|
1
|
Kim EJ, Cho A, Kim DH, Park HC, Yoon JY, Shon K, Kim E, Koo JR, Lee YK. Geriatric Nutritional Risk Index as a Prognostic Factor for Renal Progression in Patients with Type 2 Diabetes Mellitus. Nutrients 2023; 15:4636. [PMID: 37960289 PMCID: PMC10649929 DOI: 10.3390/nu15214636] [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: 10/03/2023] [Revised: 10/29/2023] [Accepted: 10/30/2023] [Indexed: 11/15/2023] Open
Abstract
The aim of this study was to evaluate whether the geriatric nutritional risk index (GNRI) is associated with chronic kidney disease (CKD) progression in patients with type 2 diabetes mellitus (DM). In total, 1100 patients with type 2 DM with a follow-up duration > 1 year were included in this longitudinal study. The risk of CKD progression was assessed according to GNRI quartiles. Patients in the lowest GNRI quartile exhibited a significantly lower estimated glomerular filtration rate (eGFR), compared with those in quartile four. Moreover, these patients had poorer glycemic control and lower hemoglobin levels, body mass index, and albumin levels. Additionally, they exhibited a greater annual decline in eGFR. Multivariate logistic regression analysis showed that old age (>60 years), baseline eGFR, the presence of proteinuria, the use of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, and low GNRI were significantly associated with CKD progression. GNRI may serve as a valuable predictive tool for identifying the risk of adverse renal outcomes in patients with type 2 DM. It may potentially serve as a more feasible measure for assessing the nutritional status of these patients, as well as for predicting their clinical outcomes.
Collapse
Affiliation(s)
- Eun Jung Kim
- Department of Internal Medicine, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong-si 18450, Republic of Korea; (E.J.K.); (J.-R.K.)
- Hallym Kidney Research Institute, Hallym University, Seoul 07441, Republic of Korea; (A.C.); (D.H.K.); (J.Y.Y.); (K.S.); (E.K.)
- Department of Internal Medicine, Graduate School of Kangwon National University, Kangwon 24341, Republic of Korea
| | - Ajin Cho
- Hallym Kidney Research Institute, Hallym University, Seoul 07441, Republic of Korea; (A.C.); (D.H.K.); (J.Y.Y.); (K.S.); (E.K.)
- Department of Internal Medicine, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul 07441, Republic of Korea
| | - Do Hyoung Kim
- Hallym Kidney Research Institute, Hallym University, Seoul 07441, Republic of Korea; (A.C.); (D.H.K.); (J.Y.Y.); (K.S.); (E.K.)
- Department of Internal Medicine, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul 07441, Republic of Korea
| | - Hayne Cho Park
- Hallym Kidney Research Institute, Hallym University, Seoul 07441, Republic of Korea; (A.C.); (D.H.K.); (J.Y.Y.); (K.S.); (E.K.)
- Department of Internal Medicine, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul 07441, Republic of Korea
| | - Joo Yeon Yoon
- Hallym Kidney Research Institute, Hallym University, Seoul 07441, Republic of Korea; (A.C.); (D.H.K.); (J.Y.Y.); (K.S.); (E.K.)
- Department of Internal Medicine, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul 07441, Republic of Korea
| | - Kyungjun Shon
- Hallym Kidney Research Institute, Hallym University, Seoul 07441, Republic of Korea; (A.C.); (D.H.K.); (J.Y.Y.); (K.S.); (E.K.)
- Department of Internal Medicine, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul 07441, Republic of Korea
| | - Eunji Kim
- Hallym Kidney Research Institute, Hallym University, Seoul 07441, Republic of Korea; (A.C.); (D.H.K.); (J.Y.Y.); (K.S.); (E.K.)
- Department of Internal Medicine, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul 07441, Republic of Korea
| | - Ja-Ryong Koo
- Department of Internal Medicine, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong-si 18450, Republic of Korea; (E.J.K.); (J.-R.K.)
- Hallym Kidney Research Institute, Hallym University, Seoul 07441, Republic of Korea; (A.C.); (D.H.K.); (J.Y.Y.); (K.S.); (E.K.)
| | - Young-Ki Lee
- Hallym Kidney Research Institute, Hallym University, Seoul 07441, Republic of Korea; (A.C.); (D.H.K.); (J.Y.Y.); (K.S.); (E.K.)
- Department of Internal Medicine, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul 07441, Republic of Korea
| |
Collapse
|
|
2
|
Fotheringham AK, Solon-Biet SM, Bielefeldt-Ohmann H, McCarthy DA, McMahon AC, Ruohonen K, Li I, Sullivan MA, Whiddett RO, Borg DJ, Cogger VC, Ballard WO, Turner N, Melvin RG, Raubenheimer D, Le Couteur DG, Simpson SJ, Forbes JM. Kidney disease risk factors do not explain impacts of low dietary protein on kidney function and structure. iScience 2021; 24:103308. [PMID: 34820603 PMCID: PMC8602032 DOI: 10.1016/j.isci.2021.103308] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 04/29/2021] [Accepted: 10/15/2021] [Indexed: 02/06/2023] Open
Abstract
The kidneys balance many byproducts of the metabolism of dietary components. Previous studies examining dietary effects on kidney health are generally of short duration and manipulate a single macronutrient. Here, kidney function and structure were examined in C57BL/6J mice randomized to consume one of a spectrum of macronutrient combinations (protein [5%–60%], carbohydrate [20%–75%], and fat [20%–75%]) from weaning to late-middle age (15 months). Individual and interactive impacts of macronutrients on kidney health were modeled. Dietary protein had the greatest influence on kidney function, where chronic low protein intake decreased glomerular filtration rates and kidney mass, whereas it increased kidney immune infiltration and structural injury. Kidney outcomes did not align with cardiometabolic risk factors including glucose intolerance, overweight/obesity, dyslipidemia, and hypertension in mice with chronic low protein consumption. This study highlights that protein intake over a lifespan is an important determinant of kidney function independent of cardiometabolic changes. Chronic high macronutrient intake from any source increases kidney function (GFR) Low protein intake led to greater kidney tubular structural injury and inflammation Lower protein intake decreased kidney mass and glomerular filtration capacity Kidney outcomes did not align with longevity or cardiometabolic outcomes
Collapse
Affiliation(s)
- Amelia K Fotheringham
- Glycation and Diabetes Complications Group, Mater Research Institute-The University of Queensland, Translational Research Institute, 37 Kent Street, Woolloongabba, Brisbane 4072, QLD, Australia.,Faculty of Medicine, University of Queensland, Brisbane 4067, QLD, Australia
| | - Samantha M Solon-Biet
- Charles Perkins Centre, University of Sydney, Sydney 2006, NSW, Australia.,School of Medical Sciences, University of Sydney, Sydney 2006, NSW, Australia
| | - Helle Bielefeldt-Ohmann
- School of Veterinary Science, University of Queensland, Gatton Campus, Gatton 4343, QLD, Australia.,School of Chemistry & Molecular Biosciences, University of Queensland, Brisbane 4067, QLD, Australia
| | - Domenica A McCarthy
- Glycation and Diabetes Complications Group, Mater Research Institute-The University of Queensland, Translational Research Institute, 37 Kent Street, Woolloongabba, Brisbane 4072, QLD, Australia
| | - Aisling C McMahon
- Charles Perkins Centre, University of Sydney, Sydney 2006, NSW, Australia.,Centre for Education and Research on Aging, and Aging and Alzheimer's Institute, Concord Hospital, Sydney 2139, NSW, Australia.,ANZAC Research Institute, Concord Hospital, University of Sydney, Sydney 2139, NSW, Australia
| | - Kari Ruohonen
- Animal Nutrition and Health, Cargill, Sandnes, Norway
| | - Isaac Li
- Faculty of Medicine, University of Queensland, Brisbane 4067, QLD, Australia
| | - Mitchell A Sullivan
- Glycation and Diabetes Complications Group, Mater Research Institute-The University of Queensland, Translational Research Institute, 37 Kent Street, Woolloongabba, Brisbane 4072, QLD, Australia
| | - Rani O Whiddett
- Glycation and Diabetes Complications Group, Mater Research Institute-The University of Queensland, Translational Research Institute, 37 Kent Street, Woolloongabba, Brisbane 4072, QLD, Australia
| | - Danielle J Borg
- Glycation and Diabetes Complications Group, Mater Research Institute-The University of Queensland, Translational Research Institute, 37 Kent Street, Woolloongabba, Brisbane 4072, QLD, Australia.,Faculty of Medicine, University of Queensland, Brisbane 4067, QLD, Australia
| | - Victoria C Cogger
- Charles Perkins Centre, University of Sydney, Sydney 2006, NSW, Australia.,Centre for Education and Research on Aging, and Aging and Alzheimer's Institute, Concord Hospital, Sydney 2139, NSW, Australia.,ANZAC Research Institute, Concord Hospital, University of Sydney, Sydney 2139, NSW, Australia
| | - William O Ballard
- School of Biotechnology and Biomolecular Sciences, University of New South Wales, Sydney 2052, NSW, Australia
| | - Nigel Turner
- Department of Pharmacology, School of Medical Sciences, Faculty of Medicine, University of New South Wales Sydney, NSW 2052, Australia
| | - Richard G Melvin
- Department of Biomedical Sciences, University of Minnesota Medical School, 1035 University Drive, Duluth 55812, MN, USA
| | - David Raubenheimer
- Charles Perkins Centre, University of Sydney, Sydney 2006, NSW, Australia.,School of Life and Environmental Sciences, University of Sydney, NSW, Australia
| | - David G Le Couteur
- Charles Perkins Centre, University of Sydney, Sydney 2006, NSW, Australia.,Centre for Education and Research on Aging, and Aging and Alzheimer's Institute, Concord Hospital, Sydney 2139, NSW, Australia.,ANZAC Research Institute, Concord Hospital, University of Sydney, Sydney 2139, NSW, Australia
| | - Stephen J Simpson
- Charles Perkins Centre, University of Sydney, Sydney 2006, NSW, Australia.,School of Life and Environmental Sciences, University of Sydney, NSW, Australia
| | - Josephine M Forbes
- Glycation and Diabetes Complications Group, Mater Research Institute-The University of Queensland, Translational Research Institute, 37 Kent Street, Woolloongabba, Brisbane 4072, QLD, Australia.,Faculty of Medicine, University of Queensland, Brisbane 4067, QLD, Australia.,Department of Medicine, University of Melbourne, Heidelberg, VIC 3084, Australia
| |
Collapse
|
|
3
|
Liu L, Wang Y, Zhang W, Chang W, Jin Y, Yao Y. Waist height ratio predicts chronic kidney disease: a systematic review and meta-analysis, 1998-2019. Arch Public Health 2019; 77:55. [PMID: 31867106 PMCID: PMC6918668 DOI: 10.1186/s13690-019-0379-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Accepted: 11/18/2019] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND The incidence of chronic kidney disease (CKD) increases each year, and obesity is an important risk factor for CKD. The main anthropometric indicators currently reflecting obesity are body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR), but the rationality and merits of various indicators vary. This article aims to find whether the WHtR is a more suitable physical measurement that can predict CKD. METHODS Pubmed, embase, the cochrane library, and web of science were systematically searched for articles published between 1998 and 2019 screening CKD through physical indicators. Two reviewers independently screened the literature according to the inclusion and exclusion criteria, extracted the data, and evaluated the quality of the methodology included in the study. Meta-analysis used the Stata 12.0 software. RESULTS Nine studies were included, with a total of 202,283 subjects. Meta-analysis showed that according to the analysis of different genders in 6 studies, regardless of sex, WHtR was the area with the largest area under the curve (AUC). Except WHtR and visceral fat index (VFI) in women which showed no statistical difference, WHtR and other indicators were statistically different. In three studies without gender-based stratification, the area under the curve AUC for WHtR remained the largest, but only the difference between WHtR and BMI was statistically significant. When the Chinese population was considered as a subgroup, the area under the curve AUC for WHtR was the largest. Except for WHtR and VFI which showed no statistical difference in women, there was a statistically significant difference between WHtR and other indicators in men and women. CONCLUSION WHtR could be better prediction for CKD relative to other physical measurements. It also requires higher-quality prospective studies to verify the clinical application of WHtR.
Collapse
Affiliation(s)
- Ling Liu
- School of Public Health,Wannan Medical College, Wenchang West Road 22, Wuhu, China
| | - Yanqiu Wang
- School of Public Health,Wannan Medical College, Wenchang West Road 22, Wuhu, China
| | - Wanjun Zhang
- School of Public Health,Wannan Medical College, Wenchang West Road 22, Wuhu, China
| | - Weiwei Chang
- School of Public Health,Wannan Medical College, Wenchang West Road 22, Wuhu, China
| | - Yuelong Jin
- School of Public Health,Wannan Medical College, Wenchang West Road 22, Wuhu, China
| | - Yingshui Yao
- School of Public Health,Wannan Medical College, Wenchang West Road 22, Wuhu, China
| |
Collapse
|