7074. [PMID: 38528132 DOI: 10.1038/s41598-024-57723-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 03/21/2024] [Indexed: 03/27/2024] Open
Abstract
The actual prevalence of diabetic kidney disease (DKD) in patients with type 2 diabetes (T2D) in Malaysia is unknown. We aimed to determine the prevalence of DKD and its associated risk factors among T2D patients in Malaysia. An analytical cross-sectional study was conducted using the year 2022 clinical audit dataset from the National Diabetes Registry. DKD was defined as albuminuria, a decreased glomerular filtration rate, or both. Among 80,360 patients, 62.2% were female, 68.4% were Malay, and the mean age was 61.4 years. A total of 56.7% (95% CI 56.4-57.1%) of patients were found to have DKD. Increasing age, male sex, Malay ethnicity, longer duration of diabetes, overweight, obesity, hypertension, diabetic retinopathy, diabetic foot ulcer, nontraumatic lower-extremity amputation, ischaemic heart disease, stroke, insulin, higher numbers of antihypertensive agents, antiplatelet agents, poorer HbA1c control, higher systolic blood pressure, non-achievement of triglyceride target, and non-attainment of HDL-cholesterol goal were independent risk factors associated with DKD. Clinicians, program managers, and health policymakers should target modifiable factors to manage DKD and prevent its progression to end-stage kidney disease in Malaysia.
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Affiliation(s)
- Kim Sui Wan
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, 40170, Shah Alam, Selangor, Malaysia.
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, 50603, Federal Territory of Kuala Lumpur, Malaysia.
| | - Noran Naqiah Hairi
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, 50603, Federal Territory of Kuala Lumpur, Malaysia
- Faculty of Public Health, Universitas Airlangga, Surabaya, 60115, East Java, Indonesia
| | - Feisul Mustapha
- Disease Control Division, Ministry of Health Malaysia, Federal Government Administration Centre, 62590, Putrajaya, Malaysia
- Perak State Health Department, Ministry of Health Malaysia, 30000, Ipoh, Perak, Malaysia
| | - Muhammad Fadhli Mohd Yusoff
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, 40170, Shah Alam, Selangor, Malaysia
| | - Halizah Mat Rifin
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, 40170, Shah Alam, Selangor, Malaysia
| | - Mastura Ismail
- Family Health Development Division, Ministry of Health Malaysia, Federal Government Administration Centre, 62590, Putrajaya, Malaysia
| | - Foong Ming Moy
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, 50603, Federal Territory of Kuala Lumpur, Malaysia
| | - Noor Ani Ahmad
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, 40170, Shah Alam, Selangor, Malaysia
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Fenta ET, Eshetu HB, Kebede N, Bogale EK, Zewdie A, Kassie TD, Anagaw TF, Mazengia EM, Gelaw SS. Prevalence and predictors of chronic kidney disease among type 2 diabetic patients worldwide, systematic review and meta-analysis. Diabetol Metab Syndr 2023; 15:245. [PMID: 38012781 PMCID: PMC10683270 DOI: 10.1186/s13098-023-01202-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 10/31/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND Diabetes is a complicated, chronic condition that requires ongoing medical attention as well as multiple risk-reduction measures beyond glucose control. The prevalence of chronic kidney disease (CKD) is highly variable in different parts of the world due to various environmental, ethnic, socioeconomic, and rural-urban differences. Diabetes is the leading cause of CKD. This study aimed to estimate the global prevalence of CKD and its associated factors among type 2 diabetes(T2DM) patients, provide scientific evidence for a better understanding of the burden of CKD among diabetes mellitus type 2 patients, and design interventional strategies. METHODS Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) checklist guideline was followed for this review and meta-analysis. The electronic databases (Pub Med, Cochrane Library, Google Scholar, and grey literature) were searched to retrieve articles by using keywords. Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument was used to assess the quality of studies. The meta-analysis was conducted using STATA 17 software. The Meta logistic regression was computed to present the pooled prevalence and Odds ratio (OR) of the determinate factors with a 95% confidence interval (CI). RESULTS In this systematic review and meta-analysis 20 studies were done in 13 different countries. The pooled magnitude of chronic kidney disease among type 2 DM patients was 27% (95% CI 21%, 33%). The prevalence of chronic kidney disease differs across countries, with the maximum in the USA and the lowest in the United Arab Emirates. Patients with CKD have an elevated risk of severe renal and cardiovascular morbidity and mortality. Renin-angiotensin system inhibitors, sodium-glucose cotransporter-2 inhibitors, glucagon-like peptide 1 receptor agonists, and, more recently, non-steroidal mineralocorticoid receptor antagonists are among the medications that have been demonstrated to slow the progression of CKD. In this systematic review and meta-analysis increased age, obesity, having a history of type 2 diabetes mellitus, smoking history, presence of hypertension, and cardiac heart disease were factors significantly associated with the presence of chronic kidney disease among type 2 diabetic patients. CONCLUSIONS The prevalence of chronic kidney disease among type 2 diabetes mellitus patients was high based on the included 20 articles. The review reported that old age, hypertension, cardiac disease, smoking, obesity, and duration of diabetes mellitus was predictor variable for chronic kidney disease among type 2 diabetic patients. Therefore, in order to lower the morbidity and mortality from chronic kidney disease among type 2 diabetic patients, it is advised to develop both preventive and curative intervention strategies, such as raising awareness, creating a supportive environment, and prescribing appropriate medication at an early stage.
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Affiliation(s)
- Eneyew Talie Fenta
- Department of public health, college of medicine and health sciences, Injibara University, Injibara, Ethiopia.
| | - Habitu Birhan Eshetu
- Department of Health Promotion and Health Behavior, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, PO. Box.196, Gondar, Ethiopia
| | - Natnael Kebede
- Department of Health Promotion, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Eyob Ketema Bogale
- Health Promotion and Behavioral science department, College of medicine and health science, Bahir Dar, Houston, Ethiopia
| | - Amare Zewdie
- Department of Public Health, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia
| | - Tadele Derbew Kassie
- Department of Public Health, College of Medicine and Health Science, Debre Markos university, Debre Markos, Ethiopia
| | - Tadele Fentabil Anagaw
- Health Promotion and Behavioral science department, College of medicine and health science, Bahir Dar, Houston, Ethiopia
| | - Elyas Melaku Mazengia
- Department of Public Health, College of Medicine and Health Science, Debre Markos university, Debre Markos, Ethiopia
| | - Sintayehu Shiferaw Gelaw
- Department of Public Health, College of Medicine and Health Science, Debre Markos university, Debre Markos, Ethiopia
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Xu MR, Jin CH, Lu JX, Li MF, Li LX. High-normal unconjugated bilirubin is associated with decreased risk of chronic kidney disease in type 2 diabetes: A real-world study. Diabetes Metab Res Rev 2023; 39:e3672. [PMID: 37309279 DOI: 10.1002/dmrr.3672] [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: 09/17/2022] [Revised: 04/01/2023] [Accepted: 05/26/2023] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To investigate the association between serum unconjugated bilirubin (UCB) within normal limits and chronic kidney disease (CKD) in T2DM patients. METHOD This cross-sectional, real-world study was performed in 8661 hospitalised T2DM patients. The subjects were stratified into quintiles based on serum UCB levels. The clinical characteristics and CKD prevalence were compared among the UCB quantile groups. The associations of serum UCB levels and quintiles with CKD were also analysed by binary logistic regression. RESULTS After controlling for age, sex, and diabetes duration (DD), the CKD prevalence (20.4%, 12.2%, 10.6%, 8.3%, and 6.4% for the first, second, third, fourth, and fifth quintiles, respectively, p < 0.001 for trend) was significantly decreased across the serum UCB quintiles. The fully adjusted regression model showed negative associations of serum UCB levels (OR: 0.660, 95% CI: 0.585-0.744; p < 0.001 for trend) and quintiles (p < 0.001) with the presence of CKD. Compared with the subjects in the lowest UCB quintile, the risk of CKD decreased by 36.2%, 54.3%, 53.8%, and 62.1%, respectively, in those from the second to the highest UCB quintile. Additionally, C-reactive protein (CRP) levels were significantly higher in the subjects with CKD than in those without CKD (p < 0.001), and significantly decreased across the UCB quintiles (p < 0.001 for trend). CONCLUSIONS Serum UCB levels within the normal range were significantly and negatively linked to CKD in T2DM patients. High-normal UCB may be an independent protective factor for CKD by its antioxidant and the following anti-inflammatory activities through its signalling activity, which was indicated by clearly decreased CRP levels across the UCB quintiles.
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Affiliation(s)
- Man-Rong Xu
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Key Clinical Center for Metabolic Disease, Shanghai, China
| | - Chun-Hua Jin
- Department of Endocrinology and Metabolism, Shanghai Songjiang District Central Hospital, Songjiang Hospital Affiliated to Shanghai Jiaotong University School of Medicine (Preparatory Stage), Shanghai, China
| | - Jun-Xi Lu
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Key Clinical Center for Metabolic Disease, Shanghai, China
| | - Mei-Fang Li
- Department of Emergency, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lian-Xi Li
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Key Clinical Center for Metabolic Disease, Shanghai, China
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An L, Yu Q, Tang H, Li X, Wang D, Tang Q, Xing H, He Y, Zhao X, Zhao S, Lee Y, Lu J. The Prevalence, Progress and Risk Factor Control of Chronic Kidney Disease in Chinese Adults With Type 2 Diabetes Mellitus in Primary Care. Front Endocrinol (Lausanne) 2022; 13:859266. [PMID: 35757423 PMCID: PMC9226338 DOI: 10.3389/fendo.2022.859266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 04/27/2022] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE This study aimed to evaluate the prevalence of chronic kidney disease (CKD) in Chinese adults with T2DM in primary care, and the association of HbA1c, blood pressure (BP) and triglycerides (TG), i.e. ABC control at follow up (FU) with the progress and regression of CKD. METHODS A total of 5123 patients with ≥3 measurements of estimated glomerular filtration rate (eGFR), urinary albumin-to-creatinine ratio (UACR), HbA1c, BP, LDL-C and TG, and FU ≥ 12 months were included into final analysis. The presence of CKD was defined as the presence of albuminuria (UACR ≥ 30 mg/g), impaired eGFR (eGFR < 60 ml/min/1.73 m2) or both, and was categorised as low, moderate and high/very high risk. The change of CKD risk for outcome was categorised as stable (no change), progress (risk increase) and regress (risk decrease) from baseline to the last visits (LV). RESULTS The prevalence of CKD, impaired eGFR and albuminuria was 29.6%, 5.8% and 27.1% at baseline, with 70.4%, 20.3%, 7.0% and 2.3% of patients distributed in low, moderate, high and very high risk group. There were 3457 (67.5%), 1120 (21.8%) and 546 (10.7%) patients had CKD outcome risk stable, progressed and regressed respectively. The proportion of patients reaching targets of BP ≤ 130/80 mmHg, HbA1c<7.5%, LDL-C<2.60 mmol/L increased from baseline to FU and LV, together with increased usage of insulin, RAS inhibitors and lipid lowering medications. After multivariable adjustment, the HbA1c<7.5% (OR: 0.66, 95%CI 0.56-0.78), TG< 1.7 mmol/L (OR: 0.81, 95%CI 0.68-0.96) at FU and BP ≤ 130/80 mmHg at LV (OR: 0.82, 95%CI 0.70-0.95) was negatively associated with CKD outcome risk progress. CONCLUSION The prevalence of CKD was high with 21.8% of patients progressing to higher CKD outcome risk at FU, attention should be paid on long term and better ABC control.
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Affiliation(s)
- Lingwang An
- Department of Endocrinology, Beijing Ruijing Diabetes Hospital, Beijing, China
| | - Qiuzhi Yu
- Department of Endocrinology, Heilongjiang Ruijing Diabetes Hospital, Haerbin, China
| | - Hong Tang
- Department of Share-care center, Chengdu Ruien Diabetes Hospital, Chengdu, China
| | - Xianglan Li
- Department of Endocrinology, Beijing Ruijing Diabetes Hospital, Beijing, China
| | - Dandan Wang
- Department of Endocrinology, Beijing Ruijing Diabetes Hospital, Beijing, China
| | - Qi Tang
- Department of Endocrinology, Beijing Ruijing Diabetes Hospital, Beijing, China
| | - Haiyang Xing
- Department of Endocrinology, Beijing Ruijing Diabetes Hospital, Beijing, China
| | - Yali He
- Department of Endocrinology, Taiyuan Diabetes Hospital, Taiyuan, China
| | - Xiaona Zhao
- Department of Endocrinology, Heilongjiang Ruijing Diabetes Hospital, Haerbin, China
| | - Shuhui Zhao
- Department of Endocrinology, Lanzhou Ruijing Diabetes Hospital, Lanzhou, China
| | - Yaujiunn Lee
- Department of Metabolism and Endocrinology, Lee’s Clinic, Pingtung, Taiwan
- *Correspondence: Yaujiunn Lee, ; Juming Lu,
| | - Juming Lu
- Department of Endocrinology, Beijing Ruijing Diabetes Hospital, Beijing, China
- Department of Endocrinology, The General Hospital of the People’s Liberation Army, Beijing, China
- *Correspondence: Yaujiunn Lee, ; Juming Lu,
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Zhao P, Yan J, Pan B, Liu J, Fu S, Cheng J, Wang L, Jing G, Li Q. Association Between the Risk of Non-Alcoholic Fatty Liver Disease in Patients with Type 2 Diabetes and Chronic Kidney Disease. Diabetes Metab Syndr Obes 2022; 15:1141-1151. [PMID: 35444436 PMCID: PMC9015107 DOI: 10.2147/dmso.s356497] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 04/01/2022] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE To explore the relationship between non-alcoholic fatty liver disease (NAFLD) and chronic kidney disease (CKD) in patients with type 2 diabetes mellitus (T2DM). METHODS A total of 1168 patients with T2DM were divided into the non-CKD and CKD groups, and the difference in the prevalence of NAFLD was compared. The differences in serum creatinine (SCr) and urine albumin-to-creatinine ratio (UACR) levels were compared between the non-NAFLD and NAFLD groups. Patients with T2DM were divided into three groups according to their UACR levels (UACR < 30 mg/g [U1 group]; UACR ≤ 30 mg/g to < 300 mg/g [U2 group]; and UACR ≥ 300 mg/g [U3 group]) or estimated glomerular filtration rate (eGFR) levels (≥ 90 mL/min [G1 group]; eGFR ≤ 60 mL/min to < 90 mL/min [G2 group]; and eGFR < 60 mL/min (G3 group]). The difference in the prevalence and risks of NAFLD in the different UACR or eGFR level groups was analyzed. RESULTS The prevalence of NAFLD in the CKD group was higher than that in the non-CKD group (63.5% vs 50.5%, p < 0.001). The SCr and UACR levels in the NAFLD group were higher than those in the non-NAFLD group (both p<0.05). The prevalence of NAFLD in the U3 group (75.6%) was higher than that in the U1 (50.5%, p < 0.05) and U2 (60.1%, p < 0.05) groups, and the prevalence of NAFLD in the U2 group (60.1%) was higher than that in the U1 group (50.5%, p < 0.05). The risk of NAFLD in the U3 group was higher than that in the U2 group (odds ratio [OR] = 3.032 and 1.473). Despite adjusting the parameters further, the NAFLD risk in the U3 group remained higher than that in the U2 group (OR = 1.660 and 2.342). CONCLUSION The risk of NAFLD in patients with T2DM is closely related to CKD.
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Affiliation(s)
- Pingping Zhao
- The First Clinical Medical College, Lanzhou University, Lanzhou, Gansu, People’s Republic of China
| | - Junxin Yan
- The First Clinical Medical College, Lanzhou University, Lanzhou, Gansu, People’s Republic of China
| | - Binjing Pan
- The First Clinical Medical College, Lanzhou University, Lanzhou, Gansu, People’s Republic of China
| | - Jingfang Liu
- The First Clinical Medical College, Lanzhou University, Lanzhou, Gansu, People’s Republic of China
- Department of Endocrinology, The First Hospital of Lanzhou University, Lanzhou, Gansu, People’s Republic of China
- Correspondence: Jingfang Liu, Department of Endocrinology, the First Hospital of Lanzhou University, Lanzhou, Gansu, 730000, People’s Republic of China, Tel +86 931-8356242, Email
| | - Songbo Fu
- The First Clinical Medical College, Lanzhou University, Lanzhou, Gansu, People’s Republic of China
- Department of Endocrinology, The First Hospital of Lanzhou University, Lanzhou, Gansu, People’s Republic of China
| | - Jianguo Cheng
- The First Clinical Medical College, Lanzhou University, Lanzhou, Gansu, People’s Republic of China
- Department of Endocrinology, The First Hospital of Lanzhou University, Lanzhou, Gansu, People’s Republic of China
| | - Liting Wang
- The First Clinical Medical College, Lanzhou University, Lanzhou, Gansu, People’s Republic of China
- Department of Endocrinology, The First Hospital of Lanzhou University, Lanzhou, Gansu, People’s Republic of China
| | - Gaojing Jing
- The First Clinical Medical College, Lanzhou University, Lanzhou, Gansu, People’s Republic of China
- Department of Endocrinology, The First Hospital of Lanzhou University, Lanzhou, Gansu, People’s Republic of China
| | - Qiong Li
- The First Clinical Medical College, Lanzhou University, Lanzhou, Gansu, People’s Republic of China
- Department of Endocrinology, The First Hospital of Lanzhou University, Lanzhou, Gansu, People’s Republic of China
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Liu J, Zhang J, Hou MH, Du WX. Clinical efficacy of linagliptin combined with irbesartan in patients with diabetic nephropathy. Pak J Med Sci 2022; 38:52-56. [PMID: 35035400 PMCID: PMC8713209 DOI: 10.12669/pjms.38.1.4417] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 07/23/2021] [Accepted: 07/31/2021] [Indexed: 11/15/2022] Open
Abstract
Objective To determine the clinical efficacy of linagliptin combined with irbesartan in patients with diabetic nephropathy (DN). Methods Seventy-two patients who were admitted to our department of endocrinology in our hospital during January 2018 and June 2019 were randomly divided into a control group (administered with irbesartan only, n=36) and a treatment group (treated with irbesartan and linagliptin, n=36). The course of treatment lasted for three months. FBG (fasting blood glucose), 2hPBG (2h postprandial blood sugar), HbA1C (hemoglobin A1c), Cys-C (cystatin C), SCr (serum creatinine), BUN (blood urea nitrogen), UACR (urine albumin-to-creatinine ratio), CRP (C-reactive protein), IL-6 (interleukin-6), and SOD (superoxide dismutase) were tested pre- and post-treatment to evaluate the clinical efficacy and adverse effects of the two treatment plans after three months of treatment. Results Compared with the pre-treatment levels, FBG, 2hPBG, HbA1c, Cys-C, SCr, BUN, UACR, CRP, IL-6, and SOD in both groups were significantly improved following the three-month treatment (P<0.05, respectively). Post-treatment levels of FBG, 2hPBG, HbA1c, Cys-C, SCr, BUN, UACR, CRP, and IL-6 in the treatment group were significantly lower than in the control group (P<0.05, respectively), while the treatment group exhibited a higher level of SOD compared with the control group (P<0.05). No serious adverse reaction occurred in either group (P>0.05). Conclusion Combined-modality treatment with linagliptin and irbesartan shows favorable clinical efficacy in treating diabetic nephropathy as it effectively protects the kidneys and improves kidney function by inhibiting inflammatory and oxidative stress responses.
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Affiliation(s)
- Jie Liu
- Jie Liu, Department of Endocrinology, Affiliated Hospital of Hebei University, Baoding 071000, Hebei, China
| | - Jing Zhang
- Jing Zhang, Department of Cardiology, Affiliated Hospital of Hebei University, Baoding 071000, Hebei, China
| | - Ming-Hui Hou
- Ming-hui Hou, Department of Endocrinology, Affiliated Hospital of Hebei University, Baoding 071000, Hebei, China
| | - Wei-Xuan Du
- Wei-xuan Du Department of Education, Affiliated Hospital of Hebei University, Baoding 071000, Hebei, China
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Sas KM, Lin J, Wang CH, Zhang H, Saha J, Rajendiran TM, Soni T, Nair V, Eichinger F, Kretzler M, Brosius FC, Michailidis G, Pennathur S. Renin-angiotensin system inhibition reverses the altered triacylglycerol metabolic network in diabetic kidney disease. Metabolomics 2021; 17:65. [PMID: 34219205 PMCID: PMC8312633 DOI: 10.1007/s11306-021-01816-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 06/24/2021] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Dyslipidemia is a significant risk factor for progression of diabetic kidney disease (DKD). Determining the changes in individual lipids and lipid networks across a spectrum of DKD severity may identify lipids that are pathogenic to DKD progression. METHODS We performed untargeted lipidomic analysis of kidney cortex tissue from diabetic db/db and db/db eNOS-/- mice along with non-diabetic littermate controls. A subset of mice were treated with the renin-angiotensin system (RAS) inhibitors, lisinopril and losartan, which improves the DKD phenotype in the db/db eNOS-/- mouse model. RESULTS Of the three independent variables in this study, diabetes had the largest impact on overall lipid levels in the kidney cortex, while eNOS expression and RAS inhibition had smaller impacts on kidney lipid levels. Kidney lipid network architecture, particularly of networks involving glycerolipids such as triacylglycerols, was substantially disrupted by worsening kidney disease in the db/db eNOS-/- mice compared to the db/db mice, a feature that was reversed with RAS inhibition. This was associated with decreased expression of the stearoyl-CoA desaturases, Scd1 and Scd2, with RAS inhibition. CONCLUSIONS In addition to the known salutary effect of RAS inhibition on DKD progression, our results suggest a previously unrecognized role for RAS inhibition on the kidney triacylglycerol lipid metabolic network.
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Affiliation(s)
- Kelli M Sas
- Division of Nephrology, Department of Internal Medicine, University of Michigan, 5309 Brehm Center, 1000 Wall St., Ann Arbor, Michigan, 48105, USA
| | - Jiahe Lin
- Department of Statistics, University of Michigan, Ann Arbor, Michigan, 48109, USA
| | - Chih-Hong Wang
- Division of Nephrology, Department of Internal Medicine, University of Michigan, 5309 Brehm Center, 1000 Wall St., Ann Arbor, Michigan, 48105, USA
| | - Hongyu Zhang
- Division of Nephrology, Department of Internal Medicine, University of Michigan, 5309 Brehm Center, 1000 Wall St., Ann Arbor, Michigan, 48105, USA
| | - Jharna Saha
- Division of Nephrology, Department of Internal Medicine, University of Michigan, 5309 Brehm Center, 1000 Wall St., Ann Arbor, Michigan, 48105, USA
| | - Thekkelnaycke M Rajendiran
- Department of Pathology, University of Michigan, Ann Arbor, Michigan, 48109, USA
- Michigan Regional Comprehensive Metabolomics Resource Core, Ann Arbor, Michigan, 48105, USA
| | - Tanu Soni
- Michigan Regional Comprehensive Metabolomics Resource Core, Ann Arbor, Michigan, 48105, USA
| | - Viji Nair
- Division of Nephrology, Department of Internal Medicine, University of Michigan, 5309 Brehm Center, 1000 Wall St., Ann Arbor, Michigan, 48105, USA
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, Michigan, 48109, USA
| | - Felix Eichinger
- Division of Nephrology, Department of Internal Medicine, University of Michigan, 5309 Brehm Center, 1000 Wall St., Ann Arbor, Michigan, 48105, USA
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, Michigan, 48109, USA
| | - Matthias Kretzler
- Division of Nephrology, Department of Internal Medicine, University of Michigan, 5309 Brehm Center, 1000 Wall St., Ann Arbor, Michigan, 48105, USA
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, Michigan, 48109, USA
| | - Frank C Brosius
- Division of Nephrology, Department of Internal Medicine, University of Michigan, 5309 Brehm Center, 1000 Wall St., Ann Arbor, Michigan, 48105, USA
- Division of Nephrology, Department of Medicine, University of Arizona, Tucson, Arizona, 85724, USA
| | - George Michailidis
- Department of Statistics and Computer and Information Sciences, University of Florida, Gainesville, Florida, 32611, USA
| | - Subramaniam Pennathur
- Division of Nephrology, Department of Internal Medicine, University of Michigan, 5309 Brehm Center, 1000 Wall St., Ann Arbor, Michigan, 48105, USA.
- Michigan Regional Comprehensive Metabolomics Resource Core, Ann Arbor, Michigan, 48105, USA.
- Department of Molecular and Integrative Physiology, University of Michigan, Ann Arbor, Michigan, 48109, USA.
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Zhou Y, Chen K, Du X, Tang J, Shi B. Risk Factors for Albuminuria in Normotensive Older Adults with Type 2 Diabetes Mellitus and Normal Renal Function: A Cross-Sectional Study. Diabetes Ther 2021; 12:697-705. [PMID: 33515179 PMCID: PMC7947076 DOI: 10.1007/s13300-021-01003-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 01/12/2021] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Diabetes mellitus (DM) is prevalent in developed and developing countries, including China. However, few studies have examined the potential risk factors for albuminuria in normotensive older adults with type 2 DM and normal renal function. METHODS We recruited normotensive older adults (≥ 65 years) with type 2 DM and normal renal function from the First Affiliated Hospital of Soochow University from January to December 2019. We stratified participants according to their urine albumin to creatinine ratio (ACR) into the following groups: normal ACR (ACR1), microalbuminuria (ACR2), and macroalbuminuria (ACR3). Demographic characteristics, anthropometric parameters, and metabolic profiles were recorded. Creatinine clearance (Ccr) and homeostasis model assessment-insulin resistance (HOMA-IR) were calculated. Logistic regression was used to examine risk factors for albuminuria. RESULTS A total of 250 older adults were enrolled during the study period, including 124, 82, and 44 with normal albuminuria, microalbuminuria, and macroalbuminuria, respectively. We found that an extended duration of DM (odds ratio [OR] 1.085, 95% confidence interval [CI] 1.012-1.164, P = 0.022), elevated systolic blood pressure (OR 1.049, 95%CI 1.018-1.081, P < 0.01), elevated glycated hemoglobin (OR 1.734, 95% CI 1.332-2.258, P < 0.01), low insulin (OR 0.871, 95% CI 0.804-0.944, P < 0.01), and low C-peptide (OR 0.365, 95% CI 0.239-0.588, P < 0.01) were independent risk factors for albuminuria. CONCLUSION Elevated blood pressure, low insulin, low C-peptide, and poor glycemic control were significant risk factors for albuminuria. These parameters may serve as early indicators for intervention.
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Affiliation(s)
- Yingyi Zhou
- Endocrine Department, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Ke Chen
- Thoracic Surgery Department, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Xuan Du
- Endocrine Department, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Jiali Tang
- Endocrine Department, Xishan Hospital, Wuxi, China
| | - Bimin Shi
- Endocrine Department, The First Affiliated Hospital of Soochow University, Suzhou, China.
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Rehman T, Shamanna SB, Chinnakali P, Mohanraj PS, Senthilkumar GP, Sarveswaran G, Sakthivel M. Burden of diabetic kidney disease among persons with type 2 diabetes mellitus registered in a tertiary care center, Puducherry. Diabetes Metab Syndr 2020; 14:991-993. [PMID: 32619949 DOI: 10.1016/j.dsx.2020.06.037] [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: 01/31/2020] [Revised: 06/15/2020] [Accepted: 06/16/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND & AIMS To determine burden of diabetic kidney disease (DKD) and estimate yield and number needed to screen (NNS) in a tertiary diabetes care center. METHODS DKD was diagnosed if estimated Glomerular Filtration Rate (eGFR) < 60 ml/min/1.73 m2 or Urinary Albumin Creatinine Ratio (UACR) ≥30 mg/g in two urine samples. RESULTS Of 511 participants, 206 (40%) had DKD. Using both UACR and eGFR, yield and NNS were 39% and three, respectively. CONCLUSION Using eGFR alone, yield and NNS to find a case of DKD among consecutive adult (≥18 years age) patients with type 2 diabetes mellitus were 26.4% and 4, respectively.
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Affiliation(s)
- Tanveer Rehman
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
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10
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Yang L, Chu TK, Lian J, Lo CW, Zhao S, He D, Qin J, Liang J. Individualised risk prediction model for new-onset, progression and regression of chronic kidney disease in a retrospective cohort of patients with type 2 diabetes under primary care in Hong Kong. BMJ Open 2020; 10:e035308. [PMID: 32641324 PMCID: PMC7348646 DOI: 10.1136/bmjopen-2019-035308] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES This study is aimed to develop and validate a prediction model for multistate transitions across different stages of chronic kidney disease (CKD) in patients with type 2 diabetes mellitus under primary care. SETTING We retrieved the anonymised electronic health records of a population-based retrospective cohort in Hong Kong. PARTICIPANTS A total of 26 197 patients were included in the analysis. PRIMARY AND SECONDARY OUTCOME MEASURES The new-onset, progression and regression of CKD were defined by the transitions of four stages that were classified by combining glomerular filtration rate and urine albumin-to-creatinine ratio. We applied a multiscale multistate Poisson regression model to estimate the rates of the stage transitions by integrating the baseline demographic characteristics, routine laboratory test results and clinical data from electronic health records. RESULTS During the mean follow-up time of 1.8 years, there were 2632 patients newly diagnosed with CKD, 1746 progressed to the next stage and 1971 regressed into an earlier stage. The models achieved the best performance in predicting the new-onset and progression with the predictors of sex, age, body mass index, systolic blood pressure, diastolic blood pressure, serum creatinine, haemoglobin A1c, total cholesterol, low-density lipoprotein, high-density lipoprotein, triglycerides and drug prescriptions. CONCLUSIONS This study demonstrated that individual risks of new-onset and progression of CKD can be predicted from the routine physical and laboratory test results. The individualised prediction curves developed from this study could potentially be applied to routine clinical practices, to facilitate clinical decision making, risk communications with patients and early interventions.
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Affiliation(s)
- Lin Yang
- School of Nursing, Hong Kong Polytechnic University, Hong Kong, Hong Kong
| | - Tsun Kit Chu
- Department of Family Medicine and Primary Healthcare, New Territory West Cluster, Hospital Authority, Hong Kong, Hong Kong
| | - Jinxiao Lian
- School of Optometry, Hong Kong Polytechnic University, Hong Kong, Hong Kong
| | - Cheuk Wai Lo
- Department of Family Medicine and Primary Healthcare, New Territory West Cluster, Hospital Authority, Hong Kong, Hong Kong
| | - Shi Zhao
- School of Nursing, Hong Kong Polytechnic University, Hong Kong, Hong Kong
- JC School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong, China
- Shenzhen Research Institute of Chinese University of Hong Kong, Shenzhen, China
| | - Daihai He
- Department of Applied Mathematics, Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Jing Qin
- School of Nursing, Hong Kong Polytechnic University, Hong Kong, Hong Kong
| | - Jun Liang
- Department of Family Medicine and Primary Healthcare, New Territory West Cluster, Hospital Authority, Hong Kong, Hong Kong
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11
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Jitraknatee J, Ruengorn C, Nochaiwong S. Prevalence and Risk Factors of Chronic Kidney Disease among Type 2 Diabetes Patients: A Cross-Sectional Study in Primary Care Practice. Sci Rep 2020; 10:6205. [PMID: 32277150 PMCID: PMC7148316 DOI: 10.1038/s41598-020-63443-4] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 03/31/2020] [Indexed: 12/11/2022] Open
Abstract
This cross-sectional study aimed to investigate the prevalence and risk factors of chronic kidney disease (CKD) among 1,096 primary care type 2 diabetes (T2DM) patients in northern Thailand between October 2016 and September 2017. CKD was defined as estimated glomerular rate filtration values of <60 mL/min/1.73 m2. Prevalence with confidence intervals across CKD advanced stages 3–5 were estimated. Factors associated with CKD were evaluated by multivariate logistic regression. The overall prevalence of CKD was 24.4% (21.9–27.0), with severities of 11.4% (9.7–13.4), 6.8% (5.5–8.5), 4.6% (3.5–6.0), and 1.6% (1.0–2.5) for stages 3 A, 3B, 4, and 5, respectively. Regarding age and glycaemic control, individuals older than 75 years and those with a haemoglobin A1c ≥ 8% had the highest prevalence of 61.3% (51.7–70.1) and 38.6% (34.3–43.2), respectively. The multivariable logistic regression model explained 87.3% of the probability of CKD. The six independent significant risk factors of CKD were older age, retinopathy, albuminuria, haemoglobin A1c ≥ 7%, anaemia, and uric acid>7.5 mg/dL. A relatively high prevalence of CKD, especially in older patients and those with diabetic complications-related to poor glycaemic control, was encountered in this primary care practice. Early identification may help to target optimise care and prevention programs for CKD among T2DM patients.
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Affiliation(s)
| | - Chidchanok Ruengorn
- Department of Pharmaceutical Care, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, 50200, Thailand.,Pharmacoepidemiology and Statistics Research Center (PESRC), Faculty of Pharmacy, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Surapon Nochaiwong
- Department of Pharmaceutical Care, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, 50200, Thailand. .,Pharmacoepidemiology and Statistics Research Center (PESRC), Faculty of Pharmacy, Chiang Mai University, Chiang Mai, 50200, Thailand.
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12
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Zhang XX, Kong J, Yun K. Prevalence of Diabetic Nephropathy among Patients with Type 2 Diabetes Mellitus in China: A Meta-Analysis of Observational Studies. J Diabetes Res 2020; 2020:2315607. [PMID: 32090116 PMCID: PMC7023800 DOI: 10.1155/2020/2315607] [Citation(s) in RCA: 80] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 11/06/2019] [Accepted: 11/30/2019] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Diabetic nephropathy (DN) is an important cause of end-stage renal disease and is recognized as a public health problem worldwide. However, there have been no nationwide surveys of DN prevalence in China. This study is aimed at estimating the pooled prevalence of DN among patients with type 2 diabetes in China. METHODS Published studies on the prevalence of DN among patients with type 2 diabetes published from January 1980 to October 2019 were systematically reviewed using PubMed, Embase, Google Scholar, Chinese Wanfang databases, and Chinese National Knowledge Infrastructure. The pooled prevalence of DN was estimated with the random effects model using R software. Prevalence estimates were also stratified by study design, methodological approach, and study population characteristics. RESULTS Thirty studies with a total of 79,364 participants were included in our study. The overall pooled prevalence of DN was 21.8% [95% confidence interval (CI): 18.5-25.4%]. Subgroup analysis found that the prevalence of DN varied significantly according to different DM and DN diagnostic criteria (P < 0.05); the pooling estimate was the highest in the west region of 41.3%, followed by that in the east region of China with 22.3%, northeast region with 20.7%, and central region with 15.6% (P < 0.05); the pooling estimate was the highest in the west region of 41.3%, followed by that in the east region of China with 22.3%, northeast region with 20.7%, and central region with 15.6% (P < 0.05); the pooling estimate was the highest in the west region of 41.3%, followed by that in the east region of China with 22.3%, northeast region with 20.7%, and central region with 15.6% (. CONCLUSIONS The prevalence of DN is high in Chinese patients with type 2 diabetes and shows geographic and gender variation. These data indicate that national strategies aimed at primary and secondary prevention of DN and screening programs for DN are urgently needed to reduce the risk and burden of DN in China.
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Affiliation(s)
- Xin-Xin Zhang
- Department of Ophthalmology Laboratory, The Fourth Affiliated Hospital of China Medical University, Shenyang 110006, China
| | - Jun Kong
- Department of Ophthalmology Laboratory, The Fourth Affiliated Hospital of China Medical University, Shenyang 110006, China
| | - Ke Yun
- Department of Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang 110001, China
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13
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Liu P, Ma L, Zhao H, Shen Z, Zhou X, Yan M, Zhao T, Zhang H, Qiu X, Li P. Association between LXR- α and ABCA1 Gene Polymorphisms and the Risk of Diabetic Kidney Disease in Patients with Type 2 Diabetes Mellitus in a Chinese Han Population. J Diabetes Res 2020; 2020:8721536. [PMID: 33426085 PMCID: PMC7772016 DOI: 10.1155/2020/8721536] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 10/17/2020] [Accepted: 12/15/2020] [Indexed: 12/13/2022] Open
Abstract
We designed a case-control study and selected LXR-α rs7120118 C>T and ABCA1 rs2230806 A>G polymorphisms to determine the correlation between these polymorphisms and diabetic kidney disease (DKD) susceptibility in a Chinese Han population. Three hundred DKD patients and 346 type 2 diabetes mellitus (DM) patients without kidney disease were recruited. Our results showed that rs7120118 was associated with DKD (genotype, P = .027; allele, P < .011). rs7120118 was associated with a higher risk of DKD under a dominant model adjustment by age and sex (P = .015) and an additive model (P = .040); rs2230806 was associated with a higher risk of DKD under an recessive model (P < .03); the combined effect of rs7120118 CC+rs2230806 GG genotype showed an association of DKD adjustment for age and sex (P = .009). In subgroup analysis of patients without hypercholesterolemia, the rs2230806 genotype frequencies were different between the two groups (P = .042). rs2230806 was associated with increased risk of DKD under a recessive model adjustment for age and sex (P = .013) and an additive model (P = .031). Our results suggest that LXR-α rs7120118 is significantly associated with a higher risk of DKD, and ABCA1 rs2230806 is significantly associated with a higher risk of DKD without hypercholesterolemia in Chinese Han individuals.
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Affiliation(s)
- Peng Liu
- Shunyi Hospital, Beijing Traditional Chinese Medicine Hospital, Beijing, China
| | - Liang Ma
- Clinical Laboratory, China-Japan Friendship Hospital, Beijing, China
| | - Hailing Zhao
- Beijing Key Lab for Immune-Mediated Inflammatory Diseases, Institute of Clinical Medical Science, China-Japan Friendship Hospital, Beijing, China
| | - Zhengri Shen
- Shunyi Hospital, Beijing Traditional Chinese Medicine Hospital, Beijing, China
| | - Xuefeng Zhou
- Beijing Key Lab for Immune-Mediated Inflammatory Diseases, Institute of Clinical Medical Science, China-Japan Friendship Hospital, Beijing, China
| | - Meihua Yan
- Beijing Key Lab for Immune-Mediated Inflammatory Diseases, Institute of Clinical Medical Science, China-Japan Friendship Hospital, Beijing, China
| | - Tingting Zhao
- Beijing Key Lab for Immune-Mediated Inflammatory Diseases, Institute of Clinical Medical Science, China-Japan Friendship Hospital, Beijing, China
| | - Haojun Zhang
- Beijing Key Lab for Immune-Mediated Inflammatory Diseases, Institute of Clinical Medical Science, China-Japan Friendship Hospital, Beijing, China
| | - Xinping Qiu
- Shunyi Hospital, Beijing Traditional Chinese Medicine Hospital, Beijing, China
| | - Ping Li
- Beijing Key Lab for Immune-Mediated Inflammatory Diseases, Institute of Clinical Medical Science, China-Japan Friendship Hospital, Beijing, China
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14
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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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15
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Association of Smoking-Related Knowledge, Attitude, and Practices (KAP) with Nutritional Status and Diet Quality: A Cross-Sectional Study in China. BIOMED RESEARCH INTERNATIONAL 2019; 2019:5897478. [PMID: 31531358 PMCID: PMC6720361 DOI: 10.1155/2019/5897478] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 07/23/2019] [Accepted: 07/28/2019] [Indexed: 12/18/2022]
Abstract
Background Smoking is the second leading cause of death. Limited studies are available about smoking and overall diet quality. The current study was aimed at finding an association of s-KAP (smoking-related knowledge, attitude, and practices) with nutritional status and diet quality. Methodology The current study was a cross-sectional community-based study conducted in Jurong city, China. Validated questionnaires were used for the collection of data regarding s-KAP and dietary intake. Correlation and multivariate linear regression analysis were used for the association of s-KAP scores with diet quality scores and nutritional status. Results The total numbers of participants were 7998 with a mean age of 59.3±11.4 years, including 38.5% males and 41.5% females. s-KAP scores were categorized into two groups, i.e., High s-KAP group and low s-KAP group. The High s-KAP group had significantly higher (P<0.05) diet scores and BMI but lower (P<0.05) WC (waist circumference) and WHR (waist to hip ratio) than the Low s-KAP group. Independent positive association (P<0.05) of s-KAP scores with diet scores was observed after the adjustment for age, gender, physical activity, alcohol consumptions, monthly income, and anthropometric measures (BMI, WC, and WHR). Similarly, smoking was positively associated (P<0.05) with diet scores after adjustment for covariates. Conclusion In conclusion, the higher s-KAP scores indicated more knowledge regarding the harmful consequences of the smoking outcomes, positive attitude, less smoking practices, and having a good plan to quit smoking. Individuals with high s-KAP scores had good diet quality and lower adiposity measures. Furthermore, s-KAP scores and smoking status were having an independent positive association with diet scores.
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16
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Liu ZX, Hong Q, Peng DH, Yang Y, Yu WL, Shui H, Zhou X, Liu SM. Evaluation of serum free fatty acids in chronic renal failure: evidence from a rare case with undetectable serum free fatty acids and population data. Lipids Health Dis 2019; 18:151. [PMID: 31286991 PMCID: PMC6615299 DOI: 10.1186/s12944-019-1093-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 07/01/2019] [Indexed: 12/25/2022] Open
Abstract
Background Free fatty acid (FFA) accumulation in proximal tubules plays a fundamental role in the progress of kidney disease. Here, we reported a rare case with undetectable serum FFAs and further evaluated the changes of serum FFAs in patients with chronic renal failure (CRF). Methods We analyzed the clinical data of a rare case and 574 CRF patients. The mRNA expression of lipoprotein lipase (LPL), hepatic lipase (HL) and fatty acid synthase (FASN) were determined in the rare case and 30 age-matched healthy males with qPCR. Results This rare case had serious proteinuria, hyperglycemia, lipid disorders and bilateral renal glomerular filtration dysfunction. Compared with healthy males, this case showed a 1.49-fold increase of LPL expression (P < 0.01), a 3.38-fold reduction of HL expression (P < 0.001), and no significant change of FASN expression (P > 0.05). In total, 21.6% of CRF patients showed abnormal FFAs. Biochemical parameters such as blood urea nitrogen (BUN) and creatinine (CREA) significantly differed among groups with low-, normal- or high-level-FFAs. Moreover, serum FFAs was found to be associated with BUN. FFAs decreased in the group with higher BUN (> 17.4 mmol/L) and in the group with lower estimated glomerular filtration rate (eGFR) (< 15 mL/min/1.73m2). Conclusions The proteinuria, HL low expression and renal function failure may contribute to the FFA reduction, which might imply that the renal function is severely damaged. Electronic supplementary material The online version of this article (10.1186/s12944-019-1093-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Zhen-Xian Liu
- Department of Clinical Laboratory, Center for Gene Diagnosis and Program of Clinical Laboratory, Zhongnan Hospital, Wuhan University, 169 Donghu Road, Wuhan, 430071, Hubei Province, China
| | - Qian Hong
- Department of Nephrology, Renmin Hospital of Huangmei County, Huanggang, 435500, Hubei Province, China.,Department of Nephrology, Zhongnan Hospital, Wuhan University, 169 Donghu Road, Wuhan, 430071, Hubei Province, China
| | - Ding-Hui Peng
- Department of Clinical Laboratory, Center for Gene Diagnosis and Program of Clinical Laboratory, Zhongnan Hospital, Wuhan University, 169 Donghu Road, Wuhan, 430071, Hubei Province, China
| | - Ying Yang
- Department of Clinical Laboratory, Center for Gene Diagnosis and Program of Clinical Laboratory, Zhongnan Hospital, Wuhan University, 169 Donghu Road, Wuhan, 430071, Hubei Province, China
| | - Wen-Li Yu
- Department of Nephrology, Zhongnan Hospital, Wuhan University, 169 Donghu Road, Wuhan, 430071, Hubei Province, China
| | - Hua Shui
- Department of Nephrology, Zhongnan Hospital, Wuhan University, 169 Donghu Road, Wuhan, 430071, Hubei Province, China
| | - Xin Zhou
- Department of Clinical Laboratory, Center for Gene Diagnosis and Program of Clinical Laboratory, Zhongnan Hospital, Wuhan University, 169 Donghu Road, Wuhan, 430071, Hubei Province, China
| | - Song-Mei Liu
- Department of Clinical Laboratory, Center for Gene Diagnosis and Program of Clinical Laboratory, Zhongnan Hospital, Wuhan University, 169 Donghu Road, Wuhan, 430071, Hubei Province, China.
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