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Zhao M, Dong Y, Chen L, Shen H. Influencing factors of stroke in patients with type 2 diabetes: A systematic review and meta-analysis. PLoS One 2024; 19:e0305954. [PMID: 38913694 PMCID: PMC11196000 DOI: 10.1371/journal.pone.0305954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 06/09/2024] [Indexed: 06/26/2024] Open
Abstract
BACKGROUND Stroke stands as a significant macrovascular complication among individuals with Type 2 diabetes mellitus (T2DM), often resulting in the primary cause of mortality and disability within this patient demographic. Presently, numerous studies have been conducted to investigate the underlying causes of stroke in individuals with T2DM, yet the findings exhibit inconsistencies. OBJECTIVE This paper aims to consolidate and summarize the available evidence concerning the influential factors contributing to stroke among patients diagnosed with T2DM. METHODS We conducted a comprehensive search across multiple databases, including Cochrane Library, PubMed, Web Of Science, Embase, China Biology Medicine (CBM), China National Knowledge Infrastructure (CNKI), Wanfang and Weipu up to August 2023. Google Scholar was also searched to retrieve gray literature. We calculated odds ratios (OR) and 95% confidence intervals (CI) using Stata software. RESULTS Our analysis encompassed 43 observational studies, exploring factors across sociodemographic, biochemical, complications, and hypoglycemic agent categories. The findings identified several risk factors for stroke in patients with T2DM: age, gender, T2DM duration, hypertension, body-mass index (BMI), smoking, Glycated hemoglobin (HbA1c), estimated Glomerular Filtration Rate (eGFR), albuminuria, Triglycerides (TG), Low density lipoprotein cholesterol (LDL-C), Coronary heart disease (CHD), Atrial fibrillation (AF), diabetic retinopathy (DR), Peripheral vascular disease (PVD), and carotid plaque. Conversely, exercise, High density lipoprotein cholesterol (HDL-C), metformin (MET), pioglitazone, and metformin combination therapy emerged as protective factors. CONCLUSION This study underscores the multitude of influencing factors contributing to stroke in people with T2DM patients, among which the microvascular complications of T2DM play an most important role. Therefore, we emphasize the importance of screening for microvascular complications in patients with T2DM. However, due to limitations arising from the number of articles reviewed, there remain areas where clarity is lacking. Further research efforts are warranted to expand upon and reinforce our current findings.
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Affiliation(s)
- Mengjiao Zhao
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, 310053, China
| | - Yongze Dong
- Department of Nursing, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital), Hangzhou Medical College, Hangzhou, 310014, China
| | - Luchen Chen
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, 310053, China
| | - Huajuan Shen
- Department of Nursing, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital), Hangzhou Medical College, Hangzhou, 310014, China
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Zhang D, Fu Z, Wan X, Wu X, Ding L. Correlation between geriatric nutritional risk index and intradialytic hypotension in elderly patients undergoing maintenance hemodialysis: a case-control study. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2024; 43:80. [PMID: 38849963 PMCID: PMC11161997 DOI: 10.1186/s41043-024-00551-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 04/15/2024] [Indexed: 06/09/2024]
Abstract
BACKGROUND There is a correlation between nutritional status and treatment outcomes and long-term survival in MHD patients but there is limited research on the relationship between GNRI and IDH. This case-control study aimed to investigate the correlation between Geriatric Nutritional Risk Index (GNRI) and intradialytic hypotension (IDH) in elderly patients undergoing maintenance hemodialysis (MHD). METHODS This study was carried out on 129 cases of MHD patients with IDH and 258 non-IDH-controls in Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China, between June 2020 and May 2022. Professional researchers collected patients' general information on gender, primary disease, dialysis-related indicators, anthropometric measures, laboratory biochemicals, and GNRI. Logistic regression analysis was used to evaluate the correlation between GNRI and IDH. RESULTS A total of 385 elderly MHD patients were included. Compared with GNRI Q4 group, the odds ratios for the risk of IDH in GNRI Q3 group, GNRI Q2 group, and GNRI Q1 group of elderly MHD patients were 1.227, 2.196, and 8.350, respectively, showing a significant downward trend (P-trend < 0.05). The area under the curve of GNRI for predicting IDH was 0.839 (95% CI: 0.799-0.879). Between different genders, a decrease in GNRI was closely related to an increase in IDH risk (P for trend < 0.05). CONCLUSIONS This research shows a significant association between GNRI and the incidence of IDH among elderly MHD patients and has an important warning effect. Encouraging the incorporation of GNRI assessment into the clinical assessment protocols of older patients with MHD may help to improve the nutritional status of those suffering from it and reduce the risk of IDH.
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Affiliation(s)
- Dan Zhang
- Ruijin Hospital, Shanghai Jiaotong University School of Medicine, 888 Shuangding Road, Jiading District, Shanghai, 201801, China
| | - Zhoushan Fu
- Ruijin Hospital, Shanghai Jiaotong University School of Medicine, 888 Shuangding Road, Jiading District, Shanghai, 201801, China
| | - Xiaoqin Wan
- Ruijin Hospital, Shanghai Jiaotong University School of Medicine, 888 Shuangding Road, Jiading District, Shanghai, 201801, China
| | - Xiaojing Wu
- Ruijin Hospital, Shanghai Jiaotong University School of Medicine, 888 Shuangding Road, Jiading District, Shanghai, 201801, China
| | - Lin Ding
- Ruijin Hospital, Shanghai Jiaotong University School of Medicine, 888 Shuangding Road, Jiading District, Shanghai, 201801, China.
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Duan Q, Huang H, Zhang S, Wang Y, Lu D, Wan L, Sun Y, Wu Y. Association between composite dietary antioxidant index and kidney stone prevalence in adults: data from National Health and Nutrition Examination Survey (NHANES, 2007-2018). Front Nutr 2024; 11:1389714. [PMID: 38840700 PMCID: PMC11150772 DOI: 10.3389/fnut.2024.1389714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 04/29/2024] [Indexed: 06/07/2024] Open
Abstract
Background The high prevalence of kidney stones in adults worldwide has prompted research into potential interventions, one of which involves exploring the consumption of antioxidants that may confer protective effects. However, the relationship between the composite dietary antioxidant index (CDAI), a crucial measure used to assess an individual's overall antioxidant capacity from daily dietary intake, and kidney stones remains unclear. Therefore, we conducted cross-sectional analysis to examine the association between CDAI and kidney stone prevalence. Methods The analysis was conducted utilizing data from the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2018. Antioxidant intake was derived from two 24-h dietary recalls surveys, while CDAI, a comprehensive measure that includes antioxidants like vitamins A, C, and E, zinc, selenium, and carotenoids, was calculated. Multivariate logistic regression and restricted cubic spline (RCS) regression were utilized to examine the association between CDAI and the prevalence of kidney stones. Results The study included a total of 28,516 participants, with 2,748 individuals having a history of kidney stones. The median of CDAI was -0.01 (-2.02, 2.37). Individuals in the fourth quartile of CDAI exhibited a significantly lower prevalence of kidney stones compared to those in the first quartile (Odds Ratio [OR] = 0.769 [0.633-0.935]), even after adjusting for potential confounding factors (including age, sex, race, education level, poverty income ratio, smoking status, drinking status, body mass index (BMI), energy intake levels, physical activity level, serum calcium concentration, estimated glomerular filtration rate (eGFR), hypertension, diabetes and supplement use). The RCS analysis revealed a non-linear relationship between CDAI and kidney stone prevalence, with inflection points identified at 0.06 (p for non-linearity = 0.039). Subgroup analysis demonstrated consistent CDAI-kidney stone prevalence associations across all subsets. Furthermore, a significant inverse correlation was observed between CDAI and inflammatory markers. Conclusion This study provides evidence supporting a reciprocal correlation between adult dietary antioxidant intake, as measured by CDAI, and kidney stone prevalence. These findings emphasize the potential benefits of consuming dietary antioxidants in lowering the risk of kidney stone formation.
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Affiliation(s)
- Qixin Duan
- Department of Urology, Nanyang Central Hospital, Nanyang, Henan, China
- Department of Urology, Affiliated Sanming First Hospital of Fujian Medical University, Sanming, Fujian, China
| | - Han Huang
- Department of Urology, Affiliated Sanming First Hospital of Fujian Medical University, Sanming, Fujian, China
| | - Shuang Zhang
- Department of Nursing, Nanyang Central Hospital, Nanyang, Henan, China
| | - Yang Wang
- Department of Urology, Nanyang Central Hospital, Nanyang, Henan, China
| | - Dongming Lu
- Department of Urology, Affiliated Sanming First Hospital of Fujian Medical University, Sanming, Fujian, China
| | - Lixin Wan
- Department of Oncology, Nanyang Central Hospital, Nanyang, Henan, China
| | - Yingming Sun
- Department of Medical and Radiation Oncology, Affiliated Sanming First Hospital of Fujian Medical University, Sanming, Fujian, China
| | - Yongyang Wu
- Department of Urology, Affiliated Sanming First Hospital of Fujian Medical University, Sanming, Fujian, China
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Rostami S, Alavi SM, Daghagheleh R, Maraghi E, Hosseini SA. A randomized clinical trial investigating the impact of magnesium supplementation on clinical and biochemical measures in COVID-19 patients. Virol J 2024; 21:91. [PMID: 38654355 PMCID: PMC11040844 DOI: 10.1186/s12985-024-02362-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 04/08/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND This study sought to examine the impact of magnesium supplementation on clinical outcomes and biochemical factors among hospitalized patients with COVID-19. METHODS This double-blind, randomized clinical trial was conducted at Razi Hospital, Ahvaz, Iran, between September 2021 and March 2022. Participants aged 18-70 years with moderate disease severity were enrolled. Magnesium supplementation (300 mg daily) was administered to the intervention group, while the control group received a placebo. Clinical outcomes, including the need for oxygen therapy, oxygen saturation, respiratory rate, fever, hs-CRP and TNF-α levels, as well as quality of life and mental health, were assessed. Blood samples were collected to measure biochemical variables. RESULTS The main result was the count of individuals requiring oxygen therapy. Additional outcomes comprised of oxygen saturation, respiratory rate, fever, hs-CRP and TNF-α levels, as well as quality of life and mental health. Out of 64 participants, 60 completed the study. The results showed that magnesium supplementation significantly reduced the number of patients requiring oxygen therapy (9 vs. 14; P < 0.001). Moreover, the magnesium group demonstrated improved oxygen saturation compared to the control group (4.55 ± 2.35 vs. 1.8 ± 1.67; P < 0.001). Furthermore, we observed a noteworthy enhancement in the quality of life and depression score in the magnesium group. No significant differences were observed in respiratory rate, fever, hs-CRP, and TNF-α levels (P > 0.05). CONCLUSION The findings suggest that magnesium supplementation may have beneficial effects on clinical outcomes and arterial oxygen saturation in COVID-19 patients. More investigation is necessary to delve into its potential mechanisms and long-term effects on patient outcomes. TRIAL REGISTRATION This study is registered on Iranian Registry of Clinical Trials (IRCT) under identifier IRCT20210413050957N1. (The registration date: May 1, 2021).
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Affiliation(s)
- Sepideh Rostami
- Department of Nutrition, School of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Seyed Mohammad Alavi
- Jundishapur Infectious and Tropical Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Robab Daghagheleh
- Department of Nutrition, School of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Elham Maraghi
- Department of Biostatistics and Epidemiology, Public Health Faculty, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Seyed Ahmad Hosseini
- Department of Nutrition, School of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
- Nutrition and Metabolic Disease Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
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Habibzadeh A, Rahimlou M, Ravankhah M, Vahid F, Tabrizi R. Association between dietary total antioxidant capacity and the risk of stroke: a nested case-control study. BMC Nutr 2024; 10:56. [PMID: 38622676 PMCID: PMC11017524 DOI: 10.1186/s40795-024-00867-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2024] [Accepted: 04/08/2024] [Indexed: 04/17/2024] Open
Abstract
BACKGROUND Oxidative stress after ischemic stroke contribute to neuronal cell injury. Unhealthy and unbalanced dietary patterns can increase the risk of several diseases, including stroke and cardiometabolic ones. However, the association between dietary total antioxidant capacity (DTAC) of antioxidant and stroke is controversial. Our study aimed to establish a correlation between DTAC and its impact on the occurrence of stroke. METHODS This nested case-control study included 79 stroke cases and 158 healthy controls. We used data from the Fasa Adults Cohort Study (FACS) comprising 10,035 individuals at baseline. To assess the nutritional status of each individual, a 125-item food frequency questionnaire (FFQ) has been used to evaluate their dietary habits and intakes over the past year. DTAC was calculated using the ferric-reducing antioxidant power (FRAP) international databases. The stroke was confirmed by an experienced neurologist using standard imaging methods. Conditional logistic regression analyses were performed to evaluate the association between DTAC and stroke. RESULTS The assessment of DTAC revealed that there was no statistically significant distinction between cases (mean ± SD: 5.31 ± 2.65) and controls (5.16 ± 2.80) with a p-value of 0.95. Even after adjusting for the potentially important confounding factors such as age, sex, event time, energy intake, smoking, hypertension, and diabetes, the association remains non-significant (adjusted odds ratio (OR) = 1.06, 95% CI: 0.94, 1.20, p-value = 0.33). CONCLUSIONS Our results did not confirm a significant link between DTAC and stroke risk. These findings emphasize the intricate interplay of factors influencing stroke risk and highlight the need for further research to unravel these relationships more comprehensively.
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Affiliation(s)
- Adrina Habibzadeh
- Student Research Committee, Fasa University of Medical Sciences, Fasa, Iran
- USERN Office, Fasa University of Medical Sciences, Fasa, Iran
| | - Mehran Rahimlou
- Department of Nutrition, School of Public Health, Zanjan University of Medical Sciences, Zanjan, Iran.
| | - Mahdi Ravankhah
- School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Farhad Vahid
- Nutrition & Health Research Group, Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Reza Tabrizi
- Noncommunicable Diseases Research Center, Fasa University of Medical Science, Fasa, Iran.
- Clinical Research Development Unit, Valiasr Hospital, Fasa University of Medical Sciences, Fasa, Iran.
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Arabshahi V, Togha M, Khorsha F. The association between dietary glycemic index and disease severity among the women with episodic migraine. Nutr Neurosci 2024:1-11. [PMID: 38593064 DOI: 10.1080/1028415x.2024.2338343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
PURPOSE To our knowledge, no studies have evaluated the association between dietary glycemic index (GI) and glycemic load (GL) with migraine-related clinical symptoms. METHODS This cross-sectional study was conducted among 266 women with episodic migraine. The migraine disability assessment (MIDAS) was used to evaluate migraine-related disability in the recent three months. Visual analogue scales (VAS) were also employed to examine migraine-related pains. Glycemic index and glycemic load indices were calculated using the nutritional information obtained from the food frequency questionnaire. RESULTS The study participants had a mean age of 34.32 ± 7.86 years. It was observed that individuals in the quartile 4 of GI and GL reported significantly higher consumption of calories, carbohydrates, proteins, and fats (P < 0.05). In the unadjusted models, those in the quartile 4 of GI and GL had significantly increased odds of experiencing severe pain (based on VAS score) (OR = 2.09, 95% CI = 1.37-2.70, P < 0.001 for dietary GI, and OR = 1.75, 95% CI = 1.16-2.79, P = 0.005 for dietary GL). Additionally, compared to participants in the quartile 1 of GI and GL, those in the quartile 4 of GI and GL were more likely to suffer from severe disability (P < 0.05). CONCLUSION We found a significant positive correlation between the consumption of foods with higher GI and GL and the clinical conditions related to migraine disease. However, due to the cross-sectional nature of the study, it is not possible to establish a cause-and-effect relationship for the observed results.
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Affiliation(s)
- Vajiheh Arabshahi
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Mansoureh Togha
- Department of Neurology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Headache Department, Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Faezeh Khorsha
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
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Rahimlou M, Mousavi MA, Chiti H, Peyda M, Mousavi SN. Association of maternal exposure to endocrine disruptor chemicals with cardio-metabolic risk factors in children during childhood: a systematic review and meta-analysis of cohort studies. Diabetol Metab Syndr 2024; 16:82. [PMID: 38576015 PMCID: PMC10993545 DOI: 10.1186/s13098-024-01320-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 03/26/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND In the present systematic review and meta-analysis, the association of maternal exposure to the endocrine disrupting chemicals (EDCs) with cardio-metabolic risk factors in children during childhood for the first time. METHOD The PubMed, Scopus, EMBASE, and Web of Science databases were systematically searched, up to Feb 2023. In total 30 cohort studies had our inclusion criteria. A random-effects model was used for the variables that had considerable heterogeneity between studies. The Newcastle-Ottawa Scale (NOS) tool was used to classify the quality score of studies. All statistical analyses were conducted using Stata 14 and P-value < 0.05 considered as a significant level. RESULTS In the meta-analysis, maternal exposure to the EDCs was weakly associated with higher SBP (Fisher_Z: 0.06, CI: 0.04, 0.08), BMI (Fisher_Z: 0.07, CI: 0.06, 0.08), and WC (Fisher_Z: 0.06, CI: 0.03, 0.08) z-scores in children. A significant linear association was found between maternal exposure to the bisphenol-A and pesticides with BMI and WC z-score in children (p < 0.001). Subgroup analysis showed significant linear association of BPA and pesticides, in the urine samples of mothers at the first trimester of pregnancy, with BMI and WC z-score in children from 2-8 years (p < 0.05). CONCLUSION Prenatal exposure to the EDCs in the uterine period could increase the risk of obesity in children. Maternal exposure to bisphenol-A and pesticides showed the strongest association with the obesity, especially visceral form, in the next generation.
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Affiliation(s)
- Mehran Rahimlou
- Department of Nutrition, School of Public Health, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Mir Ali Mousavi
- Department of General Surgery, Ayatollah Mousavi Hospital, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Hossein Chiti
- Zanjan Metabolic Diseases Research Center, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Mazyar Peyda
- Department of Environmental Health Engineering, School of Public Health, Zanjan University of Medical Sciences, Honarestan St., Janbazan St., Zanjan, Iran
| | - Seyedeh Neda Mousavi
- Zanjan Metabolic Diseases Research Center, Zanjan University of Medical Sciences, Zanjan, Iran.
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Talebi S, Zeraattalab-Motlagh S, Rahimlou M, Sadeghi E, Rashedi MH, Ghoreishy SM, Mohammadi H. Dietary fat intake with risk of gestational diabetes mellitus and preeclampsia: a systematic review and meta-analysis of prospective cohort studies. Nutr Rev 2024:nuae033. [PMID: 38568994 DOI: 10.1093/nutrit/nuae033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2024] Open
Abstract
CONTEXT Gestational diabetes mellitus (GDM) and preeclampsia (PE) are commonly observed medical complications in pregnancy. Dietary total fat and fatty acids associated with GDM and PE risk have been examined in several epidemiological studies. In some instances, systematic reviews and meta-analyses might provide more accurate dietary recommendations. OBJECTIVES This systematic review and dose-response meta-analysis was conducted to investigate the association between dietary total fat and fatty acids and the risk of GDM and PE. DATA SOURCES Research on dietary fat intake and the risk of GDM and PE was conducted through systematic searches of the PubMed, Scopus, and Web of Science databases for articles published up to August 19, 2023. An investigation of associations between dietary intake of total fat and fatty acids and the risk of GDM and PE was performed using prospective cohort study designs. RESULTS Twenty-one prospective cohort studies were considered eligible. Findings indicated that higher intakes of total fat (relative risk [RR], 1.08; 95% confidence interval [CI], 1.02-1.14), animal fat (RR, 1.56; 95%CI, 1.34-1.89), vegetable fat (RR, 1.23; 95%CI, 1.05-1.45), dietary cholesterol (RR, 1.48; 95%CI, 1.10-2.00), and omega-3 fatty acid (RR, 1.11; 95%CI, 1.02-1.20) are associated with a greater risk of GDM. However, no significant association was found between dietary total fat and fatty acids and the risk of PE. Dose-response meta-analyses suggested every 10% increment in total energy intake from total fat, 5% from animal fat, 5% from vegetable fat, and 100 mg from cholesterol was related to 15%, 12%, 7%, 14%, and 20% higher GDM risk, respectively. CONCLUSIONS Overall, total fat, animal fat, vegetable fat, dietary cholesterol, and omega-3 fatty acid consumption are associated with a small but statistically significant increase in GDM risk. PROTOCOL REGISTRATION PROSPERO (CRD42023466844).
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Affiliation(s)
- Sepide Talebi
- Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Mehran Rahimlou
- Department of Nutrition, School of Public Health, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Erfan Sadeghi
- Department of Biostatistics, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Minoo Hasan Rashedi
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Mojtaba Ghoreishy
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
- Student Research Committee, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Hamed Mohammadi
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
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He X, Zhang X, Si C, Feng Y, Zhu Q, Li S, Shu L. Ultra-processed food consumption and chronic kidney disease risk: a systematic review and dose-response meta-analysis. Front Nutr 2024; 11:1359229. [PMID: 38606016 PMCID: PMC11007045 DOI: 10.3389/fnut.2024.1359229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 03/19/2024] [Indexed: 04/13/2024] Open
Abstract
BackgroundHigh intake of ultra-processed food (UPF) has been associated with increased risk of chronic kidney disease(CKD), but the results remain inconsistent. We therefore performed this systematic review and dose–response meta-analysis of observational studies that shed light on the association between UPF consumption and the risk of CKD.MethodsA systematic literature search of PubMed, Embase, Web of Science, Scopus and China National Knowledge Infrastructure (CNKI) databases was carried out to find the eligible articles published up to October 31, 2023. Random-effects or fixed-effects models were used to pool the relative risks(RRs) and their 95% confidence intervals (CIs).The potential sources of heterogeneity across studies were examined using the Cochran’s Q test and I-square(I2). Publication bias was examined using the visual inspection of asymmetry in funnel plots and quantified by Begg’s and Egger’s tests.ResultsEight studies (six cohort and two cross-sectional studies) exploring the association between UPF consumption and risk of CKD, were included in the final analysis. The pooled analyses revealed that high consumption of UPF was associated with an increased risk of CKD (RR = 1.25; 95%CI: 1.09–1.42, p < 0.0001). Moreover, a 10% increase of UPF consumption was associated with a 7% higher risk of CKD (RR = 1.07; 95%CI: 1.04–1.10, p < 0.001). Dose–response analysis of all included studies showed a linear association between UPF consumption and the risk of CKD (RR = 1.02; 95%CI:0.99–1.05, Pdose–response = 0.178, Pnonlinearity = 0.843).ConclusionOur findings indicate that high consumption of UPF is significantly associated with an increased risk of CKD. Future research with prospective design is required to confirm this positive association.Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023478483, PROSPERO identifier CRD42023478483.
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Affiliation(s)
- Xingzhen He
- Department of Digestion, Zhejiang Hospital, Hangzhou, Zhejiang, China
| | - Xiaoyan Zhang
- Department of Nutrition, Zhejiang Hospital, Hangzhou, Zhejiang, China
| | - Caijuan Si
- Department of Nutrition, Zhejiang Hospital, Hangzhou, Zhejiang, China
| | - Yuliang Feng
- Department of Digestion, Zhejiang Hospital, Hangzhou, Zhejiang, China
| | - Qin Zhu
- Department of Digestion, Zhejiang Hospital, Hangzhou, Zhejiang, China
- Department of Nutrition, Zhejiang Hospital, Hangzhou, Zhejiang, China
| | - Songtao Li
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Long Shu
- Department of Nutrition, Zhejiang Hospital, Hangzhou, Zhejiang, China
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Rahimlou M, Baghdadi G, Khodi A, Rahimi Z, Saki N, Banaei Jahromi N, Cheraghian B, Tavasolian R, Hosseini SA. Polyphenol consumption and Nonalcoholic fatty liver disease risk in adults. Sci Rep 2024; 14:6752. [PMID: 38514756 PMCID: PMC10957908 DOI: 10.1038/s41598-024-57416-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 03/18/2024] [Indexed: 03/23/2024] Open
Abstract
In this cross-sectional investigation, the primary objective was to explore the correlation between the consumption of polyphenols and the likelihood of non-alcoholic fatty liver disease (NAFLD) in the adult population participating in the Hoveyzeh cohort. Data from the Hoveyzeh cohort study, part of the Persian Cohort Study, involving 10,009 adults aged 35-70, were analyzed. Exclusions were made for missing data, extreme energy intake, and liver cancer patients. Dietary habits were assessed using a food frequency questionnaire, and polyphenol intake was calculated using the Phenol Explorer database. Logistic regression analyses, adjusted for confounders, were performed to assess the relationship between polyphenol subclasses (total polyphenols, total flavonoids, phenolic acid, and lignin) and NAFLD. Among 9894 participants, those in the highest quintile of total polyphenol (OR 0.65, CI 0.5-0.84; P = 0.007), phenolic acid (OR 0.67, CI 0.52-0.86; P < 0.001), and lignin intake (OR 0.69, CI 0.52-0.87; P = 0.001) demonstrated lower odds of NAFLD compared to the lowest quintile, even after adjusting for confounding factors. However, no significant association was found between total flavonoid intake and NAFLD (OR 1.26, CI 0.96-1.67; P = 0.47). Subgroup analysis indicated a significant inverse association between total polyphenols and NAFLD in women (OR 0.64, CI 0.42-0.93; P = 0.001). Higher intake of total polyphenols, phenolic acid, and lignin was associated with reduced odds of NAFLD among adults in the Hoveyzeh cohort. This suggests that dietary patterns rich in these polyphenols may play a role in mitigating the risk of NAFLD. Further interventional and longitudinal studies are needed to validate these findings and explore potential preventive strategies involving polyphenol-rich diets.
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Affiliation(s)
- Mehran Rahimlou
- Department of Nutrition, School of Public Health, Zanjan University of Medical Sciences, Zanjan, Iran
- Department of Nutrition, School of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Ghazal Baghdadi
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Khodi
- Taylor's University, Subang Jaya, Malaysia
| | - Zahra Rahimi
- Department of Biostatistics and Epidemiology, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Nader Saki
- Department of Otolaryngology, Head and Neck Surgery, Hearing Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Nasrin Banaei Jahromi
- Department of Nutrition, School of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Nutrition and Metabolic Disease Research Center, Clinical Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Bahman Cheraghian
- Alimentary Tract Research Center, Department of Biostatistics & Epidemiology, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Ronia Tavasolian
- Department of Nutrition, School of Public Health, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Seyed Ahmad Hosseini
- Department of Nutrition, School of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
- Nutrition and Metabolic Disease Research Center, Clinical Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
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11
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Nazari M, Mirzaie K, Keshavarz S. Association between Lifelines Diet Score (LLDS) and some novel anthropometric indices, including Body Roundness Index (BRI), A Body Shape Index (ABSI), Visceral Adiposity Index (VAI), and Body Adiposity Index (BAI), in Iranian women: a cross-sectional study. BMC Womens Health 2024; 24:172. [PMID: 38475785 DOI: 10.1186/s12905-024-03013-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 03/05/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Anthropometry is a reliable method to assess obesity status, and previous studies have shown the association of several dietary quality scores with obesity using anthropometric indices. This study aimed to evaluate the association between LLDS and anthropometric measurements. METHODS A total of 217 women between the ages of 18 and 48 participated in the study. Anthropometric values, biochemical tests, and body composition were assessed for each participant using standard protocols and methods. The LLDS was determined based on 12 components using a reliable and valid food frequency questionnaire (FFQ) that contained 147 items. RESULTS We detected a marginally significant inverse association between the LLDS and VAI scores in the second tertile. Study participants in the second tertile of LLDS had lower odds of having high VAI than those in the reference tertile after adjusting for age, energy intake, physical activity, education, and economic status (OR: -0.16; 95% CI: -0.8, 0.06; P = 0.06). There was no statistically significant trend for the association between LLDS and all assessed anthropometric indices, including BRI, ABSI, VAI, and BAI, across tertiles of LLDS in the crude and all adjusted models (P-trend > 0.05). CONCLUSIONS There was no significant association between LLDS and some novel anthropometric indices, including BRI, ABSI, VAI, and BAI. However, after adjusting for probable confounders, a marginally significant inverse association between LLDS and VAI was detected.
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Affiliation(s)
- Matin Nazari
- Department of Nutrition, Science and Research Branch, Islamic Azad University, Tehran, Iran.
| | - Khadijeh Mirzaie
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Seyedali Keshavarz
- Department of Nutrition, Science and Research Branch, Islamic Azad University, Tehran, Iran.
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12
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Almeida PP, Da Cruz BO, Thomasi B, Menezes ÁC, Brito ML, Costa NDS, Ito RVA, Degani VAN, Daleprane JB, Magliano DC, Tavares-Gomes AL, Stockler-Pinto MB. Brazil Nut-Enriched Diet Modulates Enteric Glial Cells and Gut Microbiota in an Experimental Model of Chronic Kidney Disease. JOURNAL OF THE AMERICAN NUTRITION ASSOCIATION 2024; 43:201-212. [PMID: 37611162 DOI: 10.1080/27697061.2023.2247057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 08/05/2023] [Accepted: 08/08/2023] [Indexed: 08/25/2023]
Abstract
Introduction: Chronic kidney disease (CKD) promotes gut dysbiosis, and enteric glial reactivity, a feature of intestinal inflammation. Brazil nut modulated enteric glial profile in healthy animals and could modulate these cells in 5/6 nephrectomized rats.Methods: A 5/6 nephrectomy-induced CKD and Sham-operated rats were divided as follows: CKD and Sham received a standard diet and CKD-BN and Sham-BN received a 5% Brazil nut enriched-diet. The protein content of glial fibrillary acid protein (GFAP), enteric glial marker, and GPx protein content and activity were assessed in the colon. The major phyla of gut microbiota were assessed.Results: CKD-BN group presented a decrease in GFAP content (p = 0.0001). The CKD-BN group modulated the abundance of Firmicutes, increasing its proportion compared to the CKD group. The CKD-BN group showed increased GPx activity in the colon (p = 0.0192), despite no significant difference in protein content.Conclusion: Brazil nut-enriched diet consumption decreased enteric glial reactivity and modulated gut microbiota in the CKD experimental model.
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Affiliation(s)
- Patricia Pereira Almeida
- Cardiovascular Sciences Post Graduate Program, Fluminense Federal University (UFF), Niterói, Rio de Janeiro, Brazil
| | - Beatriz Oliveira Da Cruz
- Cardiovascular Sciences Post Graduate Program, Fluminense Federal University (UFF), Niterói, Rio de Janeiro, Brazil
| | - Beatriz Thomasi
- Department of Physiology, Neuroscience Program, Michigan State University (MSU), East Lansing, Michigan, USA
| | - Ágatha Cristie Menezes
- Cardiovascular Sciences Post Graduate Program, Fluminense Federal University (UFF), Niterói, Rio de Janeiro, Brazil
| | - Michele Lima Brito
- Pathology Post Graduate Program, Fluminense Federal University (UFF), Niterói, Rio de Janeiro, Brazil
| | - Nathalia da Silva Costa
- Cardiovascular Sciences Post Graduate Program, Fluminense Federal University (UFF), Niterói, Rio de Janeiro, Brazil
| | | | - Viviane Alexandre Nunes Degani
- Clinic and Animal Reproduction Post Graduate Program, Fluminense Federal University (UFF), Niterói, Rio de Janeiro, Brazil
| | - Julio Beltrame Daleprane
- Laboratory for Studies of Interactions Between Nutrition and Genetics, LEING, Department of Basic and Experimental Nutrition, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - D'Angelo Carlo Magliano
- Pathology Post Graduate Program, Fluminense Federal University (UFF), Niterói, Rio de Janeiro, Brazil
| | - Ana Lúcia Tavares-Gomes
- Neurosciences Post Graduate Program, Fluminense Federal University (UFF), Niterói, Rio de Janeiro, Brazil
| | - Milena Barcza Stockler-Pinto
- Cardiovascular Sciences Post Graduate Program, Fluminense Federal University (UFF), Niterói, Rio de Janeiro, Brazil
- Pathology Post Graduate Program, Fluminense Federal University (UFF), Niterói, Rio de Janeiro, Brazil
- Nutrition Sciences Post Graduate Program, Fluminense Federal University (UFF), Niterói, Rio de Janeiro, Brazil
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13
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Ruperto M, Barril G. Clinical Significance of Nutritional Status, Inflammation, and Body Composition in Elderly Hemodialysis Patients-A Case-Control Study. Nutrients 2023; 15:5036. [PMID: 38140295 PMCID: PMC10745431 DOI: 10.3390/nu15245036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 12/02/2023] [Accepted: 12/06/2023] [Indexed: 12/24/2023] Open
Abstract
Nutritional and inflammatory disorders are factors that increase the risk of adverse clinical outcomes and mortality in elderly hemodialysis (HD) patients. This study aimed to examine nutritional and inflammation status as well as body composition in older adults on HD compared to matched controls. A case-control study was conducted on 168 older participants (84 HD patients (cases) and 84 controls) age- and sex-matched. Demographic, clinical, anthropometric, and laboratory parameters were collected from medical records. The primary outcome was nutritional status assessment using a combination of nutritional and inflammatory markers along with the geriatric nutritional risk index (GNRI). Sarcopenic obesity (SO) was studied by the combined application of anthropometric measures. Body composition and hydration status were assessed by bioelectrical impedance analysis (BIA). Univariate and multivariate regression analyses were performed to identify nutritional and inflammatory independent risk indicators in elderly HD patients and controls. A significantly high prevalence of nutritional risk measured by the GNRI was found in HD patients (32.1%) compared to controls (6.0%) (p < 0.001). Elderly HD patients were overweight and had lower percent arm muscle circumference, phase angle (PA), serum albumin (s-albumin), as well as higher percent extracellular body water (ECW%) and serum C-reactive protein (s-CRP) than controls (all at least, p < 0.01). SO was higher in HD patients (15.50%) than in controls (14.30%). By multi-regression analyses, age < 75 years (OR: 0.119; 95%CI: 0.036 to 0.388), ECW% (OR: 1.162; 95%CI: 1.061 to 1.273), PA (OR: 0.099; 95%CI: 0.036 to 0.271), as well as BMI, s-albumin ≥ 3.8 g/dL, and lower s-CRP were independently related between cases and controls (all at least, p < 0.05). Elderly HD patients had increased nutritional risk, SO, inflammation, overhydration, and metabolic derangements compared to controls. This study highlights the importance of identifying nutritional risk along with inflammation profile and associated body composition disorders in the nutritional care of elderly HD patients. Further studies are needed to prevent nutritional disorders in elderly HD patients.
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Affiliation(s)
- Mar Ruperto
- Department of Pharmaceutical & Health Sciences, School of Pharmacy, Universidad San Pablo-CEU, CEU Universities, Urbanización Montepríncipe, 28660 Alcorcón, Madrid, Spain
| | - Guillermina Barril
- Nephrology Department, Hospital Universitario La Princesa, C/Diego de León 62, 28006 Madrid, Spain
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14
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Yoshida S, Shiraishi R, Nakayama Y, Taira Y. Can Nutrition Contribute to a Reduction in Sarcopenia, Frailty, and Comorbidities in a Super-Aged Society? Nutrients 2023; 15:2991. [PMID: 37447315 DOI: 10.3390/nu15132991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 06/28/2023] [Accepted: 06/28/2023] [Indexed: 07/15/2023] Open
Abstract
Many countries are facing the advent of super-aging societies, where sarcopenia and frailty will become pertinent problems. The prevalence of comorbidities is a major problem in countries with aged populations as elderly people suffer from various diseases, such as diabetes, heart failure, chronic kidney disease and dementia. All of these diseases are associated with sarcopenia and frailty, and they frequently cause falls, fractures, and a decline in activities of daily living. Fractures in the elderly people are associated with bone fragility, which is influenced by diabetes and chronic kidney disease. Nutritional support for chronic disease patients and sarcopenic individuals with adequate energy and protein intake, vitamin D supplementation, blood glucose level management for individuals with diabetes, obesity prevention, nutritional education for healthy individuals, and the enlightenment of society could be crucial to solve the health-related problems in super-aging societies.
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Affiliation(s)
- Sadao Yoshida
- Department of Rehabilitation, Chuzan Hospital, 6-2-1 Matsumoto, Okinawa 904-2151, Okinawa, Japan
- Department of Health and Nutrition, Okinawa University, 555 Kokuba, Naha 902-8521, Okinawa, Japan
- Faculty of Health Sciences, Kinjo University, 1200 Kasama-machi, Hakusan 924-8511, Ishikawa, Japan
| | - Ryo Shiraishi
- Department of Rehabilitation, Chuzan Hospital, 6-2-1 Matsumoto, Okinawa 904-2151, Okinawa, Japan
| | - Yuki Nakayama
- Department of Rehabilitation, Chuzan Hospital, 6-2-1 Matsumoto, Okinawa 904-2151, Okinawa, Japan
| | - Yasuko Taira
- Faculty of Nutrition, Chuzan Hospital, 6-2-1 Matsumoto, Okinawa 904-2151, Okinawa, Japan
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15
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Fat-to-Muscle Ratio Is Independently Associated with Hyperuricemia and a Reduced Estimated Glomerular Filtration Rate in Chinese Adults: The China National Health Survey. Nutrients 2022; 14:nu14194193. [PMID: 36235845 PMCID: PMC9573307 DOI: 10.3390/nu14194193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 10/04/2022] [Accepted: 10/07/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND The effects of the fat-to-muscle ratio (FMR) on hyperuricemia and a reduction in the estimated glomerular filtration rate (eGFR) are still unclear. METHODS Data from the China National Health Survey were used to explore the associations of the FMR with hyperuricemia and reduced eGFR. The fat mass and muscle mass were measured through bioelectrical impedance analysis. Mediation analysis was used to estimate the mediated effect of hyperuricemia on the association between the FMR and reduced eGFR. RESULTS A total of 31171 participants were included. For hyperuricemia, compared with the Q1 of the FMR, the ORs (95% CI) of Q2, Q3 and Q4 were 1.60 (1.32-1.95), 2.31 (1.91-2.80) and 2.71 (2.15-3.43) in men and 1.91 (1.56-2.34), 2.67 (2.12-3.36) and 4.47 (3.40-5.89) in women. For the reduced eGFR, the ORs (95% CI) of Q2, Q3 and Q4 of the FMR were 1.48 (1.18-1.87), 1.38 (1.05-1.82) and 1.45 (1.04-2.04) in men aged 40-59, but no positive association was found in younger men or in women. Hyperuricemia mediated the association between the FMR and reduced eGFR in men. The OR (95% CI) of the indirect effect was 1.08 (1.05-1.10), accounting for 35.11% of the total effect. CONCLUSIONS The FMR was associated with hyperuricemia and reduced eGFR, and the associations varied based on sex and age. The effect of the FMR on the reduced eGFR was significantly mediated by hyperuricemia in men.
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16
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Su G, Saglimbene V, Wong G, Natale P, Ruospo M, Craig JC, Hegbrant J, Carrero JJ, Strippoli GFM. Healthy Lifestyle and Mortality Among Adults Receiving Hemodialysis: The DIET-HD Study. Am J Kidney Dis 2021; 79:688-698.e1. [PMID: 34547395 DOI: 10.1053/j.ajkd.2021.07.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 07/28/2021] [Indexed: 01/08/2023]
Abstract
RATIONALE & OBJECTIVE A healthy lifestyle promotes cardiovascular health and reduces cardiac-related mortality in the general population but its benefits for people receiving maintenance hemodialysis are uncertain. STUDY DESIGN Prospective cohort study. SETTING & PARTICIPANTS 5,483 of 9,757 consecutive adults receiving maintenance hemodialysis (January 2014 to June 2017, median dialysis vintage: 3.6 yrs) in a multinational private dialysis network and with complete lifestyle data. EXPOSURES Based on the American Heart Association's recommendations for cardiovascular prevention, a modified healthy lifestyle score was the sum of four components addressing use of smoking tobacco, physical activity, diet, and control of systolic blood pressure. OUTCOMES Cardiovascular and all-cause mortality. ANALYTICAL APPROACH Adjusted proportional hazards (aHRs) regression analyses with country as a random effect to estimate the associations between lifestyle score (low [0-2 points] as the referent, medium [3-5], and high [6-8]) and mortality. Associations were expressed as aHRs with 95% confidence intervals (CIs). RESULTS During a median of 3.8 years (17,451 person-years in total), there were 2,163 deaths, of which 826 were related to cardiovascular disease. Compared to patients with a low lifestyle score, the aHRs (95% CIs) for all-cause mortality among those with medium and high lifestyle scores were 0.75 (0.65-0.85) and 0.64 (0.54-0.76), respectively. Compared to patients with a low lifestyle score, the aHRs (95% CIs) for cardiovascular mortality among those with medium and high lifestyle scores were 0.73 (0.59-0.91) and 0.65 (0.49-0.85), respectively. LIMITATIONS Self-reported lifestyle, data-driven approach. CONCLUSIONS A healthier lifestyle is associated with lower all-cause and cardiovascular mortality among patients receiving maintenance hemodialysis.
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Affiliation(s)
- Guobin Su
- National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Department of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou city, Guangdong Province, China; Department of Nephrology, Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou city, Guangdong Province, China; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden;; European Renal Nutrition Working Group of the European Renal Association-European Dialysis Transplant Association (ERA-EDTA)
| | - Valeria Saglimbene
- Faculty of Medicine and Health, Sydney School of Public Health, The University of Sydney, Edward Ford Building A27, NSW 2006, Australia; Department of Emergency and Organ Transplantation, University of Bari, Bari, Piazza Giulio Cesare, 70124 Bari, Italy
| | - Germaine Wong
- Faculty of Medicine and Health, Sydney School of Public Health, The University of Sydney, Edward Ford Building A27, NSW 2006, Australia; Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Patrizia Natale
- Faculty of Medicine and Health, Sydney School of Public Health, The University of Sydney, Edward Ford Building A27, NSW 2006, Australia; Department of Emergency and Organ Transplantation, University of Bari, Bari, Piazza Giulio Cesare, 70124 Bari, Italy
| | - Marinella Ruospo
- Department of Emergency and Organ Transplantation, University of Bari, Bari, Piazza Giulio Cesare, 70124 Bari, Italy
| | - Jonathan C Craig
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Jorgen Hegbrant
- Division of Nephrology, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Juan Jesus Carrero
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden;; European Renal Nutrition Working Group of the European Renal Association-European Dialysis Transplant Association (ERA-EDTA)
| | - Giovanni F M Strippoli
- Faculty of Medicine and Health, Sydney School of Public Health, The University of Sydney, Edward Ford Building A27, NSW 2006, Australia; Department of Emergency and Organ Transplantation, University of Bari, Bari, Piazza Giulio Cesare, 70124 Bari, Italy.
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17
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Sorraya N, Farrokhzad A, Hassani B, Talebi S. Association between serum potassium and risk of all-cause mortality among chronic kidney diseases patients: A systematic review and dose-response meta-analysis of more than one million participants. Food Sci Nutr 2021; 9:5312-5323. [PMID: 34532036 PMCID: PMC8441339 DOI: 10.1002/fsn3.2478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Revised: 07/02/2021] [Accepted: 07/06/2021] [Indexed: 11/10/2022] Open
Abstract
We aimed to perform a meta-analysis, using prospective cohort studies, to test the association between serum potassium and all-cause mortality among chronic kidney diseases (CKD) patients. A systematic search was performed using PubMed-MEDLINE and Scopus, up to July 2020. Prospective cohort studies which reported risk estimates of all-cause mortality in CKD patients with different serum potassium levels were included in the present meta-analysis. Thirteen studies were included in the analysis. A nonlinear dose-response meta-analysis suggested that there is a J-shaped association between serum potassium levels and the risk of all-cause mortality, with a nadir at serum potassium of 4.5 mmol/L. Subgroup analyses indicated that the strength and shape of the association between serum potassium and all-cause mortality may be influenced by age. Our meta-analysis provides supportive evidence that there is a J-shape association between serum potassium and all-cause mortality among CKD patients.
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Affiliation(s)
- Nasim Sorraya
- Department of Community NutritionSchool of Nutrition and Food ScienceFood Security Research CenterIsfahan University of Medical SciencesIsfahanIran
| | | | - Bahar Hassani
- Department of NutritionAhvaz Jundishapur University of Medical SciencesAhvazIran
- Department of Health Safety and Environment (HSE)Razi Petrochemical CompanyMahshahrIran
| | - Shokoofeh Talebi
- Department of Clinical NutritionSchool of Nutrition and Food ScienceFood Security Research CenterIsfahan University of Medical SciencesIsfahanIran
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18
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Liang K, Chen Z. Unraveling the Obesity Paradox Through Bariatric Surgery. JAMA Surg 2020; 155:1173-1174. [PMID: 32965461 DOI: 10.1001/jamasurg.2020.3778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Kaifeng Liang
- The William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, London, England
| | - Zheyuan Chen
- The William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, London, England
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19
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Protein-Energy Wasting Assessment and Clinical Outcomes in Patients with Acute Kidney Injury: A Systematic Review with Meta-Analysis. Nutrients 2020; 12:nu12092809. [PMID: 32933198 PMCID: PMC7551057 DOI: 10.3390/nu12092809] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 08/23/2020] [Accepted: 09/10/2020] [Indexed: 12/13/2022] Open
Abstract
Nutritional assessment is essential to identify patients with acute kidney injury (AKI) who are protein-energy wasting (PEW) and at risk of poor clinical outcomes. This systematic review aimed to investigate the relationship of nutritional assessments for PEW with clinical outcomes in patients with AKI. A systematic search was performed in PubMed, Scopus, and Cochrane Library databases using search terms related to PEW, nutrition assessment, and AKI to identify prospective cohort studies that involved AKI adult patients with at least one nutritional assessment performed and reported relevant clinical outcomes, such as mortality, length of stay, and renal outcomes associated with the nutritional parameters. Seventeen studies reporting eight nutritional parameters for PEW assessment were identified and mortality was the main clinical outcome reported. A meta-analysis showed that PEW assessed using subjective global assessment (SGA) was associated with greater mortality risk (RR: 1.99, 95% CI: 1.36–2.91). Individual nutrition parameters, such as serum chemistry, body mass, muscle mass, and dietary intakes, were not consistently associated with mortality. In conclusion, SGA is a valid tool for PEW assessment in patients with AKI, while other nutrition parameters in isolation had limited validity for PEW assessment.
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20
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Tatematsu M, Inaguma D, Yamada T, Sakamoto I, Sakakibara M. The impact of gender difference on the relationship between serum high-density lipoprotein level and cardiovascular events in incident dialysis patients: a multicenter prospective cohort study. Int Urol Nephrol 2020; 52:1357-1365. [DOI: 10.1007/s11255-020-02498-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 05/06/2020] [Indexed: 12/24/2022]
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21
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Body Mass Index and risk of frailty in older adults: A systematic review and meta-analysis. ACTA ACUST UNITED AC 2020. [DOI: 10.1016/j.obmed.2020.100196] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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22
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Broers NJH, Canaud B, Dekker MJE, van der Sande FM, Stuard S, Wabel P, Kooman JP. Three compartment bioimpedance spectroscopy in the nutritional assessment and the outcome of patients with advanced or end stage kidney disease: What have we learned so far? Hemodial Int 2020; 24:148-161. [PMID: 31970883 PMCID: PMC7216830 DOI: 10.1111/hdi.12812] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 12/05/2019] [Accepted: 12/06/2019] [Indexed: 12/15/2022]
Abstract
Bioimpedance spectroscopy (BIS) is an easily applicable tool to assess body composition. The three compartment model BIS (3C BIS) conventionally expresses body composition as lean tissue index (LTI) (lean tissue mass [LTM]/height in meters squared) and fat tissue index (FTI) (adipose tissue mass/height in meters squared), and a virtual compartment reflecting fluid overload (FO). It has been studied extensively in relation to diagnosis and treatment guidance of fluid status disorders in patients with advanced‐stage or end‐stage renal disease. It is the aim of this article to provide a narrative review on the relevance of 3C BIS in the nutritional assessment in this population. At a population level, LTI decreases after the start of hemodialysis, whereas FTI increases. LTI below the 10th percentile is a consistent predictor of outcome whereas a low FTI is predominantly associated with outcome when combined with a low LTI. Recent research also showed the connection between low LTI, inflammation, and FO, which are cumulatively associated with an increased mortality risk. However, studies toward nutritional interventions based on BIS data are still lacking in this population. In conclusion, 3C BIS, by disentangling the components of body mass index, has contributed to our understanding of the relevance of abnormalities in different body compartments in chronic kidney disease patients, and appears to be a valuable prognostic tool, at least at a population level. Studies assessing the effect of BIS guided nutritional intervention could further support its use in the daily clinical care for renal patients.
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Affiliation(s)
- Natascha J H Broers
- Department of Internal Medicine, Division of Nephrology, Maastricht University Medical Center+, Maastricht, The Netherlands.,NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Bernard Canaud
- Research and Development, Fresenius Medical Care Deutschland GmbH, Bad Homburg, Germany
| | - Marijke J E Dekker
- Department of Internal Medicine, Division of Nephrology, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Frank M van der Sande
- Department of Internal Medicine, Division of Nephrology, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Stefano Stuard
- Research and Development, Fresenius Medical Care Deutschland GmbH, Bad Homburg, Germany
| | - Peter Wabel
- Research and Development, Fresenius Medical Care Deutschland GmbH, Bad Homburg, Germany
| | - Jeroen P Kooman
- Department of Internal Medicine, Division of Nephrology, Maastricht University Medical Center+, Maastricht, The Netherlands.,NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
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23
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The relationship of blood neutrophil-to-lymphocyte ratio with nutrition markers and health outcomes in hemodialysis patients. Int Urol Nephrol 2019; 51:1239-1247. [PMID: 31089947 DOI: 10.1007/s11255-019-02166-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2018] [Accepted: 04/30/2019] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Adverse outcomes in hemodialysis patients have been attributed, in part, to the pro-inflammatory state prevalent in this population. This study examines the relationship between blood neutrophil-to-lymphocyte ratio (NLR) with nutrition markers and health outcomes in hemodialysis (HD) patients. DESIGN This is a 12-month prospective cohort study that recruited 77 participants from May to Jun 2017. SETTINGS AND SUBJECTS Patients receiving maintenance hemodialysis. MAIN OUTCOMES Hospitalization, transplants and mortality. RESULTS Of the 77 participants, 63.8% were hospitalized, 10 (13%) died of cardiovascular diseases and 6 (7.8%) had a kidney transplant. Spearman correlations using baseline values showed an inverse significant correlation between the total number of hospitalizations and BMI kg/m2 (BMI rho = - 0.37, P <0.001); a significant inverse correlation between NLR and albumin (rho = - 0.22, P = 0.028); and a significant direct correlation between baseline NLR and BMI kg/m2 (rho = 0.22, P = 0.028). Participants were grouped by their NLR value into quartiles for outcomes analysis: quartile 1 (NLR ≤ 1.75), quartile 2 (NLR 1.76-2.6), quartile 3 (NLR 2.7-3.9) and quartile 4 (NLR ≥ 4). The percentage of patients with the lowest level of inflammation (NLR ≤ 1.75) was greater for not hospitalized patients than for hospitalized (39.3% vs 16.3%, P = 0.025) and not hospitalized participants had higher BMI kg/m2 (mean ± SD) at baseline compared to those hospitalized (29.11 ± 5.4 vs 26.22 ± 5.34, P = 0.026). In a multivariate cox regression analysis, participants in the lowest quartile (NLR ≤ 1.75) were compared to the rest on hospitalization, mortality and transplant. Years in dialysis, BMI kg/m2 and NLR ≤ 1.75 were significant predictors of hospitalization after adjustment (P = 0.021, P = 0.005, P = 0.039; respectively) and we observed an association of low NLR with a hazard ratio (HR 0.44, 95% CI 0.20-0.96, P = 0.039), BMI (HR 0.90, 95% CI 0.85-0.97, P = 0.005) and years in dialysis (HR 0.90, 95% CI 0.83-0.98, P = 0.021) for hospitalization in overall participants. In a further analysis comparing the effect of low NLR in the subgroup of diabetic vs non-diabetics, it was observed that BMI kg/m2 was a significant predictor for hospitalization in the non-diabetic subgroup (P = 0.040) but not significant in the case of diabetics (P = 0.128) after adjustments. Years in dialysis and NLR ≤ 1.75 were significant predictors of hospitalizations in the subgroup of diabetic before and after adjustment (P = 0.049, P = 0.044; respectively). Having a low NLR decreased 73% the risk for hospitalization (HR 0.27 95% CI 0.07-0.96, P = 0.044) in this subgroup. Survival and hospitalization curves were analyzed by comparing all participants and the diabetic subgroup, in the lowest inflammation quartile vs the rest (NLR ≤ 1.75 vs NLR > 1.75). Participants with NLR ≤ 1.75 had 100% survival rate (log-rank test, P = 0.059) and lower hospitalization rate (log-rank test, P = 0.025); participants with diabetes had lower hospitalization rate (log-rank test, P = 0.039). CONCLUSION NLR at baseline was associated with nutritional markers (albumin, BMI). Low NLR at baseline was a predictor of lower risk for hospitalizations in HD patients with diabetes.
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Kusnanto K, Murtadho MA, Herawati L, Arifin H. The Comparison of Progressive Muscle Relaxation Frequency on Anxiety, Blood Pressure, and Pulse of Haemodialysis Patients. JURNAL NERS 2019. [DOI: 10.20473/jn.v14i1.15700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Introduction: Haemodialysis is one of the kidney replacements therapies, but, as it cannot wholly replace kidney function, it still causes complications such as increased blood pressure and pulse which can lead to anxiety for the patient. The purpose of this study was to explain the effect of Progressive Muscle Relaxation (PMR) on anxiety, blood pressure and pulse in haemodialysis patients.Methods: The study design was a true pre-post-test control group design experiment. The total sample was 105 haemodialysis patients taken by purposive sampling technique and divided into two intervention groups and one control group. The independent variable was PMR, and the dependent variables were anxiety, blood pressure and pulse. Data were obtained using a questionnaire and analysed using the Kruskal Wallis Test and Mann-Whitney U test with a significance level <0.05.Results: The results of the PMR two times per week group analysis for one month showed a significant influence on anxiety (p=0.000), blood pressure (p=0.000), and pulse rate (p=0.000). Mann-Whitney U Test Results showed a significant effect on anxiety (p=0.004), blood pressure (p=0.000), and pulse (p=0.000).Conclusion: Haemodialysis patients who performed PMR interventions showed a promising outcome on a decrease in anxiety, blood pressure and pulse. The regular application of PMR interventions can control vital signs in patients undergoing haemodialysis
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Schrauben SJ, Hsu JY, Wright Nunes J, Fischer MJ, Srivastava A, Chen J, Charleston J, Steigerwalt S, Tan TC, Fink JC, Ricardo AC, Lash JP, Wolf M, Feldman HI, Anderson AH. Health Behaviors in Younger and Older Adults With CKD: Results From the CRIC Study. Kidney Int Rep 2019; 4:80-93. [PMID: 30596171 PMCID: PMC6308910 DOI: 10.1016/j.ekir.2018.09.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 09/04/2018] [Indexed: 10/31/2022] Open
Abstract
INTRODUCTION A cornerstone of kidney disease management is participation in guideline-recommended health behaviors. However, the relationship of these health behaviors with outcomes, and the identification of barriers to health behavior engagement, have not been described among younger and older adults with chronic kidney disease. METHODS Data from a cohort study of 5499 individuals with chronic kidney disease was used to identify health behavior patterns with latent class analysis stratified by age <65 and ≥65 years. Cox models, stratified by diabetes, assessed the association of health behavior patterns with chronic kidney disease (CKD) progression, atherosclerotic events, and death. Logistic regression was used to assess for barriers to health behavior engagement. RESULTS Three health behavior patterns were identified: 1 "healthy" pattern, and 2 "less healthy" patterns comprising 1 pattern with more obesity and sedentary activity and 1 with more smoking and less obesity. Less healthy patterns were associated with an increased hazard of poor outcomes. Among participants <65 years of age, the less healthy patterns (vs. healthy pattern) was associated with an increased hazard of death in diabetic individuals (hazard ratio [HR] = 2.17, 95% confidence interval [CI] = 1.09-4.29; and HR = 2.50, 95% CI = 1.39-4.50) and cardiovascular events among nondiabetic individuals (HR = 1.49, 95% CI = 1.04-2.43; and HR = 2.97, 95% CI = 1.49-5.90). Individuals with the more obese/sedentary pattern had an increased risk of CKD progression in those who were diabetic (HR = 1.34, 95% CI = 1.13-1.59). Among older adults, the less healthy patterns were associated with increased risk of death (HR = 2.97, 95% CI = 1.43-6.19; and HR = 3.47, 95% CI = 1.48-8.11) in those who were nondiabetic. Potential barriers to recommended health behaviors include lower health literacy and self-efficacy. CONCLUSION Identifying health behavior patterns and barriers may help target high-risk groups for strategies to increase participation in health behaviors.
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Affiliation(s)
- Sarah J. Schrauben
- Division of Renal, Electrolyte, and Hypertension, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Jesse Y. Hsu
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Julie Wright Nunes
- Department of Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Michael J. Fischer
- Department of Medicine, University of Illinois at Chicago, and Center of Management for Complex Chronic Healthcare, Jesse Brown Veterans Affairs Medical Center, Chicago, Illinois, USA
| | - Anand Srivastava
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Jing Chen
- Department of Medicine, Tulane University, New Orleans, Louisiana, USA
| | | | - Susan Steigerwalt
- Department of Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | | | - Jeffrey C. Fink
- Department of Medicine, University of Maryland, Baltimore, Maryland, USA
| | - Ana C. Ricardo
- Department of Medicine, University of Illinois at Chicago, and Center of Management for Complex Chronic Healthcare, Jesse Brown Veterans Affairs Medical Center, Chicago, Illinois, USA
| | - James P. Lash
- Department of Medicine, University of Illinois at Chicago, and Center of Management for Complex Chronic Healthcare, Jesse Brown Veterans Affairs Medical Center, Chicago, Illinois, USA
| | - Myles Wolf
- Department of Medicine, Duke University, Durham, North Carolina, USA
| | - Harold I. Feldman
- Division of Renal, Electrolyte, and Hypertension, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Amanda H. Anderson
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Silva RE, Baldim JL, Chagas-Paula DA, Soares MG, Lago JHG, Gonçalves RV, Novaes RD. Predictive metabolomic signatures of end-stage renal disease: A multivariate analysis of population-based data. Biochimie 2018; 152:14-30. [PMID: 29913183 DOI: 10.1016/j.biochi.2018.06.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Accepted: 06/13/2018] [Indexed: 01/27/2023]
Abstract
The variability of molecular signatures and predictive low molecular weight markers of chronic kidney disease (CKD) in different populations are poorly understood. Thus, in a large sample with 4763 people we compare the molecular signatures and metabolites with diagnostic relevance in plasma and urine of CKD patients of different geographical origins. From an integrated model based on dynamic networks and multivariate statistics, metabolites with predictive value obtained from targeted and untargeted molecular analysis, interactions between metabolic pathways affected by CKD, and the methodological quality of metabolomic studies were analyzed. The metabolites 3-methylhistidine, citrulline, kynurenine, p-cresol sulfate, urea, and citrate presented consistent expression in all population groups. Only increased kynurenine and p-cresol sulfate in plasma samples obtained acceptable scores as CKD biomarkers, independent of geographic origin. Metabolites such as leucine, alanine, isoleucine, serine, histidine, and citrate were nodal points, indicating that protein metabolism pathways are similarly impaired in Asian, European and North American patients. Based on our integrated model, we show that the metabolome of CKD patients exhibits a strong geographic influence, leading to unique metabolic signatures. Contrary to the likelihood of molecular similarities between geographically distinct populations, metabolic convergences in protein metabolism pathways and the molecules kynurenine and p-cresol sulfate were relevant as general predictors of CKD. In general, the quality assessment indicated that the current evidence is based on research models with variable methodological quality, whose limitations described in this study should be considered in the refinement of molecular approaches.
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Affiliation(s)
- Robson E Silva
- School of Medicine, Federal University of Alfenas, Alfenas, 37130-001, Minas Gerais, Brazil
| | - João L Baldim
- Center of Human and Natural Sciences, Federal University of ABC, 09210-580, Santo André, SP, Brazil
| | - Daniela A Chagas-Paula
- Institute of Chemistry, Federal University of Alfenas, Alfenas, 37130-001, Minas Gerais, Brazil
| | - Marisi G Soares
- Institute of Chemistry, Federal University of Alfenas, Alfenas, 37130-001, Minas Gerais, Brazil
| | - João H G Lago
- Center of Human and Natural Sciences, Federal University of ABC, 09210-580, Santo André, SP, Brazil
| | - Reggiani V Gonçalves
- Department of Animal Biology, Federal University of Viçosa, Viçosa, 36570-000, Minas Gerais, Brazil
| | - Rômulo D Novaes
- Institute of Biomedical Sciences, Department of Structural Biology, Federal University of Alfenas, Alfenas, 37130-001, Minas Gerais, Brazil.
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Jiang J, Ni L, Ren W, Zhou X, Su K, Wang L, Lan L, Chen W, Wu Y. Nutritional status in short daily hemodialysis versus conventional hemodialysis patients in China. Int Urol Nephrol 2018; 50:755-762. [PMID: 29404929 DOI: 10.1007/s11255-018-1804-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Accepted: 01/21/2018] [Indexed: 11/24/2022]
Abstract
PURPOSE Malnutrition is the main determinant of mortality and morbidity in maintenance hemodialysis patients. In many countries except for China, it has been reported that short daily hemodialysis (SDHD) could improve nutritional status. We will report here the nutritional results obtained in the SDHD therapy period compared with conventional hemodialysis (cHD) therapy period in Chinese patients. METHODS This study compared 29 SDHD patients (SDHD group), each patient served as his own control, with 30 cHD patients (cHD group) serving as the parallel controls. The hematologic parameters, anthropometric measurements, modified quantitative subjective global assessment (MQSGA) score, weekly standard Kt/V (std Kt/V) and average daily intake of protein were measured at baseline (SDHD0 or cHD0 period), at 3 months (SDHD1 or cHD1 period) and at 6 months (SDHD2 or cHD2 period). RESULTS The average daily intake of protein, dry weight, body mass index, mid-arm circumference, mid-arm muscle circumference, serum albumin, prealbumin, cholesterol, hemoglobin, weekly std Kt/V values at SDHD2 were higher than the corresponding values at SDHD0 (p < 0.05, p < 0.05, p < 0.001, p < 0.05, p < 0.05, p < 0.05, p < 0.001, p < 0.05, p < 0.05, p < 0.001 and p < 0.001, respectively). Meanwhile, the average daily intake of protein, serum albumin, prealbumin, cholesterol, hemoglobin, weekly std Kt/V values at SDHD2 were higher than the corresponding values at cHD2 (p < 0.05, p < 0.001, p < 0.05, p < 0.05, p < 0.001 and p < 0.001, respectively), whereas the MQSGA score at SDHD2 was lower than the score at SDHD0 and cHD0 (p < 0.05, respectively). CONCLUSIONS SDHD may improve the nutritional status compared with cHD in Chinese patients undergoing maintenance hemodialysis.
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Affiliation(s)
- Jielong Jiang
- Department of Nephrology, The First Affiliated Hospital of University of Science and Technology of China, Anhui Provincial Hospital, Hefei, 230001, China
| | - Lijun Ni
- Department of Nephrology, The First Affiliated Hospital of University of Science and Technology of China, Anhui Provincial Hospital, Hefei, 230001, China
| | - Wei Ren
- Department of Nephrology, The First Affiliated Hospital of University of Science and Technology of China, Anhui Provincial Hospital, Hefei, 230001, China
| | - Xiaowan Zhou
- Department of Nephrology, The First Affiliated Hospital of University of Science and Technology of China, Anhui Provincial Hospital, Hefei, 230001, China
| | - Keliang Su
- Department of Nephrology, The First Affiliated Hospital of University of Science and Technology of China, Anhui Provincial Hospital, Hefei, 230001, China
| | - Lihua Wang
- Department of Nephrology, The First Affiliated Hospital of University of Science and Technology of China, Anhui Provincial Hospital, Hefei, 230001, China
| | - Lei Lan
- Department of Nephrology, The First Affiliated Hospital of University of Science and Technology of China, Anhui Provincial Hospital, Hefei, 230001, China
| | - Wei Chen
- Department of Nephrology, The First Affiliated Hospital of University of Science and Technology of China, Anhui Provincial Hospital, Hefei, 230001, China
| | - Yuanbo Wu
- Department of Neurology, The First Affiliated Hospital of University of Science and Technology of China, Anhui Provincial Hospital, 17, Lujiang Road, Hefei, 230001, Anhui, China.
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