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Lu C, Cheng S, Fan W, Zhang Z, Wang J. The relationship of platelet distribution width with all-cause and cardiovascular mortality in peritoneal dialysis patients. Ren Fail 2024; 46:2300730. [PMID: 38343320 PMCID: PMC10863511 DOI: 10.1080/0886022x.2023.2300730] [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: 07/10/2023] [Accepted: 12/26/2023] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND Cardiovascular disease (CVD) is a major complication in peritoneal dialysis (PD) patients. Previous studies have demonstrated that platelet distribution width (PDW) is associated with cardiovascular events in hemodialysis (HD) patients. In this study, we hypothesized that elevated PDW can predict all-cause and cardiovascular mortality in PD patients. METHODS We recruited PD patients for a single-center retrospective cohort study from 1 January 2007, to 30 June 2020. Receiver-operating characteristic (ROC) curves were made to determine the PDW cutoff value for predicting all-cause mortality. The propensity score matching (PSM) method was used to improve the equilibrium between groups. The relation of PDW with all-cause and cardiovascular mortality was analyzed by Cox proportional hazards models. Restricted cubic spline (RCS) models were used to determine whether there was a linear relationship between PDW and all-cause and cardiovascular mortality. RESULTS A total of 720 PD patients were screened, and 426 PD patients were enrolled after PSM. After adjusting for confounders, Cox proportional hazards models showed that the PDW value was positively correlated with the risk of all-cause and cardiovascular mortality (HR = 1.162, 95% CI 1.057-1.278, p = 0.002 and HR = 1.200, 95% CI 1.041-1.382, p = 0.012). The adjusted RCS analysis further showed that the relationship of PDW with all-cause and cardiovascular mortality was linear (p for nonlinearly = 0.143 and 0.062). CONCLUSION Elevated PDW is independently associated with all-cause and cardiovascular mortality in PD patients.
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Affiliation(s)
- Chunyu Lu
- Jinling Hospital Department of Nephrology, Nanjing Medical University, Nanjing, PR China
| | - Shuiqin Cheng
- National Clinical Research Center of Kidney Disease, Jinling Hospital, Nanjing University School of Medicine, Nanjing, PR China
| | - Wenjing Fan
- National Clinical Research Center of Kidney Disease, Jinling Hospital, Nanjing University School of Medicine, Nanjing, PR China
| | - Zhihong Zhang
- National Clinical Research Center of Kidney Disease, Jinling Hospital, Nanjing University School of Medicine, Nanjing, PR China
| | - Jinquan Wang
- Jinling Hospital Department of Nephrology, Nanjing Medical University, Nanjing, PR China
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Liu L, Peng S, Wei Y, Yu W, Liao J, Du W, Shi Y, He Q, Wu D, Chen L, Han S, Zhang L, Shen J, Jiang X, Li J, Peng L, Zhang B, Yao Y, Zhang Q. Association of complete blood count parameters with the risk of incident pulmonary heart disease in pneumoconiosis: a retrospective cohort study. BMJ Open 2024; 14:e078992. [PMID: 39067887 DOI: 10.1136/bmjopen-2023-078992] [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] [Indexed: 07/30/2024] Open
Abstract
BACKGROUND Pneumoconiosis mostly combines pulmonary and cardiovascular diseases, among which pulmonary heart disease (PHD) is of major concern due to its significant impact on the survival of pneumoconiosis patients. White cell count (WCC), red cell distribution width (RDW) and platelet parameters are thought to affect inflammatory responses and may be predictors of various cardiovascular diseases. However, very few studies have focused on PHD. OBJECTIVES To examine the relationship between baseline complete blood count parameters (WCC, RDW, platelet parameters) and the risk of incident PHD in pneumoconiosis patients. DESIGN A retrospective cohort study. SETTING This was a single-centre, retrospective cohort study that used data from an Occupational Disease Hospital, Chengdu, Sichuan. PARTICIPANTS A total of 946 pneumoconiosis patients from January 2012 to November 2021 were included in the study. Female patients and patients who had PHD, coronary heart disease, hypertensive heart disease, cardiomyopathy, heart failure, oncological disease, multiple organ dysfunction, AIDS at baseline and follow-up time of less than 6 months were also excluded. OUTCOME MEASURES We identified PHD according to the patient's discharge diagnosis. We constructed Cox proportional hazard regression models to assess the HR of incident PHD in pneumoconiosis, as well as 95% CIs. RESULTS In the multiple Cox proportional hazard regression analysis, platelet count (PLT) and plateletcrit (PCT) above the median at baseline were associated with an increased risk of PHD in pneumoconiosis with adjusted HR of 1.52 (95% CI 1.09 to 2.12) and 1.42 (95% CI 1.02 to 1.99), respectively. CONCLUSION Higher baseline PLT and PCT are associated with a higher risk of PHD in pneumoconiosis.
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Affiliation(s)
- Lifang Liu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Shanshan Peng
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yuhao Wei
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Wenao Yu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jiaqiang Liao
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Wen Du
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Ying Shi
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Qiurong He
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Dongsheng Wu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Li Chen
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Su Han
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Ling Zhang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jiang Shen
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xia Jiang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jiayuan Li
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Lijun Peng
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Ben Zhang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yuqin Yao
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Qin Zhang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
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Kasirer Y, Shchors I, Hammerman C, Bin-Nun A. Platelet Indices: Universally Available Clinical Adjunct for Diagnosing Necrotizing Enterocolitis. Am J Perinatol 2024; 41:e1575-e1580. [PMID: 36918160 DOI: 10.1055/a-2053-7759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
OBJECTIVE Platelet function parameters can be predictive of several adult diseases and their severity. However, few studies report on the association between platelet indices and neonatal diseases, specifically necrotizing enterocolitis (NEC). The objective of this study is to investigate whether platelet indices are associated with NEC diagnosis and NEC-related mortality. STUDY DESIGN We retrospectively examined records from infants admitted to the neonatal intensive care unit with a diagnosis of NEC, verified by the presence of pneumatosis on X-ray or pathology at surgery. We compared them with an age-matched group of prematures without NEC. We investigated platelet count, mean platelet volume (MPV), platelet distribution width and red cell distribution width to platelet ratio (RPR) and delta platelets from birth to the time of NEC diagnosis or day of life 14 in the control group. RESULTS Sixty-nine infants with NEC and 78 control infants were studied. Basic sociodemographic data were similar in both groups. All platelet parameters measured-except for MPV-were significantly associated with NEC diagnosis. Although MPV was not associated with the diagnosis of NEC (p = 0.800), it was significantly associated with NEC-related mortality (p < 0.001). Only total platelet count and RPR were significantly associated with both NEC diagnosis (p < 0.0001) and mortality (p = 0.04 and 0.01, respectively). On multivariable analysis only the change in platelet count from birth to time of diagnosis remained significant. CONCLUSION While not definitive, this study demonstrates that these routinely available, inexpensive, and easily calculated platelet indices can provide a clinical adjunct in the often-elusive attempts to definitively diagnose NEC in preterm neonates. KEY POINTS · Platelet indices were associated with NEC diagnosis.. · MPV was predictive of NEC-related mortality.. · Delta platelet count from birth was significantly related to NEC diagnosis..
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Affiliation(s)
- Yair Kasirer
- Department of Neonatology, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Irina Shchors
- Department of Neonatology, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Cathy Hammerman
- Department of Neonatology, Shaare Zedek Medical Center, Jerusalem, Israel
- Faculty of Medicine, Department of Pediatrics, The Hebrew University, Jerusalem, Israel
| | - Alona Bin-Nun
- Department of Neonatology, Shaare Zedek Medical Center, Jerusalem, Israel
- Faculty of Medicine, Department of Pediatrics, The Hebrew University, Jerusalem, Israel
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Yuan Y, Liang X, He M, Wu Y, Jiang X. Haemoglobin, albumin, lymphocyte, and platelet score as an independent predictor for renal prognosis in IgA nephropathy. Front Endocrinol (Lausanne) 2024; 15:1339921. [PMID: 38737556 PMCID: PMC11088234 DOI: 10.3389/fendo.2024.1339921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 04/15/2024] [Indexed: 05/14/2024] Open
Abstract
Objective The haemoglobin, albumin, lymphocyte, and platelet (HALP) score, a convenient and composite laboratory biomarker, can reflect inflammation and systemic nutritional status. This study was performed to investigate the effect of the HALP score on the prognosis of patients with IgA nephropathy (IgAN). Methods This is a retrospective single centre study that enrolled 895 biopsy-confirmed IgAN patients from June 2019 to June 2022 who were followed for more than 1 year. Kaplan-Meier curves and Cox regression analyses were performed to determine the relationship between HALP and adverse outcomes. The restricted cubic splines was used to identify the possible associations. The optimal cut-off value of HALP for renal poor outcome was identified by the area under the receiver operating characteristic curve (AUC). Results A total of 895 patients finally participated in the study and were divided into three groups (tertial 1-3) according to the baseline HALP score. More severe clinicopathologic features were observed in the lower HALP group, and Kaplan-Meier analysis showed patients in tertial 1 had a higher risk of kidney failure than the other groups (log-rank=11.02, P= 0.004). Multivariate Cox regression revealed that HALP score was an independent risk factor for renal prognosis in IgAN (adjusted HR: 0.967, 95% CI: 0.945-0.990, P = 0.006). The results of subgroup analysis suggested that HALP was more important in patients under the age of 50, BMI ≤ 23.9 and eGFR ≤ 90 mL/min/1.73 m2. The best cut-off HALP for renal survival was 38.83, sensitivity 72.1%, and specificity 55.9% (AUC: 0.662). Patients were further grouped according to HALP cut-off values and propensity matched. Multivariate Cox regression analysis revealed that HALP remained an independent predictor of IgAN in the matched cohort (HR 0.222, CI: 0.084-0.588, P=0.002). Conclusion HALP is a novel and potent composite parameter to predict kidney outcome in patients with IgAN.
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Affiliation(s)
- Yuan Yuan
- Department of Nephrology, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, China
- Key Laboratory of Zhejiang Province, Management of Kidney Disease, Hangzhou, China
- Key Laboratory of Precise Prevention and Treatment of Rheumatism Syndrome of Renal Wind Disease, Hangzhou, China
| | - Xiaoli Liang
- Department of Nephrology, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, China
| | - Minhui He
- Department of Nephrology, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, China
| | - Yufan Wu
- Department of Nephrology, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, China
| | - Xue Jiang
- Department of Nephrology, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, China
- Key Laboratory of Zhejiang Province, Management of Kidney Disease, Hangzhou, China
- Key Laboratory of Precise Prevention and Treatment of Rheumatism Syndrome of Renal Wind Disease, Hangzhou, China
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Sági B, Vas T, Csiky B, Nagy J, Kovács TJ. Are Platelet-Related Parameters Prognostic Predictors of Renal and Cardiovascular Outcomes in IgA Nephropathy? J Clin Med 2024; 13:991. [PMID: 38398303 PMCID: PMC10889748 DOI: 10.3390/jcm13040991] [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: 01/02/2024] [Revised: 02/03/2024] [Accepted: 02/06/2024] [Indexed: 02/25/2024] Open
Abstract
Background: IgA nephropathy (IgAN) is associated with chronic inflammation. Platelet-related parameters, such as the platelet (PLT) count, platelet-to-albumin ratio (PAR), and platelet-to-lymphocyte ratio (PLR), were examined as potential prognostic indicators for renal and cardiovascular (CV) outcomes in IgAN. We were interested in whether platelet-related parameters are risk factors for ESKD and CV events in IgAN patients. Methods: In a monocentric retrospective study, 124 IgAN patients were divided into two groups based on the cut-off value of the PAR. All-cause mortality, major CV events, and end-stage renal disease were the primary combined endpoints. Secondary endpoints, such as CV or renal endpoints, were also analyzed separately. Results: The patients' mean age was 43.7 ± 13.5 years, and the follow-up time was 124 ± 67 months. The K-M curve showed that the PLR, PAR, and PLT were strongly associated with primary combined (p = 0.002, p = 0.004, p = 0.001) and renal outcomes (p < 0.001, p < 0.001, p < 0.001), but not with CV outcomes in IgAN. However, when combined with left ventricular hypertrophy (LVH) or metabolic syndrome (MetS), the PAR was found to be a significant predictor of both primary (p < 0.001, p < 0.001) and secondary outcomes (p = 0.001 and p = 0.038; p = 0.001 and p = 0.015). Additionally, the PLR correlated with albuminuria (r = -0.165, p = 0.033) and LVH (r = -0.178, p = 0.025), while PLT correlated with eGFR (r = 0.158, p = 0.040). Conclusions. Elevated PARs and PLRs may predict progression to end-stage kidney disease, but in combination with LVH and MetS, they were related to CV events in IgAN. The determination of PARs and PLRs can be useful and cost-effective parameters for assessing both cardiovascular and renal risks in IgAN.
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Affiliation(s)
- Balázs Sági
- 2nd Department of Internal Medicine and Nephrology, Diabetes Center, Clinical Center, Medical School, University of Pécs, 7624 Pécs, Hungary; (B.S.); (B.C.); (J.N.)
- Triton Life Dialysis Center, 7624 Pécs, Hungary
| | - Tibor Vas
- 2nd Department of Internal Medicine and Nephrology, Diabetes Center, Clinical Center, Medical School, University of Pécs, 7624 Pécs, Hungary; (B.S.); (B.C.); (J.N.)
| | - Botond Csiky
- 2nd Department of Internal Medicine and Nephrology, Diabetes Center, Clinical Center, Medical School, University of Pécs, 7624 Pécs, Hungary; (B.S.); (B.C.); (J.N.)
- Triton Life Dialysis Center, 7624 Pécs, Hungary
| | - Judit Nagy
- 2nd Department of Internal Medicine and Nephrology, Diabetes Center, Clinical Center, Medical School, University of Pécs, 7624 Pécs, Hungary; (B.S.); (B.C.); (J.N.)
| | - Tibor József Kovács
- 2nd Department of Internal Medicine and Nephrology, Diabetes Center, Clinical Center, Medical School, University of Pécs, 7624 Pécs, Hungary; (B.S.); (B.C.); (J.N.)
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Wang J, Ma X, Si X, Wu M, Han W. Mean platelet volume and the association with all-cause mortality and cardiovascular mortality among incident peritoneal dialysis patients. BMC Cardiovasc Disord 2023; 23:543. [PMID: 37940871 PMCID: PMC10634175 DOI: 10.1186/s12872-023-03551-x] [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: 06/13/2023] [Accepted: 10/09/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND While mean platelet volume (MPV) is linked to severity and all-cause mortality in patients with sepsis, its association with all-cause mortality and cardiovascular mortality in patients treated with peritoneal dialysis (PD) remains unknown. OBJECTIVES The purpose of this study was to estimate the relationship between MPV and all-cause mortality and cardiovascular mortality among patients treated with PD. METHOD We retrospectively collected 1322 patients treated with PD from November 1, 2005 to August 31, 2019. All-cause mortality and cardiovascular mortality was identified as the primary outcome. MPV was classified into three categories by means of X-tile software. The correlation between MPV and all-cause mortality was assessed by Cox model. Survival curves were performed by Kaplan-Meier method. RESULTS The median follow-up period was 50 months (30-80 months), and a total of 360 deaths were recorded. With respect to all-cause mortality, patients in MVP ≥ 10.2 fL had considerably higher risk of all-cause mortality among three models (HR 0.68, 95%CI 0.56-0.84; HR 0.70, 95%CI 0.56-0.87; HR 0.73, 95%CI 0.59-0.91; respectively). Moreover, patients treated with PD, whose MVP ≥ 10.2 fL, also suffered from significantly higher risk of cardiovascular mortality in model 1, 2, and 3 (HR 0.63, 95%CI 0.46-0.85; HR 0.66, 95%CI 0.48-0.91; HR 0.69, 95%CI 0.50-0.95; respectively). CONCLUSIONS This study indicates that MPV is independently correlated with both all-cause mortality and cardiovascular mortality in PD.
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Affiliation(s)
- Jianghai Wang
- Emergency Department of Dongying People's Hospital, Dongying, 257091, China
| | - Xiaochen Ma
- Emergency Department of Dongying People's Hospital, Dongying, 257091, China
| | - Xuepeng Si
- Obstetrics Department of Dongying People's Hospital, Dongying, 257091, China
| | - Mingyang Wu
- Department of Nephrology of Zhucheng People's Hospital, Weifang, China
| | - Wang Han
- Emergency Department of Dongying People's Hospital, Dongying, 257091, China.
- Emergency Department of Dongying People's Hospital, Dongying, 257000, China.
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Jiang W, Chen Y, Yan C, Ma Y, Chen Q, Zhan X. Mean platelet volume may predict all-cause and cardiovascular mortality among incident peritoneal dialysis patients. Ren Fail 2023; 45:2261541. [PMID: 37755338 PMCID: PMC10538463 DOI: 10.1080/0886022x.2023.2261541] [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: 06/06/2023] [Accepted: 09/17/2023] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND The association between mean platelet volume (MPV) and mortality in patients with cardiovascular disease has been demonstrated. However, the association between MPV and mortality in peritoneal dialysis (PD) patients remains unclear. METHODS Patients catheterized at the First Affiliated Hospital, Nanchang University, between November 1, 2005, and August 31, 2019, were enrolled. The primary endpoints were all-cause and cardiovascular mortality. Patients were divided into two groups according to the cutoff value, which was determined using maximally selected rank statistics. The mortality hazard ratio was evaluated using Cox regression models. RESULTS Among the 1322 PD patients enrolled, the mean age was 49.3 ± 14.5 years, 57.6% were men, and 18.8% had diabetes. During a median follow-up of 50 months (IQR: 30-80), 360 patients died; among these, 167 deaths were attributed to cardiovascular diseases. Survival analysis revealed that all-cause and cardiovascular mortality rates were lower in the higher-MPV group than in the lower-MPV group (p < .001 and p < .001, respectively). After full adjustment, a higher MPV was significantly associated with a hazard ratio of 0.77 for all-cause mortality (95% CI: 0.60-0.98, p = .036) and 0.75 for cardiovascular mortality (95% CI: 0.51-0.97, p = .041). Subgroup analysis showed that a significant interaction existed between age and MPV (p < .001). Decreased MPV was associated with higher mortality risk only in patients < 60 years old. CONCLUSIONS Our results showed that lower MPV can be associated with a higher risk of all-cause and cardiovascular mortality in patients with PD.
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Affiliation(s)
- Wenyu Jiang
- Department of Nephrology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Yanbing Chen
- Department of Nephrology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Caixia Yan
- Department of Nephrology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Yujiao Ma
- Department of Nephrology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Qinkai Chen
- Department of Nephrology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Xiaojiang Zhan
- Department of Nephrology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
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Jiang Z, Ye G, Zhang S, Zhang L. Association of anemia and platelet activation with necrotizing enterocolitis with or without sepsis among low birth weight neonates: a case-control study. Front Pediatr 2023; 11:1172042. [PMID: 37719451 PMCID: PMC10500066 DOI: 10.3389/fped.2023.1172042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 08/15/2023] [Indexed: 09/19/2023] Open
Abstract
Background This study aims to evaluate the value of the proportion of large platelets (PLCR) and platelet crit (PCT) in predicting necrotizing enterocolitis (NEC) in low birth weight (LBW) neonates. Methods A total of 155 LBW (<2,500 g) neonates with NEC, who were admitted to the neonatal intensive care unit (NICU) of the hospital from January 1, 2017, to November 30, 2019, were included in the case group. According to the 1:3 case-control study design, a total of 465 LBW neonates without NEC (three for each LBW neonate with NEC), who were admitted to the NICU and born ≤24 h before or after the birth of the subjects, were included in the control group. Results During the study period, a total of 6,946 LBW neonates were born, of which 155 had NEC, including 92 who also had sepsis. Neonatal sepsis was the most important risk factor and confounding factor for NEC in LBW neonates. Further stratified analysis showed that in LBW neonates without sepsis, anemia [P = 0.001, odds ratio (OR) = 4.367, 95% confidence interval (CI): 1.853-10.291], high PLCR (P < 0.001, OR = 2.222, 95% CI: 1.633-3.023), and high PCT (P = 0.024, OR = 1.368, 95% CI: 1.042-1.795) increased the risk of NEC and the receiver operating characteristic curve area of PLCR, sensitivity, specificity, and cutoff value were 0.739, 0.770, 0.610, and 33.55, respectively. Conclusions The results showed that 2/100 LBW neonates were at risk for NEC, and the stratified analysis of the confounding factors of sepsis identified the risk factors of NEC in LBW neonates. This study first reported the significance of PLCR in the early prediction of NEC occurrence in LBW neonates without sepsis.
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Affiliation(s)
- Zhou Jiang
- Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Guangyong Ye
- Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Songying Zhang
- Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Long Zhang
- Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Zhu HM, Xiong YY, Chen YB, Xiao J. Serum platelet distribution width predicts cardiovascular and all-cause mortality in patients undergoing peritoneal dialysis. Postgrad Med 2023; 135:394-401. [PMID: 36749999 DOI: 10.1080/00325481.2023.2178755] [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: 02/09/2023]
Abstract
BACKGROUND Platelet distribution width (PDW) is a predictor for all-cause mortality in patients with cardiovascular diseases (CVD). This study aimed to evaluate the prognostic implication of PDW in predicting cardiovascular and all-cause mortality in patients undergoing peritoneal dialysis (PD). METHODS In total, 762 PD patients from a single center were recruited retrospectively from 2005 to 2017 and followed up until 2021. The primary and secondary outcomes were cardiovascular and all-cause mortality, respectively. Survival analysis was conducted using Kaplan-Meier estimates and Cox regression analysis. RESULTS During a median of 52.2 months of follow-up, 135 (17.7%) cases of CVD and 253 (33.2%) cases of all-cause mortality were reported. After multivariate adjustment, high levels of PDW were associated with an increased risk of death from CVD (HR: 1.583; 95% CI: 1.109-2.258; P = 0.011) and all-cause mortality (HR: 1.313; 95% CI: 1.006-1.758; P = 0.045). Subgroup analysis indicated a stronger association between PDW and all-cause mortality among female participants (P-value for interaction = 0.033). Higher levels of PDW predicted an increased risk of all-cause mortality in female patients (HR: 1.986; 95% CI,1.261-3.127). CONCLUSION High levels of PDW are independently associated with cardiovascular and all-cause mortality in the PD population, and differences by sex exist in the association of PDW with all-cause mortality.
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Affiliation(s)
- Heng-Mei Zhu
- Department of Nephrology, First Affiliated Hospital of Nanchang University, Nanchang, China.,Department of Nephrology, South China Hospital, Medical School, Shenzhen University, Shenzhen, China
| | - Yi-Yi Xiong
- Medical College of Nanchang University, Nanchang, China
| | - Yan-Bing Chen
- Department of Nephrology, First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Jun Xiao
- Department of Nephrology, First Affiliated Hospital of Nanchang University, Nanchang, China
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Effect of Mean Platelet Volume to Platelet Count Ratio on Mortality in Peritoneal Dialysis. Mediators Inflamm 2022; 2022:6922809. [PMID: 36405991 PMCID: PMC9671719 DOI: 10.1155/2022/6922809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 10/15/2022] [Indexed: 11/12/2022] Open
Abstract
Background and Aims Mean platelet volume to platelet count ratio (MPV/PC) has been found to be an independent risk factor for mortality in various diseases, including cardiovascular disease, cancer, and hemodialysis. We aimed to evaluate the association between MPV/PC and all-cause and cardiovascular (CV) mortality in peritoneal dialysis (PD) patients. Methods and Results We conducted a retrospective cohort study at a single center and enrolled 1473 PD patients who were catheterized at our PD center from January 1, 2006, to December 31, 2013. All patients were divided into four groups according to the quartiles of baseline MPV/PC levels and followed up until December 31, 2018. A total of 453 patients died, and 221 deaths were caused by cardiovascular disease during a median follow-up time of 48.0 (21.9-82.2) months. There was a significant interaction by age of association between MPV/PC level and all-cause mortality (P = 0.009), and multivariate Cox regression analysis showed that higher MPV/PC level was related to a decreased risk of all-cause and CV mortality in PD patients aged < 60 years (HR = 0.62, 95%CI = 0.40 − 0.96, P = 0.032; HR = 0.49, 95%CI = 0.26 − 0.93, P = 0.029, respectively), rather than in patients aged ≥ 60 years (HR = 1.37, 95%CI = 0.84 − 2.22, P = 0.208; HR = 1.50, 95%CI = 0.77 − 2.92, P = 0.237, respectively). Conclusion Our results indicated that low MPV/PC level was an independent risk factor for all-cause and CV mortality in PD patients aged less than 60 years.
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CELTİK A, ALATAS Z, YİLMAZ M, SEZİS-DEMİRCİ M, ASCİ G, OZKAHYA M, OK E. Ortalama trombosit hacmi ve ortalama trombosit hacmi/trombosit sayısı oranının periton diyalizi başlandıktan bir yıl sonraki değişimi. EGE TIP DERGISI 2022. [DOI: 10.19161/etd.1174180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Aim: Cardiovascular diseases are the most common cause of mortality in patients undergoing peritoneal dialysis. Thrombocyte indices which are indicators of platelet activation are predictors of cardiovascular events. We aim to examine the change in platelet count, mean platelet volume, and mean platelet volume to platelet count ratio one year after initiation of peritoneal dialysis in patients with end-stage renal disease. Materials and Methods: This retrospective study included 28 patients. Demographic and clinical characteristics of the patients at the time of initiation of peritoneal dialysis were recorded from the patient files. Laboratory data within the last month before the initiation of peritoneal dialysis and in the first year were recorded from the patient files. The mean platelet volume to platelet count ratio was calculated as mean platelet volume (femtolitres) divided by platelet count (number of thousand platelets/microliter). Results: The mean age was 51.1 ± 14.6 years, and 42.8% of the patients were male. Diabetic nephropathy and hypertensive nephropathy were the most common causes of end-stage renal disease. One year after the initiation of peritoneal dialysis, the urea level decreased significantly, and C-reactive protein level increased significantly. Platelet count increased from 240 ± 55 x10 3 /μL to 274 ± 53 x10 3 /μL (p=0.003) and mean platelet volume decreased from 10.7 ± 1.0 fl to 10.2 ± 0.8 fl (p
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Affiliation(s)
- Aygul CELTİK
- Ege University Faculty of Medicine, Department of Internal Medicine, Department of Nephrology, Izmir, Turkiye
| | - Zalal ALATAS
- Ege University Faculty of Medicine, Department of Internal Medicine, Department of Nephrology, Izmir, Turkiye
| | - Mumtaz YİLMAZ
- Ege University Faculty of Medicine, Department of Internal Medicine, Department of Nephrology, Izmir, Turkiye
| | - Meltem SEZİS-DEMİRCİ
- Ege University Faculty of Medicine, Department of Internal Medicine, Department of Nephrology, Izmir, Turkiye
| | - Gulay ASCİ
- Ege University Faculty of Medicine, Department of Internal Medicine, Department of Nephrology, Izmir, Turkiye
| | - Mehmet OZKAHYA
- Ege University Faculty of Medicine, Department of Internal Medicine, Department of Nephrology, Izmir, Turkiye
| | - Ercan OK
- Ege University Faculty of Medicine, Department of Internal Medicine, Department of Nephrology, Izmir, Turkiye
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12
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Tan J, Song G, Wang S, Dong L, Liu X, Jiang Z, Qin A, Tang Y, Qin W. Platelet-to-Albumin Ratio: A Novel IgA Nephropathy Prognosis Predictor. Front Immunol 2022; 13:842362. [PMID: 35664006 PMCID: PMC9162245 DOI: 10.3389/fimmu.2022.842362] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 04/20/2022] [Indexed: 02/05/2023] Open
Abstract
Background Chronic inflammation is related to the development of IgA nephropathy (IgAN). Emerging studies have reported that platelet-related parameters including platelet (PLT), platelet-to-albumin ratio (PAR), and platelet-to-lymphocyte ratio (PLR) are proved to be novel prognostic indicators for several inflammatory diseases. Whether platelet-related parameters could serve as predictors for IgAN remains unknown. Methods A total of 966 IgAN patients were enrolled in this retrospective study and were divided into several groups based on the optimal cut-off value of the platelet-related parameters. End-stage renal disease was used as the renal endpoint. A 1:2 propensity score (PS) match was then carried out to eliminate significant differences at baseline. The area under the receiver operating characteristic curve (AUROC), Kaplan–Meier (K-M) curve, and Cox proportional hazards analyses were performed to evaluate their predictive effect. Results Without considering the effect of covariates, the K-M curve showed that PLT, PLR, and PAR were strongly correlated with the renal outcomes of IgAN. However, the AUROC revealed that the PAR and PLR had better predictive power than the PLT. Multivariate Cox regression adjusting for demographic data, pathological findings, treatment, and laboratory results indicated that compared with PLR, albumin and PLT, PAR seemed to be a better marker of adverse renal outcome, implying that PAR was the only platelet-related parameter that could be used as an independent risk factor. Notably, high PAR patients seemed to have more severe clinical manifestations and pathological lesions. However, after eliminating the influence of different baselines on outcome variables, the PAR could still predict the poor prognosis of IgAN. To more accurately evaluate the predictive power of the PAR, we analyzed the predictive effect of the PAR on patients with different clinicopathological characteristics through subgroup analysis. It was indicated that the PAR might better predict the prognosis and outcome of patients whose disease was already very severe. Conclusion PAR might be used as an independent risk factor for IgAN progression.
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Affiliation(s)
- Jiaxing Tan
- Division of Nephrology, Department of Medicine, West China Hospital, Sichuan University, Chengdu, China.,West China School of Medicine, Sichuan University, Chengdu, China
| | - Guojiao Song
- West China School of Medicine, Sichuan University, Chengdu, China
| | - Siqing Wang
- Division of Nephrology, Department of Medicine, West China Hospital, Sichuan University, Chengdu, China.,West China School of Medicine, Sichuan University, Chengdu, China
| | - Lingqiu Dong
- Division of Nephrology, Department of Medicine, West China Hospital, Sichuan University, Chengdu, China.,West China School of Medicine, Sichuan University, Chengdu, China
| | - Xiang Liu
- Division of Nephrology, Department of Medicine, West China Hospital, Sichuan University, Chengdu, China.,West China School of Medicine, Sichuan University, Chengdu, China
| | - Zheng Jiang
- Division of Nephrology, Department of Medicine, West China Hospital, Sichuan University, Chengdu, China.,West China School of Medicine, Sichuan University, Chengdu, China
| | - Aiya Qin
- Division of Nephrology, Department of Medicine, West China Hospital, Sichuan University, Chengdu, China.,West China School of Medicine, Sichuan University, Chengdu, China
| | - Yi Tang
- Division of Nephrology, Department of Medicine, West China Hospital, Sichuan University, Chengdu, China.,West China School of Medicine, Sichuan University, Chengdu, China
| | - Wei Qin
- Division of Nephrology, Department of Medicine, West China Hospital, Sichuan University, Chengdu, China.,West China School of Medicine, Sichuan University, Chengdu, China
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13
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Zhao X, Niu Q, Gan L, Hou FF, Liang X, Ni Z, Chen X, Chen Y, McCullough K, Robinson B, Zuo L. Thrombocytopenia predicts mortality in Chinese hemodialysis patients- an analysis of the China DOPPS. BMC Nephrol 2022; 23:11. [PMID: 34979949 PMCID: PMC8722075 DOI: 10.1186/s12882-021-02579-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 10/22/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Hemodialysis (HD) patients have a higher mortality rate compared with general population. Our previous study revealed that platelet counts might be a potential risk factor. The role of platelets in HD patients has rarely been studied. The aim of this study is to examine if there is an association of thrombocytopenia (TP) with elevated risk of all-cause mortality and cardiovascular (CV) death in Chinese HD patients. METHODS Data from a prospective cohort study, China Dialysis Outcomes and Practice Patterns Study (DOPPS) 5, were analyzed. Demographic data, comorbidities, platelet counts and other lab data, and death records which extracted from the medical record were analyzed. TP was defined as the platelet count below the lower normal limit (< 100*109/L). Associations between platelet counts and all-cause and CV mortality were evaluated using Cox regression models. Stepwise multivariate logistic regression was used to identify the independent associated factors, and subgroup analyses were also carried out. RESULTS Of 1369 patients, 11.2% (154) had TP at enrollment. The all-cause mortality rates were 26.0% vs. 13.3% (p < 0.001) in patients with and without TP. TP was associated with higher all-cause mortality after adjusted for covariates (HR:1.73,95%CI:1.11,2.71), but was not associated with CV death after fully adjusted (HR:1.71,95%CI:0.88,3.33). Multivariate logistic regression showed that urine output < 200 ml/day, cerebrovascular disease, hepatitis (B or C), and white blood cells were independent impact factors (P < 0.05). Subgroup analysis found that the effect of TP on all-cause mortality was more prominent in patients with diabetes or hypertension, who on dialysis thrice a week, with lower ALB (< 4 g/dl) or higher hemoglobin, and patients without congestive heart failure, cerebrovascular disease, or hepatitis (P < 0.05). CONCLUSION In Chinese HD patients, TP is associated with higher risk of all-cause mortality, but not cardiovascular mortality. Platelet counts may be a useful prognostic marker for clinical outcomes among HD patients, though additional study is needed.
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Affiliation(s)
- Xinju Zhao
- Department of Nephrology, Peking University People's Hospital, Unit 10C in Ward Building; 11 Xizhimennan Street, Xicheng District, Beijing, 100044, China
| | - Qingyu Niu
- Department of Nephrology, Peking University People's Hospital, Unit 10C in Ward Building; 11 Xizhimennan Street, Xicheng District, Beijing, 100044, China
| | - Liangying Gan
- Department of Nephrology, Peking University People's Hospital, Unit 10C in Ward Building; 11 Xizhimennan Street, Xicheng District, Beijing, 100044, China
| | - Fan Fan Hou
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center of Kidney Disease, State Key Laboratory of Organ Failure Research, 1838 North Guangzhou Avenue, Guangzhou, China
| | - Xinling Liang
- Division of Nephrology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Zhaohui Ni
- Department of Nephrology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Xiaonong Chen
- Division of Nephrology, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Yuqing Chen
- Renal Division, Peking University First Hospital, Beijing, China
| | | | - Bruce Robinson
- Arbor Research Collaborative for Health, Ann Arbor, MI, USA
| | - Li Zuo
- Department of Nephrology, Peking University People's Hospital, Unit 10C in Ward Building; 11 Xizhimennan Street, Xicheng District, Beijing, 100044, China.
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14
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Chen H, Shen M, Niu R, Mu X, Jiang Q, Peng R, Yuan Y, Wang H, Wang Q, Yang H, Guo H, He M, Zhang X, Wu T. Associations of coagulation factor X and XI with incident acute coronary syndrome and stroke: A nested case-control study. J Thromb Haemost 2021; 19:2781-2790. [PMID: 34351069 PMCID: PMC9290014 DOI: 10.1111/jth.15486] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 06/23/2021] [Accepted: 07/30/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Coagulation cascade contributes to thrombotic and hemorrhagic diseases, but it remains unclear whether coagulation factors X (FX) and XI (FXI) levels are associated with cardiovascular diseases. OBJECTIVE To evaluate prospective associations of FX and FXI levels with incident acute coronary syndrome (ACS), stroke, and their subtypes (acute myocardial infarction, unstable angina, ischemic stroke, and hemorrhagic stroke). METHODS We performed a nested case-control study (n = 1846) within the Dongfeng-Tongji cohort from 2013 to 2016 matched on age (within 1 year), sex, and sampling date (within 1 month) by incidence density sampling, and measured plasma FX and FXI levels by enzyme-linked immunosorbent assay. FX and FXI levels were categorized into three groups (low, <25th; middle, 25th to <75th; and high ≥75th percentiles) according to distributions, and conditional logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS After adjustment for traditional cardiovascular risk factors, compared with middle groups, the OR (95% CI) in high levels of FX and FXI were 1.11 (0.79-1.56) and 0.96 (0.68-1.36) for incident ACS, and 1.01 (0.63-1.62) and 1.72 (1.14-2.60) for incident stroke, respectively. As for subtypes of ACS and stroke, only high FXI levels were significantly associated with incident ischemic stroke (OR 1.66, 95% CI 1.05-2.65). Moreover, all associations remained steady after additional adjustment for platelet and leukocyte. CONCLUSION FXI levels were associated with a greater risk of incident ischemic stroke but not hemorrhagic stroke or ACS. FX levels were not associated with incident ACS or stroke.
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Affiliation(s)
- Huiting Chen
- Department of Occupational and Environmental HealthKey Laboratory of Environment and HealthMinistry of Education and State Key Laboratory of Environmental Health (Incubating)School of Public HealthTongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| | - Miaoyan Shen
- Department of Occupational and Environmental HealthKey Laboratory of Environment and HealthMinistry of Education and State Key Laboratory of Environmental Health (Incubating)School of Public HealthTongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| | - Rundong Niu
- Department of Occupational and Environmental HealthKey Laboratory of Environment and HealthMinistry of Education and State Key Laboratory of Environmental Health (Incubating)School of Public HealthTongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| | - Xuanwen Mu
- Department of Occupational and Environmental HealthKey Laboratory of Environment and HealthMinistry of Education and State Key Laboratory of Environmental Health (Incubating)School of Public HealthTongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| | - Qin Jiang
- Department of Occupational and Environmental HealthKey Laboratory of Environment and HealthMinistry of Education and State Key Laboratory of Environmental Health (Incubating)School of Public HealthTongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| | - Rong Peng
- Department of Occupational and Environmental HealthKey Laboratory of Environment and HealthMinistry of Education and State Key Laboratory of Environmental Health (Incubating)School of Public HealthTongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| | - Yu Yuan
- Department of Occupational and Environmental HealthKey Laboratory of Environment and HealthMinistry of Education and State Key Laboratory of Environmental Health (Incubating)School of Public HealthTongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| | - Hao Wang
- Department of Occupational and Environmental HealthKey Laboratory of Environment and HealthMinistry of Education and State Key Laboratory of Environmental Health (Incubating)School of Public HealthTongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| | - Qiuhong Wang
- Department of Occupational and Environmental HealthKey Laboratory of Environment and HealthMinistry of Education and State Key Laboratory of Environmental Health (Incubating)School of Public HealthTongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| | - Handong Yang
- Department of Cardiovascular DiseasesSinopharm Dongfeng General HospitalHubei University of MedicineShiyanChina
| | - Huan Guo
- Department of Occupational and Environmental HealthKey Laboratory of Environment and HealthMinistry of Education and State Key Laboratory of Environmental Health (Incubating)School of Public HealthTongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| | - Meian He
- Department of Occupational and Environmental HealthKey Laboratory of Environment and HealthMinistry of Education and State Key Laboratory of Environmental Health (Incubating)School of Public HealthTongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| | - Xiaomin Zhang
- Department of Occupational and Environmental HealthKey Laboratory of Environment and HealthMinistry of Education and State Key Laboratory of Environmental Health (Incubating)School of Public HealthTongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| | - Tangchun Wu
- Department of Occupational and Environmental HealthKey Laboratory of Environment and HealthMinistry of Education and State Key Laboratory of Environmental Health (Incubating)School of Public HealthTongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
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15
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Yang Y, Yuan J, Liu L, Qie S, Yang L, Yan Z. Platelet-to-albumin ratio: a risk factor associated with technique failure and mortality in peritoneal dialysis patients. Ren Fail 2021; 43:1359-1367. [PMID: 34592885 PMCID: PMC8491659 DOI: 10.1080/0886022x.2021.1977319] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Background Peritoneal dialysis (PD) patients have a high incidence of poor clinical outcomes, which is related to the inflammatory and nutritional status of this population. Platelet-to-albumin ratio (PAR), recently identified as a useful biomarker to monitor inflammation and nutrition, can predict a poor prognosis in various diseases. The aim of this study was to investigate the association between PAR and technique failure and mortality in PD patients. Methods This single-center retrospective study enrolled 405 PD patients from 1 January 2011 to 31 December 2019 and collected complete demographic characteristics, clinical laboratory baseline data. The outcomes were technique failure and mortality. The associations between PAR and technique failure, death were analyzed by Cox proportional hazard models and competing risk regression models with kidney transplantation as a competing event. The areas under the curve (AUC) of receiver-operating characteristic analysis were used to determine the predictive values of PAR for technique failure and mortality. Results During a median follow-up period of 24.0 (range, 4.0–91.0) months, 139 (34.3%) PD patients experienced technique failure, 61 (15.1%) PD patients died. The patients with higher PAR levels had increased risk of technique failure and mortality. After adjustment for confounding factors, we found that high PAR levels were risk factor for both technique failure (subdistribution hazard ratio [SHR] 1.775; 95%CI, 1.157–2.720; p = 0.033] and mortality [SHR 3.710; 95%CI, 1.870–7.360; p < 0.001]. The predictive ability of PAR was superior to platelet and albumin based on AUC calculations for technique failure and mortality. Conclusions PAR was a risk factor associated with technique failure and mortality in PD patients.
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Affiliation(s)
- Yuqi Yang
- Department of Nephrology, Guizhou Provincial People's Hospital, Guiyang, China.,NHC Key Laboratory of Pulmonary Immunologic Disease, Guizhou Provincial People's Hospital, Guiyang, China
| | - Jing Yuan
- Department of Nephrology, Guizhou Provincial People's Hospital, Guiyang, China.,NHC Key Laboratory of Pulmonary Immunologic Disease, Guizhou Provincial People's Hospital, Guiyang, China
| | - Lu Liu
- Department of Nephrology, Guizhou Provincial People's Hospital, Guiyang, China.,NHC Key Laboratory of Pulmonary Immunologic Disease, Guizhou Provincial People's Hospital, Guiyang, China
| | - Shuwen Qie
- Department of Nephrology, Guizhou Provincial People's Hospital, Guiyang, China.,NHC Key Laboratory of Pulmonary Immunologic Disease, Guizhou Provincial People's Hospital, Guiyang, China
| | - Li Yang
- Department of Nephrology, Guizhou Provincial People's Hospital, Guiyang, China.,NHC Key Laboratory of Pulmonary Immunologic Disease, Guizhou Provincial People's Hospital, Guiyang, China
| | - Zha Yan
- Department of Nephrology, Guizhou Provincial People's Hospital, Guiyang, China.,NHC Key Laboratory of Pulmonary Immunologic Disease, Guizhou Provincial People's Hospital, Guiyang, China
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16
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Yu Z, Xiong J, Yang K, Huang Y, He T, Yu Y, Zhao J. The association between platelet indices and cardiovascular events in chronic kidney disease patients without dialysis. Int Urol Nephrol 2021; 53:961-971. [PMID: 33387224 DOI: 10.1007/s11255-020-02696-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 10/27/2020] [Indexed: 01/04/2023]
Abstract
PURPOSE Previous studies have indicated that platelet indices are related to the pathogenesis of cardiovascular diseases (CVD). However, it is unclear which platelet-related indicators are associated with CVD events in patients with chronic kidney disease (CKD) without dialysis. METHODS We performed a single-center prospective cohort study involved 1391 CKD patients to explore the relationship between platelet indices and CVD events in CKD patients. A nomogram was generated to predict CVD-free survival after 3 and 5 years of follow-up in terms of the fitted Cox regression model. And the time-dependent receiver-operating characteristic (ROC) curves were applied to evaluate the prediction accuracy of platelet indices on CVD events. RESULTS During a median follow-up of 3.41 years, 211 (15.2%) patients experienced CVD events. Results showed that platelet counts (PLT), plateletcrit (PCT), platelet-large cell ratio (P-LCR), and platelet distribution width (PDW) among 5 platelet indices were significantly lower in advanced CKD stages. Cox regression model showed that PLT, PDW, and PCT were associated with CVD events. However, after multivariable-adjusted, low level of PLT, hazard ratio (HR) 0.994 and 95% confidence interval (95% CI 0.989-1.000, p = 0.04), and PDW, HR 0.936 (95% CI 0.878-0.998, p = 0.044) predicted CVD events. The area under the ROC curve (AUC) of platelet indices assessed by time-dependent ROC curve analysis showed that only PLT and PDW were significant for predicting CVD events for 5 years. CONCLUSIONS We demonstrated that PLT and PDW among 5 platelet indices were independently associated with CVD events in patients with CKD.
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Affiliation(s)
- Zhikai Yu
- Department of Nephrology, The Key Laboratory for the Prevention and Treatment of Chronic Kidney Disease of Chongqing, Kidney Center of PLA, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, 400037, People's Republic of China
| | - Jiachuan Xiong
- Department of Nephrology, The Key Laboratory for the Prevention and Treatment of Chronic Kidney Disease of Chongqing, Kidney Center of PLA, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, 400037, People's Republic of China
| | - Ke Yang
- Department of Nephrology, The Key Laboratory for the Prevention and Treatment of Chronic Kidney Disease of Chongqing, Kidney Center of PLA, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, 400037, People's Republic of China
| | - Yinhui Huang
- Department of Nephrology, The Key Laboratory for the Prevention and Treatment of Chronic Kidney Disease of Chongqing, Kidney Center of PLA, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, 400037, People's Republic of China
| | - Ting He
- Department of Nephrology, The Key Laboratory for the Prevention and Treatment of Chronic Kidney Disease of Chongqing, Kidney Center of PLA, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, 400037, People's Republic of China
| | - Yanlin Yu
- Department of Nephrology, The Key Laboratory for the Prevention and Treatment of Chronic Kidney Disease of Chongqing, Kidney Center of PLA, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, 400037, People's Republic of China
| | - Jinghong Zhao
- Department of Nephrology, The Key Laboratory for the Prevention and Treatment of Chronic Kidney Disease of Chongqing, Kidney Center of PLA, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, 400037, People's Republic of China.
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17
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Zhao WM, Tao SM, Liu GL. Neutrophil-to-lymphocyte ratio in relation to the risk of all-cause mortality and cardiovascular events in patients with chronic kidney disease: a systematic review and meta-analysis. Ren Fail 2020; 42:1059-1066. [PMID: 33081569 PMCID: PMC7668415 DOI: 10.1080/0886022x.2020.1832521] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Aim To systematically evaluate the relationship between the neutrophil-to-lymphocyte ratio (NLR) and the risk of all-cause mortality or cardiovascular events in patients with chronic kidney disease (CKD). Methods PubMed, Embase, and Web of Science databases were searched for cohort studies that were published since the databases were launched, until 1 April 2020. We selected papers according to specific inclusion and exclusion criteria, extracted data, and evaluated the quality of the citations. Data from eligible studies were used to calculate the combined hazard ratios (HRs) and 95% confidence intervals (CI). Results The search identified 1048 potentially eligible records, and 10 studies (n = 1442) were selected. Eight studies reported all-cause mortality, and two studies reported cardiovascular events. The combined HR of all-cause mortality was 1.45 (95% CI 1.20–1.75) and the HR of cardiovascular events was 1.52 (95% CI 1.33–1.72) when NLR was considered as a categorical variable. Similarly, the association between NLR and all-cause mortality was confirmed (HR 1.35; 95% CI 1.23–1.48) when NLR was used as a continuous variable. Conclusion NLR is a predictor of all-cause mortality and cardiovascular events in patients with chronic kidney disease.
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Affiliation(s)
- Wen-Man Zhao
- Department of Nephrology, The Second Hospital of Anhui Medical University, Hefei, China
| | - Shu-Man Tao
- Department of Nephrology, The Second Hospital of Anhui Medical University, Hefei, China
| | - Gui-Ling Liu
- Department of Nephrology, The Second Hospital of Anhui Medical University, Hefei, China
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18
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Hou J, Duan Y, Liu X, Li R, Tu R, Pan M, Dong X, Mao Z, Huo W, Chen G, Guo Y, Li S, Wang C. Associations of long-term exposure to air pollutants, physical activity and platelet traits of cardiovascular risk in a rural Chinese population. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 738:140182. [PMID: 32594998 DOI: 10.1016/j.scitotenv.2020.140182] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 06/05/2020] [Accepted: 06/11/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Long-term exposure to air pollutants relate to increase risk of cardiovascular diseases that may be partially attributable to platelet dysfunction. Physical activity (PA) may attenuate inflammation to modulate platelet function. Thus, this study aimed to evaluate associations of air pollutants and PA with platelet traits of cardiovascular risk. METHODS A total of 31,282 participants were obtained from the Henan Rural Cohort (n = 39,259). The concentrations of particulate matter (PM) (PM with an aerodynamic diameter ≤1.0 μm (PM1), ≤2.5 μm (PM2.5), or ≤10 μm (PM10)) and nitrogen dioxide (NO2) were evaluated by using a spatiotemporal model incorporated into satellites data. Independent and combined effects of air pollutants and PA on platelet traits were analyzed by linear mixed models. RESULTS Positive associations of PM1, PM2.5, PM10 and NO2 with platelet indices (mean platelet volume (MPV), platelet distribution width (PDW) and platelet large cell ratio (P-LCR), the MPV to platelet counts (PLT) ratio (MPVP)) were observed, whereas negative associations of PM10 and NO2 with PLT or plateletcrit (PCT) were observed; negative interaction effects of PM2.5 PM10 and NO2 and PA on MPV, PDW or P-LCR were found; negative interaction effects of PM1, PM2.5 and PM10 and PA on PCT were observed. CONCLUSIONS Long-term exposure to air pollutants were related to increase platelet size and these associations were attenuated by increased PA, implying that PA is a costless and affordable method to decrease adverse effects on platelet traits in relation to air pollutants.
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Affiliation(s)
- Jian Hou
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Yanying Duan
- Department of Occupational and Environmental Health, Xiangya School of Public Health, Central South University, Changsha 410078, China
| | - Xiaotian Liu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Ruiying Li
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Runqi Tu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Mingming Pan
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Xiaokang Dong
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Zhenxing Mao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Wenqian Huo
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Gongbo Chen
- Department of Global Health, School of Health Sciences, Wuhan University, Wuhan, China
| | - Yuming Guo
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Shanshan Li
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China.
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19
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Peng F, Sun L, Chen T, Zhu Y, Zhou W, Li P, Chen Y, Zhuang Y, Huang Q, Long H. Albumin-globulin ratio and mortality in patients on peritoneal dialysis: a retrospective study. BMC Nephrol 2020; 21:51. [PMID: 32059708 PMCID: PMC7023751 DOI: 10.1186/s12882-020-1707-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 01/28/2020] [Indexed: 01/14/2023] Open
Abstract
Background Albumin-globulin ratio (AGR), a variable based on serum albumin and non-albumin proteins, has been demonstrated as a predictor of mortality in patients with malignant neoplasm. The aim of this study was to evaluate the prognostic value of AGR on peritoneal dialysis (PD) patients. Methods We retrospectively analyzed 602 incident PD patients from January 1st, 2008, to December 31st, 2017, at our center and followed them until December 31st, 2018. Kaplan-Meier curves and multivariate Cox regression models were applied to analyze the association between AGR and all-cause of mortality and cardiovascular mortality. Results The median follow-up time was 32.17 (interquartile range = 32.80) months. During follow-up, 131 (21.8%) patients died, including 57 patients (43.5%) who died due to cardiovascular diseases. Kaplan-Meier curves showed that patients with AGR > 1.26 had better rates of survival than those with AGR ≤ 1.25 (p < 0.001). After adjusting for potential confounders, the lower AGR level was significantly associated with an increased all-cause and cardiovascular mortality [hazard ratio (HR): 1.57, 95% confidence interval (CI): 1.07–2.32, p = 0.022 and HR: 2.01, 95% CI: 1.10–3.69, p = 0.023 respectively]. Conclusions Patients with a low AGR level had an increased all-cause and cardiovascular mortality. AGR may be a useful index in identifying patients on PD at risk for CVD and all-cause of mortality.
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Affiliation(s)
- Fenfen Peng
- Department of Nephrology, Zhujiang Hospital of Southern Medical University, Guangzhou, 510280, China
| | - Lingzhi Sun
- Department of Nephrology, Zhujiang Hospital of Southern Medical University, Guangzhou, 510280, China
| | - Ting Chen
- Department of Nephrology, Zhujiang Hospital of Southern Medical University, Guangzhou, 510280, China
| | - Yan Zhu
- Department of Nephrology, Zhujiang Hospital of Southern Medical University, Guangzhou, 510280, China
| | - Weidong Zhou
- Department of Nephrology, Zhujiang Hospital of Southern Medical University, Guangzhou, 510280, China
| | - Peilin Li
- Department of Nephrology, Zhujiang Hospital of Southern Medical University, Guangzhou, 510280, China
| | - Yihua Chen
- Department of Nephrology, Zhujiang Hospital of Southern Medical University, Guangzhou, 510280, China
| | - Yiyi Zhuang
- Department of Nephrology, Zhujiang Hospital of Southern Medical University, Guangzhou, 510280, China
| | - Qianyin Huang
- Department of Nephrology, Zhujiang Hospital of Southern Medical University, Guangzhou, 510280, China.
| | - Haibo Long
- Department of Nephrology, Zhujiang Hospital of Southern Medical University, Guangzhou, 510280, China.
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20
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Gao E, Hou J, Zhou Y, Ma J, Li T, Zhang J, Wang L, Chen W, Yuan J. Mediation effect of platelet indices on the association of daytime nap duration with 10-year ASCVD risk. Platelets 2020; 32:82-89. [PMID: 32009507 DOI: 10.1080/09537104.2020.1719055] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Daytime nap is associated with the risk of atherosclerotic cardiovascular disease (ASCVD). However, the contribution of platelet to the association of daytime nap with ASCVD remains unclear. We analyzed the mediation effect of abnormal platelet indices on the association between daytime nap and 10-year ASCVD risk. The participants of this study were 2445 adults aged 30 to 74 years without ASCVD from the baseline Wuhan residents (n = 3053) of the Wuhan-Zhuhai (WHZH) Cohort Study. Participants completed the questionnaire and physical examination (including blood pressure, height, weight, and blood biochemical indicators). We assessed the association of daytime nap or nocturnal sleep duration with 10-year ASCVD risk and mediation effects of platelet indices on the associations using generalized linear models (GLM). Individuals with daytime nap duration of 30 or 60 min had a 1.37- (95%CI: 1.05, 1.78) or 1.44- (95%CI: 1.17, 1.78) fold increased risk of 10-year ASCVD compared with non-nappers. As compared with non-nappers, MPV values or MPV/PLT ratio mediated 15.29% or 6.18% of the association of daytime nap duration of 30 min with 10-year ADCVD risk as well as 19.21% or 7.61% of the association of daytime nap duration of 60 min with 10-year ADCVD risk (all p < .05). Platelet might partially contribute to increased 10-year ASCVD risk in individuals with daytime nap duration of 30 or 60 min.
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Affiliation(s)
- Erwei Gao
- Department of Occupational and Environmental Health, Huazhong University of Science and Technology , Wuhan, PR. China.,Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, PR. China
| | - Jian Hou
- Department of Occupational and Environmental Health, Huazhong University of Science and Technology , Wuhan, PR. China.,Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, PR. China
| | - Yun Zhou
- Department of Occupational and Environmental Health, Huazhong University of Science and Technology , Wuhan, PR. China.,Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, PR. China
| | - Jixuan Ma
- Department of Occupational and Environmental Health, Huazhong University of Science and Technology , Wuhan, PR. China.,Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, PR. China
| | - Tian Li
- Department of Occupational and Environmental Health, Huazhong University of Science and Technology , Wuhan, PR. China.,Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, PR. China
| | - Jiafei Zhang
- Department of Occupational and Environmental Health, Huazhong University of Science and Technology , Wuhan, PR. China.,Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, PR. China
| | - Lu Wang
- Department of Occupational and Environmental Health, Huazhong University of Science and Technology , Wuhan, PR. China.,Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, PR. China
| | - Weihong Chen
- Department of Occupational and Environmental Health, Huazhong University of Science and Technology , Wuhan, PR. China.,Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, PR. China
| | - Jing Yuan
- Department of Occupational and Environmental Health, Huazhong University of Science and Technology , Wuhan, PR. China.,Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, PR. China
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21
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Go H, Ohto H, Nollet KE, Takano S, Kashiwabara N, Chishiki M, Maeda H, Imamura T, Kawasaki Y, Momoi N, Hosoya M. Using Platelet Parameters to Anticipate Morbidity and Mortality Among Preterm Neonates: A Retrospective Study. Front Pediatr 2020; 8:90. [PMID: 32232019 PMCID: PMC7082741 DOI: 10.3389/fped.2020.00090] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 02/21/2020] [Indexed: 02/01/2023] Open
Abstract
Background: Platelets participate in many physiological and pathological functions and some platelet parameters predict adult diseases. However, few studies report whether platelet parameters may reflect neonatal disease and mortality in a large cohort. Objective: We aimed to investigate whether platelet parameters could predict bronchopulmonary dysplasia (BPD), necrotizing enterocolitis (NEC), intraventricular hemorrhage (IVH), and NICU mortality. Study Design and Methods: This retrospective cohort study examined records from 2006 to 2017 at the neonatal intensive care unit (NICU) of Fukushima Medical University Hospital. We retrospectively investigated platelet count, plateletcrit (PCT), mean platelet volume (MPV), and platelet distribution width (PDW) on the first day of life in preterm newborns born <32 weeks' gestation admitted to our NICU from 2006 to 2017. Receiver operating characteristic (ROC) and multiple regression analyses, along with Cox proportional hazard modeling, identified independent predictors of morbidities and mortality in preterm newborns. Results: Of 1,501 neonates admitted to our NICU, a total of 305 preterm newborns were included in this study. Gestational age, birth weight, and Apgar score were significantly lower in non-survivors than in survivors. Platelet count, PCT, PDW and PMI did not differ significantly between the two groups, whereas mean MPV in non-survivors was significantly higher than in survivors (10.5 fl vs. 10.0 fl, p = 0.001). Multivariate Cox hazard modeling showed that shorter GA [HR: 0.628, 95% CI: 0.464-0.840, p = 0.003], male sex [HR: 0.269, 95% CI: 0.113-0.640, p = 0.001], and MPV [HR: 1.469, 95% CI: 1.046-2.063, p = 0.026] independently predicted overall survival. Per receiver operating curve, an MPV threshold of 10.2 fl. MPV predicts prognosis in neonates with a sensitivity of 72.4% and a specificity of 58.6% (AUC = 0.685, 95% CI: 0.600-0.789, p = 0.001). Furthermore, multivariate analysis revealed that platelet parameters were not associated with BPD and NEC, whereas small for gestational age (SGA), Apgar score at 5 min, and low PCT were associated with intraventricular hemorrhage (IVH). Conclusion: This study demonstrates that low PCT predicts IVH, and MPV ≥ 10.2 fL correlates with mortality among infants born after <32 weeks' gestation.
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Affiliation(s)
- Hayato Go
- Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Hitoshi Ohto
- Department of Advanced Cancer Immunotherapy, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Kenneth E Nollet
- Department of Blood Transfusion and Transplantation Immunology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Shunya Takano
- Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Nozomi Kashiwabara
- Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Mina Chishiki
- Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Hajime Maeda
- Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Takashi Imamura
- Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Yukihiko Kawasaki
- Department of Pediatrics, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Nobuo Momoi
- Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Mitsuaki Hosoya
- Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Japan
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22
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Bernardi M, Fedullo AL, Di Giacinto B, Squeo MR, Aiello P, Dante D, Romano S, Magaudda L, Peluso I, Palmery M, Spataro A. Cardiovascular Risk Factors and Haematological Indexes of Inflammation in Paralympic Athletes with Different Motor Impairments. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2019; 2019:6798140. [PMID: 31827693 PMCID: PMC6885819 DOI: 10.1155/2019/6798140] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 10/30/2019] [Indexed: 12/16/2022]
Abstract
Haematological indexes of both inflammation and platelet activation have been suggested as predictive markers of cardiovascular disease (CVD), which has high prevalence in Paralympic athletes (PA). Different mechanisms could play a role in increasing CVD risk in PA with spinal cord injury (PA-SCI), lower limb amputation (PA-LLA), or upper limb impairment (PA-ULI). We compared, in 4 groups of PA competing in power, intermittent (mixed metabolism), and endurance sports, Framingham Risk Score (FRS), metabolic syndrome criteria (MetS-C), inflammation (INFLA) Score, 5 haematological indexes of platelet activation (mean platelet volume (MPV), platelet distribution width (PDW), and the ratios between MPV and platelet (MPVPR), between MPV and lymphocyte (MPVLR), and between PDW and lymphocyte (PDWLR)) and the endogenous antioxidants uric acid (UA) and bilirubin (BR). A retrospective chart review of PA from preparticipation examinations' records (London 2012 and Sochi 2014 Paralympics) was performed. We included 25 PA-SCI (13 with high and 12 with low lesion, PA-SCI-H and PA-SCI-L), 15 PA-LLA, and 10 PA-ULI. FRS and INFLA Score did not differ among groups, but PA-SCI-H had lower HDL, compared to PA-SCI-L and PA-ULI. PA-LLA had more MetS diagnostic criteria with significant higher glucose levels than other groups. PA-SCI-H had significantly lower lymphocytes' count compared to PA-LLA and higher MPV, PDW, MPVPR, MPVLR, and PDWLR. SCI-H had lower BR, haemoglobin, haematocrit, proteins, and creatinine. No interaction was found between the 3 kinds of sitting sports and the 2 groups of health conditions (PA-SCI and PA-LLA). In conclusion, PA-LLA had a higher cardiometabolic risk, whereas PA-SCI-H had a higher platelet-derived cardiovascular risk. Further larger studies are needed to investigate the relationship between indexes of inflammation/oxidation and dietary habit, body composition, and physical fitness/performance in PA with motor impairments.
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Affiliation(s)
- Marco Bernardi
- Department of Physiology and Pharmacology “V. Erspamer”, Sapienza University of Rome, Italy
- Comitato Italiano Paralimpico, Rome, Italy
| | | | | | | | - Paola Aiello
- Department of Physiology and Pharmacology “V. Erspamer”, Sapienza University of Rome, Italy
- Research Centre for Food and Nutrition, Council for Agricultural Research and Economics (CREA-AN), Rome, Italy
| | - Donatella Dante
- Department of Physiology and Pharmacology “V. Erspamer”, Sapienza University of Rome, Italy
| | - Silvio Romano
- Department of Life, Health and Environmental Sciences, University of L'Aquila, Italy
| | - Ludovico Magaudda
- Sport Medicine Unit AOU “G. Martino”, BIOMORF Department University of Messina, Italy
| | - Ilaria Peluso
- Research Centre for Food and Nutrition, Council for Agricultural Research and Economics (CREA-AN), Rome, Italy
| | - Maura Palmery
- Department of Physiology and Pharmacology “V. Erspamer”, Sapienza University of Rome, Italy
| | - Antonio Spataro
- Institute of Sport Medicine and Science, Sport e Salute, Rome, Italy
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23
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He S, Lei W, Li J, Yu K, Yu Y, Zhou L, Zhang X, He M, Guo H, Yang H, Wu T. Relation of Platelet Parameters With Incident Cardiovascular Disease (The Dongfeng-Tongji Cohort Study). Am J Cardiol 2019; 123:239-248. [PMID: 30413247 DOI: 10.1016/j.amjcard.2018.10.016] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 09/28/2018] [Accepted: 10/02/2018] [Indexed: 11/18/2022]
Abstract
Prospective studies on the relations between platelet count (PLT), mean platelet volume (MPV), platelet distribution width (PDW), and incident cardiovascular disease (CVD) were still limited. This study aimed to investigate the above-mentioned prospective relations in the middle-aged and older Chinese populations based on the Dongfeng-Tongji cohort. We included 31,751 participants who were free of coronary heart disease (CHD), stroke, cancer, or severely abnormal electrocardiogram at baseline. During a median follow-up of 5.9 years, we identified 5,683 incident CVD cases, including 4,423 CHD and 1,260 stroke cases. Cox proportional hazard models were used to estimate the hazard ratios (HRs) and 95% confident intervals (CIs) for the relation analyses. Compared with participants with 146 ≤ PLT ≤ 233 10E9/L, the adjusted HR (95% CI) of those with PLT < 146 10E9/L was 0.80 (0.68 to 0.95) for incident stroke. Compared with participants with 7.3 ≤ MPV ≤ 10.3 fl, the adjusted HRs (95% CIs) of those with MPV < 7.3 fl were 0.81 (0.75 to 0.88), 0.80 (0.73 to 0.88) and 0.84 (0.71 to 1.00) for incident CVD, CHD and stroke, respectively. Compared with participants with 13.2 ≤ PDW ≤ 18.1 %, the adjusted HRs (95% CIs) of those with PDW < 13.2 % were 0.80 (0.73 to 0.87) and 0.78 (0.70 to 0.86) for incident CVD and CHD, respectively. In conclusion, lower levels of PLT and MPV were significantly related to lower risk of stroke, while lower levels of MPV and PDW were significantly related to lower risks of CVD and CHD.
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Affiliation(s)
- Shiqi He
- Department of Occupational and Environmental Health and Ministry of Education Key Lab for Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wenhui Lei
- Department of Occupational and Environmental Health and Ministry of Education Key Lab for Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jun Li
- Department of Occupational and Environmental Health and Ministry of Education Key Lab for Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Kuai Yu
- Department of Occupational and Environmental Health and Ministry of Education Key Lab for Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yanqiu Yu
- Department of Occupational and Environmental Health and Ministry of Education Key Lab for Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lue Zhou
- Department of Occupational and Environmental Health and Ministry of Education Key Lab for Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaomin Zhang
- Department of Occupational and Environmental Health and Ministry of Education Key Lab for Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Meian He
- Department of Occupational and Environmental Health and Ministry of Education Key Lab for Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Huan Guo
- Department of Occupational and Environmental Health and Ministry of Education Key Lab for Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Handong Yang
- Dongfeng Central Hospital, Dongfeng Motor Corporation and Hubei University of Medicine, Shiyan, China
| | - Tangchun Wu
- Department of Occupational and Environmental Health and Ministry of Education Key Lab for Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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24
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Cai L, Yu J, Yu J, Peng Y, Ullah H, Yi C, Lin J, Yang X, Yu X. Prognostic value of inflammation-based prognostic scores on outcome in patients undergoing continuous ambulatory peritoneal dialysis. BMC Nephrol 2018; 19:297. [PMID: 30367618 PMCID: PMC6204053 DOI: 10.1186/s12882-018-1092-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 10/09/2018] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Inflammation-based prognostic scores have been used as outcome predictors in patients with cancer or on hemodialysis. However, their role in patients on continuous ambulatory peritoneal dialysis (CAPD) remains unclear. This study aimed to examine the prognostic value of inflammation-based composite scores for mortality in CAPD patients. METHODS This study was conducted in CAPD patients enrolled from January 1, 2006 to December 31, 2014 and followed until December 31, 2016. Three inflammation-based prognostic scores, including Glasgow prognostic score (GPS), prognostic nutritional index (PNI), and prognostic index (PI), were conducted in this study. The associations between these scores and all-cause or cardiovascular mortality were evaluated by Kaplan-Meier method and Cox proportional hazards models. The areas under the curve (AUC) of receiver-operating characteristic (ROC) analysis were used to determine the predictive values of mortality. RESULTS A total of 1501 patients were included. During a median follow-up of 38.7 (range, 21.6-62.3) months, 346 (23.1%) patients died, of which 168 (48.6%) were due to cardiovascular diseases (CVD). After adjustment for confounders, the results showed that elevated GPS, PNI, and PI scores were all independently associated with all-cause [GPS: Score 1: hazard ratio(HR) 3.94, 95% confidence interval(CI) 2.90-5.35; Score 2: HR 7.56, 95% CI 5.35-10.67; PNI: HR 1.82, 95% CI 1.36-2.43; PI: Score 1: HR 2.08, 95% CI 1.63-2.65; Score 2: HR 3.03, 95% CI 2.00-4.60)] and CVD mortality(GPS: Score 1: HR 4.41, 95% CI 2.76-7.03; Score 2: HR 9.64, 95% CI 5.72-16.26; PNI: HR 1.63, 95% CI 1.06-2.51; PI: Score 1: HR 2.57, 95% CI 1.81-3.66, Score 2: HR 3.85, 95% CI 1.99-7.46).The AUC values of GPS score were 0.798 (95% CI0.770-0.826) for all-cause mortality and 0.781 (95% CI 0.744-0.817) for CVD mortality, both of which significantly higher than those of PNI and PI scores (P < 0.001, respectively). CONCLUSIONS All elevated GPS, PNI, and PI scores were independently associated with all-cause and CVD mortality. The GPS score showed better predictive value than PNI and PI scores in CAPD patients.
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Affiliation(s)
- Lu Cai
- Department of Nephrology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080 China
- Key Laboratory of Nephrology, Ministry of Health and Guangdong Province, Guangzhou, China
| | - Jianwen Yu
- Department of Nephrology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080 China
- Key Laboratory of Nephrology, Ministry of Health and Guangdong Province, Guangzhou, China
| | - Jing Yu
- Department of Nephrology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080 China
- Key Laboratory of Nephrology, Ministry of Health and Guangdong Province, Guangzhou, China
| | - Yuan Peng
- Department of Nephrology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080 China
- Key Laboratory of Nephrology, Ministry of Health and Guangdong Province, Guangzhou, China
| | - Habib Ullah
- Department of Nephrology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080 China
- Key Laboratory of Nephrology, Ministry of Health and Guangdong Province, Guangzhou, China
| | - Chunyan Yi
- Department of Nephrology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080 China
- Key Laboratory of Nephrology, Ministry of Health and Guangdong Province, Guangzhou, China
| | - Jianxiong Lin
- Department of Nephrology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080 China
- Key Laboratory of Nephrology, Ministry of Health and Guangdong Province, Guangzhou, China
| | - Xiao Yang
- Department of Nephrology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080 China
- Key Laboratory of Nephrology, Ministry of Health and Guangdong Province, Guangzhou, China
| | - Xueqing Yu
- Department of Nephrology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080 China
- Key Laboratory of Nephrology, Ministry of Health and Guangdong Province, Guangzhou, China
- Institute of Nephrology, Guangdong Medical University, Zhanjiang, China
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