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Chen D, Yu R, Yin S, Qiu W, Fang J, Peng XE. Hepatitis B virus infection as a risk factor for chronic kidney disease: a systematic review and meta-analysis. BMC Infect Dis 2024; 24:620. [PMID: 38909191 PMCID: PMC11193185 DOI: 10.1186/s12879-024-09546-z] [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: 08/24/2023] [Accepted: 06/20/2024] [Indexed: 06/24/2024] Open
Abstract
BACKGROUND Currently, several studies have observed that chronic hepatitis B virus infection is associated with the pathogenesis of kidney disease. However, the extent of the correlation between hepatitis B virus infection and the chronic kidney disease risk remains controversial. METHODS In the present study, we searched all eligible literature in seven databases in English and Chinese. The random effects model was used to conduct a meta-analysis. Quality of included studies was assessed using the Newcastle-Ottawa Quality Scale. RESULTS In this analysis, a total of 31 studies reporting the association between hepatitis B virus infection and chronic kidney disease risk were included. The results showed a significant positive association between hepatitis B virus infection and the risk of chronic kidney disease (pooled OR, 1.20; 95% CI, 1.12-1.29), which means that hepatitis B virus increases the risk of developing chronic kidney disease. CONCLUSION This study found that hepatitis B virus infection was associated with a significantly increased risk of chronic kidney disease. However, the current study still cannot directly determine this causal relationship. Thus, more comprehensive prospective longitudinal studies are needed in the future to provide further exploration and explanation of the association between hepatitis B virus and the risk of developing chronic kidney disease.
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Affiliation(s)
- Danjing Chen
- Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, 350122, People's Republic of China
| | - Rong Yu
- Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, 350122, People's Republic of China
| | - Shuo Yin
- Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, 350122, People's Republic of China
| | - Wenxin Qiu
- Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, 350122, People's Republic of China
| | - Jiangwang Fang
- Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, 350122, People's Republic of China
| | - Xian-E Peng
- Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, 350122, People's Republic of China.
- Department of Epidemiology and Health Statistics, Key Laboratory of Gastrointestinal Cancer, School of Basic Medical Sciences, Fujian Medical University, Ministry of Education, Fujian Medical University, Xuefu North Road 1st, Shangjie Town, Minhou Country, Fuzhou, Fujian, 350108, China.
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Liu X, Zhou Y. Influence of hepatitis B virus on the prevalence of diabetes complications in patients with type 2 diabetes. J Diabetes Investig 2022; 14:429-434. [PMID: 36510700 PMCID: PMC9951573 DOI: 10.1111/jdi.13954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 11/03/2022] [Accepted: 11/16/2022] [Indexed: 12/15/2022] Open
Abstract
AIMS/INTRODUCTION Diabetes and hepatitis B are both global problems. The influence of diabetes on complications and prognosis of hepatitis B has been widely studied. However, the association between hepatitis B virus (HBV) infection and the prevalence of diabetes-related complications is less documented and is uncertain. MATERIALS AND METHODS This was a retrospective study. We collected information from a large clinical database. A total of 1,090 Chinese inpatients with type 2 diabetes were included. RESULTS The participants were divided into two groups, including 135 patients with HBV infection and 955 patients without HBV infection. Patients with HBV infection were younger and had worse control of blood glucose than those without HBV infection. No significant difference was found in the prevalence of diabetic retinopathy, neuropathy, nephropathy, diabetic ketosis or diabetic ketoacidosis between the patients with HBV infection and the patients without HBV infection. The prevalence of macrovascular complications was 54.1% and 64.4% in diabetes patients complicated with HBV infection and without HBV infection, respectively. The P-value was <0.05. However, through the logistic regression analysis, we found HBV infection was not an independent risk factor for macrovascular complications of diabetes. CONCLUSION There was no significant correlation between the prevalence of macrovascular complications, microvascular complications of diabetes, diabetic ketosis or diabetic ketoacidosis and HBV infection status.
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Affiliation(s)
- Xi‐yu Liu
- Department of EndocrinologyDongyang People's HospitalDongyangChina
| | - Yan Zhou
- Department of EndocrinologyDongyang People's HospitalDongyangChina
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Jeong S, Oh YH, Choi S, Chang J, Kim SM, Son JS, Lee G, Kim W, Park SM. Metabolic Dysfunction-Associated Fatty Liver Disease Better Predicts Incident Cardiovascular Disease. Gut Liver 2021; 16:589-598. [PMID: 34730107 PMCID: PMC9289825 DOI: 10.5009/gnl210256] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Revised: 07/17/2021] [Accepted: 08/03/2021] [Indexed: 11/22/2022] Open
Abstract
Background/Aims Metabolic dysfunction (MD)-associated fatty liver disease is a new positive diagnostic criterion based on hepatic steatosis and MD. However, a comprehensive evaluation on the association of MD and hepatic steatosis with incident cardiovascular disease (CVD) has yet to be performed. Methods This retrospective cohort study included 333,389 participants from the Korean National Health Insurance Service database who received a health examination between 2009 and 2010. Hepatic steatosis was defined using the Korean National Health and Nutrition Examination Survey-derived nonalcoholic fatty liver disease scoring system. Cox proportional hazards regression was adopted to determine the adjusted hazard ratio (aHR) with 95% confidence interval (CI) for CVD according to the presence of hepatic steatosis and MD, as well as the composite term. Results This study included 179,437 men and 153,952 women with a median age of 57 years. Hepatic steatosis with MD (aHR, 2.00; 95% CI, 1.89 to 2.13) and without MD (aHR, 1.30; 95% CI, 1.10 to 1.54) significantly increased the risk of CVD compared to no steatosis without MD (reference). However, steatosis revealed no significant difference in the risk of CVD compared to no steatosis among participants with one MD (aHR, 1.09; 95% CI, 0.91 to 1.30). In participants with steatosis, the presence of one and ≥2 MDs had aHR values of 1.25 (95% CI, 0.87 to 1.79) and 1.71 (95% CI, 1.22 to 2.41), respectively, compared to no MD. Conclusions Combined consideration of hepatic steatosis and MD was significantly associated with increased CVD risk and showed better predictive performance for CVD than hepatic steatosis or MD alone.
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Affiliation(s)
- Seogsong Jeong
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Korea
| | - Yun Hwan Oh
- Department of Family Medicine, Jeju National University School of Medicine, Jeju, Korea
| | - Seulggie Choi
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Korea
| | - Jooyoung Chang
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Korea
| | - Sung Min Kim
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Korea
| | - Joung Sik Son
- Department of Family Medicine, Korea University Guro Hospital, Seoul, Korea
| | - Gyeongsil Lee
- Department of Family Medicine, Seoul National University Hospital, Seoul, Korea
| | - Won Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea.,Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Sang Min Park
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Korea.,Department of Family Medicine, Seoul National University Hospital, Seoul, Korea
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Fabrizi F, Cerutti R, Donato FM, Messa P. HBV infection is a risk factor for chronic kidney disease: Systematic review and meta-analysis. Rev Clin Esp 2021; 221:600-611. [PMID: 34183297 DOI: 10.1016/j.rceng.2019.10.014] [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: 03/16/2019] [Accepted: 10/06/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND The activity of hepatitis B virus (HBV) as a risk factor for the incidence and progression of chronic kidney disease (CKD) has not been clarified. AIM We evaluated the impact of infection with HBV on the risk of CKD in the general population. MATERIAL AND METHODS We carried out a systematic review of the published medical literature to assess whether a relationship between hepatitis B infection and an increased risk of CKD in the adult general population occurs. We adopted the random effects model of DerSimonian and Laird to provide a summary estimate of the risk of chronic kidney disease (defined by lowered glomerular filtration rate and/or detectable proteinuria) with HBV infection across the published studies. Meta-regression and stratified analyses were also performed. RESULTS We retrieved 33 studies (n = 7,849,849 patients) published in 26 different articles, and separate meta-analyses were performed according to the outcome. Pooling results from cohort studies (11 studies, n = 1,056,645 patients) demonstrated a relationship between positive HBV serologic status and increased incidence of CKD, the summary estimate for adjusted HR with HBV across the surveys, 1.40 (95% CI, 1.16-1.69) (P < .001). Between-study heterogeneity was noted (Q value, 49.5, P < .0001). No relationship between HBV and prevalence of CKD was noted in the subset of cross-sectional studies (10 studies; n = 3,222,545 patients), adjusted OR, 1.04 (95% IC 0.90-1.218; P = .5). Meta-regression analysis reported a relationship between positive HBsAg status and incidence of CKD in the general population (P < .015). CONCLUSIONS It appears that exposure to HBV infection seems to be associated with an increased risk of developing CKD in the adult general population. Studies aimed to understand the mechanisms responsible of such association are under way.
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Affiliation(s)
- F Fabrizi
- Division of Nephrology, Dialysis and Renal Transplantation, Maggiore Policlinico Hospital and Cà Granda IRCCS Foundation, Milano, Italy.
| | - R Cerutti
- Division of Nephrology, Dialysis and Renal Transplantation, Maggiore Policlinico Hospital and Cà Granda IRCCS Foundation, Milano, Italy
| | - F M Donato
- Division of Gastroenterology and Hepatology, Maggiore Policlinico Hospital and Ca' Granda IRCCS Foundation, Milano, Italy
| | - P Messa
- Division of Nephrology, Dialysis and Renal Transplantation, Maggiore Policlinico Hospital and Cà Granda IRCCS Foundation, Milano, Italy; University School of Medicine, Milano, Italy
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Xi C, Wang C, Rong G, Deng J. A Nomogram Model that Predicts the Risk of Diabetic Nephropathy in Type 2 Diabetes Mellitus Patients: A Retrospective Study. Int J Endocrinol 2021; 2021:6672444. [PMID: 33897777 PMCID: PMC8052141 DOI: 10.1155/2021/6672444] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 03/23/2021] [Accepted: 03/29/2021] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE To construct a novel nomogram model that predicts the risk of diabetic nephropathy (DN) incidence in Chinese patients with type 2 diabetes mellitus (T2DM). METHODS Questionnaire surveys, physical examinations, routine blood tests, and biochemical index evaluations were conducted on 1095 patients with T2DM from Guilin. A least absolute contraction selection operator (LASSO) regression and multivariable logistic regression analysis were used to screen out DN risk factors. A logistic regression analysis incorporating the screened risk factors was used to establish a predictive nomogram model. The performance of the nomogram model was evaluated using the C-index, an area under the receiver operating characteristic curve (AUC), calibration plots, and a decision curve analysis. Bootstrapping was applied for internal validation. RESULTS Independent predictors for DN incidence risk included gender, age, hypertension, medicine use, duration of diabetes, body mass index, blood urea nitrogen level, serum creatinine level, neutrophil to lymphocyte ratio, and red blood cell distribution width. The nomogram model exhibited moderate prediction ability with a C-index of 0.819 (95% confidence interval (CI): 0.783-0.853) and an AUC of 0.813 (95%CI: 0.778-0.848). The C-index from internal validation reached 0.796 (95%CI: 0.763-0.829). The decision curve analysis displayed that the DN risk nomogram was clinically applicable when the risk threshold was between 1 and 83%. CONCLUSION Our novel and simple nomogram containing 10 factors may be useful in predicting DN incidence risk in T2DM patients.
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Affiliation(s)
- Chunfeng Xi
- Department of Laboratory Medicine, Affiliated Hospital of Guilin Medical University, Guilin, Guangxi, China
| | - Caimei Wang
- Department of Laboratory Medicine, Affiliated Hospital of Guilin Medical University, Guilin, Guangxi, China
| | - Guihong Rong
- Department of Laboratory Medicine, Affiliated Hospital of Guilin Medical University, Guilin, Guangxi, China
| | - Jinhuan Deng
- Department of Laboratory Medicine, Affiliated Hospital of Guilin Medical University, Guilin, Guangxi, China
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Fabrizi F, Cerutti R, Donato FM, Messa P. HBV infection is a risk factor for chronic kidney disease: Systematic review and meta-analysis. Rev Clin Esp 2020; 221:S0014-2565(19)30325-X. [PMID: 32037008 DOI: 10.1016/j.rce.2019.10.010] [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: 03/16/2019] [Revised: 09/27/2019] [Accepted: 10/06/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND The activity of hepatitis B virus (HBV) as a risk factor for the incidence and progression of chronic kidney disease (CKD) has not been clarified. AIM We evaluated the impact of infection with HBV on the risk of CKD in the general population. MATERIAL AND METHODS We carried out a systematic review of the published medical literature to assess whether a relationship between hepatitis B infection and an increased risk of CKD in the adult general population occurs. We adopted the random effects model of DerSimonian and Laird to provide a summary estimate of the risk of chronic kidney disease (defined by lowered glomerular filtration rate and/or detectable proteinuria) with HBV infection across the published studies. Meta-regression and stratified analyses were also performed. RESULTS We retrieved 33 studies (n=7,849,849 patients) published in 26 different articles, and separate meta-analyses were performed according to the outcome. Pooling results from cohort studies (11 studies, n=1,056,645 patients) demonstrated a relationship between positive HBV serologic status and increased incidence of CKD, the summary estimate for adjusted HR with HBV across the surveys, 1.40 (95% CI, 1.16-1.69) (P<.001). Between-study heterogeneity was noted (Q value, 49.5, P<.0001). No relationship between HBV and prevalence of CKD was noted in the subset of cross-sectional studies (10 studies; n=3,222,545 patients), adjusted OR, 1.04 (95% IC 0.90-1.218; P=.5). Meta-regression analysis reported a relationship between positive HBsAg status and incidence of CKD in the general population (P<.015). CONCLUSIONS It appears that exposure to HBV infection seems to be associated with an increased risk of developing CKD in the adult general population. Studies aimed to understand the mechanisms responsible of such association are under way.
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Affiliation(s)
- F Fabrizi
- División de Nefrología, Hospital Maggiore, Fundación IRCCS, Milán, Italia.
| | - R Cerutti
- División de Nefrología, Hospital Maggiore, Fundación IRCCS, Milán, Italia
| | - F M Donato
- División de Gastroenterología, Hospital Maggiore, Fundación IRCCS, Milán, Italia
| | - P Messa
- División de Nefrología, Hospital Maggiore, Fundación IRCCS, Milán, Italia; Escuela Universitaria de Medicina, Milán, Italia
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Wijarnpreecha K, Thongprayoon C, Nissaisorakarn P, Lekuthai N, Jaruvongvanich V, Nakkala K, Rajapakse R, Cheungpasitporn W. Association between Helicobacter pylori and end-stage renal disease: A meta-analysis. World J Gastroenterol 2017; 23:1497-1506. [PMID: 28293097 PMCID: PMC5330835 DOI: 10.3748/wjg.v23.i8.1497] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2016] [Revised: 12/09/2016] [Accepted: 01/18/2017] [Indexed: 02/06/2023] Open
Abstract
AIM To investigate the prevalence and association of Helicobacter pylori (H. pylori) with end-stage renal disease (ESRD).
METHODS SA comprehensive literature search was completed from inception until October 2016. Studies that reported prevalence, relative risks, odd ratios, hazard ratios or standardized incidence ratio of H. pylori among ESRD patients were included. Participants without H. pylori were used as comparators to assess the association between H. pylori infection and ESRD. Pooled risk ratios and 95%CI was calculated using a random-effect model. Adjusted point estimates from each study were combined by the generic inverse variance method of DerSimonian and Laird.
RESULTS Of 4546 relevant studies, thirty-seven observational studies met all inclusion criteria. Thirty-five cross-sectional studies were included in the analyses to assess the prevalence and association of H. pylori with ESRD. The estimated prevalence of H. pylori among ESRD patients was 44% (95%CI: 40%-49%). The pooled RR of H. pylori in patients with ESRD was 0.77 (95%CI: 0.59-1.00) when compared with the patients without ESRD. Subgroup analysis showed significantly reduced risk of H. pylori in adult ESRD patients with pooled RR of 0.71 (95%CI: 0.55-0.94). The data on the risk of ESRD in patients with H. pylori were limited. Two cohort studies were included to assess the risk of ESRD in patients with H. pylori. The pooled risk RR of ESRD in patients with H. pylori was 0.61 (95%CI: 0.03-12.20).
CONCLUSION The estimated prevalence of H. pylori in ESRD patients is 44%. Our meta-analysis demonstrates a decreased risk of H. pylori in adult ESRD patients.
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Fabrizi F, Donato FM, Messa P. Association between hepatitis B virus and chronic kidney disease: a systematic review and meta-analysis. Ann Hepatol 2017; 16:21-47. [PMID: 28051791 DOI: 10.5604/16652681.1226813] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
UNLABELLED Background. Hepatitis B virus infection and chronic kidney disease are prevalent and remain a major public health problem worldwide. It remains unclear how infection with hepatitis B virus impacts on the development and progression of chronic kidney disease. AIM To evaluate the effect of infection with HBV on the risk of chronic kidney disease in the general population. MATERIAL AND METHODS We conducted a systematic review of the published medical literature to determine if hepatitis B infection is associated with increased likelihood of chronic kidney disease. We used the random effects model of DerSimonian and Laird to generate a summary estimate of the relative risk for chronic kidney disease (defined by reduced glomerular filtration rate and/or detectable proteinuria) with hepatitis B virus across the published studies. Meta-regression and stratified analysis were also conducted. RESULTS We identified 16 studies (n = 394,664 patients) and separate meta-analyses were performed according to the outcome. The subset of longitudinal studies addressing ESRD (n = 2; n = 91,656) gave a pooled aHR 3.87 (95% CI, 1.48; 6.25, P < 0.0001) among HBV-infected patients and no heterogeneity was recorded. In meta-regression, we noted the impact of male (P = 0.006) and duration of follow- up (P = 0.007) upon the adjusted hazard ratio of incidence of chronic kidney disease (including end-stage renal disease). No relationship occurred between HBV positive status and prevalent chronic disease (n = 7, n = 109,889 unique patients); adjusted odds ratio, were 1.07 (95% CI, 0.89; 1.25) and 0.93 (95% CI, 0.76; 1.10), respectively. CONCLUSIONS HBV infection is possibly associated with a risk of developing reduced glomerular filtration rate in the general population; no link between HBV sero-positive status and frequency of chronic kidney disease or proteinuria was noted in cross-sectional surveys.
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Affiliation(s)
- Fabrizio Fabrizi
- Division of Nephrology Maggiore Hospital and IRCCS Foundation, Milano, Italy
| | - Francesca M Donato
- Division of Gastroenterology, Maggiore Hospital and IRCCS Foundation, Milano, Italy
| | - Piergiorgio Messa
- Division of Nephrology Maggiore Hospital and IRCCS Foundation, Milano, Italy
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Zhou F, Zhong X, Chen J, Li C, Shang M, Jiang C, Yang H, Zhao W, Liu L. Helicobacter pylori infection associated with type 2 diabetic nephropathy in patients with dyspeptic symptoms. Diabetes Res Clin Pract 2015; 110:328-34. [PMID: 26547504 DOI: 10.1016/j.diabres.2015.09.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Revised: 08/04/2015] [Accepted: 09/04/2015] [Indexed: 12/22/2022]
Abstract
AIMS The aim of this conventional case-control study was to investigate the prevalence and relationship between Helicobacter pylori infection in type 2 diabetes mellitus (DM) and diabetic nephropathy (DN). METHODS A total of 241 type 2 DM patients and 69 non-diabetic subjects with dyspeptic symptoms were enrolled in the study. Gastroduodenal lesions were observed by gastrointestinal endoscopy and the presence of H. pylori was identified by rapid urease test and serum IgG antibodies to H. pylori. According to the urinary albumin excretion rate (UAE), patients were classified into diabetes mellitus group (DM group, with UAE <30 mg/24h); diabetic nephropathy group 1 (DN group 1, with UAE 30 mg/24 h to <300 mg/24 h); and diabetic nephropathy group 2 (DN group 2 ≥ 300 mg/24 h). The 69 non-diabetic subjects were used as control group. The serum levels of inflammatory factors such as tumor necrosis factor-α (TNF-α) and interleukin (IL)-8 were determined using ELISA. RESULTS The prevalence of H. pylori infection in DN group 1 and DN group 2 was 45/72 (62.5%) and 34/53 (64.15%), respectively, which was significantly higher than in control [28/65 (43.1%)] and DM groups [42.9% (27/63)]. No significant differences of H. pylori prevalence were detected between DN groups as well as DM and control groups. Interestingly, in both DN groups, higher levels of IL-8, TNF-α and urinary albumin excretion rate were found in H. pylori positive subjects. CONCLUSIONS Diabetic nephropathy patients are more susceptible to H. pylori infection. Our data support an association between H. pylori infection and diabetic nephropathy.
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Affiliation(s)
- Fei Zhou
- Department of Nephrology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, PR China; Department of Nephrology, People's Hospital of Linzi District, Zibo, Shandong 255400, PR China
| | - Xiaoqin Zhong
- Department of Gastroenterology, People's Hospital of Linzi District, Zibo, Shandong 255400, PR China
| | - Jingbo Chen
- Department of Gastrointestinal Surgery, Qianfoshan Hospital affiliated to Shandong University, Jinan, Shandong, 250014, PR China
| | - Chunguo Li
- Department of Nephrology, People's Hospital of Linzi District, Zibo, Shandong 255400, PR China
| | - Ming Shang
- Department of Nephrology, People's Hospital of Linzi District, Zibo, Shandong 255400, PR China
| | - Cheng Jiang
- Department of Nephrology, People's Hospital of Linzi District, Zibo, Shandong 255400, PR China
| | - Hairong Yang
- Department of Nephrology, People's Hospital of Linzi District, Zibo, Shandong 255400, PR China
| | - Weidong Zhao
- Department of Gastroenterology, People's Hospital of Linzi District, Zibo, Shandong 255400, PR China
| | - Liqiu Liu
- Department of Nephrology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, PR China.
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Chan JCN, So W, Ma RCW, Tong PCY, Wong R, Yang X. The Complexity of Vascular and Non-Vascular Complications of Diabetes: The Hong Kong Diabetes Registry. CURRENT CARDIOVASCULAR RISK REPORTS 2011; 5:230-239. [PMID: 21654912 PMCID: PMC3085116 DOI: 10.1007/s12170-011-0172-6] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Diabetes is a complex disease characterized by chronic hyperglycemia and multiple phenotypes. In 1995, we used a doctor-nurse-clerk team and structured protocol to establish the Hong Kong Diabetes Registry in a quality improvement program. By 2009, we had accrued 2616 clinical events in 9588 Chinese type 2 diabetic patients with a follow-up duration of 6 years. The detailed phenotypes at enrollment and follow-up medications have allowed us to develop a series of risk equations to predict multiple endpoints with high sensitivity and specificity. In this prospective database, we were able to validate findings from clinical trials in real practice, confirm close links between cardiovascular and renal disease, and demonstrate the emerging importance of cancer as a leading cause of death. In addition to serving as a tool for risk stratification and quality assurance, ongoing data analysis of the registry also reveals secular changes in disease patterns and identifies unmet needs.
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Affiliation(s)
- Juliana C. N. Chan
- Hong Kong Institute of Diabetes and Obesity, Shatin, NT Hongkong SAR
- Department of Medicine and Therapeutics, The Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, NT Hongkong SAR
- Qualigenics Diabetes Centre, Hong Kong SAR, China
| | - Wingyee So
- Hong Kong Institute of Diabetes and Obesity, Shatin, NT Hongkong SAR
- Department of Medicine and Therapeutics, The Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, NT Hongkong SAR
| | - Ronald C. W. Ma
- Hong Kong Institute of Diabetes and Obesity, Shatin, NT Hongkong SAR
- Department of Medicine and Therapeutics, The Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, NT Hongkong SAR
| | - Peter C. Y. Tong
- Hong Kong Institute of Diabetes and Obesity, Shatin, NT Hongkong SAR
- Department of Medicine and Therapeutics, The Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, NT Hongkong SAR
- Qualigenics Diabetes Centre, Hong Kong SAR, China
| | - Rebecca Wong
- Department of Medicine and Therapeutics, The Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, NT Hongkong SAR
| | - Xilin Yang
- Hong Kong Institute of Diabetes and Obesity, Shatin, NT Hongkong SAR
- Department of Medicine and Therapeutics, The Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, NT Hongkong SAR
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So WY, Tong PC, Ko GT, Ma RC, Ozaki R, Kong AP, Yang X, Ho CS, Lam CC, Chan JC. Low plasma adiponectin level, white blood cell count and Helicobacter pylori titre independently predict abnormal pancreatic beta-cell function. Diabetes Res Clin Pract 2009; 86:89-95. [PMID: 19747747 DOI: 10.1016/j.diabres.2009.08.010] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2009] [Revised: 08/07/2009] [Accepted: 08/20/2009] [Indexed: 01/11/2023]
Abstract
Adiponectin is an adipocytokine with insulin sensitizing effect while chronic inflammation damages pancreatic beta-cells leading to reduced insulin response. We aimed to prove the hypothesis that adiponectin levels and inflammatory markers (white blood cell counts [WCC], Helicobacter pylori [HP] titers, high sensitivity C-reactive protein [hs-CRP]) may interact to affect risk of diabetes. We studied 288 Chinese men (age-median: 41.0 years, IQR: 35.3-46.0 years) being recruited from the community in Hong Kong. The mean adiponectin level was 5.39+/-2.81 microg/ml and 40.9% (n=107) had low adiponectin level (<4 microg/ml). On multiple regression analysis, adiponectin was negatively associated with diabetes, HOMA insulin resistance top quartile, plasma glucose (PG) and 2h insulin; and positively associated with HOMA insulin sensitivity index. WCC was independently associated with PG and 15' insulin, and negatively associated with HOMA insulin sensitivity top quartile. HP titre was associated with 30' PG level and diabetes. hs-CRP did not enter the multivariable model. In conclusion, adiponectin, WCC and HP titer are independent predictors for hyperglycemia and reduced insulin sensitivity in Chinese men. These findings may explain the high risk for diabetes in Chinese population despite their relatively low adiposity.
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Affiliation(s)
- Wing-Yee So
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
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Cheng AYS, Kong APS, Wong VWS, So WY, Chan HLY, Ho CS, Lam CWK, Tam JS, Chow CC, Cockram CS, Chan JCN, Tong PCY. Chronic hepatitis B viral infection independently predicts renal outcome in type 2 diabetic patients. Diabetologia 2006; 49:1777-84. [PMID: 16736132 DOI: 10.1007/s00125-006-0294-4] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2005] [Accepted: 03/29/2006] [Indexed: 01/07/2023]
Abstract
AIMS/HYPOTHESIS We examined the association between chronic hepatitis B virus (HBV) infection and clinical outcomes in a consecutive cohort of Chinese patients with type 2 diabetes. SUBJECTS, MATERIALS AND METHODS Between 1995 and 1999, 2,838 type 2 diabetes patients underwent comprehensive assessments and blood screening for hepatitis B surface antigen (HBsAg). The risk of occurrence of cardiovascular events and end-stage renal disease (defined as need for dialysis, doubling of serum creatinine or serum creatinine > or =500 micromol/l) was compared between HBsAg-positive and HBsAg-negative groups. RESULTS At baseline, HBV-infected patients (n=286, 10.1%) were younger (51.0+/-11.5 vs 53.7+/-12.7 years, p=0.004), had earlier onset of diabetes (51.0+/-11.5 vs 53.7+/-12.7 years, p=0.001) and a higher frequency of retinopathy (28 vs 22%, p=0.03) than non-HBV-infected patients. After a median follow-up of 3.5 years (interquartile range: 1.7-5.9 years) and adjustment of age, glycaemic control and other potential confounding factors, HBV-infected patients were more likely to develop end-stage renal disease than non-HBV infected patients (8.7 vs 6.4%) with a hazard ratio of 4.5 (95% CI 1.1-18.6). The difference in the frequency of cardiovascular endpoints was not statistically significant. CONCLUSIONS In Chinese type 2 diabetes patients, chronic HBV infection was associated with increased risk of end-stage renal disease, and this was independent of other potential confounding factors. Early identification of HBV status and close surveillance of renal function are important in patients with type 2 diabetes who are living in areas where HBV is endemic or who are at risk of chronic HBV infection.
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Affiliation(s)
- A Y S Cheng
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, NT, Hong Kong SAR, People's Republic of China
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Nilsson HO, Pietroiusti A, Gabrielli M, Zocco MA, Gasbarrini G, Gasbarrini A. Helicobacter pylori and extragastric diseases--other Helicobacters. Helicobacter 2005; 10 Suppl 1:54-65. [PMID: 16178972 DOI: 10.1111/j.1523-5378.2005.00334.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
The involvement of Helicobacter pylori in the pathogenesis of extragastric diseases continues to be an interesting topic in the field of Helicobacter-related pathology. Although conflicting findings have been reported for most of the disorders, a role of H. pylori seems to be important especially for the development of cardiovascular and hematologic disorders. Previously isolated human and animal Helicobacter sp. flexispira and "Helicobacter heilmannii" strains have been validated using polyphasic taxonomy. A novel enterohepatic Helicobacter has been isolated from mastomys and mice, adding to the list of helicobacters that colonize the liver. Genetic targets that may aid the classification of novel Helicobacter species have emerged. Animal models of Helicobacter-induced gastric and hepatobiliary diseases have offered insights to the mechanisms associated with premalignant transformation.
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Current literature in diabetes. Diabetes Metab Res Rev 2005; 21:71-8. [PMID: 15624121 DOI: 10.1002/dmrr.534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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