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Gela YY, Limenh LW, Simegn W, Ayenew W, Chanie GS, Seid AM, Beyna AT, Esubalew D, Mitku ML, Mengesha AK, Melese M. Poor sleep quality and associated factors among adult chronic kidney disease patients. Front Med (Lausanne) 2024; 11:1366010. [PMID: 38751978 PMCID: PMC11094326 DOI: 10.3389/fmed.2024.1366010] [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: 01/05/2024] [Accepted: 04/11/2024] [Indexed: 05/18/2024] Open
Abstract
Background Poor sleep quality is a common concern in chronic kidney disease (CKD) patients, which can accelerate the progression of chronic renal disease and negatively impact their health-related quality of life, potentially leading to greater morbidity and mortality rates. It can also have an effect on the immune system, cognitive function, and emotional well-being of CKD patients. Furthermore, poor sleep quality may contribute to drug noncompliance and decreased participation in the entire treatment plan. Nonetheless, no research has been undertaken in Ethiopia on the prevalence of poor sleep quality and its associated factors among CKD patients. Objective This study aimed to assess the prevalence of poor quality of sleep and associated factors among chronic kidney disease patients at the University of Gondar Comprehensive Specialized and Felege Hiwot Referral Hospitals in 2020. Methods A cross-sectional study design was implemented at the University of Gondar Comprehensive Specialized and Felege Hiwot Referral Hospitals between February and April 2020. The study participants were chosen through systematic random sampling techniques. The Pittsburgh Sleep Quality Index (PSQI), a validated assessment tool, was utilized to measure sleep quality. A PSQI total score > 5 was used as an indicator of poor sleep quality. Subsequently, the data obtained were entered into Epi Data version 3.0 and then transferred to STATA 14 for analysis. Both bivariable and multivariable binary logistic regression analyses were performed to recognize factors associated with poor sleep quality. In the multivariable logistic regression analysis, variables demonstrating a p-value of ≤0.05 were considered statistically associated to poor sleep quality. Results In this study, 424 CKD patients were included. Among screened CKD patients, 42.9% tested positive for poor sleep quality with a 95% CI (38 to 47%). Independent predictors of poor sleep quality among CKD patients were common mental disorder [AOR = 1.8, 95% CI (1.19-2.89)], anemia [AOR = 2.7, 95% CI (1.71-4.36)], declined eGFR between 60 and 89.9 [AOR = 1.6; 95% CI (2.28-5.54)], 30-59.9 [AOR = 2.6, 95% CI (1.53-4.43)], and ≤ 30 [AOR = 3.8, 95% CI (1.17-12.61)], age > 50 years [AOR = 1.7(1.11-2.69)] and duration of disease 2.9 [AOR = 2.9, 95% CI (1.77-4.90)]. Conclusion In our study, almost 1 out of 2 CKD patients assessed for poor sleep quality tested positive. It was noted that poor sleep quality was more frequent among CKD patients with common mental disorders, anemia, decreased eGFR levels, individuals aged over 50 years, and those with a longer duration of the disease. Consequently, it's advised to regularly screen these CKD patients for poor sleep quality.
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Affiliation(s)
- Yibeltal Yismaw Gela
- Department of Physiology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Liknaw Workie Limenh
- Department of Pharmaceutics, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Wudneh Simegn
- Department of Social and Administrative Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Wondim Ayenew
- Department of Social and Administrative Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Gashaw Sisay Chanie
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Abdulwase Mohammed Seid
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Alemante Tafese Beyna
- Department of Pharmacology, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Dereje Esubalew
- Department of Human Physiology, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia
| | - Melese Legesse Mitku
- Department of Pharmaceutical Chemistry, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Assefa Kebad Mengesha
- Department of Pharmacology, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mihret Melese
- Department of Physiology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Liu X, Lin B, Yao S, Pan Z. Impact of Anemia on Cardiovascular Events and All-Cause Death Among Participants Who Received Intense Blood Pressure Treatment: A Secondary Analysis of SPRINT. Rev Cardiovasc Med 2024; 25:6. [PMID: 39077655 PMCID: PMC11262380 DOI: 10.31083/j.rcm2501006] [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: 08/14/2023] [Revised: 09/16/2023] [Accepted: 09/25/2023] [Indexed: 07/31/2024] Open
Abstract
Background To investigate whether anemia is associated with incident cardiovascular events and all-cause death among participants who received intensive blood pressure (BP) treatment in the Systolic Blood Pressure Intervention Trial (SPRINT). Methods A total of 4394 participants who received intensive BP control (systolic BP < 120 mmHg) in SPRINT were included. Anemia status was self-reported. Our primary outcome was a composite of cardiovascular events, and the secondary outcome was all-cause death. Cox regression was used to compare the incidence of outcomes between participants with anemia and non-anemia. In order to balance the baseline characteristics between the 2 groups, inverse probability of treatment weighting (IPTW) was applied. Hazard ratios (HRs), along with 95% confidence intervals (CIs), were then calculated. Results There were 4394 participants who received intensive BP control (537 participants with anemia). Participants with anemia were older (mean age 68.86 versus 67.75, p = 0.01) and more likely to be female (64.8% versus 31.8%, p < 0.001). The presence of anemia was strongly associated with composite cardiovascular events after adjusting for potential confounders (HR 1.66, 95% CI 1.18-2.34, p = 0.004). The association remained statistically significant even in the population after IPTW (HR 1.55, 95% CI 1.06-2.27, p = 0.024). The secondary outcome revealed that participants with anemia had a higher rate of all-cause death compared to those without anemia. The HR of all-cause death for participants with anemia was 1.61 (95% CI 1.00-2.57, p = 0.049) in the population after IPTW. Conclusions Anemia appears to be an independent risk factor for composite cardiovascular events and all-cause death among participants who received intensive BP control in SPRINT. Clinical Trial Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT01206062. All SPRINT anonymized data can be found at the National Heart, Lung and Blood Institute (NHLBI) Biologic Specimen and Data Repository (https://biolincc.nhlbi.nih.gov/home/).
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Affiliation(s)
- Xiaochuan Liu
- Department of General Practice, Zhongshan Hospital, Fudan University, 200032 Shanghai, China
| | - Beiru Lin
- Department of General Practice, Hainan West Central Hospital, 571700 Danzhou, Hainan, China
| | - Sichen Yao
- Department of General Practice, Wujing Community Health Service Center, 200241 Shanghai, China
- Center of Community-Based Health Research, Fudan University, 200032 Shanghai, China
| | - Zhigang Pan
- Department of General Practice, Zhongshan Hospital, Fudan University, 200032 Shanghai, China
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Ceulemans A, Pinckaers FM, Postma AA, van Zwam WH, van Oostenbrugge RJ. Association Between Anemia and Clinical Outcome in Acute Ischemic Stroke Patients Treated With Endovascular Treatment. J Stroke 2024; 26:87-94. [PMID: 38246723 PMCID: PMC10850445 DOI: 10.5853/jos.2023.01669] [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: 05/21/2023] [Revised: 09/14/2023] [Accepted: 10/20/2023] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND AND PURPOSE Endovascular treatment (EVT) is the preferred treatment option in eligible acute ischemic stroke (AIS) patients with a large vessel occlusion of the anterior circulation. Several comorbidities have been identified that can affect clinical outcomes. Various studies have investigated the association between anemia and clinical outcome and found conflicting. RESULTS . The aim is to investigate the association between pre-EVT anemia and clinical outcomes at different time points post-EVT, primarily focusing on the National Institutes of Health Stroke Scale (NIHSS) at 24-48 hours. METHODS We prospectively included 560 AIS patients who received EVT in the Maastricht University Medical Center+. Hemoglobin levels (Hb; g/dL) were determined on admission. Hb levels were also categorized into two groups: anemia (male: Hb ≤12.9 g/dL; female: Hb ≤11.9 g/dL) and no anemia. Multiple imputation was used to handle missing data. Multivariable regression was used to investigate the association between anemia or Hb levels and clinical outcomes. RESULTS Anemia was present in 26% of the patients. Multivariable regression did not show a significant association between anemia or Hb levels and NIHSS at 24-48 hours (adjusted β [aβ]anemia: 1.44, 95% confidence interval [CI]: -0.47 to 3.36; aβHb: -0.37, 95% CI: -0.88 to 0.13). However, multivariable regression showed significant associations with modified Rankin Scale (adjusted common odds ratio [acOR]anemia: 1.66, 95% CI: 1.12 to 2.48; acORHb: 0.83, 95% CI: 0.75 to 0.93) and poor functional outcome at 90 days (adjusted OR [aOR]anemia: 2.09, 95% CI: 1.21 to 3.63; aORHb: 0.80, 95% CI: 0.69 to 0.92). CONCLUSION Anemia was not independently associated with early neurological deficit (NIHSS) post-AIS, suggesting it is more suitable as a general frailty marker.
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Affiliation(s)
- Angelique Ceulemans
- School for Cardiovascular Diseases (CARIM), Maastricht University, Maastricht, The Netherlands
- Department of Neurology, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Florentina M.E. Pinckaers
- School for Cardiovascular Diseases (CARIM), Maastricht University, Maastricht, The Netherlands
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Alida A. Postma
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+, Maastricht, The Netherlands
- School for Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, The Netherlands
| | - Wim H. van Zwam
- School for Cardiovascular Diseases (CARIM), Maastricht University, Maastricht, The Netherlands
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Robert J. van Oostenbrugge
- School for Cardiovascular Diseases (CARIM), Maastricht University, Maastricht, The Netherlands
- Department of Neurology, Maastricht University Medical Center+, Maastricht, The Netherlands
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Donat-Vargas C, Mico V, San-Cristobal R, Martínez-González MÁ, Salas-Salvadó J, Corella D, Fitó M, Alonso-Gómez ÁM, Wärnberg J, Vioque J, Romaguera D, López-Miranda J, Estruch R, Damas-Fuentes M, Lapetra J, Serra-Majem L, Bueno-Cavanillas A, Tur JA, Cinza-Sanjurjo S, Pintó X, Delgado-Rodríguez M, Matía-Martín P, Vidal J, Causso C, Ros E, Toledo E, Manzanares JM, Ortega-Azorín C, Castañer O, Peña-Orihuela PJ, Zazo JM, Muñoz Bravo C, Martinez-Urbistondo D, Chaplin A, Casas R, Cano Ibáñez N, Tojal-Sierra L, Gómez-Perez AM, Pascual Roquet-Jalmar E, Mestre C, Barragán R, Schröder H, Garcia-Rios A, Candela García I, Ruiz-Canela M, Babio N, Malcampo M, Daimiel L, Martínez A. Dietary Iron, Anemia Markers, Cognition, and Quality of Life in Older Community-Dwelling Subjects at High Cardiovascular Risk. Nutrients 2023; 15:4440. [PMID: 37892515 PMCID: PMC10610130 DOI: 10.3390/nu15204440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 10/05/2023] [Accepted: 10/10/2023] [Indexed: 10/29/2023] Open
Abstract
Anemia causes hypo-oxygenation in the brain, which could lead to cognitive disorders. We examined dietary iron intake as well as anemia markers (i.e., hemoglobin, hematocrit, mean corpuscular volume) and diabetes coexistence in relation to neuropsychological function and quality of life. In this study, 6117 community-dwelling adults aged 55-75 years (men) and 60-75 years (women) with overweight/obesity and metabolic syndrome were involved. We performed the Mini-Mental State Examination (MMSE), the Trail Making Test parts A and B (TMT-A/B), Semantic Verbal Fluency of animals (VFT-a), Phonological Verbal Fluency of letter P (VFT-p), Digit Span Test (DST), the Clock Drawing Test (CDT), and the Short Form-36 Health Survey (SF36-HRQL test). Dietary iron intake did not influence neuropsychological function or quality of life. However, anemia and lower levels of anemia markers were associated with worse scores in all neurophysiological and SF36-HRQL tests overall, but were especially clear in the MMSE, TMT-B (cognitive flexibility), and the physical component of the SF36-HRQL test. The relationships between anemia and diminished performance in the TMT-A/B and VFT tasks were notably pronounced and statistically significant solely among participants with diabetes. In brief, anemia and reduced levels of anemia markers were linked to inferior cognitive function, worse scores in different domains of executive function, as well as a poorer physical, but not mental, component of quality of life. It was also suggested that the coexistence of diabetes in anemic patients may exacerbate this negative impact on cognition. Nevertheless, dietary iron intake showed no correlation with any of the outcomes. To make conclusive recommendations for clinical practice, our findings need to be thoroughly tested through methodologically rigorous studies that minimize the risk of reverse causality.
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Affiliation(s)
- Carolina Donat-Vargas
- ISGlobal, Campus Mar, 08036 Barcelona, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain; (J.V.); (A.B.-C.); (N.C.I.); (H.S.)
| | - Víctor Mico
- Cardiometabolic Nutrition Group, IMDEA Food, CEI UAM + CSIC, 28049 Madrid, Spain; (V.M.); (R.S.-C.); (M.D.-R.)
| | - Rodrigo San-Cristobal
- Cardiometabolic Nutrition Group, IMDEA Food, CEI UAM + CSIC, 28049 Madrid, Spain; (V.M.); (R.S.-C.); (M.D.-R.)
| | - Miguel Ángel Martínez-González
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (D.C.); (M.F.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (M.D.-F.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (E.R.); (E.T.); (C.O.-A.); (P.J.P.-O.); (A.C.); (R.C.); (L.T.-S.); (A.M.G.-P.); (C.M.); (R.B.); (A.G.-R.); (M.R.-C.); (N.B.)
- Department of Preventive Medicine and Public Health, University of Navarra, IDISNA, 31008 Pamplona, Spain
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA 02115, USA
| | - Jordi Salas-Salvadó
- Unitat de Nutrició Humana, Departament de Bioquímica i Biotecnologia, Universitat Rovira i Virgili, 43201 Reus, Spain; (J.S.-S.); (J.M.M.)
- Food, Nutrition, Development and Mental Health Research Group, Institut d’Investigació Pere Virgili (IISPV), 43204 Reus, Spain
- Department of Preventive Medicine, University of Valencia, 46010 Valencia, Spain
| | - Dolores Corella
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (D.C.); (M.F.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (M.D.-F.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (E.R.); (E.T.); (C.O.-A.); (P.J.P.-O.); (A.C.); (R.C.); (L.T.-S.); (A.M.G.-P.); (C.M.); (R.B.); (A.G.-R.); (M.R.-C.); (N.B.)
- Department of Preventive Medicine, University of Valencia, 46010 Valencia, Spain
| | - Montserrat Fitó
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (D.C.); (M.F.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (M.D.-F.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (E.R.); (E.T.); (C.O.-A.); (P.J.P.-O.); (A.C.); (R.C.); (L.T.-S.); (A.M.G.-P.); (C.M.); (R.B.); (A.G.-R.); (M.R.-C.); (N.B.)
- Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d’Investigació Médica (IMIM), 08003 Barcelona, Spain; (O.C.); (M.M.)
| | - Ángel Maria Alonso-Gómez
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (D.C.); (M.F.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (M.D.-F.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (E.R.); (E.T.); (C.O.-A.); (P.J.P.-O.); (A.C.); (R.C.); (L.T.-S.); (A.M.G.-P.); (C.M.); (R.B.); (A.G.-R.); (M.R.-C.); (N.B.)
- Bioaraba Health Research Institute, Osakidetza Basque Health Service, Araba University Hospital, University of the Basque Country UPV/EHU, 01009 Vitoria-Gasteiz, Spain
| | - Julia Wärnberg
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (D.C.); (M.F.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (M.D.-F.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (E.R.); (E.T.); (C.O.-A.); (P.J.P.-O.); (A.C.); (R.C.); (L.T.-S.); (A.M.G.-P.); (C.M.); (R.B.); (A.G.-R.); (M.R.-C.); (N.B.)
- EpiPHAAN Research Group, Department of Nursing, School of Health Sciences, University of Málaga-IBIMA (Instituto de Investigación Biomédica de Málaga), 29071 Málaga, Spain
| | - Jesús Vioque
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain; (J.V.); (A.B.-C.); (N.C.I.); (H.S.)
- Instituto de Investigación Sanitaria y Biomédica de Alicante, Universidad Miguel Hernández (ISABIAL-UMH), 03010 Alicante, Spain
| | - Dora Romaguera
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (D.C.); (M.F.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (M.D.-F.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (E.R.); (E.T.); (C.O.-A.); (P.J.P.-O.); (A.C.); (R.C.); (L.T.-S.); (A.M.G.-P.); (C.M.); (R.B.); (A.G.-R.); (M.R.-C.); (N.B.)
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
| | - José López-Miranda
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (D.C.); (M.F.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (M.D.-F.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (E.R.); (E.T.); (C.O.-A.); (P.J.P.-O.); (A.C.); (R.C.); (L.T.-S.); (A.M.G.-P.); (C.M.); (R.B.); (A.G.-R.); (M.R.-C.); (N.B.)
- Lipids and Atherosclerosis Unit, Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, 14004 Córdoba, Spain
| | - Ramon Estruch
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (D.C.); (M.F.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (M.D.-F.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (E.R.); (E.T.); (C.O.-A.); (P.J.P.-O.); (A.C.); (R.C.); (L.T.-S.); (A.M.G.-P.); (C.M.); (R.B.); (A.G.-R.); (M.R.-C.); (N.B.)
- Department of Internal Medicine, Institut d’Investigació Biomèdica August Pi I Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, 08036 Barcelona, Spain
| | - Miguel Damas-Fuentes
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (D.C.); (M.F.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (M.D.-F.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (E.R.); (E.T.); (C.O.-A.); (P.J.P.-O.); (A.C.); (R.C.); (L.T.-S.); (A.M.G.-P.); (C.M.); (R.B.); (A.G.-R.); (M.R.-C.); (N.B.)
- Department of Endocrinology, Instituto de Investigación Biomédica de Málaga (IBIMA), Virgen de la Victoria Hospital, University of Málaga, 29016 Málaga, Spain
| | - José Lapetra
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (D.C.); (M.F.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (M.D.-F.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (E.R.); (E.T.); (C.O.-A.); (P.J.P.-O.); (A.C.); (R.C.); (L.T.-S.); (A.M.G.-P.); (C.M.); (R.B.); (A.G.-R.); (M.R.-C.); (N.B.)
- Department of Family Medicine, Research Unit, Distrito Sanitario Atención Primaria Sevilla, 41013 Sevilla, Spain
| | - Luís Serra-Majem
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (D.C.); (M.F.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (M.D.-F.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (E.R.); (E.T.); (C.O.-A.); (P.J.P.-O.); (A.C.); (R.C.); (L.T.-S.); (A.M.G.-P.); (C.M.); (R.B.); (A.G.-R.); (M.R.-C.); (N.B.)
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Preventive Medicine Service, Centro Hospitalario Universitario Insular Materno Infantil (CHUIMI), Canarian Health Service, 35016 Las Palmas, Spain
| | - Aurora Bueno-Cavanillas
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain; (J.V.); (A.B.-C.); (N.C.I.); (H.S.)
- Department of Preventive Medicine and Public Health, University of Granada, 18016 Granada, Spain
| | - Josep Antoni Tur
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (D.C.); (M.F.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (M.D.-F.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (E.R.); (E.T.); (C.O.-A.); (P.J.P.-O.); (A.C.); (R.C.); (L.T.-S.); (A.M.G.-P.); (C.M.); (R.B.); (A.G.-R.); (M.R.-C.); (N.B.)
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
- Research Group on Community Nutrition & Oxidative Stress, University of Balearic Islands, 07122 Palma de Mallorca, Spain
| | - Sergio Cinza-Sanjurjo
- CS Milladoiro, Área Sanitaria de Santiago de Compostela, 15706 Santiago de Compostela, Spain;
- Instituto de Investigación de Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
- Departamento de Medicina, Universidad de Santiago de Compostela, 15701 Santiago de Compostela, Spain
| | - Xavier Pintó
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (D.C.); (M.F.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (M.D.-F.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (E.R.); (E.T.); (C.O.-A.); (P.J.P.-O.); (A.C.); (R.C.); (L.T.-S.); (A.M.G.-P.); (C.M.); (R.B.); (A.G.-R.); (M.R.-C.); (N.B.)
- Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, 08907 Barcelona, Spain
| | - Miguel Delgado-Rodríguez
- Cardiometabolic Nutrition Group, IMDEA Food, CEI UAM + CSIC, 28049 Madrid, Spain; (V.M.); (R.S.-C.); (M.D.-R.)
- Division of Preventive Medicine, Faculty of Medicine, University of Jaén, 23071 Jaén, Spain
| | - Pilar Matía-Martín
- Department of Endocrinology and Nutrition, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain;
| | - Josep Vidal
- Department of Endocrinology, IDIBAPS, Hospital Clinic, University of Barcelona, 08036 Barcelona, Spain;
- Biomedical Research Centre for Diabetes and Metabolic Diseases Network (CIBERDEM), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
| | - Claudia Causso
- Servicio de Endocrinologia Hospital General de Villalba, 28400 Madrid, Spain;
| | - Emilio Ros
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (D.C.); (M.F.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (M.D.-F.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (E.R.); (E.T.); (C.O.-A.); (P.J.P.-O.); (A.C.); (R.C.); (L.T.-S.); (A.M.G.-P.); (C.M.); (R.B.); (A.G.-R.); (M.R.-C.); (N.B.)
- Lipid Clinic, Department of Endocrinology and Nutrition, Institut d’Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clínic, 08036 Barcelona, Spain
| | - Estefanía Toledo
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (D.C.); (M.F.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (M.D.-F.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (E.R.); (E.T.); (C.O.-A.); (P.J.P.-O.); (A.C.); (R.C.); (L.T.-S.); (A.M.G.-P.); (C.M.); (R.B.); (A.G.-R.); (M.R.-C.); (N.B.)
- Department of Preventive Medicine and Public Health, University of Navarra, IDISNA, 31008 Pamplona, Spain
| | - Josep Maria Manzanares
- Unitat de Nutrició Humana, Departament de Bioquímica i Biotecnologia, Universitat Rovira i Virgili, 43201 Reus, Spain; (J.S.-S.); (J.M.M.)
| | - Carolina Ortega-Azorín
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (D.C.); (M.F.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (M.D.-F.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (E.R.); (E.T.); (C.O.-A.); (P.J.P.-O.); (A.C.); (R.C.); (L.T.-S.); (A.M.G.-P.); (C.M.); (R.B.); (A.G.-R.); (M.R.-C.); (N.B.)
- Department of Preventive Medicine, University of Valencia, 46010 Valencia, Spain
| | - Olga Castañer
- Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d’Investigació Médica (IMIM), 08003 Barcelona, Spain; (O.C.); (M.M.)
| | - Patricia Judith Peña-Orihuela
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (D.C.); (M.F.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (M.D.-F.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (E.R.); (E.T.); (C.O.-A.); (P.J.P.-O.); (A.C.); (R.C.); (L.T.-S.); (A.M.G.-P.); (C.M.); (R.B.); (A.G.-R.); (M.R.-C.); (N.B.)
- Lipids and Atherosclerosis Unit, Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, 14004 Córdoba, Spain
| | - Juan Manuel Zazo
- Department of Preventive Medicine and Public Health, School of Medicine, Instituto de Investigación Biomédica de Málaga, University of Málaga, 29590 Málaga, Spain;
| | - Carlos Muñoz Bravo
- Department of Public Health and Psychiatry, University of Malaga-IBIMA (Instituto de Investigación Biomédica de Málaga), 29071 Málaga, Spain
| | | | - Alice Chaplin
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (D.C.); (M.F.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (M.D.-F.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (E.R.); (E.T.); (C.O.-A.); (P.J.P.-O.); (A.C.); (R.C.); (L.T.-S.); (A.M.G.-P.); (C.M.); (R.B.); (A.G.-R.); (M.R.-C.); (N.B.)
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
| | - Rosa Casas
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (D.C.); (M.F.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (M.D.-F.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (E.R.); (E.T.); (C.O.-A.); (P.J.P.-O.); (A.C.); (R.C.); (L.T.-S.); (A.M.G.-P.); (C.M.); (R.B.); (A.G.-R.); (M.R.-C.); (N.B.)
- Department of Internal Medicine, Institut d’Investigació Biomèdica August Pi I Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, 08036 Barcelona, Spain
| | - Naomi Cano Ibáñez
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain; (J.V.); (A.B.-C.); (N.C.I.); (H.S.)
- Department of Preventive Medicine and Public Health, University of Granada, 18016 Granada, Spain
- Instituto de Investigación Biosanitaria ibs.Granada, 18012 Granada, Spain
| | - Lucas Tojal-Sierra
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (D.C.); (M.F.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (M.D.-F.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (E.R.); (E.T.); (C.O.-A.); (P.J.P.-O.); (A.C.); (R.C.); (L.T.-S.); (A.M.G.-P.); (C.M.); (R.B.); (A.G.-R.); (M.R.-C.); (N.B.)
- Bioaraba Health Research Institute, Osakidetza Basque Health Service, Araba University Hospital, University of the Basque Country UPV/EHU, 01009 Vitoria-Gasteiz, Spain
| | - Ana María Gómez-Perez
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (D.C.); (M.F.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (M.D.-F.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (E.R.); (E.T.); (C.O.-A.); (P.J.P.-O.); (A.C.); (R.C.); (L.T.-S.); (A.M.G.-P.); (C.M.); (R.B.); (A.G.-R.); (M.R.-C.); (N.B.)
- Department of Endocrinology, Instituto de Investigación Biomédica de Málaga (IBIMA), Virgen de la Victoria Hospital, University of Málaga, 29016 Málaga, Spain
| | | | - Cristina Mestre
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (D.C.); (M.F.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (M.D.-F.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (E.R.); (E.T.); (C.O.-A.); (P.J.P.-O.); (A.C.); (R.C.); (L.T.-S.); (A.M.G.-P.); (C.M.); (R.B.); (A.G.-R.); (M.R.-C.); (N.B.)
- Unitat de Nutrició Humana, Departament de Bioquímica i Biotecnologia, Universitat Rovira i Virgili, 43201 Reus, Spain; (J.S.-S.); (J.M.M.)
- Food, Nutrition, Development and Mental Health Research Group, Institut d’Investigació Pere Virgili (IISPV), 43204 Reus, Spain
| | - Rocío Barragán
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (D.C.); (M.F.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (M.D.-F.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (E.R.); (E.T.); (C.O.-A.); (P.J.P.-O.); (A.C.); (R.C.); (L.T.-S.); (A.M.G.-P.); (C.M.); (R.B.); (A.G.-R.); (M.R.-C.); (N.B.)
- Department of Preventive Medicine, University of Valencia, 46010 Valencia, Spain
| | - Helmut Schröder
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain; (J.V.); (A.B.-C.); (N.C.I.); (H.S.)
- Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d’Investigació Médica (IMIM), 08003 Barcelona, Spain; (O.C.); (M.M.)
| | - Antonio Garcia-Rios
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (D.C.); (M.F.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (M.D.-F.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (E.R.); (E.T.); (C.O.-A.); (P.J.P.-O.); (A.C.); (R.C.); (L.T.-S.); (A.M.G.-P.); (C.M.); (R.B.); (A.G.-R.); (M.R.-C.); (N.B.)
- Lipids and Atherosclerosis Unit, Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, 14004 Córdoba, Spain
| | | | - Miguel Ruiz-Canela
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (D.C.); (M.F.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (M.D.-F.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (E.R.); (E.T.); (C.O.-A.); (P.J.P.-O.); (A.C.); (R.C.); (L.T.-S.); (A.M.G.-P.); (C.M.); (R.B.); (A.G.-R.); (M.R.-C.); (N.B.)
- Department of Preventive Medicine and Public Health, University of Navarra, IDISNA, 31008 Pamplona, Spain
| | - Nancy Babio
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (D.C.); (M.F.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (M.D.-F.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (E.R.); (E.T.); (C.O.-A.); (P.J.P.-O.); (A.C.); (R.C.); (L.T.-S.); (A.M.G.-P.); (C.M.); (R.B.); (A.G.-R.); (M.R.-C.); (N.B.)
- Unitat de Nutrició Humana, Departament de Bioquímica i Biotecnologia, Universitat Rovira i Virgili, 43201 Reus, Spain; (J.S.-S.); (J.M.M.)
- Food, Nutrition, Development and Mental Health Research Group, Institut d’Investigació Pere Virgili (IISPV), 43204 Reus, Spain
| | - Mireia Malcampo
- Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d’Investigació Médica (IMIM), 08003 Barcelona, Spain; (O.C.); (M.M.)
| | - Lidia Daimiel
- Nutritional Control of the Epigenome Group, Precision Nutrition and Obesity Program, IMDEA Food, CEI UAM + CSIC, 28049 Madrid, Spain;
| | - Alfredo Martínez
- Cardiometabolic Nutrition Group, IMDEA Food, CEI UAM + CSIC, 28049 Madrid, Spain; (V.M.); (R.S.-C.); (M.D.-R.)
- Biomedical Research Centre for Obesity Physiopathology and Nutrition Network (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (M.Á.M.-G.); (D.C.); (M.F.); (Á.M.A.-G.); (J.W.); (D.R.); (J.L.-M.); (R.E.); (M.D.-F.); (J.L.); (L.S.-M.); (J.A.T.); (X.P.); (E.R.); (E.T.); (C.O.-A.); (P.J.P.-O.); (A.C.); (R.C.); (L.T.-S.); (A.M.G.-P.); (C.M.); (R.B.); (A.G.-R.); (M.R.-C.); (N.B.)
- Department of Nutrition, Food Sciences and Physiology, University of Navarra, 31008 Pamplona, Spain
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Kuipers S, Willemse SW, Greving JP, Bron EE, van Oostenbrugge RJ, van Osch MJ, Biessels GJ, Kappelle LJ. Lower haemoglobin concentrations are associated with impaired cognition in patients with carotid artery occlusion. CEREBRAL CIRCULATION - COGNITION AND BEHAVIOR 2023; 5:100169. [PMID: 37404564 PMCID: PMC10316002 DOI: 10.1016/j.cccb.2023.100169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 04/01/2023] [Accepted: 06/09/2023] [Indexed: 07/06/2023]
Abstract
Background Patients with carotid artery occlusion (CAO) are vulnerable to cognitive impairment (CI). Anaemia is associated with CI in the general population. We hypothesized that lower haemoglobin is associated with cognitive impairment (CI) in patients with CAO and that this association is accentuated by cerebral blood flow (CBF). Methods 104 patients (mean age 66±8 years, 77% men) with complete CAO from the Heart-Brain Connection study were included. Anaemia was defined as haemoglobin < 12 g/dL for women and < 13 g/dL for men. Cognitive test results were standardized into z-scores (using a reference group) in four cognitive domains. Patients were classified as cognitively impaired when ≥ one domain was impaired. The association between lower haemoglobin and both cognitive domain z-scores and the presence of CI was assessed with adjusted (age, sex, education and ischaemic stroke) regression models. Total CBF (measured with phase contrast MRI) and the interaction term haemoglobin*CBF were additionally added to the analyses. Results Anaemia was present in 6 (6%) patients and was associated with CI (RR 2.54, 95% CI 1.36; 4.76). Lower haemoglobin was associated with the presence of CI (RR per minus 1 g/dL haemoglobin 1.15, 95% CI 1.02; 1.30). This association was strongest for the attention-psychomotor speed domain (RR for impaired attention-psychomotor speed functioning per minus 1 g/dL haemoglobin 1.27, 95% CI 1.09;1.47) and ß for attention-psychomotor speed z-scores per minus 1 g/dL haemoglobin -0.19, 95% CI -0.33; -0.05). Adjustment for CBF did not affect these results and we found no interaction between haemoglobin and CBF in relation to cognition. Conclusion Lower haemoglobin concentrations are associated with CI in patients with complete CAO, particularly in the domain attention-psychomotor speed. CBF did not accentuate this association. If validated in longitudinal studies, haemoglobin might be a viable target to prevent cognitive deterioration in patients with CAO.
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Affiliation(s)
- Sanne Kuipers
- Department of Neurology, UMC Utrecht Brain Centre, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Sean W. Willemse
- Department of Neurology, UMC Utrecht Brain Centre, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Jacoba P. Greving
- Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Esther E. Bron
- Department of Radiology & Nuclear Medicine, Erasmus MC, Rotterdam, the Netherlands
| | | | | | - Geert Jan Biessels
- Department of Neurology, UMC Utrecht Brain Centre, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - L. Jaap Kappelle
- Department of Neurology, UMC Utrecht Brain Centre, University Medical Centre Utrecht, Utrecht, the Netherlands
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Chen Y, Li P, Zhang L, Zhang Y, Xie L, Niu J. Prevalence and predisposing factors of depressive symptoms in continuous ambulatory peritoneal dialysis patients: a cross-sectional single center study. BMC Nephrol 2023; 24:104. [PMID: 37085800 PMCID: PMC10122367 DOI: 10.1186/s12882-023-03166-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 04/12/2023] [Indexed: 04/23/2023] Open
Abstract
BACKGROUND The aim of this study was to identify the prevalence of the depressive symptoms and the factors associated with the depressive symptoms in peritoneal dialysis patients. METHODS A cross-sectional study was carried out to evaluate the prevalence and associated factors of depression in 132 continuous ambulatory peritoneal dialysis patients. Depression was evaluated using Zung Self-Rating Depression Scale. Sociodemographic and clinical characteristic were also investigated. Univariate analysis and multivariate logistic regression analysis were performed to select factors associated with depressive symptoms. RESULTS Their median age was 57.5 years, and 58.3% were male. The rate of depressive symptoms in peritoneal dialysis patients was 78.0%. The rate of moderate/severe depressive symptoms was 64.4%. Multivariable logistic regression analysis showed that lower serum hemoglobin was significantly associated with increased risks of depression (OR = 0.989, 95CI%=0.979-0.998, p = 0.023). CONCLUSION Depression was highly prevalent in the peritoneal dialysis patients. Serum hemoglobin was independent risk factor for depressive symptoms in peritoneal dialysis patients.
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Affiliation(s)
- Yu Chen
- Department of Nephrology, Shanghai Fifth People's Hospital, Fudan University, 801 Heqing Rd, Shanghai, 200240, China
| | - Peng Li
- Department of Nephrology, Shanghai Fifth People's Hospital, Fudan University, 801 Heqing Rd, Shanghai, 200240, China
| | - Lei Zhang
- Department of Nephrology, Shanghai Fifth People's Hospital, Fudan University, 801 Heqing Rd, Shanghai, 200240, China
| | - Yanfei Zhang
- Department of Nephrology, Shanghai Fifth People's Hospital, Fudan University, 801 Heqing Rd, Shanghai, 200240, China
| | - Luyi Xie
- Department of Nephrology, Shanghai Fifth People's Hospital, Fudan University, 801 Heqing Rd, Shanghai, 200240, China
| | - Jianying Niu
- Department of Nephrology, Shanghai Fifth People's Hospital, Fudan University, 801 Heqing Rd, Shanghai, 200240, China.
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7
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Kara O, Elibol T, Koc Okudur S, Smith L, Soysal P. Associations between anemia and insomnia or excessive daytime sleepiness in older adults. Acta Clin Belg 2022; 78:223-228. [PMID: 36036443 DOI: 10.1080/17843286.2022.2116895] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
OBJECTIVE Sleep disorders including excessive daytime sleepiness (EDS), insomnia and anemia are both common. The aim of this study is to investigate associations between anemia and insomnia/EDS in the elderly. METHODS A total of 744 older outpatients were included in this cross-sectional study. Anemia was defined as a hemoglobin concentration below 12 g/dL in females and <13 g/dl in males. Patients were divided into two groups as anemic and non-anemic. The Epworth Sleepiness Scale score of ≥11 points indicates EDS. Insomnia Severity Index with scores of ≥8 indicates insomnia. RESULTS The mean age was 79.8±7.7 years. The prevalence of insomnia, EDS and anemia was 62.1%, 23.8%, and 47.2%, respectively. Insomnia (66.3% vs 58.5%) and EDS (29.6% vs 18.6%) were more common in patients with anemia compared to those without anemia (p<0.05). In univariate analysis, there were significant associations between anemia and insomnia [odds ratio (OR):1.4, 95% confidence interval (CI):1.0-1.9], and EDS (OR:1.8,95% CI:1.3-2.6). In multivariate analysis, the relationship between insomnia and nocturia, chronic obstructive pulmonary disease (COPD), and number of drugs used persisted, whereas being male, of an older age, coronary arterial disease, COPD, Parkinson's disease, dementia, and urinary incontinence were associated with EDS (p<0.05), but there was no significant relationships between anemia and insomnia/EDS (p>0.05). CONCLUSION The present data suggests that an elderly who has anemia is 1.4 times more likely to experience insomnia and 1.8 times more likely to experience EDS than those without anemia.
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Affiliation(s)
- Osman Kara
- Department of Hematology, Bahcesehir University Medical Park Goztepe Hospital, Istanbul, Turkey
| | - Tayfun Elibol
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Istanbul Medeniyet University, Istanbul, Turkey
| | - Saadet Koc Okudur
- Department of Geriatric Medicine, Manisa State Hospital, Manisa, Turkey
| | - Lee Smith
- Centre for Health, Performance, and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Pinar Soysal
- Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
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Jiang Y, Wang L, Lu Z, Chen S, Teng Y, Li T, Li Y, Xie Y, Zhao M. Brain Imaging Changes and Related Risk Factors of Cognitive Impairment in Patients With Heart Failure. Front Cardiovasc Med 2022; 8:838680. [PMID: 35155623 PMCID: PMC8826966 DOI: 10.3389/fcvm.2021.838680] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Accepted: 12/31/2021] [Indexed: 12/13/2022] Open
Abstract
Background/Aims To explore the imaging changes and related risk factors of heart failure (HF) patients with cognitive impairment (CI). Methods A literature search was systematically carried out in PubMed, Web of Science, Embase, and Cochrane Library. In this systematic review, important relevant information was extracted according to the inclusion and exclusion criteria. The methodological quality was assessed by three scales according to the different study types. Results Finally, 66 studies were included, involving 33,579 patients. In the imaging changes, the severity of medial temporal lobe atrophy (MTA) and the decrease of gray Matter (GM) volume were closely related to the cognitive decline. The reduction of cerebral blood flow (CBF) may be correlated with CI. However, the change of white matter (WM) volume was possibly independent of CI in HF patients. Specific risk factors were analyzed, and the data indicated that the increased levels of B-type natriuretic peptide (BNP)/N-terminal pro-B-type natriuretic peptide (NT-proBNP), and the comorbidities of HF, including atrial fibrillation (AF), diabetes mellitus (DM) and anemia were definitely correlated with CI in patients with HF, respectively. Certain studies had also obtained independent correlation results. Body mass index (BMI), depression and sleep disorder exhibited a tendency to be associated with CI. Low ejection fraction (EF) value (<30%) was inclined to be associated with the decline in cognitive function. However, no significant differences were noted between heart failure with preserved ejection fraction (HFpEF) and heart failure with reduced ejection fraction (HFrEF) in cognitive scores. Conclusion BNP/NT-proBNP and the comorbidities of HF including AF, DM and anemia were inextricably correlated with CI in patients with HF, respectively. These parameters were independent factors. The severity of MTA, GM volume, BMI index, depression, sleep disorder, and low EF value (<30%) have a disposition to associated with CI. The reduction in the CBF volume may be related to CI, whereas the WM volume may not be associated with CI in HF patients. The present systematic review provides an important basis for the prevention and treatment of CI following HF.
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Affiliation(s)
- Yangyang Jiang
- Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China
| | - Lei Wang
- Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China
| | - Ziwen Lu
- Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China
| | - Shiqi Chen
- Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China
| | - Yu Teng
- Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China
| | - Tong Li
- Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China
| | - Yang Li
- Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China
| | - Yingzhen Xie
- Department of Encephalopathy, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China
| | - Mingjing Zhao
- Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China
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Bashir MT, McNeil C, Rasul U, Murray A. Haemoglobin Concentration and Cognitive Ability in the Aberdeen Children of the 1950s. Cureus 2022; 14:e21806. [PMID: 35251870 PMCID: PMC8890452 DOI: 10.7759/cureus.21806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Haemoglobin concentrations decrease with age. Abnormally low and high haemoglobin concentrations are associated with reduced cognition; however, the evidence for these associations in cohort data is limited. This study aims to assess the relationship between haemoglobin concentration and cognition in a well-characterised cohort of older adults. Methods Two hundred and fifty-two healthy participants were drawn from the Aberdeen Children of the 1950s cohort, aged between 59 to 65 years. Participants underwent cognitive tests of processing speed, memory, verbal and nonverbal reasoning, and language ability and these were used to construct a global cognitive score, g, using principal component analysis. Haemoglobin concentration in the blood was measured concurrently. Hierarchical multiple regression models were constructed assessing the relationship between haemoglobin concentration and each cognitive measure and these were corrected for age, sex, education, C-reactive protein, hypertension, and body mass index. Results Significant linear association between haemoglobin concentration and nonverbal reasoning demonstrated that low haemoglobin levels are associated with lower scores. A quadratic relationship was found for haemoglobin concentration and immediate memory scores in which low and high haemoglobin levels were associated with lower scores. Conclusions Haemoglobin concentration was found to have a significant linear association with nonverbal reasoning scores and a significant quadratic association with memory scores. The results from this study help to understand the association between haemoglobin and different aspects of cognition.
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Beason-Held LL, Fournier D, Shafer AT, Fabbri E, An Y, Huang CW, Bilgel M, Wong DF, Ferrucci L, Resnick SM. Disease Burden Affects Aging Brain Function. J Gerontol A Biol Sci Med Sci 2021; 77:1810-1818. [PMID: 34329447 PMCID: PMC9757056 DOI: 10.1093/gerona/glab218] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Most older adults live with multiple chronic disease conditions, yet the effect of multiple diseases on brain function remains unclear. METHODS We examine the relationship between disease multimorbidity and brain activity using regional cerebral blood flow (rCBF) 15O-water PET scans from 97 cognitively normal participants (mean baseline age 76.5) in the Baltimore Longitudinal Study of Aging (BLSA). Multimorbidity index scores, generated from the presence of 13 health conditions, were correlated with PET data at baseline and in longitudinal change (n=74) over 5.05 (2.74 SD) years. RESULTS At baseline, voxel-based analysis showed that higher multimorbidity scores were associated with lower relative activity in orbitofrontal, superior frontal, temporal pole and parahippocampal regions, and greater activity in lateral temporal, occipital and cerebellar regions. Examination of the individual health conditions comprising the index score showed hypertension and chronic kidney disease individually contributed to the overall multimorbidity pattern of altered activity. Longitudinally, both increases and decreases in activity were seen in relation to increasing multimorbidity over time. These associations were identified in orbitofrontal, lateral temporal, brainstem, and cerebellar areas. CONCLUSION Together, these results show that greater multimorbidity is associated with widespread areas of altered brain activity, supporting a link between health and changes in aging brain function.
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Affiliation(s)
| | | | - Andrea T Shafer
- Intramural Research Program, National Institute on Aging, NIH
| | - Elisa Fabbri
- Intramural Research Program, National Institute on Aging, NIH
| | - Yang An
- Intramural Research Program, National Institute on Aging, NIH
| | | | - Murat Bilgel
- Intramural Research Program, National Institute on Aging, NIH
| | - Dean F Wong
- Department of Radiology, Washington University School of Medicine
| | - Luigi Ferrucci
- Intramural Research Program, National Institute on Aging, NIH
| | - Susan M Resnick
- Intramural Research Program, National Institute on Aging, NIH
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11
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Cheng JH, Wang QZ, Luan XQ, Zhu J, Feng WQ, Huang GQ, Lin SS, He JC. The Association Between Admission Anemia and Poststroke Depression. J Nerv Ment Dis 2021; 209:421-425. [PMID: 33660687 DOI: 10.1097/nmd.0000000000001314] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT Poststroke depression (PSD) is the most frequent and important neuropsychiatric problem afflicting these patients. Anemia is common in many of these individuals presenting with acute stroke. This study determined whether there is a relationship between anemia on hospital admission and PSD. Two hundred eighty-four acute stroke patients were included in the study. Among them, there were 88 PSD patients, whereas another 196 were non-PSD patients. Clinical depression symptoms were diagnosed according to DSM-4 (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) criteria and a HAMD-17 (the 17-item Hamilton Depression Scale) score ≥8 at 1 month after stroke. In the PSD patients, 27.3% of them presented with anemia, whereas only 12.8% of the non-PSD patients had this condition. There was a negative correlation between hemoglobin level and HAMD-17 score in all patients. A binary logistic regression analysis revealed that anemia was independently associated with PSD after adjustment for sex, National Institutes of Health Stroke Scale scores, mRS (modified Rankin Scale) scores, BI (Barthel Index) scores, RBC (red blood cell), and hematocrit. In conclusion, anemia at admission is associated with PSD seen in these patients 1 month later. Therefore, anemia is a possible predictor of PSD.
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Affiliation(s)
- Jian-Hua Cheng
- Department of Neurology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
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12
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Abstract
Background Several recent genome-wide association studies suggested insomnia and anemia may share some common genetic components. We thus examined whether adults with anemia had higher odds of having insomnia relative to those without anemia in a cross-sectional study and a meta-analysis. Methods Included in this cross-sectional study were 12,614 Chinese adults who participated in an ongoing cohort, the Kailuan Study. Anemia was defined as hemoglobin levels below 12.0 g/dL in women and 13.0 g/dL in men. Insomnia was assessed using the Chinese version of the Athens Insomnia Scale (AIS). A total AIS score ≥6 was considered insomnia. The association between anemia and insomnia was assessed using a logistic regression model, adjusting for potential confounders such as age, sex, chronic disease status, and plasma C-reactive protein concentrations. A meta-analysis was conducted using the fixed effects model to pool results from our study and three previously published cross-sectional studies on this topic in adult populations. Results Individuals with anemia had greater odds of having insomnia (adjusted odds ratio [OR]: 1.32; 95% confidence interval [CI]: 1.03–1.70) compared with individuals without anemia. A significant association persisted after we excluded individuals with chronic inflammation, as suggested by C-reactive protein levels >1 mg/L (adjusted OR: 1.68; 95% CI: 1.22–2.32). The meta-analysis results, including 22,134 participants, also identified a positive association between anemia and insomnia (pooled OR: 1.39; 95% CI: 1.22–1.57). Conclusions The presence of anemia was significantly associated with a higher likelihood of having insomnia in adults. Due to the nature of the cross-sectional study design, results should be interpreted with caution.
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Kim HB, Park B, Shim JY. Anemia in Association with Cognitive Impairment: A Systematic Review and Meta-Analysis. J Alzheimers Dis 2020; 72:803-814. [PMID: 31640093 DOI: 10.3233/jad-190521] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Prevalence of both anemia and cognitive impairment tends to increase with age. Individual studies have recently shown that anemia could be associated with cognitive impairment. OBJECTIVE To investigate the association between anemia and cognitive impairment including dementia. METHODS Two of the authors systematically searched PubMed, EMBASE, and the Cochrane library to retrieve observational studies reporting a relationship between anemia and cognitive impairment from 1964 to July 10, 2019. Case-control and cohort studies were included, and odds ratios (ORs) or relative risks (RRs) with 95% confidence intervals (CIs) for the risk of cognitive impairment were calculated using a random-effects model. RESULTS In total, 16 observational studies including eight case-control studies and eight cohort studies were included in the final analysis. Anemia was significantly linked to cognitive impairment (OR or RR 1.51; 95% CI: 1.32-1.73) in a random-effects meta-analysis, albeit with medium heterogeneity (I2 = 47.8%). Meta-estimates of dementia from prospective population-based cohort studies were similar (RR 1.46; 95% CI: 1.22-1.76) without substantial heterogeneity (I2 = 23.2%). CONCLUSION Our meta-analysis indicates that anemia is associated with cognitive impairment. Further prospective research is warranted to determine the cause-effect relationship of anemia with cognitive impairment and whether treatment of anemia might reduce the risk of dementia.
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Affiliation(s)
- Hong-Bae Kim
- Department of Family Medicine, Myongji Hospital, Hanyang University College of Medicine, Goyang, Republic of Korea
| | - Byoungjin Park
- Department of Family Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jae-Yong Shim
- Department of Family Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
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14
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Mutual Interaction of Clinical Factors and Specific microRNAs to Predict Mild Cognitive Impairment in Patients Receiving Hemodialysis. Cells 2020; 9:cells9102303. [PMID: 33076478 PMCID: PMC7650531 DOI: 10.3390/cells9102303] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 10/12/2020] [Accepted: 10/13/2020] [Indexed: 01/06/2023] Open
Abstract
Cognitive impairment (CI) is not uncommon in dialysis patients. Various factors have been implicated. This study aims to examine mutual interaction of various clinical factors for CI in patients receiving hemodialysis. A total of 48 hemodialysis patients in outpatient clinic were recruited from 2015 to 2017. Demographics, circulating uremic toxin concentrations, miRNA concentrations, and nerve injury protein concentrations were collected. Clinical dementia rating (CDR) scores were used to stratify the functional scores of the patients. Receiver operating characteristic (ROC) analysis was used to evaluate diagnostic test performance for predicting dichotomous results, and cumulative ROC analysis was used to examine the combined contribution of clinical factors. CDR scale 0 included 15 patients (mean age, 59.1 years); CDR > 0.5 included 33 patients (mean age, 64.0 years). On cumulative ROC analysis, the major predictors of mild CI were hemoglobin, age, sex, homocysteine, neuron-specific enolase (NSE), and miR-486. The cumulative area under the curve (AUC) on combining hemoglobin, age, and miR-486 was the highest (0.897, 95% confidence interval 0.806–0.988). Two dichotomized variables reached 81.82% sensitivity and 86.67% specificity, with the likelihood ratio for positive and negative results being 6.14 and 0.21, respectively. In conclusion, hemoglobin, age, and miR-486 display high-degree combined effects on mild CI in patients receiving hemodialysis.
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Altersberger VL, Kellert L, Al Sultan AS, Martinez-Majander N, Hametner C, Eskandari A, Heldner MR, van den Berg SA, Zini A, Padjen V, Kägi G, Pezzini A, Polymeris A, DeMarchis GM, Tiainen M, Räty S, Nannoni S, Jung S, Zonneveld TP, Maffei S, Bonati L, Lyrer P, Sibolt G, Ringleb PA, Arnold M, Michel P, Curtze S, Nederkoorn PJ, Engelter ST, Gensicke H. Effect of haemoglobin levels on outcome in intravenous thrombolysis-treated stroke patients. Eur Stroke J 2020; 5:138-147. [PMID: 32637647 PMCID: PMC7313367 DOI: 10.1177/2396987319889468] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 10/21/2019] [Indexed: 01/28/2023] Open
Abstract
INTRODUCTION Alterations in haemoglobin levels are frequent in stroke patients. The prognostic meaning of anaemia and polyglobulia on outcomes in patients treated with intravenous thrombolysis is ambiguous. PATIENTS AND METHODS In this prospective multicentre, intravenous thrombolysis register-based study, we compared haemoglobin levels on hospital admission with three-month poor outcome (modified Rankin Scale 3-6), mortality and symptomatic intracranial haemorrhage (European Cooperative Acute Stroke Study II-criteria (ECASS-II-criteria)). Haemoglobin level was used as continuous and categorical variable distinguishing anaemia (female: <12 g/dl; male: <13 g/dl) and polyglobulia (female: >15.5 g/dl; male: >17 g/dl). Anaemia was subdivided into mild and moderate/severe (female/male: <11 g/dl). Normal haemoglobin level (female: 12.0-15.5 g/dl, male: 13.0-17.0 g/dl) served as reference group. Unadjusted and adjusted odds ratios with 95% confidence intervals were calculated with logistic regression models. RESULTS Among 6866 intravenous thrombolysis-treated stroke patients, 5448 (79.3%) had normal haemoglobin level, 1232 (17.9%) anaemia - of those 903 (13.2%) had mild and 329 (4.8%) moderate/severe anaemia - and 186 (2.7%) polyglobulia. Anaemia was associated with poor outcome (ORadjusted 1.25 (1.05-1.48)) and mortality (ORadjusted 1.58 (1.27-1.95)). In anaemia subgroups, both mild and moderate/severe anaemia independently predicted poor outcome (ORadjusted 1.29 (1.07-1.55) and 1.48 (1.09-2.02)) and mortality (ORadjusted 1.45 (1.15-1.84) and ORadjusted 2.00 (1.46-2.75)). Each haemoglobin level decrease by 1 g/dl independently increased the risk of poor outcome (ORadjusted 1.07 (1.02-1.11)) and mortality (ORadjusted 1.08 (1.02-1.15)). Anaemia was not associated with occurrence of symptomatic intracranial haemorrhage. Polyglobulia did not change any outcome. DISCUSSION The more severe the anaemia, the higher the probability of poor outcome and death. Severe anaemia might be a target for interventions in hyperacute stroke. CONCLUSION Anaemia on admission, but not polyglobulia, is a strong and independent predictor of poor outcome and mortality in intravenous thrombolysis-treated stroke patients.
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Affiliation(s)
- Valerian L Altersberger
- Stroke Center and Department of Neurology, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Lars Kellert
- Department of Neurology, Klinikum der Universität München, Ludwig-Maximilians-University, Munich, Germany
- Department of Neurology, University Hospital Heidelberg, Heidelberg, Germany
| | | | | | - Christian Hametner
- Department of Neurology, University Hospital Heidelberg, Heidelberg, Germany
| | - Ashraf Eskandari
- Department of Neurology, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland
| | - Mirjam R Heldner
- Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Sophie A van den Berg
- Department of Neurology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Andrea Zini
- Stroke Unit, Department of Neuroscience, Ospedale Civile S. Agostino-Estense, Modena University Hospital, Modena, Italy
| | - Visnja Padjen
- Neurology Clinic, Clinical Centre of Serbia, Beograd, Serbia
| | - Georg Kägi
- Department of Neurology, Kantonsspital St Gallen, St Gallen, Switzerland
| | - Alessandro Pezzini
- Department of Clinical and Experimental Sciences, Neurology Clinic, University of Brescia, Brescia, Italy
| | - Alexandros Polymeris
- Stroke Center and Department of Neurology, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Gian M DeMarchis
- Stroke Center and Department of Neurology, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Marjaana Tiainen
- Neurology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Silja Räty
- Neurology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Stefania Nannoni
- Department of Neurology, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland
| | - Simon Jung
- Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Thomas P Zonneveld
- Department of Neurology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Stefania Maffei
- Stroke Unit, Department of Neuroscience, Ospedale Civile S. Agostino-Estense, Modena University Hospital, Modena, Italy
| | - Leo Bonati
- Stroke Center and Department of Neurology, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Philippe Lyrer
- Stroke Center and Department of Neurology, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Gerli Sibolt
- Neurology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Peter A Ringleb
- Department of Neurology, University Hospital Heidelberg, Heidelberg, Germany
| | - Marcel Arnold
- Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Patrik Michel
- Department of Neurology, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland
| | - Sami Curtze
- Neurology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Paul J Nederkoorn
- Department of Neurology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Stefan T Engelter
- Stroke Center and Department of Neurology, University Hospital Basel and University of Basel, Basel, Switzerland
- Neurorehabilitation Unit, University of Basel and University Center for Medicine of Aging and Rehabilitation, Felix Platter Hospital, Basel, Switzerland
| | - Henrik Gensicke
- Stroke Center and Department of Neurology, University Hospital Basel and University of Basel, Basel, Switzerland
- Neurorehabilitation Unit, University of Basel and University Center for Medicine of Aging and Rehabilitation, Felix Platter Hospital, Basel, Switzerland
| | - for the Thrombolysis in Stroke Patients (TRISP) collaborators
- Stroke Center and Department of Neurology, University Hospital Basel and University of Basel, Basel, Switzerland
- Department of Neurology, Klinikum der Universität München, Ludwig-Maximilians-University, Munich, Germany
- Department of Neurology, University Hospital Heidelberg, Heidelberg, Germany
- Department of Clinical Neurosciences, University of Calgary, Calgary, Canada
- Neurology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Department of Neurology, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland
- Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
- Department of Neurology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
- Stroke Unit, Department of Neuroscience, Ospedale Civile S. Agostino-Estense, Modena University Hospital, Modena, Italy
- Neurology Clinic, Clinical Centre of Serbia, Beograd, Serbia
- Department of Neurology, Kantonsspital St Gallen, St Gallen, Switzerland
- Department of Clinical and Experimental Sciences, Neurology Clinic, University of Brescia, Brescia, Italy
- Neurorehabilitation Unit, University of Basel and University Center for Medicine of Aging and Rehabilitation, Felix Platter Hospital, Basel, Switzerland
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Abstract
PURPOSE To review the recent developments on the effect of chronic high mean arterial blood pressure (MAP) on cerebral blood flow (CBF) autoregulation and supporting the notion that CBF autoregulation impairment has connection with chronic cerebral diseases. Method: A narrative review of all the relevant papers known to the authors was conducted. Results: Our understanding of the connection between cerebral perfusion impairment and chronic high MAP and cerebral disease is rapidly evolving, from cerebral perfusion impairment being the result of cerebral diseases to being the cause of cerebral diseases. We now better understand the intertwined impact of hypertension and Alzheimer's disease (AD) on cerebrovascular sensory elements and recognize cerebrovascular elements that are more vulnerable to these diseases. Conclusion: We conclude with the suggestion that the sensory elements pathology plays important roles in intertwined mechanisms of chronic high MAP and AD that impact cerebral perfusion.
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Affiliation(s)
- Noushin Yazdani
- College of Public Health, University of South Florida , Tampa, FL, USA
| | - Mark S Kindy
- Department of Pharmaceutical Sciences, College of Pharmacy, University of South Florida , Tampa, FL, USA.,Biomedical Research, James A. Haley VA Medical Center , Tampa, FL, USA
| | - Saeid Taheri
- Department of Pharmaceutical Sciences, College of Pharmacy, University of South Florida , Tampa, FL, USA.,Byrd Neuroscience Institute, University of South Florida , Tampa, FL, USA
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Pu L, Zou Y, Wu SK, Wang F, Zhang Y, Li GS, Wang JW, Zhang LX, Zhao MH, Wang L. Prevalence and associated factors of depressive symptoms among chronic kidney disease patients in China: Results from the Chinese Cohort Study of Chronic Kidney Disease (C-STRIDE). J Psychosom Res 2020; 128:109869. [PMID: 31739085 DOI: 10.1016/j.jpsychores.2019.109869] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 11/06/2019] [Accepted: 11/09/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Depression is the most common mental disorder in patients with chronic kidney disease (CKD), and previous studies have found that: (a) depression can accelerate the progression of CKD; and (b) depression is an independent risk factor for hospitalization and death among patients with CKD. Therefore, the objective of the current study was to investigate the prevalence of depression in Chinese patients with CKD, and to identify variables associated with depression. METHODS The study analyzed baseline data from a multicenter prospective cohort study of Chinese patients with chronic kidney disease (the C-STRIDE study). In all, 2995 participants in CKD stages 1 to 4 who completed a survey of depressive symptoms were included in the analyses. Depressive symptoms were assessed by the Zung Self-Rating Depression Scale (ZSDS). A ZSDS ≥50 was used as the cut-off score for the presence of depressive symptoms. Multivariable logistic regression was used to identify variables associated with depression. RESULTS The mean estimated glomerular filtration rate (eGFR) in the study sample was 51.59±29.49 ml/min/1.73 m2. The prevalence of depressive symptoms was 37.8% and increased significantly with CKD stage. Being female, a higher level of education, a low income, a larger economic impact of disease cost, comorbid cardiovascular disease, anemia, and impaired physical ability were independently associated with depressive symptoms. CONCLUSION Our study revealed that depressive symptoms were common among patients with CKD in China. Sociodemographic variables and the clinical characteristics of disease severity were strongly associated with depressive symptoms.
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Affiliation(s)
- Lei Pu
- Renal Department and Institute of Nephrology, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu 610072, China; School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, China
| | - Yang Zou
- Renal Department and Institute of Nephrology, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu 610072, China; School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, China
| | - Shu-Kun Wu
- Renal Department and Institute of Nephrology, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu 610072, China; School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, China
| | - Fang Wang
- Renal Department and Institute of Nephrology, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu 610072, China; School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, China
| | - Yuan Zhang
- Renal Department and Institute of Nephrology, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu 610072, China; School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, China
| | - Gui-Sen Li
- Renal Department and Institute of Nephrology, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu 610072, China; School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, China
| | - Jing-Wei Wang
- Renal Division, Department of Medicine, Peking University First Hospital, Peking University Institute of Nephrology, Key Laboratory of Renal Disease, Ministry of Health of China, Key Laboratory of Chronic Kidney Disease Prevention and Treatment (Peking University), Ministry of Education, Beijing 100034, China
| | - Lu-Xia Zhang
- Renal Division, Department of Medicine, Peking University First Hospital, Peking University Institute of Nephrology, Key Laboratory of Renal Disease, Ministry of Health of China, Key Laboratory of Chronic Kidney Disease Prevention and Treatment (Peking University), Ministry of Education, Beijing 100034, China
| | - Ming-Hui Zhao
- Renal Division, Department of Medicine, Peking University First Hospital, Peking University Institute of Nephrology, Key Laboratory of Renal Disease, Ministry of Health of China, Key Laboratory of Chronic Kidney Disease Prevention and Treatment (Peking University), Ministry of Education, Beijing 100034, China
| | - Li Wang
- Renal Department and Institute of Nephrology, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu 610072, China; School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, China.
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Qin T, Yan M, Fu Z, Song Y, Lu W, Fu A, Yin P. Association between anemia and cognitive decline among Chinese middle-aged and elderly: evidence from the China health and retirement longitudinal study. BMC Geriatr 2019; 19:305. [PMID: 31718564 PMCID: PMC6849217 DOI: 10.1186/s12877-019-1308-7] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Accepted: 10/10/2019] [Indexed: 11/13/2022] Open
Abstract
Background Our objective was to characterize the relationship of anemia and hemoglobin concentrations with cross-sectional cognitive functions and changes in cognitive functions over 2 years in a large sample of Chinese middle aged and elderly. Methods Ten thousand nine hundred eighteen adults aged 45 years or older participating in the China Health and Retirement Longitudinal Study (CHARLS) were used for cross-sectional analyses and 9324 were used for longitudinal analysis. Cognitive functions were assessed by memory recall (episodic memory), mental status (TICS), and global cognitive function at baseline survey (Visit 1) and first follow-up survey (Visit 2). The lower the cognitive test score, the worse the cognitive function. Anemia was defined as hemoglobin concentrations lower than 13 g/dl for men and lower than 12 g/dl for women. Adjusted multivariate regression analyses were used to explore the relationships of different cognitive domains with anemia and hemoglobin concentration. Results Overall, the prevalence of anemia was 12.86% and the mean hemoglobin concentration was 14.37 ± 2.20 g/dl. After adjusting for socio-demographic and health-related covariates, the cross-sectional association between anemia and global cognitive function [β (95%CI) = − 0.49(− 0.69~ − 0.29)], episodic memory [β (95%CI) = − 0.14(− 0.23~ − 0.05)], and TICS [β (95%CI) = − 0.23(− 0.38~ − 0.08)] were significant and did not differ by gender. The hemoglobin concentration was also associated with global cognitive function among the whole sample (P < 0.05 for all). The longitudinal analyses showed global cognitive function and episodic memory were associated with anemia independent of covariates (P < 0.05 for all). Sensitivity analyses further provided significant results showing the association between anemia and cognition decline (P < 0.05). Conclusion There was a cross-sectional and longitudinal association between anemia and accelerated decline in cognitive functions in Chinese middle-aged and elderly. This suggests that anemia and low hemoglobin concentrations are independent risk factors of cognitive decline.
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Affiliation(s)
- Tingting Qin
- Department of Biliary-Pancreatic Surgery, Affiliated Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Mingming Yan
- Department of Epidemiology and Biostatistics and State Key Laboratory of Environment Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030, Hubei, China
| | - Zhen Fu
- Department of Epidemiology and Biostatistics and State Key Laboratory of Environment Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030, Hubei, China
| | - Yating Song
- Department of Epidemiology and Biostatistics and State Key Laboratory of Environment Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030, Hubei, China
| | - Wanrong Lu
- Department of Epidemiology and Biostatistics and State Key Laboratory of Environment Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030, Hubei, China
| | - A'dan Fu
- Department of Nursing, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, 26 Shengli Rd, Wuhan, 430014, Hubei, China.
| | - Ping Yin
- Department of Epidemiology and Biostatistics and State Key Laboratory of Environment Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030, Hubei, China.
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Kim YJ, Han KD, Cho KH, Kim YH, Park YG. Anemia and health-related quality of life in South Korea: data from the Korean national health and nutrition examination survey 2008-2016. BMC Public Health 2019; 19:735. [PMID: 31196013 PMCID: PMC6567528 DOI: 10.1186/s12889-019-6930-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 05/01/2019] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Anemia is associated with impaired quality of life (QoL). We examined the relationship between anemia and QoL in the Korean population using the EuroQol five-dimensional (EQ-5D) questionnaire. METHODS Data of 30,526 subjects were included from the Korean National Health and Nutrition Examination Survey (2008-2016). The QoL was assessed using three-levels of the EQ-5D questionnaire (G1, G2, and G3). Analysis of variance was used to compare the prevalence of anemia according to the three levels of health status in each of the five dimensions of EQ-5D. Multiple linear regression analysis was used to evaluate the association between hemoglobin level and QoL, and multivariable logistic regression analysis was used to evaluate the odds ratios (ORs) and 95% confidence intervals (CIs) for low levels of each of the five dimensions of EQ-5D. RESULTS As the level of EQ-5D was worse (from G1 to G3), the prevalence of anemia increased (p for trend < 0.001). Hemoglobin level and EQ-5D showed positive association after adjusting for all covariates such as age, sex, smoking, alcohol drinking, exercise, education, income, marital status, urban living, diabetes mellitus, hypertension, hypercholesterolemia, chronic kidney disease, total calorie intake, and protein intake. Subjects with anemia had increased ORs for low levels (G2 + G3) of each dimension of EQ-5D compared to subjects without anemia. ORs and 95% CIs for mobility, self-care, and usual activities were 1.208(1.078, 1.353), 1.161(0.98, 1.376), and 1.331(1.173, 1.51), respectively, after adjusting for all covariates. Pain/discomfort and anxiety/depression were not associated with increased ORs for low levels of EQ-5D. CONCLUSIONS In South Korea, low QoL was associated with anemia, particularly in the mobility, self-care, and usual activities dimensions of EQ-5D.
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Affiliation(s)
- Young-Ju Kim
- Department of Medical Lifescience, The Catholic University College of Medicine, 222, Banpo-daero, Seocho-gu, Seoul, 137-701, South Korea
| | - Kyung Do Han
- Department of Medical Lifescience, The Catholic University College of Medicine, 222, Banpo-daero, Seocho-gu, Seoul, 137-701, South Korea
| | - Kyung-Hwan Cho
- Department of Medical Lifescience, The Catholic University College of Medicine, 222, Banpo-daero, Seocho-gu, Seoul, 137-701, South Korea
| | - Yang-Hyun Kim
- Department of Family Medicine, Korea University College of Medicine, 73 Inchon-ro, Seoungbuk-Gu, Seoul, 136-705, South Korea
| | - Yong-Gyu Park
- Department of Medical Statistics, The Catholic University College of Medicine, 222, Banpo-daero, Seocho-gu, Seoul, 137-701, South Korea.
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Clement P, Mutsaerts HJ, Václavů L, Ghariq E, Pizzini FB, Smits M, Acou M, Jovicich J, Vanninen R, Kononen M, Wiest R, Rostrup E, Bastos-Leite AJ, Larsson EM, Achten E. Variability of physiological brain perfusion in healthy subjects - A systematic review of modifiers. Considerations for multi-center ASL studies. J Cereb Blood Flow Metab 2018; 38:1418-1437. [PMID: 28393659 PMCID: PMC6120130 DOI: 10.1177/0271678x17702156] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Quantitative measurements of brain perfusion are influenced by perfusion-modifiers. Standardization of measurement conditions and correction for important modifiers is essential to improve accuracy and to facilitate the interpretation of perfusion-derived parameters. An extensive literature search was carried out for factors influencing quantitative measurements of perfusion in the human brain unrelated to medication use. A total of 58 perfusion modifiers were categorized into four groups. Several factors (e.g., caffeine, aging, and blood gases) were found to induce a considerable effect on brain perfusion that was consistent across different studies; for other factors, the modifying effect was found to be debatable, due to contradictory results or lack of evidence. Using the results of this review, we propose a standard operating procedure, based on practices already implemented in several research centers. Also, a theory of 'deep MRI physiotyping' is inferred from the combined knowledge of factors influencing brain perfusion as a strategy to reduce variance by taking both personal information and the presence or absence of perfusion modifiers into account. We hypothesize that this will allow to personalize the concept of normality, as well as to reach more rigorous and earlier diagnoses of brain disorders.
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Affiliation(s)
- Patricia Clement
- 1 Department of Radiology and nuclear medicine, Ghent University, Ghent, Belgium
| | - Henk-Jan Mutsaerts
- 2 Cognitive Neurology Research Unit, Sunnybrook Healthy Sciences Centre, Toronto, Canada.,3 Academic Medical Center, Amsterdam, the Netherlands
| | - Lena Václavů
- 3 Academic Medical Center, Amsterdam, the Netherlands
| | - Eidrees Ghariq
- 4 Leiden University Medical Center, Leiden, the Netherlands
| | | | | | - Marjan Acou
- 1 Department of Radiology and nuclear medicine, Ghent University, Ghent, Belgium
| | - Jorge Jovicich
- 7 Magnetic Resonance Imaging Laboratory Center for Mind/Brain Sciences, University of Trento, Mattarello, Italy
| | | | | | | | - Egill Rostrup
- 10 Department of Diagnostics, Glostrup Hospital, University of Copenhagen, Denmark
| | | | | | - Eric Achten
- 1 Department of Radiology and nuclear medicine, Ghent University, Ghent, Belgium
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21
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Liu HS, Hartung EA, Jawad AF, Ware JB, Laney N, Port AM, Gur RC, Hooper SR, Radcliffe J, Furth SL, Detre JA. Regional Cerebral Blood Flow in Children and Young Adults with Chronic Kidney Disease. Radiology 2018; 288:849-858. [PMID: 29893643 DOI: 10.1148/radiol.2018171339] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Purpose To investigate the pathophysiologic effects of chronic kidney disease (CKD) on brain function in children with CKD by correlating cerebral blood flow (CBF) with clinical and behavioral indexes. Materials and Methods In this prospective study, 73 pediatric patients with CKD (mean age, 15.80 years ± 3.63; range, 9-25 years) and 57 control subjects (mean age, 15.65 years ± 3.76; range, 9-25 years) were recruited. CBF measurements were acquired with an MRI arterial spin labeling scheme. Neurocognitive measurements were performed with traditional and computerized neurocognitive batteries. Clinical data were also collected. Group-level global and regional CBF differences between patients with CKD and control subjects were assessed. Regression analyses were conducted to evaluate the associations among regional CBF, clinical variables, and cognitive performance. Results Patients with CKD showed higher global CBF compared with control subjects that was attributable to reduced hematocrit level (mean, 60.2 mL/100 g/min ± 9.0 vs 56.5 mL/100 g/min ± 8.0, respectively). White matter CBF showed correlation with blood pressure (r = 0.244, P = .039), a finding suggestive of altered cerebrovascular autoregulation. Regional CBF differences between patients and control subjects included regions in the "default mode" network. In patients with CKD, positive extrema in the precuneus showed a strong correlation with executive function (ρ = 0.608, P = .001). Conclusion Systemic effects of estimated glomerular filtration rate, hematocrit level, and blood pressure on CBF and alterations in regional CBF may reflect impaired brain function underlying neurocognitive symptoms in CKD. These findings further characterize the nature of alterations in brain physiologic features in children, adolescents, and young adults with CKD.
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Affiliation(s)
- Hua-Shan Liu
- From the School of Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei, Taiwan; Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pa; International Ph.D. Program in Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei, Taiwan; Research Center of Translational Imaging, College of Medicine, Taipei Medical University, Taipei, Taiwan (H.S.L.); Division of Nephrology, Department of Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pa (E.A.H.); Department of Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pa (A.F.J.); Department of Radiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pa (J.B.W.); Division of Nephrology, Children's Hospital of Philadelphia, Philadelphia, Pa (N.L.); Brain Behavior Laboratory, Department of Psychiatry, University of Pennsylvania, Philadelphia, Pa (A.M.P.); Brain Behavior Laboratory, Department of Psychiatry, University of Pennsylvania, Philadelphia, Pa (R.C.G.); Department of Allied Health Sciences, University of North Carolina School of Medicine, Chapel Hill, NC (S.R.H.); Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pa (J.R.); Division of Nephrology, Departments of Pediatrics and Epidemiology, Perelman School of Medicine at the University of Pennsylvania; Division of Nephrology, Children's Hospital of Philadelphia, Philadelphia, Pa (S.L.F.); and Departments of Neurology and Radiology, Perelman School of Medicine at the University of Pennsylvania, 3W Gates Pavilion, 3400 Spruce St, Philadelphia, PA 19104 (J.A.D.)
| | - Erum A Hartung
- From the School of Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei, Taiwan; Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pa; International Ph.D. Program in Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei, Taiwan; Research Center of Translational Imaging, College of Medicine, Taipei Medical University, Taipei, Taiwan (H.S.L.); Division of Nephrology, Department of Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pa (E.A.H.); Department of Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pa (A.F.J.); Department of Radiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pa (J.B.W.); Division of Nephrology, Children's Hospital of Philadelphia, Philadelphia, Pa (N.L.); Brain Behavior Laboratory, Department of Psychiatry, University of Pennsylvania, Philadelphia, Pa (A.M.P.); Brain Behavior Laboratory, Department of Psychiatry, University of Pennsylvania, Philadelphia, Pa (R.C.G.); Department of Allied Health Sciences, University of North Carolina School of Medicine, Chapel Hill, NC (S.R.H.); Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pa (J.R.); Division of Nephrology, Departments of Pediatrics and Epidemiology, Perelman School of Medicine at the University of Pennsylvania; Division of Nephrology, Children's Hospital of Philadelphia, Philadelphia, Pa (S.L.F.); and Departments of Neurology and Radiology, Perelman School of Medicine at the University of Pennsylvania, 3W Gates Pavilion, 3400 Spruce St, Philadelphia, PA 19104 (J.A.D.)
| | - Abbas F Jawad
- From the School of Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei, Taiwan; Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pa; International Ph.D. Program in Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei, Taiwan; Research Center of Translational Imaging, College of Medicine, Taipei Medical University, Taipei, Taiwan (H.S.L.); Division of Nephrology, Department of Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pa (E.A.H.); Department of Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pa (A.F.J.); Department of Radiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pa (J.B.W.); Division of Nephrology, Children's Hospital of Philadelphia, Philadelphia, Pa (N.L.); Brain Behavior Laboratory, Department of Psychiatry, University of Pennsylvania, Philadelphia, Pa (A.M.P.); Brain Behavior Laboratory, Department of Psychiatry, University of Pennsylvania, Philadelphia, Pa (R.C.G.); Department of Allied Health Sciences, University of North Carolina School of Medicine, Chapel Hill, NC (S.R.H.); Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pa (J.R.); Division of Nephrology, Departments of Pediatrics and Epidemiology, Perelman School of Medicine at the University of Pennsylvania; Division of Nephrology, Children's Hospital of Philadelphia, Philadelphia, Pa (S.L.F.); and Departments of Neurology and Radiology, Perelman School of Medicine at the University of Pennsylvania, 3W Gates Pavilion, 3400 Spruce St, Philadelphia, PA 19104 (J.A.D.)
| | - Jeffrey B Ware
- From the School of Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei, Taiwan; Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pa; International Ph.D. Program in Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei, Taiwan; Research Center of Translational Imaging, College of Medicine, Taipei Medical University, Taipei, Taiwan (H.S.L.); Division of Nephrology, Department of Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pa (E.A.H.); Department of Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pa (A.F.J.); Department of Radiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pa (J.B.W.); Division of Nephrology, Children's Hospital of Philadelphia, Philadelphia, Pa (N.L.); Brain Behavior Laboratory, Department of Psychiatry, University of Pennsylvania, Philadelphia, Pa (A.M.P.); Brain Behavior Laboratory, Department of Psychiatry, University of Pennsylvania, Philadelphia, Pa (R.C.G.); Department of Allied Health Sciences, University of North Carolina School of Medicine, Chapel Hill, NC (S.R.H.); Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pa (J.R.); Division of Nephrology, Departments of Pediatrics and Epidemiology, Perelman School of Medicine at the University of Pennsylvania; Division of Nephrology, Children's Hospital of Philadelphia, Philadelphia, Pa (S.L.F.); and Departments of Neurology and Radiology, Perelman School of Medicine at the University of Pennsylvania, 3W Gates Pavilion, 3400 Spruce St, Philadelphia, PA 19104 (J.A.D.)
| | - Nina Laney
- From the School of Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei, Taiwan; Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pa; International Ph.D. Program in Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei, Taiwan; Research Center of Translational Imaging, College of Medicine, Taipei Medical University, Taipei, Taiwan (H.S.L.); Division of Nephrology, Department of Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pa (E.A.H.); Department of Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pa (A.F.J.); Department of Radiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pa (J.B.W.); Division of Nephrology, Children's Hospital of Philadelphia, Philadelphia, Pa (N.L.); Brain Behavior Laboratory, Department of Psychiatry, University of Pennsylvania, Philadelphia, Pa (A.M.P.); Brain Behavior Laboratory, Department of Psychiatry, University of Pennsylvania, Philadelphia, Pa (R.C.G.); Department of Allied Health Sciences, University of North Carolina School of Medicine, Chapel Hill, NC (S.R.H.); Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pa (J.R.); Division of Nephrology, Departments of Pediatrics and Epidemiology, Perelman School of Medicine at the University of Pennsylvania; Division of Nephrology, Children's Hospital of Philadelphia, Philadelphia, Pa (S.L.F.); and Departments of Neurology and Radiology, Perelman School of Medicine at the University of Pennsylvania, 3W Gates Pavilion, 3400 Spruce St, Philadelphia, PA 19104 (J.A.D.)
| | - Allison M Port
- From the School of Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei, Taiwan; Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pa; International Ph.D. Program in Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei, Taiwan; Research Center of Translational Imaging, College of Medicine, Taipei Medical University, Taipei, Taiwan (H.S.L.); Division of Nephrology, Department of Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pa (E.A.H.); Department of Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pa (A.F.J.); Department of Radiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pa (J.B.W.); Division of Nephrology, Children's Hospital of Philadelphia, Philadelphia, Pa (N.L.); Brain Behavior Laboratory, Department of Psychiatry, University of Pennsylvania, Philadelphia, Pa (A.M.P.); Brain Behavior Laboratory, Department of Psychiatry, University of Pennsylvania, Philadelphia, Pa (R.C.G.); Department of Allied Health Sciences, University of North Carolina School of Medicine, Chapel Hill, NC (S.R.H.); Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pa (J.R.); Division of Nephrology, Departments of Pediatrics and Epidemiology, Perelman School of Medicine at the University of Pennsylvania; Division of Nephrology, Children's Hospital of Philadelphia, Philadelphia, Pa (S.L.F.); and Departments of Neurology and Radiology, Perelman School of Medicine at the University of Pennsylvania, 3W Gates Pavilion, 3400 Spruce St, Philadelphia, PA 19104 (J.A.D.)
| | - Ruben C Gur
- From the School of Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei, Taiwan; Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pa; International Ph.D. Program in Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei, Taiwan; Research Center of Translational Imaging, College of Medicine, Taipei Medical University, Taipei, Taiwan (H.S.L.); Division of Nephrology, Department of Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pa (E.A.H.); Department of Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pa (A.F.J.); Department of Radiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pa (J.B.W.); Division of Nephrology, Children's Hospital of Philadelphia, Philadelphia, Pa (N.L.); Brain Behavior Laboratory, Department of Psychiatry, University of Pennsylvania, Philadelphia, Pa (A.M.P.); Brain Behavior Laboratory, Department of Psychiatry, University of Pennsylvania, Philadelphia, Pa (R.C.G.); Department of Allied Health Sciences, University of North Carolina School of Medicine, Chapel Hill, NC (S.R.H.); Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pa (J.R.); Division of Nephrology, Departments of Pediatrics and Epidemiology, Perelman School of Medicine at the University of Pennsylvania; Division of Nephrology, Children's Hospital of Philadelphia, Philadelphia, Pa (S.L.F.); and Departments of Neurology and Radiology, Perelman School of Medicine at the University of Pennsylvania, 3W Gates Pavilion, 3400 Spruce St, Philadelphia, PA 19104 (J.A.D.)
| | - Stephen R Hooper
- From the School of Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei, Taiwan; Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pa; International Ph.D. Program in Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei, Taiwan; Research Center of Translational Imaging, College of Medicine, Taipei Medical University, Taipei, Taiwan (H.S.L.); Division of Nephrology, Department of Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pa (E.A.H.); Department of Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pa (A.F.J.); Department of Radiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pa (J.B.W.); Division of Nephrology, Children's Hospital of Philadelphia, Philadelphia, Pa (N.L.); Brain Behavior Laboratory, Department of Psychiatry, University of Pennsylvania, Philadelphia, Pa (A.M.P.); Brain Behavior Laboratory, Department of Psychiatry, University of Pennsylvania, Philadelphia, Pa (R.C.G.); Department of Allied Health Sciences, University of North Carolina School of Medicine, Chapel Hill, NC (S.R.H.); Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pa (J.R.); Division of Nephrology, Departments of Pediatrics and Epidemiology, Perelman School of Medicine at the University of Pennsylvania; Division of Nephrology, Children's Hospital of Philadelphia, Philadelphia, Pa (S.L.F.); and Departments of Neurology and Radiology, Perelman School of Medicine at the University of Pennsylvania, 3W Gates Pavilion, 3400 Spruce St, Philadelphia, PA 19104 (J.A.D.)
| | - Jerilynn Radcliffe
- From the School of Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei, Taiwan; Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pa; International Ph.D. Program in Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei, Taiwan; Research Center of Translational Imaging, College of Medicine, Taipei Medical University, Taipei, Taiwan (H.S.L.); Division of Nephrology, Department of Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pa (E.A.H.); Department of Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pa (A.F.J.); Department of Radiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pa (J.B.W.); Division of Nephrology, Children's Hospital of Philadelphia, Philadelphia, Pa (N.L.); Brain Behavior Laboratory, Department of Psychiatry, University of Pennsylvania, Philadelphia, Pa (A.M.P.); Brain Behavior Laboratory, Department of Psychiatry, University of Pennsylvania, Philadelphia, Pa (R.C.G.); Department of Allied Health Sciences, University of North Carolina School of Medicine, Chapel Hill, NC (S.R.H.); Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pa (J.R.); Division of Nephrology, Departments of Pediatrics and Epidemiology, Perelman School of Medicine at the University of Pennsylvania; Division of Nephrology, Children's Hospital of Philadelphia, Philadelphia, Pa (S.L.F.); and Departments of Neurology and Radiology, Perelman School of Medicine at the University of Pennsylvania, 3W Gates Pavilion, 3400 Spruce St, Philadelphia, PA 19104 (J.A.D.)
| | - Susan L Furth
- From the School of Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei, Taiwan; Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pa; International Ph.D. Program in Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei, Taiwan; Research Center of Translational Imaging, College of Medicine, Taipei Medical University, Taipei, Taiwan (H.S.L.); Division of Nephrology, Department of Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pa (E.A.H.); Department of Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pa (A.F.J.); Department of Radiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pa (J.B.W.); Division of Nephrology, Children's Hospital of Philadelphia, Philadelphia, Pa (N.L.); Brain Behavior Laboratory, Department of Psychiatry, University of Pennsylvania, Philadelphia, Pa (A.M.P.); Brain Behavior Laboratory, Department of Psychiatry, University of Pennsylvania, Philadelphia, Pa (R.C.G.); Department of Allied Health Sciences, University of North Carolina School of Medicine, Chapel Hill, NC (S.R.H.); Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pa (J.R.); Division of Nephrology, Departments of Pediatrics and Epidemiology, Perelman School of Medicine at the University of Pennsylvania; Division of Nephrology, Children's Hospital of Philadelphia, Philadelphia, Pa (S.L.F.); and Departments of Neurology and Radiology, Perelman School of Medicine at the University of Pennsylvania, 3W Gates Pavilion, 3400 Spruce St, Philadelphia, PA 19104 (J.A.D.)
| | - John A Detre
- From the School of Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei, Taiwan; Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pa; International Ph.D. Program in Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei, Taiwan; Research Center of Translational Imaging, College of Medicine, Taipei Medical University, Taipei, Taiwan (H.S.L.); Division of Nephrology, Department of Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pa (E.A.H.); Department of Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pa (A.F.J.); Department of Radiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pa (J.B.W.); Division of Nephrology, Children's Hospital of Philadelphia, Philadelphia, Pa (N.L.); Brain Behavior Laboratory, Department of Psychiatry, University of Pennsylvania, Philadelphia, Pa (A.M.P.); Brain Behavior Laboratory, Department of Psychiatry, University of Pennsylvania, Philadelphia, Pa (R.C.G.); Department of Allied Health Sciences, University of North Carolina School of Medicine, Chapel Hill, NC (S.R.H.); Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pa (J.R.); Division of Nephrology, Departments of Pediatrics and Epidemiology, Perelman School of Medicine at the University of Pennsylvania; Division of Nephrology, Children's Hospital of Philadelphia, Philadelphia, Pa (S.L.F.); and Departments of Neurology and Radiology, Perelman School of Medicine at the University of Pennsylvania, 3W Gates Pavilion, 3400 Spruce St, Philadelphia, PA 19104 (J.A.D.)
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Urback AL, Metcalfe AWS, Korczak DJ, MacIntosh BJ, Goldstein BI. Magnetic resonance imaging of cerebrovascular reactivity in healthy adolescents. J Neurosci Methods 2018; 306:1-9. [PMID: 29879447 DOI: 10.1016/j.jneumeth.2018.06.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 05/24/2018] [Accepted: 06/02/2018] [Indexed: 10/14/2022]
Abstract
BACKGROUND Cerebrovascular reactivity (CVR), an important measure of cerebrovascular health in adults, has not been examined in healthy adolescents. Beyond the direct importance of understanding CVR in healthy youth, studies on this topic can yield insights regarding brain disease. We set out to evaluate 3 different CVR modelling approaches. NEW METHOD Thirty-nine healthy adolescents (ages 13-19 years, 20 females) completed six blocks of 15-second breath-holds separated by 30-second blocks of free-breathing. CVR was measured using blood-oxygenation-level dependent functional magnetic resonance imaging at 3-Tesla; voxel-wise analyses were complemented by regional analyses in five major subdivisions of the brain. Hemodynamic response functions were modelled using: (1) an individualized delay term (double-gamma variate convolved with a boxcar function), (2) with a standard 9-second delay term, and (3) a sine-cosine regressor. RESULTS Individual-delay yielded superior model fit or larger cluster volumes. Regional analysis found differences in CVR and time-to-peak CVR. Males had higher brain-wide CVR in comparison to females (p = 0.025, η2part = 0.345). BMI and blood pressure were not significantly associated with CVR (all p > 0.4). COMPARISON WITH EXISTING METHODS This was the first study to compare these methods in youth. Regional differences were similar to adult studies. CONCLUSIONS These findings lend support to future breath-hold CVR studies in youth, and highlight the merit of applying individualized-delay estimates. Regional variability and sex-related differences in CVR suggest that these variables should be considered in future studies, particularly those that examine disease states with predilection for specific brain regions or those diseases characterized by sex differences.
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Affiliation(s)
- Adam L Urback
- Department of Psychiatry, Sunnybrook Health Sciences Centre, 2075 Bayview Ave., FG-53, Toronto, ON, M4N 3M5, Canada; Department of Pharmacology, University of Toronto, Medicine, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada.
| | - Arron W S Metcalfe
- Department of Psychiatry, Sunnybrook Health Sciences Centre, 2075 Bayview Ave., FG-53, Toronto, ON, M4N 3M5, Canada; Canadian Partnership for Stroke Recovery, Sunnybrook Health Sciences Centre, 2075 Bayview Ave., Room M6 180, Toronto, ON, M4N 3M5, Canada.
| | - Daphne J Korczak
- Department of Psychiatry, University of Toronto, Medicine, 250 College Street, Room 835, Toronto, ON, M5T 1R8, Canada; Department of Psychiatry, Hospital For Sick Children, 555 University Avenue, Room 1145, Elm Wing, Toronto, ON, M5G 1X8, Canada.
| | - Bradley J MacIntosh
- Canadian Partnership for Stroke Recovery, Sunnybrook Health Sciences Centre, 2075 Bayview Ave., Room M6 180, Toronto, ON, M4N 3M5, Canada; University of Toronto, Department of Medical Biophysics, 101 College Street Suite 15-701, Toronto, ON, M5G 1L7, Canada.
| | - Benjamin I Goldstein
- Department of Psychiatry, Sunnybrook Health Sciences Centre, 2075 Bayview Ave., FG-53, Toronto, ON, M4N 3M5, Canada; Department of Pharmacology, University of Toronto, Medicine, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada; Department of Psychiatry, University of Toronto, Medicine, 250 College Street, Room 835, Toronto, ON, M5T 1R8, Canada.
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Chen-Edinboro LP, Murray-Kolb LE, Simonsick EM, Ferrucci L, Allen R, Payne ME, Spira AP. Association Between Non-Iron-Deficient Anemia and Insomnia Symptoms in Community-Dwelling Older Adults: The Baltimore Longitudinal Study of Aging. J Gerontol A Biol Sci Med Sci 2018; 73:380-385. [PMID: 28329301 PMCID: PMC5861876 DOI: 10.1093/gerona/glw332] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Accepted: 12/13/2016] [Indexed: 11/14/2022] Open
Abstract
Background Anemia is associated with poorer sleep in children, and clinically, anemia is linked to insomnia. However, the association between anemia and insomnia in older adults is understudied. Methods We examined the cross-sectional association between anemia and insomnia in 1,053 adults (71.4 ± 10.6 years) in the Baltimore Longitudinal Study of Aging. Participants were classified as nonanemic, non-iron-deficient anemic, or iron-deficient anemic based on hemoglobin, ferritin, transferrin saturation, and mean cell volume. Insomnia symptoms were evaluated by the Women's Health Initiative Insomnia Rating Scale (WHIIRS). A total score (range 0-20) was generated, and participants were also classified as having 0, 1, or 2+ symptoms. Results Overall, 10.5% of participants had non-iron-deficient anemia, 0.9% had iron-deficient anemia, and 88.5% had no anemia. Due to its low prevalence, the iron-deficient anemic group was dropped from analyses. In models adjusted for demographics, number of medical conditions, and Center for Epidemiologic Studies Depression Scale score, non-iron-deficient anemic individuals had significantly higher WHIIRS total scores, indicating greater insomnia severity, compared to those without anemia (predicted adjusted mean WHIIRS of 7.24 [95% confidence interval (CI): 6.40-8.08] vs 5.92 [95% CI: 5.65-6.19]). They also had twice the risk of reporting ≥2 insomnia symptoms (vs 0 symptoms; relative risk ratio = 2.20, 95% CI: 1.25-3.89). Conclusions Results suggest that individuals with non-iron-deficient anemia are more likely to experience insomnia symptoms than those who are nonanemic. These results may have implications for insomnia treatment or the identification of underlying frailty in individuals with sleep problems.
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Affiliation(s)
- Lenis P Chen-Edinboro
- School of Health and Applied Human Sciences, University of North Carolina Wilmington
| | - Laura E Murray-Kolb
- Department of Nutritional Sciences, The Pennsylvania State University, University Park
| | - Eleanor M Simonsick
- Intramural Research Program, National Institute on Aging, Baltimore, Maryland
| | - Luigi Ferrucci
- Intramural Research Program, National Institute on Aging, Baltimore, Maryland
| | - Richard Allen
- Department of Neurology, Johns Hopkins University, Baltimore, Maryland
| | - Martha E Payne
- Office of Research Development, Duke University School of Medicine, Durham, North Carolina
| | - Adam P Spira
- Department of Mental Health, Johns Hopkins University, Baltimore, Maryland
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, Maryland
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Akpinar CK, Gurkas E, Aytac E. Moderate to Severe Anemia Is Associated with Poor Functional Outcome in Acute Stroke Patients Treated with Mechanical Thrombectomy. INTERVENTIONAL NEUROLOGY 2017; 7:12-18. [PMID: 29628940 DOI: 10.1159/000480642] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Background Anemia will negatively affect cerebral collaterals and penumbra. Eventually, it may cause worse clinical outcomes and even increase mortality rates in stroke patients. Anemia has recently been suggested to be an independent risk factor for ischemic stroke. Therefore, we aimed to investigate the effects of the presence of anemia on clinical outcomes in ischemic stroke patients undergoing mechanical thrombectomy. Methods This was a retrospective study involving the prospectively and consecutively collected data of 90 adult patients between January 2015 and August 2016. Hemoglobin (Hb) cutoff levels were accepted as 12 g/dL for women and 13 g/dL for men. Patients having anemia were further divided into three subgroups as severe anemia (Hb <8 g/dL for both genders), moderate anemia (Hb <10 g/dL for both genders), and mild anemia (Hb <13 g/dL for men and Hb <12 g/dL for women). Results Forty of the subjects (44.4%) had anemia. Moderate anemia was detected in 14 out of 90 patients (15.5%) and severe anemia was found in only four of them (4.4%). Poor functional outcome (mRS 3-6) was similar in both anemic and non-anemic patients (37.5% vs. 38%, respectively, p = 0.08), but poor functional outcome was found to be statistically significant with severe anemic group (Hb <8 mg/dL) (p = 0.003). In multiple logistic regression analysis, moderate and severe anemia has been found to increase the mortality (p = 0.032). Conclusions Our study demonstrated a poor functional outcome only in moderate to severe anemic patients. Clinicians should keep in mind the negative effect of moderate to severe anemia in the clinical course of acute stroke patients treated with mechanical thrombectomy.
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Affiliation(s)
| | - Erdem Gurkas
- Neurology Clinic, Gulhane Training and Research Hospital, Ankara, Turkey
| | - Emrah Aytac
- Neurology, Medical Faculty, Firat University, Elazig, Turkey
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Su YC, Lim SN, Yang FY, Lin SK. Evaluation of cerebral blood flow in acute ischemic stroke patients with atrial fibrillation: A sonographic study. J Formos Med Assoc 2017; 116:287-294. [DOI: 10.1016/j.jfma.2016.05.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Revised: 04/22/2016] [Accepted: 05/16/2016] [Indexed: 11/30/2022] Open
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Shen Z, Ruan Q, Yu Z, Sun Z. Chronic kidney disease-related physical frailty and cognitive impairment: a systemic review. Geriatr Gerontol Int 2017; 17:529-544. [PMID: 27240548 DOI: 10.1111/ggi.12758] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Accepted: 01/12/2016] [Indexed: 11/28/2022]
Abstract
AIM The objective of this review was to assess chronic kidney disease-related frailty and cognitive impairment, as well as their probable causes, mechanisms and the interventions. METHODS Studies from 1990 to 2015 were reviewed to evaluate the relationship between chronic kidney disease and physical frailty and cognitive impairment. Of the 1694 studies from the initial search, longitudinal studies (n = 22) with the keywords "Cognitive and CKD" and longitudinal or cross-sectional studies (n = 5) with the keywords "Frailty and CKD" were included in final analysis. RESULTS By pooling current research, we show clear evidence for a relationship between chronic kidney disease and frailty and cognitive impairment in major studies. Vascular disease is likely an important mediator, particularly for cognitive impairment. However, non-vascular factors also play an important role. Many of the other mechanisms that contribute to impaired cognitive function and increased frailty in CKD remain to be elucidated. In limited studies, medication therapy did not obtain the ideal effect. There are limited data on treatment strategies, but addressing the vascular disease risk factors earlier in life might decrease the subsequent burden of frailty and cognitive impairment in this population. Multidimensional interventions, which address both microvascular health and other factors, may have substantial benefits for both the cognitive impairments and physical frailty in this vulnerable population. CONCLUSIONS Chronic kidney disease is a potential cause of frailty and cognitive impairment. Vascular and non-vascular factors are the possible causes. The mechanism of chronic kidney disease-induced physical frailty and cognitive impairment suggests that multidimensional interventions may be effective therapeutic strategies in the early stage of chronic kidney disease. Geriatr Gerontol Int 2017; 17: 529-544.
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Affiliation(s)
- Zhiyuan Shen
- Department of Urology, Huadong Hospital, Fudan University, 221 West Yan'an Road, Shanghai, China
| | - Qingwei Ruan
- Shanghai Institute of Geriatrics and Gerontology, Shanghai Key Laboratory of Clinical Geriatrics, Department of Geriatrics, Huadong Hospital, and Research Center of Aging and Medicine, Shanghai Medical College, Fudan University, Shanghai, China
| | - Zhuowei Yu
- Shanghai Institute of Geriatrics and Gerontology, Shanghai Key Laboratory of Clinical Geriatrics, Department of Geriatrics, Huadong Hospital, and Research Center of Aging and Medicine, Shanghai Medical College, Fudan University, Shanghai, China
| | - Zhongquan Sun
- Department of Urology, Huadong Hospital, Fudan University, 221 West Yan'an Road, Shanghai, China
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27
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Nissen M, Cernaianu G, Thränhardt R, Vahdad MR, Barenberg K, Tröbs RB. Does metabolic alkalosis influence cerebral oxygenation in infantile hypertrophic pyloric stenosis? J Surg Res 2017; 212:229-237. [PMID: 28550912 DOI: 10.1016/j.jss.2017.01.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2016] [Revised: 12/30/2016] [Accepted: 01/19/2017] [Indexed: 01/08/2023]
Abstract
BACKGROUND This pilot study focuses on regional tissue oxygenation (rSO2) in patients with infantile hypertrophic pyloric stenosis in a perioperative setting. To investigate the influence of enhanced metabolic alkalosis (MA) on cerebral (c-rSO2) and renal (r-rSO2) tissue oxygenation, two-site near-infrared spectroscopy (NIRS) technology was applied. MATERIALS AND METHODS Perioperative c-rSO2, r-rSO2, capillary blood gases, and electrolytes from 12 infants were retrospectively compared before and after correction of MA at admission (T1), before surgery (T2), and after surgery (T3). RESULTS Correction of MA was associated with an alteration of cerebral oxygenation without affecting renal oxygenation. When compared to T1, 5-min mean (± standard deviation) c-rSO2 increased after correction of MA at T2 (72.74 ± 4.60% versus 77.89 ± 5.84%; P = 0.058), reaching significance at T3 (80.79 ± 5.29%; P = 0.003). Furthermore, relative 30-min c-rSO2 values at first 3 h of metabolic compensation were significantly lowered compared with postsurgical states at 16 and 24 h. Cerebral oxygenation was positively correlated with levels of sodium (r = 0.37; P = 0.03) and inversely correlated with levels of bicarbonate (r = -0.34; P = 0.05) and base excess (r = -0.36; P = 0.04). Analysis of preoperative and postoperative cerebral and renal hypoxic burden yielded no differences. However, a negative correlation (r = -0.40; P = 0.03) regarding hematocrite and mean r-rSO2, indirectly indicative of an increased renal blood flow under hemodilution, was obtained. CONCLUSIONS NIRS seems suitable for the detection of a transiently impaired cerebral oxygenation under state of pronounced MA in infants with infantile hypertrophic pyloric stenosis. Correction of MA led to normalization of c-rSO2. NIRS technology constitutes a promising tool for optimizing perioperative management, especially in the context of a possible diminished neurodevelopmental outcome after pyloromyotomy.
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Affiliation(s)
- Matthias Nissen
- Department of Pediatric Surgery, St. Mary's Hospital, St. Elisabeth Group, Ruhr-University of Bochum, Herne, Germany.
| | - Grigore Cernaianu
- Department of Pediatrics and Adolescent Medicine, Pediatric Surgery, University of Cologne, Cologne, Germany
| | - Rene Thränhardt
- Department of Pediatric Surgery, St. Mary's Hospital, St. Elisabeth Group, Ruhr-University of Bochum, Herne, Germany
| | - Mohammad R Vahdad
- Department of Pediatric Surgery, University Hospital Giessen/Marburg, Marburg, Germany
| | - Karin Barenberg
- Department of Pediatric Surgery, St. Mary's Hospital, St. Elisabeth Group, Ruhr-University of Bochum, Herne, Germany
| | - Ralf-Bodo Tröbs
- Department of Pediatric Surgery, St. Mary's Hospital, St. Elisabeth Group, Ruhr-University of Bochum, Herne, Germany
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28
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Vulser H, Wiernik E, Hoertel N, Thomas F, Pannier B, Czernichow S, Hanon O, Simon T, Simon JM, Danchin N, Limosin F, Lemogne C. Association between depression and anemia in otherwise healthy adults. Acta Psychiatr Scand 2016; 134:150-60. [PMID: 27238642 DOI: 10.1111/acps.12595] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/28/2016] [Indexed: 12/11/2022]
Abstract
OBJECTIVE It remains debated whether anemia is associated with depression, independently of physical health factors. We report a large-scale cross-sectional study examining this association in adults free of chronic disease and medication from the general population. METHOD Hemoglobin levels were measured among 44 173 healthy participants [63% men; mean [standard deviation] age = 38.4 (11.1) years] from the 'Investigations Préventives et Cliniques' (IPC) cohort study. Depression was measured with the Questionnaire of Depression 2nd version, Abridged. Logistic regression analyses were performed to examine the association between anemia and depression, while adjusting for a wide range of sociodemographic characteristics and health-related factors (i.e., sex, age, living status, education level, occupational status, alcohol intake, smoking status, physical activity, and body mass index). RESULTS Depressed participants were significantly more likely to have anemia compared to non-depressed participants, even after adjustment for sociodemographic and health-related variables [odds ratio = 1.36; 95% confidence interval = (1.18; 1.57)]. Anemia prevalence increased with depression severity, suggesting a dose-response relationship (P for trend <0.001). CONCLUSION In healthy adults from the general population, we found a significant and robust association between depression and anemia. Further studies are needed to assess the longitudinal relationship between both conditions and determine the mechanisms underlying this association.
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Affiliation(s)
- H Vulser
- Faculty of Medicine, Paris Descartes University, Sorbonne Paris Cité, Paris, France.,Department of Psychiatry, Western Paris University Hospital Group, AP-HP, Paris, France
| | - E Wiernik
- Centre for Research in Epidemiology and Population Health, U1018, Inserm, Villejuif, France.,Versailles St-Quentin University, Versailles, France
| | - N Hoertel
- Faculty of Medicine, Paris Descartes University, Sorbonne Paris Cité, Paris, France.,Department of Psychiatry, Western Paris University Hospital Group, AP-HP, Paris, France.,Centre of Psychiatry and Neuroscience, U894, Inserm, Paris, France
| | - F Thomas
- Research Department, IPC Center, Paris, France
| | - B Pannier
- Research Department, IPC Center, Paris, France.,Department of Cardiology, Manhes Hospital, Fleury-Mérogis, France
| | - S Czernichow
- Versailles St-Quentin University, Versailles, France.,Population-based Epidemiologic Cohorts, UMS 11, Inserm, Villejuif, France.,Department of Nutrition, Ambroise Paré Hospital, AP-HP, Boulogne-Billancourt, France
| | - O Hanon
- Faculty of Medicine, Paris Descartes University, Sorbonne Paris Cité, Paris, France.,Department of Geriatrics, Broca Hospital, AP-HP, Paris, France
| | - T Simon
- Pierre and Marie Curie University, Paris, France.,Department of Pharmacology, St Antoine Hospital, AP-HP, Paris, France
| | - J-M Simon
- Department of Radiation Oncology, Pitié-Salpêtrière Hospital Group, AP-HP, Paris, France
| | - N Danchin
- Faculty of Medicine, Paris Descartes University, Sorbonne Paris Cité, Paris, France.,Department of Cardiology, Western Paris University Hospital Group, AP-HP, Paris, France
| | - F Limosin
- Faculty of Medicine, Paris Descartes University, Sorbonne Paris Cité, Paris, France.,Department of Psychiatry, Western Paris University Hospital Group, AP-HP, Paris, France.,Centre of Psychiatry and Neuroscience, U894, Inserm, Paris, France
| | - C Lemogne
- Faculty of Medicine, Paris Descartes University, Sorbonne Paris Cité, Paris, France.,Department of Psychiatry, Western Paris University Hospital Group, AP-HP, Paris, France.,Centre of Psychiatry and Neuroscience, U894, Inserm, Paris, France
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29
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Anemia increases the mortality risk in patients with stroke: A meta-analysis of cohort studies. Sci Rep 2016; 6:26636. [PMID: 27211606 PMCID: PMC4876389 DOI: 10.1038/srep26636] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Accepted: 05/06/2016] [Indexed: 01/08/2023] Open
Abstract
The impact of anemia on the outcome of patients with stroke remains inconsistent. We performed a meta-analysis of cohort studies to assess the mortality risk in stroke patients with and without anemia. Systematic searches were conducted in the PubMed, China National Knowledge Infrastructure, Web of Science and Wanfang databases to identify relevant studies from inception to November 2015. The estimated odds ratio with a 95% confidence interval was pooled. subgroup analyses and sensitivity analyses were also conducted. We used Begg’s funnel plot and Egger’s test to detect the potential publication bias. Thirteen cohort studies with a total of 19239 patients with stroke were included in this meta-analysis. The heterogeneity among studies was slight (I2 = 59.0%, P = 0.031). The results from a random-effect model suggest that anemia is associated with an increased mortality risk in patients with stroke (adjusted odds ratio = 1.39, 95% confidence interval: 1.22–1.58, P < 0.001). The subgroup analyses are consistent with the total results. This meta-analysis of 13 cohort studies finds that anemia increases the mortality risk in patients with stroke. Future studies should perform longer follow-up to confirm this finding and explore its possible mechanism.
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30
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Schneider ALC, Jonassaint C, Sharrett AR, Mosley TH, Astor BC, Selvin E, Coresh J, Gottesman RF. Hemoglobin, Anemia, and Cognitive Function: The Atherosclerosis Risk in Communities Study. J Gerontol A Biol Sci Med Sci 2015; 71:772-9. [PMID: 26363510 DOI: 10.1093/gerona/glv158] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Accepted: 08/04/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Our objective was to characterize the relationship of low and high hemoglobin concentrations and normocytic, microcytic, and macrocytic anemia with cross-sectional cognition and change in cognition over a median of 6 years. METHODS Cross-sectional and prospective analyses of 13,133 participants (mean age 57 years, 56% women, 24% black, 10% anemia) in the Atherosclerosis Risk in Communities (ARIC) study (baseline 1990-1992) were carried out. Anemia was defined as hemoglobin concentrations lower than 13g/dl for men and lower than 12g/dl for women and was subclassified as normocytic (mean corpuscular volume [MCV] 80-100 fL), microcytic (MCV < 80 fL), and macrocytic (MCV > 100 fL). Cognition was assessed by delayed word recall test (DWRT), digit symbol substitution test (DSST), word fluency test (WFT), and global Z-score at Visit 2 (1990-1992) and Visit 4 (1996-1998). Adjusted linear regression models and splines were used. RESULTS Cross-sectionally, anemia overall was associated with lower cognitive test scores on DSST and global Z-score among men and women (all p < .05), but not on DWRT or WFT. Anemia subtypes were associated similarly with cognition, with strongest associations for the DSST and global Z-score. Additionally, elevated hemoglobin level was associated with nonsignificantly worse cognition in cross-sectional analyses, suggesting a nonlinear association of hemoglobin with cognition. In contrast, anemia overall and anemia subtypes were not associated with cognition in prospective analyses (all p > .05). CONCLUSIONS There was a cross-sectional, but not prospective, nonlinear association between hemoglobin concentrations and cognitive function, although only associations of low levels of hemoglobin (anemia) were statistically significant. Subtypes of anemia had similar magnitudes of associations with cognition.
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Affiliation(s)
- Andrea L C Schneider
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland. Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
| | | | - A Richey Sharrett
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Thomas H Mosley
- Department of Medicine, University of Mississippi Medical Center, Jackson
| | - Brad C Astor
- Department of Medicine, University of Wisconsin School of Medicine, Madison
| | - Elizabeth Selvin
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland. Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Josef Coresh
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland. Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Rebecca F Gottesman
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland. Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland
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van der Veen PH, Muller M, Vincken KL, Westerink J, Mali WPTM, van der Graaf Y, Geerlings MI. Hemoglobin, hematocrit, and changes in cerebral blood flow: the Second Manifestations of ARTerial disease-Magnetic Resonance study. Neurobiol Aging 2014; 36:1417-23. [PMID: 25618615 DOI: 10.1016/j.neurobiolaging.2014.12.019] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Revised: 12/07/2014] [Accepted: 12/15/2014] [Indexed: 11/26/2022]
Abstract
Hemoglobin and hematocrit are important determinants of blood viscosity and arterial oxygen content and may therefore influence cerebral blood flow (CBF). We examined cross-sectional and prospective associations of hemoglobin and hematocrit with CBF in 569 patients with manifest arterial disease (mean age 57 ± 10 years) with available data on magnetic resonance angiography to measure parenchymal CBF. Mean (SD) parenchymal CBF at baseline was 52.3 (9.8) mL/min/100 mL and decreased with 1.5 (11.0) mL/min/100 mL after on average 3.9 years of follow-up. Linear regression analyses showed that greater hemoglobin and hematocrit values were associated with lower baseline parenchymal CBF and more decline in parenchymal CBF over time, independent of cardiovascular risk factors, use of antiplatelet drugs, anticoagulants, or diuretics, and brain measures: adjusted mean differences (95% confidence interval [CI]) in decline in parenchymal CBF between patients in the lower and upper quartiles of hemoglobin and hematocrit were -2.48 (95% CI -3.70 to -1.25) and -3.69 (95% CI -5.45 to -1.94) mL/min/100 mL. Higher hemoglobin and hematocrit were associated with lower baseline parenchymal CBF and a greater decline in parenchymal CBF over time, possibly as a result of physiological compensating mechanisms.
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Affiliation(s)
- Pieternella H van der Veen
- Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Majon Muller
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands; Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands
| | - Koen L Vincken
- Image Sciences Institute, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Jan Westerink
- Department of Vascular Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Willem P T M Mali
- Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Yolanda van der Graaf
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Mirjam I Geerlings
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
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Willie CK, Tzeng YC, Fisher JA, Ainslie PN. Integrative regulation of human brain blood flow. J Physiol 2014; 592:841-59. [PMID: 24396059 PMCID: PMC3948549 DOI: 10.1113/jphysiol.2013.268953] [Citation(s) in RCA: 558] [Impact Index Per Article: 55.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Accepted: 12/24/2013] [Indexed: 02/06/2023] Open
Abstract
Herein, we review mechanisms regulating cerebral blood flow (CBF), with specific focus on humans. We revisit important concepts from the older literature and describe the interaction of various mechanisms of cerebrovascular control. We amalgamate this broad scope of information into a brief review, rather than detailing any one mechanism or area of research. The relationship between regulatory mechanisms is emphasized, but the following three broad categories of control are explicated: (1) the effect of blood gases and neuronal metabolism on CBF; (2) buffering of CBF with changes in blood pressure, termed cerebral autoregulation; and (3) the role of the autonomic nervous system in CBF regulation. With respect to these control mechanisms, we provide evidence against several canonized paradigms of CBF control. Specifically, we corroborate the following four key theses: (1) that cerebral autoregulation does not maintain constant perfusion through a mean arterial pressure range of 60-150 mmHg; (2) that there is important stimulatory synergism and regulatory interdependence of arterial blood gases and blood pressure on CBF regulation; (3) that cerebral autoregulation and cerebrovascular sensitivity to changes in arterial blood gases are not modulated solely at the pial arterioles; and (4) that neurogenic control of the cerebral vasculature is an important player in autoregulatory function and, crucially, acts to buffer surges in perfusion pressure. Finally, we summarize the state of our knowledge with respect to these areas, outline important gaps in the literature and suggest avenues for future research.
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Affiliation(s)
- Christopher K Willie
- Centre for Heart, Lung and Vascular Health, School of Health and Exercise Sciences, University of British Columbia - Okanagan, Kelowna, British Columbia, Canada V1V 1V7.
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