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Liu L, Wu X, Tang Q, Miao Y, Bai X, Li J, Li K, Dan X, Wu Y, Yan P, Wan Q. Positive Association of Pulse Pressure with Presence of Albuminuria in Chinese Adults with Prediabetes: A Community-Based Study. Metab Syndr Relat Disord 2024; 22:302-314. [PMID: 38683639 DOI: 10.1089/met.2023.0177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2024] Open
Abstract
Purpose: There has been limited evidence for the association between pulse pressure (PP) and proteinuria in prediabetes. The aim of our study was to explore the association between PP and albuminuria in community-dwelling Chinese adults with prediabetes. Materials and Methods: PP and urinary albumin-to-creatinine ratio (ACR) were measured in 2012 prediabetic patients and 3596 control subjects with normal glucose tolerance. Multivariate logistic regression models were used to evaluate the possible association of PP with the risk of presence of albuminuria. Results: PP was positively associated with the presence of albuminuria, and subjects in the higher PP quartiles had higher urinary ACR and presence of albuminuria as compared with those in the lowest quartile in both prediabetes and control groups (all P < 0.01). Multivariate logistic regression analysis demonstrated that the highest PP quartile was positively associated with increased risk of presence of albuminuria in all prediabetic subjects [odds ratio (OR): 2.289, 95% confidence interval (CI) 1.364-3.842, P < 0.01) and prediabetic subjects without anti-hypertensive drugs (OR: 1.932, 95% CI 1.116-3.343, P < 0.01), whereas higher PP quartile has nothing to do with the risk of presence of albuminuria in control subjects with and without anti-hypertensive drugs after adjustment for potential confounders (all P > 0.01). Consistently, stratified analysis showed that in the prediabetes group, the risks of presence of albuminuria progressively elevated with increasing PP quartiles in men, those aged 60 years or older, and with overweight/obesity, normal high-density lipoprotein cholesterol, and appropriate low-density lipoprotein cholesterol (all P for trend <0.05). Conclusion: Higher PP is independently related to increased risk of presence of albuminuria in community-dwelling Chinese adults with prediabetes.
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Affiliation(s)
- Lilan Liu
- Department of Endocrinology, Hejiang People's Hospital, Luzhou, China
| | - Xian Wu
- Department of Endocrinology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Metabolic Vascular Disease Key Laboratory of Sichuan Province, Luzhou, China
- Sichuan Clinical Research Center for Nephropathy, Luzhou, China
- Cardiovascular and Metabolic Diseases Key Laboratory of Luzhou, Luzhou, China
| | - Qian Tang
- Department of Endocrinology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Metabolic Vascular Disease Key Laboratory of Sichuan Province, Luzhou, China
- Sichuan Clinical Research Center for Nephropathy, Luzhou, China
- Cardiovascular and Metabolic Diseases Key Laboratory of Luzhou, Luzhou, China
| | - Ying Miao
- Department of Endocrinology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Metabolic Vascular Disease Key Laboratory of Sichuan Province, Luzhou, China
- Sichuan Clinical Research Center for Nephropathy, Luzhou, China
- Cardiovascular and Metabolic Diseases Key Laboratory of Luzhou, Luzhou, China
| | - Xue Bai
- Department of Endocrinology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Metabolic Vascular Disease Key Laboratory of Sichuan Province, Luzhou, China
- Sichuan Clinical Research Center for Nephropathy, Luzhou, China
- Cardiovascular and Metabolic Diseases Key Laboratory of Luzhou, Luzhou, China
| | - Jia Li
- Department of Endocrinology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Metabolic Vascular Disease Key Laboratory of Sichuan Province, Luzhou, China
- Sichuan Clinical Research Center for Nephropathy, Luzhou, China
- Cardiovascular and Metabolic Diseases Key Laboratory of Luzhou, Luzhou, China
| | - Ke Li
- Department of Endocrinology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Metabolic Vascular Disease Key Laboratory of Sichuan Province, Luzhou, China
- Sichuan Clinical Research Center for Nephropathy, Luzhou, China
- Cardiovascular and Metabolic Diseases Key Laboratory of Luzhou, Luzhou, China
| | - Xiaofang Dan
- Department of Endocrinology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Metabolic Vascular Disease Key Laboratory of Sichuan Province, Luzhou, China
- Sichuan Clinical Research Center for Nephropathy, Luzhou, China
- Cardiovascular and Metabolic Diseases Key Laboratory of Luzhou, Luzhou, China
| | - Yuru Wu
- Department of Endocrinology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Metabolic Vascular Disease Key Laboratory of Sichuan Province, Luzhou, China
- Sichuan Clinical Research Center for Nephropathy, Luzhou, China
- Cardiovascular and Metabolic Diseases Key Laboratory of Luzhou, Luzhou, China
| | - Pijun Yan
- Department of Endocrinology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Metabolic Vascular Disease Key Laboratory of Sichuan Province, Luzhou, China
- Sichuan Clinical Research Center for Nephropathy, Luzhou, China
- Cardiovascular and Metabolic Diseases Key Laboratory of Luzhou, Luzhou, China
| | - Qin Wan
- Department of Endocrinology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Metabolic Vascular Disease Key Laboratory of Sichuan Province, Luzhou, China
- Sichuan Clinical Research Center for Nephropathy, Luzhou, China
- Cardiovascular and Metabolic Diseases Key Laboratory of Luzhou, Luzhou, China
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Song J, Wang P, Li H. U-shaped relationship between fasting blood glucose and urinary albumin-to-creatinine ratio in the general United States population. Front Endocrinol (Lausanne) 2024; 15:1334949. [PMID: 38559692 PMCID: PMC10978799 DOI: 10.3389/fendo.2024.1334949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 02/27/2024] [Indexed: 04/04/2024] Open
Abstract
Objective The current controversy surrounding the association between fasting blood glucose (FBG) and albuminuria necessitates further investigation. Hence, the primary objective of this study was to examine the relationship between FBG and urinary albumin-to-creatinine ratio (UACR). Methods A cohort of complete data from National Health and Nutrition Examination Survey (NHANES) participants (1999-2020) was analyzed. Linear regression analyses and a generalized additive model explored the association between FBG and UACR. Furthermore, the stability of this relationship across different populations was assessed. Results The study involved a total of 20,264 participants who were identified as U.S. citizens. By employing linear regression analysis, a statistically significant relationship was observed between elevated FBG levels and an increase in UACR (P<0.0001). Additionally, using a generalized additive model analysis, a U-shaped correlation between FBG and UACR was identified. Further examination using threshold effect analysis indicated a turning point for FBG at 5.44 mmol/L. A noteworthy finding in multiple populations is the consistent U-shaped association between FBG and UACR, except for individuals with serum uric acid levels ≥420 μmol/L and those who refrain from alcohol consumption. Conclusion The general U.S. population has a U-shaped nonlinear relationship between FBG and UACR.
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Affiliation(s)
- Jianling Song
- Department of Nephrology, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
| | - Ping Wang
- Department of Gynecology and Obstetrics, Yongfeng People’s Hospital, Jian, Jiangxi, China
| | - Hong Li
- Department of Medical Records, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
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Löfgren L, von Euler Chelpin M, Bhat M, Althage M, Hober A, Edfors F, Ruckh T, Challis B, Davidsson P, Miliotis T. Patient-Centric Quantitative Microsampling for Accurate Determination of Urine Albumin to Creatinine Ratio (UACR) in a Clinical Setting. J Appl Lab Med 2024; 9:329-341. [PMID: 38113397 DOI: 10.1093/jalm/jfad111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 10/18/2023] [Indexed: 12/21/2023]
Abstract
BACKGROUND Developing and implementing new patient-centric strategies for drug trials lowers the barrier to participation for some patients by reducing the need to travel to research sites. In early chronic kidney disease (CKD) trials, albuminuria is the key measure for determining treatment effect prior to pivotal kidney outcome trials. METHODS To facilitate albuminuria sample collection outside of a clinical research site, we developed 2 quantitative microsampling methods to determine the urinary albumin to creatinine ratio (UACR). Readout was performed by LC-MS/MS. RESULTS For the Mitra device the within-batch precision (CV%) was 2.8% to 4.6% and the between-batch precision was 5.3% to 6.1%. Corresponding data for the Capitainer device were 4.0% to 8.6% and 6.7% to 9.0%, respectively. The storage stability at room temperature for 3 weeks was 98% to 103% for both devices. The recovery for the Mitra and Capitainer devices was 104% (SD 7.0%) and 95 (SD 7.4%), respectively. The inter-assay comparison of UACR assessment generated results that were indistinguishable regardless of microsampling technique. The accuracy based on LC-MS/MS vs analysis of neat urine using a clinical chemistry analyzer was assessed in a clinical setting, resulting in 102 ± 8.0% for the Mitra device and 95 ± 10.0% for the Capitainer device. CONCLUSIONS Both UACR microsampling measurements exhibit excellent accuracy and precision compared to a clinical chemistry analyzer using neat urine. We applied our patient-centric sampling strategy to subjects with heart failure in a clinical setting. Precise UACR measurements using quantitative microsampling at home would be beneficial in clinical drug development for kidney therapies.
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Affiliation(s)
- Lars Löfgren
- Translational Science and Experimental Medicine, Cardiovascular, Renal and Metabolism, IMED Biotech Unit, AstraZeneca, Gothenburg, Sweden
| | - Marianne von Euler Chelpin
- Translational Science and Experimental Medicine, Cardiovascular, Renal and Metabolism, IMED Biotech Unit, AstraZeneca, Gothenburg, Sweden
| | - Maria Bhat
- Translational Science and Experimental Medicine, Cardiovascular, Renal and Metabolism, IMED Biotech Unit, AstraZeneca, Gothenburg, Sweden
| | - Magnus Althage
- Translational Science and Experimental Medicine, Cardiovascular, Renal and Metabolism, IMED Biotech Unit, AstraZeneca, Gothenburg, Sweden
| | - Andreas Hober
- Translational Science and Experimental Medicine, Cardiovascular, Renal and Metabolism, IMED Biotech Unit, AstraZeneca, Gothenburg, Sweden
- Science for Life Laboratory, KTH Royal Institute of Technology, Solna, Sweden
- Division of Systems Biology, Department of Protein Science, School of Chemistry, Biotechnology and Health, KTH Royal Institute of Technology, Stockholm.Sweden
| | - Fredrik Edfors
- Science for Life Laboratory, KTH Royal Institute of Technology, Solna, Sweden
- Division of Systems Biology, Department of Protein Science, School of Chemistry, Biotechnology and Health, KTH Royal Institute of Technology, Stockholm.Sweden
| | - Tim Ruckh
- R&D Digital Health, AstraZeneca, Gothenburg, Sweden
| | - Benjamin Challis
- Translational Science and Experimental Medicine, Cardiovascular, Renal and Metabolism, IMED Biotech Unit, AstraZeneca, Gothenburg, Sweden
| | - Pia Davidsson
- Translational Science and Experimental Medicine, Cardiovascular, Renal and Metabolism, IMED Biotech Unit, AstraZeneca, Gothenburg, Sweden
| | - Tasso Miliotis
- Translational Science and Experimental Medicine, Cardiovascular, Renal and Metabolism, IMED Biotech Unit, AstraZeneca, Gothenburg, Sweden
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Tao J, Sang D, Zhang X, Liu X, Wang G, Chen S, Wu S, Geng W. An elevated urinary albumin-to-creatinine ratio increases the risk of incident cardia-cerebrovascular disease in individuals with type 2 diabetes. Diabetol Metab Syndr 2024; 16:30. [PMID: 38291519 PMCID: PMC10829292 DOI: 10.1186/s13098-024-01256-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 01/02/2024] [Indexed: 02/01/2024] Open
Abstract
AIMS We aimed to explore the associations between urine albumin-to-creatinine ratio (uACR) and cardia-cerebrovascular disease (CVD) in Chinese population with type 2 diabetes(T2D). METHODS We included 8975 participants with T2D but free of prevalent CVD (including myocardial infarction, ischemic and hemorrhagic stroke) at baseline from Kailuan study who were assessed with uACR between 2014 and 2016. The participants were divided into three groups based on their baseline uACR: normal (< 3 mg/mmol), microalbuminuria (3-30 mg/mmol), and macroalbuminuria (≥ 30 mg/mmol). Cox regression models and restricted cubic spline were used to evaluate the hazard ratios (HRs) and 95% confidence intervals (CIs) of incident CVD. The area under the receiver operating characteristic curve (AUC), net reclassification improvement (NRI), and integrated discrimination improvement (IDI) were used to see if incorporating uACR into existing models could improve performance. RESULTS During a median follow-up of 4.05 years, 560 participants developed first CVD event (6.24%). After adjustment for potential confounders, participants with microalbuminuria had higher risks of CVD compared with normal uACR, with HRs of 1.57(95% CI 1.04-2.37) for myocardial infarction, 1.24(95% CI 1.00-1.54) for ischemic stroke,1.62(95% CI 0.73-3.61) for hemorrhagic stroke, and 1.30(95% CI 1.07-1.57) for total CVD. The risks gradually attenuated with uACR increase, with HRs of 2.86(95% CI 1.63-5.00) for myocardial infarction, 2.46(95% CI 1.83-3.30) for ischemic stroke, 4.69(95% CI 1.72-12.78) for hemorrhagic stroke, and 2.42(95% CI 1.85-3.15) for total CVD in macroalbuminuria. The addition of uACR to established CVD risk models improved the CVD risk prediction efficacy. CONCLUSIONS Increasing uACR, even below the normal range, is an independent risk factor for new-onset CVD in T2D population. Furthermore, uACR could improve the risk prediction for CVD among community based T2D patients.
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Affiliation(s)
- Jie Tao
- Department of Cardiology, Baoding NO. 1 Central Hospital, N0. 320, Changcheng Street, Baoding, Hebei, China
| | - Dasen Sang
- Department of Cardiology, Baoding NO. 1 Central Hospital, N0. 320, Changcheng Street, Baoding, Hebei, China
| | - Xinxin Zhang
- Department of Cardiology, Baoding NO. 1 Central Hospital, N0. 320, Changcheng Street, Baoding, Hebei, China
| | - Xin Liu
- Department of Cardiology, Baoding NO. 1 Central Hospital, N0. 320, Changcheng Street, Baoding, Hebei, China
| | - Guodong Wang
- Department of Cardiology, Kailuan General Hospital, 57 Xinhua Road(East), Tangshan, Hebei, China
| | - Shuohua Chen
- Department of Cardiology, Kailuan General Hospital, 57 Xinhua Road(East), Tangshan, Hebei, China
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, 57 Xinhua Road(East), Tangshan, Hebei, China.
| | - Wei Geng
- Department of Cardiology, Baoding NO. 1 Central Hospital, N0. 320, Changcheng Street, Baoding, Hebei, China.
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Fukuda S, Shirase U, Ogimoto S, Nakagawa M, Nakagawa K, Tominaga A, Morioka H. Association between elevated serum transaminase and moderately increased albuminuria: a cross-sectional study in western Tokushima, Japan. BMC Nephrol 2023; 24:358. [PMID: 38053047 PMCID: PMC10696726 DOI: 10.1186/s12882-023-03411-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 11/24/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND This study aimed to identify the factors relating to moderately increased albuminuria among middle-aged and older individuals in Japan. METHODS We conducted specific health examinations in which we measured albuminuria levels, and administered a questionnaire survey to record participants' lifestyles in western Tokushima Prefecture, Japan. A total of 1,660 people whose albuminuria was less than 300 mg/g creatinine (Cr) were analyzed. We divided participants into two groups-those with normal albuminuria (< 30 mg/gCr) and those with moderately increased albuminuria (≥ 30 mg/gCr, > 300 mg/gCr)-and compared their characteristics. To investigate all relevant factors, we conducted a multivariate logistic regression analysis. RESULTS The moderately increased albuminuria group were significantly older and had, among them, significantly higher percentages of a body mass index (BMI) ≥ 25 kg/m2, diabetes, hypertension, and mild liver disorder (aspartate transaminase ≥ 31 U/L or alanine aminotransferase ≥ 31 U/L or gamma-glutamyl transferase ≥ 51 U/L). (p < 0.01) In a multivariate logistic regression analysis that used microalbuminuria as an independent variable, we found the adjusted odds ratio (AOR) and 95% confidence interval (CI) to be significantly higher among individuals with diabetes (AOR: 2.04, 95% CI: 1.40-2.99); hypertension (AOR: 1.90, 95% CI: 1.36-2.65); BMI ≥ 25 kg/m2 (AOR: 1.76, 95% CI: 1.27-2.44); and mild liver disorder (AOR: 1.54, 95% CI: 1.10-2.18). CONCLUSIONS In addition to diabetes, hypertension, and BMI ≥ 25 kg/m2, this study found that among the middle-aged and older general population living in western Tokushima Prefecture, there were cases of mild liver disorder (elevated serum transaminase), which independently associated with moderately increased albuminuria. Therefore, in health checkups targeting the general population, there is a need to consider measuring albuminuria, even in those who have only mild liver dysfunction (health guidance level). TRIAL REGISTRATION N/A.
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Affiliation(s)
- Shoichi Fukuda
- Department of Public Health, Graduate School of Biomedical Sciences, Tokushima University, 3-18-15, Kuramoto, Tokushima city, Tokushima, 770-8503, Japan
| | - Ukyo Shirase
- Department of Public Health, Graduate School of Biomedical Sciences, Tokushima University, 3-18-15, Kuramoto, Tokushima city, Tokushima, 770-8503, Japan
| | - Shigeru Ogimoto
- Mima Public Health Centre, 23-23, Myouren, Anabuki, Mima city, Tokushima, 777-0005, Japan
| | - Mai Nakagawa
- Department of Public Health, Graduate School of Biomedical Sciences, Tokushima University, 3-18-15, Kuramoto, Tokushima city, Tokushima, 770-8503, Japan
| | - Kazumi Nakagawa
- Department of Public Health, Graduate School of Biomedical Sciences, Tokushima University, 3-18-15, Kuramoto, Tokushima city, Tokushima, 770-8503, Japan
| | - Ayumu Tominaga
- Department of Public Health, Graduate School of Biomedical Sciences, Tokushima University, 3-18-15, Kuramoto, Tokushima city, Tokushima, 770-8503, Japan
| | - Hisayoshi Morioka
- Department of Public Health, Graduate School of Biomedical Sciences, Tokushima University, 3-18-15, Kuramoto, Tokushima city, Tokushima, 770-8503, Japan.
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Magwai T, Modjadji P, Choma S. Association of microalbuminuria with serum lipids and inflammatory markers in an adult population in the Dikgale Health and Demographic Surveillance System site, South Africa. Cardiovasc J Afr 2022; 33:234-242. [PMID: 35687086 PMCID: PMC9887442 DOI: 10.5830/cvja-2021-055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 01/06/2021] [Indexed: 06/15/2023] Open
Abstract
BACKGROUND There is evidence that microalbuminuria (urinary albumin excretion) is an early sign of vascular damage and an established risk factor for cardiovascular morbidity and mortality. This study investigated the magnitude of microalbuminuria and its association with serum lipids and inflammatory markers among a rural black population residing in the Dikgale Health and Demographic Surveillance System site, South Africa. METHODS Data were collected from 602 presumably healthy participants (225 men and 377 women) aged ≥ 18 years. Biochemical data collection included serum lipids, glucose, insulin, high-sensitivity C-reactive protein (hs-CRP), urine albumin and creatinine. Anthropometry and blood pressure were also measured. Microalbuminuria was diagnosed with an albumin-creatinine ratio of ≥ 2.5 mg/mmol in men and ≥ 3.5 mg/mmol in women. Data were analysed using SPSS version 22.0. RESULTS The mean age of participants was 48.63 ± 20.89 years. High percentages of microalbuminaria (35.7%), high levels of interleukin 6 (17.8%), hs-CRP (32.9%), triglycerides (TG) (26.1%), low-density lipoprotein cholesterol (52.2%) and total cholesterol (32.0%), and low levels of high-density lipoprotein cholesterol (29.1%) were observed in the population. Increased glucose levels (32.8%), insulin resistance (27.6%), hypertension (45.8%), overweight (26.8%) and obesity (25.4%) were also prevalent. Microalbuminuria was associated with high hs-CRP and TG levels in the men (adjusted odds ratios = 9.434, 95% confidence interval: 1.753 - 50.778, p = 0.01). CONCLUSIONS High prevalence of microalbuminuria, hypertension, insulin resistance, overweight and obesity, as well as abnormal levels of serum lipids and inflammatory markers were observed in the population. Microalbuminuria was associated with high hs-CRP and TG levels among men.
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Affiliation(s)
- Thabo Magwai
- Department of Pathology and Medical Sciences, School of Health Care Sciences, Faculty of Health Sciences, University of Limpopo, South Africa.
| | - Perpetua Modjadji
- Department of Pathology and Medical Sciences, School of Health Care Sciences, Faculty of Health Sciences, University of Limpopo, South Africa; Department of Public Health, School of Health Care Sciences, Sefako Makgatho Health Sciences University, South Africa
| | - Solomon Choma
- Department of Pathology and Medical Sciences, School of Health Care Sciences, Faculty of Health Sciences, University of Limpopo, South Africa
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Ouyang L, Yu C, Xie Z, Su X, Xu Z, Song P, Li J, Huang H, Ding Y, Zou MH. Indoleamine 2,3-Dioxygenase 1 Deletion-Mediated Kynurenine Insufficiency in Vascular Smooth Muscle Cells Exacerbates Arterial Calcification. Circulation 2022; 145:1784-1798. [PMID: 35582948 DOI: 10.1161/circulationaha.121.057868] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND IDO1 (indoleamine 2,3-dioxygenase 1) is the rate-limiting enzyme for tryptophan metabolism. IDO1 malfunction is involved in the pathogenesis of atherosclerosis. Vascular smooth muscle cells (VSMCs) with an osteogenic phenotype promote calcification and features of plaque instability. However, it remains unclear whether aberrant IDO1-regulated tryptophan metabolism causes VSMCs osteogenic reprogramming and calcification. METHODS We generated global Apoe (apolipoprotein E) and Ido1 double knockout mice, and Apoe knockout mice with specific deletion of IDO1 in VSMCs or macrophages. Arterial intimal calcification was evaluated by a Western diet-induced atherosclerotic calcification model. RESULTS Global deficiency of IDO1 boosted calcific lesion formation without sex bias in vivo. Conditional IDO1 loss of function in VSMCs rather than macrophages promoted calcific lesion development and the abundance of RUNX2 (runt-related transcription factor 2). In contrast, administration of kynurenine via intraperitoneal injection markedly delayed the progression of intimal calcification in parallel with decreased RUNX2 expression in both Apoe-/- and Apoe-/- Ido1-/- mice. We found that IDO1 deletion restrained RUNX2 from proteasomal degradation, which resulted in enhanced osteogenic reprogramming of VSMCs. Kynurenine administration downregulated RUNX2 in an aryl hydrocarbon receptor-dependent manner. Kynurenine acted as the endogenous ligand of aryl hydrocarbon receptor, controlled resultant interactions between cullin 4B and aryl hydrocarbon receptor to form an E3 ubiquitin ligase that bound with RUNX2, and subsequently promoted ubiquitin-mediated instability of RUNX2 in VSMCs. Serum samples from patients with coronary artery calcification had impaired IDO1 activity and decreased kynurenine catabolites compared with those without calcification. CONCLUSIONS Kynurenine, an IDO1-mediated tryptophan metabolism main product, promotes RUNX2 ubiquitination and subsequently leads to its proteasomal degradation via an aryl hydrocarbon receptor-dependent nongenomic pathway. Insufficient kynurenine exerts the deleterious role of IDO1 ablation in promoting RUNX2-mediated VSMCs osteogenic reprogramming and calcification in vivo.
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Affiliation(s)
- Liu Ouyang
- Center for Molecular and Translational Medicine, Georgia State University, Atlanta (L.Q., C.Y., P.S., J.L., Y.D., M.H.Z.)
| | - Changjiang Yu
- Center for Molecular and Translational Medicine, Georgia State University, Atlanta (L.Q., C.Y., P.S., J.L., Y.D., M.H.Z.)
| | - Zhiyong Xie
- School of Pharmaceutical Sciences (Shenzhen), Sun Yat-sen University, Guangzhou, China (Z. Xie, Z. Xu)
| | - Xiaoyan Su
- Department of Nephropathy, Tungwah Hospital of Sun Yat-sen University, Dongguan, China (X.S.)
| | - Zengmei Xu
- School of Pharmaceutical Sciences (Shenzhen), Sun Yat-sen University, Guangzhou, China (Z. Xie, Z. Xu)
| | - Ping Song
- Center for Molecular and Translational Medicine, Georgia State University, Atlanta (L.Q., C.Y., P.S., J.L., Y.D., M.H.Z.)
| | - Jian Li
- Center for Molecular and Translational Medicine, Georgia State University, Atlanta (L.Q., C.Y., P.S., J.L., Y.D., M.H.Z.)
| | - Hui Huang
- Department of Cardiology, the Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, China (H.H.)
| | - Ye Ding
- Center for Molecular and Translational Medicine, Georgia State University, Atlanta (L.Q., C.Y., P.S., J.L., Y.D., M.H.Z.)
| | - Ming-Hui Zou
- Center for Molecular and Translational Medicine, Georgia State University, Atlanta (L.Q., C.Y., P.S., J.L., Y.D., M.H.Z.)
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Madrim MF, Ja'afar MH, Hod R. Prevalence of abnormal urinary cadmium and risk of albuminuria as a primary bioindicator for kidney problems among a healthy population. PeerJ 2021; 9:e12014. [PMID: 34466292 PMCID: PMC8380425 DOI: 10.7717/peerj.12014] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 07/28/2021] [Indexed: 12/25/2022] Open
Abstract
Background The prevalence of chronic kidney disease is increasing globally, ranking 27th as the cause of death in the 1990s, rising to 18th in 2010 and 10th in 2019. Non-communicable diseases such as diabetes and hypertension have been identified as the common contributing factors, while there is also evidence linking environmental pollutants, especially cadmium, to kidney disease. This study aimed at investigating the level of urinary cadmium and its relationship to albuminuria as an early indicator of kidney problems in the Kepong community. Methods Respondents were surveyed as part of several health-related programs organized by the Kepong District Health Office involving local communities in and around the district from April 2019 to December 2019. Urinalysis of two urine samples was carried out using a Mission reagent strip and an Inductively Coupled Plasma Mass Spectrometry (ICP-MS) test to detect the presence and level of urinary cadmium. Results A total of 240 respondents were enrolled from April 2019 to December 2019. Urinalysis of two urine samples was carried out using a Mission reagent strip and an Inductively Coupled Plasma Mass Spectrometry (ICP-MS) test to detect the level of urinary cadmium. The respondents’ average age was 41-year-old (±13.23). Among them, 49.6% were male, 85.0% Malay, 5.8% Chinese and 8.3% Indian. 55.0% had background of tertiary, 39.6% secondary and 5.4% primary level of education. 52.1% were categorized in B40, 34.6% in M40 and 13.3% in T20 based on monthly household income category. 26.7% were hypertensive, 6.7% diabetic, 4.2% had dyslipidemia, 51.7% had urinary cadmium above the alert level, and 27.1% had albuminuria. Discussion Risk factors for albuminuria that have been identified are age with adjusted odds ratio (AOR) 3.53 (1.41–8.83; p < 0.05), highest educational level with AOR 2.18 (1.14–4.17; p < 0.05), diabetes with AOR 3.36 (1.07–10.52; p < 0.05), and urinary cadmium with AOR 4.72 (2.33–9.59; p < 0.001), with future screening programs placing greater attention to those at risk and further research is required to determine the cause of exposure to cadmium.
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Affiliation(s)
- Mohd Faizal Madrim
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Federal Territory of Kuala Lumpur, Malaysia.,Department of Public Health Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | - Mohd Hasni Ja'afar
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Federal Territory of Kuala Lumpur, Malaysia
| | - Rozita Hod
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Federal Territory of Kuala Lumpur, Malaysia
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Sun L, Wang C, Sun W, Wang C. A Pilot Study of Nutritional Status Prior to Bariatric Surgery in South China. Front Nutr 2021; 8:697695. [PMID: 34322512 PMCID: PMC8310917 DOI: 10.3389/fnut.2021.697695] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 06/14/2021] [Indexed: 12/29/2022] Open
Abstract
Objective: The was a pilot study to assess the biochemical and historical information about bariatric patients before undergoing the surgery in the aim of identifying nutritional deficiencies and their prevalence from 2015 to 2020. Methods: Clinical data of 247 patients (105 males and 142 females) were included. Vitamins, trace elements, electrolytes, albumin, globulin, hemoglobin, folate, ferritin, microalbuminuria (MAU), and parathyroid hormone (PTH) levels were determined to explore the nutritional status according to gender, age, high body mass index (BMI), and waist circumstance (WC). Results: The mean age, mean BMI, and mean WC of the candidates were 32.95 ± 10.46 years, 38.01 ± 7.11 kg/m2, and 117.04 ± 16.18 cm, respectively. The prevalence of preoperative nutritional deficiencies was 76.88% for 25 (OH) vitamin D, 19.84% for globulin, 11.74% for albumin, 11.02% for sodium, 8.33% for folic acid, 10.48% (male) and 6.34% (female) for chloride, 4.05% for calcium, 3.07% (male) and 0.70%(female) for ferritin, 11.90% for elevated PTH, and 44.96% for MAU. Males exhibited increased prevalence of globulin and MAU relative to females (P < 0.05). Older groups are more likely to exhibit albumin deficiency (P = 0.007), globulin deficiency (P = 0.003), and zinc deficiency (P = 0.015). In addition, 25 (OH) D deficiency and albumin deficiency were more common in patients with BMI ≥ 47.5 kg/m2 (P = 0.049 and 0.015, respectively). Wider WC (≥150 cm) exhibited higher rates of albumin deficiencies (P = 0.011). Conclusion: Electrolyte and nutritional deficiencies were common in patients prior to bariatric surgery in South China. Routine evaluation of electrolyte and nutritional levels should be carried out in this population.
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Affiliation(s)
- Linli Sun
- Department of General Surgery, The Third Xiangya Hospital, Central South University, Changsha, China
| | | | - Wei Sun
- Department of Pharmacy, Third Xiangya Hospital, Central South University, Changsha, China
| | - Chunjiang Wang
- Department of Pharmacy, Third Xiangya Hospital, Central South University, Changsha, China
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Stelwagen J, Lubberts S, Steggink LC, Steursma G, Kruyt LM, Donkerbroek JW, van Roon AM, van Gessel AI, van de Zande SC, Meijer C, Gräfin Zu Eulenburg CH, Oosting SF, Nuver J, Walenkamp AME, Jan de Jong I, Lefrandt JD, Gietema JA. Vascular aging in long-term survivors of testicular cancer more than 20 years after treatment with cisplatin-based chemotherapy. Br J Cancer 2020; 123:1599-1607. [PMID: 32921790 PMCID: PMC7686327 DOI: 10.1038/s41416-020-01049-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 07/23/2020] [Accepted: 08/18/2020] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Late effects of cisplatin-based chemotherapy in testicular cancer survivors (TCS) include cardiovascular morbidity, but little data is available beyond 20 years. The objective was to assess vascular damage in very long-term TCS. METHODS TCS (treated with chemotherapy or orchiectomy only) and age-matched healthy controls were invited. Study assessment included vascular stiffness with ultrasound measurement of carotid-femoral pulse wave velocity (cf-PWV). RESULTS We included 127 TCS consisting of a chemotherapy group (70 patients) and an orchiectomy group (57 patients) along with 70 controls. Median follow-up was 28 years (range: 20-42). The cf-PWV (m/s) was higher in TCS than in controls (geometrical mean 8.05 (SD 1.23) vs. 7.60 (SD 1.21), p = 0.04). The cf-PWV was higher in the chemotherapy group than in the orchiectomy group (geometrical mean 8.39 (SD 1.22) vs. 7.61 (SD 1.21), p < 0.01). In the chemotherapy group cf-PWV increased more rapidly as a function of age compared to controls (regression coefficient b 7.59 × 10-3 vs. 4.04 × 10-3; p = 0.03). CONCLUSION Very long-term TCS treated with cisplatin-based chemotherapy show increased vascular damage compatible with "accelerated vascular aging" and continue to be at risk for cardiovascular morbidity, thus supporting the need for intensive cardiovascular risk management. CLINICAL TRIAL REGISTRATION The clinical trial registration number is NCT02572934.
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Affiliation(s)
- Johannes Stelwagen
- Department of Medical Oncology, University Medical Centre Groningen and University of Groningen, Groningen, The Netherlands
| | - Sjoukje Lubberts
- Department of Medical Oncology, University Medical Centre Groningen and University of Groningen, Groningen, The Netherlands
| | - Lars C Steggink
- Department of Medical Oncology, University Medical Centre Groningen and University of Groningen, Groningen, The Netherlands
| | - Gerrie Steursma
- Department of Medical Oncology, University Medical Centre Groningen and University of Groningen, Groningen, The Netherlands
| | - Lara M Kruyt
- Department of Medical Oncology, University Medical Centre Groningen and University of Groningen, Groningen, The Netherlands
| | - Jan Willem Donkerbroek
- Department of Medical Oncology, University Medical Centre Groningen and University of Groningen, Groningen, The Netherlands
| | - Arie M van Roon
- Department of Internal Medicine, division of Vascular Medicine, University Medical Centre Groningen and University of Groningen, Groningen, The Netherlands
| | - Anne I van Gessel
- Department of Internal Medicine, division of Vascular Medicine, University Medical Centre Groningen and University of Groningen, Groningen, The Netherlands
| | - Saskia C van de Zande
- Department of Internal Medicine, division of Vascular Medicine, University Medical Centre Groningen and University of Groningen, Groningen, The Netherlands
| | - Coby Meijer
- Department of Medical Oncology, University Medical Centre Groningen and University of Groningen, Groningen, The Netherlands
| | | | - Sjoukje F Oosting
- Department of Medical Oncology, University Medical Centre Groningen and University of Groningen, Groningen, The Netherlands
| | - Janine Nuver
- Department of Medical Oncology, University Medical Centre Groningen and University of Groningen, Groningen, The Netherlands
| | - Annemiek M E Walenkamp
- Department of Medical Oncology, University Medical Centre Groningen and University of Groningen, Groningen, The Netherlands
| | - Igle Jan de Jong
- Department of Urology, University Medical Centre Groningen and University of Groningen, Groningen, The Netherlands
| | - Joop D Lefrandt
- Department of Internal Medicine, division of Vascular Medicine, University Medical Centre Groningen and University of Groningen, Groningen, The Netherlands
| | - Jourik A Gietema
- Department of Medical Oncology, University Medical Centre Groningen and University of Groningen, Groningen, The Netherlands.
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Chen Y, Wang P, Tung S, Kuo M, Weng S, Chou C, Chang C, Tsa C, Taso C, Shen F, Chen J. Association between Pro12Ala polymorphism and albuminuria in type 2 diabetic nephropathy. J Diabetes Investig 2020; 11:923-929. [PMID: 31912623 PMCID: PMC7378428 DOI: 10.1111/jdi.13208] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 12/11/2019] [Accepted: 01/02/2020] [Indexed: 12/22/2022] Open
Abstract
AIMS/INTRODUCTION Diabetic nephropathy (DN) is a complication of diabetes mellitus that is characterized by the gradual loss of kidney function, which results in increased levels of albumin in the urine. The Pro12Ala polymorphism in the peroxisome proliferator-activated receptor-γ2 gene has been confirmed to improve insulin sensitivity, but its association with susceptibility to DN in patients with type 2 diabetes remains inconclusive. MATERIALS AND METHODS To examine whether the Pro12Ala polymorphism leads to the development of DN, a case-control study was carried out in 554 patients with type 2 diabetes. The genotypes of Pro12Ala polymorphism of the peroxisome proliferator-activated receptor gamma 2 gene were analyzed by real-time polymerase chain reaction with TaqMan® probe genotyping assay in all patients. RESULTS The mean age of the study population was 57.7 ± 8.8 years, with average diabetes duration of 12.8 ± 6.9 years. The prevalence of albuminuria was 43.5%. The frequency of genotype Pro12Pro, Pro12Ala and Ala12Ala genotype were 92.6%, 7.0%, 0.4% in our study population, and 90.4%, 8.9% and 0.7% in normal urinary albumin-to-creatinine ratio group, respectively. The Ala carriers (Pro12Ala + Ala12Ala) had significantly lower urinary albumin-to-creatinine ratio (15.0 vs 20.5 mg/g, P = 0.001) and better renal function (estimated glomerular filtration rate 81.8 [69.8-97.6] vs 78.7 mL/min/1.73 m2 [61.6-96.2]; P = 0.05) compared with those with the genotype Pro12Pro. After adjustment for age, sex and other confounders, the odds ratio of albuminuria for the Ala12 allele was 0.428 (95% confidence interval 0.195-0.940, P = 0.034]). CONCLUSIONS Our results suggest that the peroxisome proliferator-activated receptor gamma 2 Ala12 variant has significant protective effects against albuminuria and DN.
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Affiliation(s)
- Yung‐Nien Chen
- Division of Metabolism and EndocrinologyDepartment of Internal MedicineKaohsiung Chang Gung Memorial HospitalChang Gung University College of MedicineKaohsiungTaiwan
| | - Pei‐Wen Wang
- Division of Metabolism and EndocrinologyDepartment of Internal MedicineKaohsiung Chang Gung Memorial HospitalChang Gung University College of MedicineKaohsiungTaiwan
| | - Shih‐Chen Tung
- Division of Metabolism and EndocrinologyDepartment of Internal MedicineKaohsiung Chang Gung Memorial HospitalChang Gung University College of MedicineKaohsiungTaiwan
| | - Ming‐Chun Kuo
- Division of Metabolism and EndocrinologyDepartment of Internal MedicineKaohsiung Chang Gung Memorial HospitalChang Gung University College of MedicineKaohsiungTaiwan
| | - Shao‐Wen Weng
- Division of Metabolism and EndocrinologyDepartment of Internal MedicineKaohsiung Chang Gung Memorial HospitalChang Gung University College of MedicineKaohsiungTaiwan
| | - Chen‐Kai Chou
- Division of Metabolism and EndocrinologyDepartment of Internal MedicineKaohsiung Chang Gung Memorial HospitalChang Gung University College of MedicineKaohsiungTaiwan
| | - Chih‐Min Chang
- Division of Metabolism and EndocrinologyDepartment of Internal MedicineKaohsiung Chang Gung Memorial HospitalChang Gung University College of MedicineKaohsiungTaiwan
| | - Chia‐Jen Tsa
- Division of Metabolism and EndocrinologyDepartment of Internal MedicineKaohsiung Chang Gung Memorial HospitalChang Gung University College of MedicineKaohsiungTaiwan
| | - Cheng‐Feng Taso
- Division of Metabolism and EndocrinologyDepartment of Internal MedicineKaohsiung Chang Gung Memorial HospitalChang Gung University College of MedicineKaohsiungTaiwan
| | - Feng‐Chih Shen
- Division of Metabolism and EndocrinologyDepartment of Internal MedicineKaohsiung Chang Gung Memorial HospitalChang Gung University College of MedicineKaohsiungTaiwan
| | - Jung‐Fu Chen
- Division of Metabolism and EndocrinologyDepartment of Internal MedicineKaohsiung Chang Gung Memorial HospitalChang Gung University College of MedicineKaohsiungTaiwan
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Abstract
INTRODUCTION Obesity is associated with metabolic syndrome, nonalcoholic steatohepatitis, and kidney disease. BMI may not be the ideal measure of obesity when used to assess its effect on kidney disease as it does not discriminate for age, sex, ethnicity, muscle, bone, or fat mass. OBJECTIVES To assess the prevalence microalbuminuria and identify independent risk factors for development of kidney disease in the obese Indian population. METHODS Age, weight, BMI, total body fat percentage, waist-to-hip ratio, hypertension, urinary albumin-to-creatinine ratio (UACR), and HbA1c were collected from 568 obese patients, presenting for bariatric surgery. Multivariate binary logistic regression was used to identify independent risk factors for kidney disease. RESULTS A total of 114 out of 568 (20.07%) obese patients had microalbuminuria (UACR range 30-283 μg/mg). HbA1C levels ≥ 6 (p = 0.01) and hypertension (p = 0.03) were the strongest independent variables for microalbuminuria. 14.67% with a BMI < 35 kg/m2, 21.30% with a BMI 35-50 kg/m2, and 19.44% with a BMI > 50 kg/m2 had microalbuminuria. Increasing BMI however was not statistically significant (p = 0.75). Total body fat percentage (p = 0.51), waist-to-hip ratio (p = 0.96), age (p = 0.30), sex (p = 0.38), and BMI (p = 0.75) were found to be statistically insignificant. CONCLUSIONS Kidney disease afflicts 1/5th of the obese Indian patients studied. Diabetes and hypertension remained as the most significant risk factors, while age, weight, increasing BMI, waist-to-hip ratio, or increasing body fat were found to be statistically insignificant for development and progression of kidney disease.
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Prevalence of Early Chronic Kidney Disease and Main Associated Factors in Spanish Population: Populational Study. J Clin Med 2019; 8:jcm8091384. [PMID: 31487800 PMCID: PMC6780839 DOI: 10.3390/jcm8091384] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 08/30/2019] [Accepted: 09/02/2019] [Indexed: 12/12/2022] Open
Abstract
The aim of this study was to determine the prevalence of early chronic kidney disease (EKD) (stages 1 and 2) and the factors associated. This was a populational study including individuals from 18–75 years randomly selected from 18 Primary Healthcare centers in the area of Barcelonès Nord and Maresme (Catalunya, Spain). Variables: anamnesis, physical examination, blood pressure, and analysis. EKD was defined with by a glomerular filtration rate (GFR) ≥60 mL/min/1.73 m2 and albumin/creatinine ratio (ACR) ≥17 mg/g in men and ≥25 mg/g in women confirmed with two determinations. 2871 individuals: 43% men, mean age 55 years (19–75), 32.2% obese, 50.5% abdominal obesity, 21.1% hypertensive, and 10.6% diabetic. Prevalence of EKD: With one determination 157 individuals (5.5%), 110 men (9%) and 47 women (2.8%); with two determinations 109 individuals (3.8%), 85 men (7%), and 24 women (1.5%). Factors independently associated with the multivariate logistic regression model: Man (OR 3.35), blood pressure ≥ 135/85 mmHg (OR 2.29), BMI ≥ 30 kg/m2 (OR 2.48), glycemia ≥ 100 mg/dL (OR 1.73), smoker (OR 1.67) and age (OR 1.04). The prevalence varies if the diagnosis is established based on one or two analytical determinations, overestimated if only one determination is made and depends on the value chosen to define urine albumin excretion.
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Rashidbeygi E, Safabakhsh M, Delshad Aghdam S, Mohammed SH, Alizadeh S. Metabolic syndrome and its components are related to a higher risk for albuminuria and proteinuria: Evidence from a meta-analysis on 10,603,067 subjects from 57 studies. Diabetes Metab Syndr 2019; 13:830-843. [PMID: 30641817 DOI: 10.1016/j.dsx.2018.12.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Accepted: 12/07/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND & AIM Previous studies have explored the relation of metabolic syndrome (MetS), its components and the risk of albuminuria/proteinuria but their results are inconsistent. Then, we aimed to conduct a meta-analysis in order to resolve these controversies. METHOD PubMed and Scopus were systematically searched from their inception to 1 march 2018. Risk estimates and their 95% confidence intervals were extracted and pooled using the random-effects approach. RESULT A total of 57 studies, 44 studies on albuminuria and 13 studies on proteinuria, with a total sample size of 10,603,067 participants, were included in this meta-analysis. Overall, MetS was contributed to higher risks of proteinuria (OR = 2.08, 95%CI = 1.85-2.34) and albuminuria (OR = 1.92, 95%CI = 1.71-2.15), independent of diabetes status; although, this relationship was more noticeable in studies that used the WHO definition of MetS and in non-East Asian populations. Also, the relationship between MetS and proteinuria was sex independent, while, for albuminuria was significant only in men. MetS components such as obesity, impaired fasting glucose, elevated blood pressure and hypertriglyceridemia were associated with significant increases in proteinuria and albuminuria risk, while lower HDL-Cholesterol was only linked to greater risk of proteinuria. Moreover, the total impact of MetS on proteinuria was more remarkable than each component of the syndrome and an escalating dose-response association was found between the number of MetS components and albuminuria risk. CONCLUSION MetS and its components are potential risk factors for albuminuria and proteinuria.
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Affiliation(s)
- Elaheh Rashidbeygi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Maryam Safabakhsh
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Saeideh Delshad Aghdam
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Shimels Hussien Mohammed
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences-International Campus (TUMS-IC), Tehran, Iran
| | - Shahab Alizadeh
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
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Impaired glomerular filtration rate, high grade albuminuria and associated factors among adult patients admitted to tertiary Hospital in Ethiopia. BMC Nephrol 2018; 19:345. [PMID: 30509207 PMCID: PMC6278145 DOI: 10.1186/s12882-018-1153-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Accepted: 11/23/2018] [Indexed: 11/10/2022] Open
Abstract
Background Chronic Kidney Disease (CKD), the worldwide Public Health problem, is also one of the rising non-communicable diseases in low and middle-income countries. Its early detection and treatment using readily available, inexpensive therapies can slow or prevent progression to end-stage renal disease. Hence, this study was aimed at assessing impaired estimated glomerular filtration rate (eGFR), high grade albuminuria, and associated factors among adult patients admitted to Jimma University Medical Center in South west Ethiopia. Methods Hospital based cross sectional study was conducted from November 1, 2016 to April 30, 2017. Consecutive sampling method was used to select study participants. Logistic regression analysis was conducted to generate factors associated with impaired estimated GFR and albuminuria. A P-value of < 0.05 was considered statistically significant. Results The study involved 422 patients admitted to Jimma University Medical Center who had at least one test result for urinalysis and serum creatinine level during the study period. Fifty two (12.3%) of the study subjects had high grade albuminuria, 19.2, 19.4, and 32.7% had impaired estimated glomerular filtration rate according to Modification of Diet in Renal Disease (MDRD-4), Chronic Kidney Disease Epidemiology (CKD-EPI), and Cockcroft-Gault (CG) equations respectively. Old age (AOR = 2.4;95%CI:1.4–4.01), male sex (AOR = 2.1;95%CI:1.16–3.7), and hypertension (AOR = 2.23; 95%CI:1.24–4.01) were independently associated with impaired eGFR using one of the two equations while diabetes mellitus (AOR = 2.8; 95%CI:1.33–5.82) and BP measurement above optimal (AOR = 4.7; 95%CI:1.9–11.53) were associated with high grade albuminuria. Conclusions High grade albuminuria and impaired eGFR were found in significant proportion of adults admitted to the hospital for various medical conditions. Old age, hypertension, diabetes mellitus and male gender were independently associated with these alterations. These findings necessitate routine urinalysis and estimation of GFR for all hospitalized adults with known CKD risk factors.
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Miao R, Wu L, Ni P, Zeng Y, Chen Z. The comorbidity of increased arterial stiffness and microalbuminuria in a survey of middle-aged adults in China. BMC Cardiovasc Disord 2018; 18:83. [PMID: 29728070 PMCID: PMC5935953 DOI: 10.1186/s12872-018-0817-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 04/24/2018] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Increased arterial stiffness (iAS) and microalbuminuria (MAU), which may occur simultaneously or separately in the general population and share similar risk factors, are markers of macro- and microvascular injuries. Our research investigated the comorbidity of iAS and MAU in the middle-aged population and examined the heterogeneous effects of metabolic risk factors on iAS and MAU. METHODS We selected 11,911 individuals aged 45 to 60 years who underwent a health examination at the 3rd Xiangya Hospital between 2010 and 2014. Metabolic syndrome (MetS) was determined according to IDF/NHLBI/AHA-2009 criteria. Multinomial logistic regression was applied to evaluate the influence of MetS, components of MetS and clusters of MetS on the co-occurrence (MAU(+)/iAS(+)) or non-co-occurrence (MAU(+)/iAS(-) and MAU(-)/iAS(+)) of MAU and iAS. RESULTS Reference group was MAU(-)/iAS(-). A positive effect of MetS on the presence of MAU(+)/iAS(-), MAU(-)/iAS(+), or MAU(+)/iAS(+) is listed in ascending order based on odds ratios (ORs = 2.11, 2.41, 4.61, respectively; P < 0.05). Compared with MAU(+)/iAS(-), Elevated blood pressure (BP) (OR = 1.62 vs. 4.83, P < 0.05), triglycerides(TG) (OR = 1.20 vs. 1.37, P < 0.05) were more strongly associated with MAU(-)/iAS(+), whereas fasting blood glucose (FBG) was less associated (OR = 1.37 vs. 1.31, P < 0.05). Decreased high-density lipoprotein cholesterol(HDL-c) (OR = 1.84, P < 0.01) and elevated waist circumference(WC) (OR = 1.28 P < 0.01) were the most strongly associated with MAU(+)/iAS(-). Compared with the individuals without MetS, individuals with the elevated BP, FBG, TG and decreased HDL-c cluster had the greatest likelihood of presenting a MAU(-)/iAS(+) (OR = 5.98, P < 0.01) and MAU(+)/iAS(+) (OR = 13.17, P < 0.01), these likelihood was even greater than the cluster with simultaneous alteration in all five MetS components (OR = 3.89 and 10.77, respectively, P < 0.01), which showed the most strongly association with MAU(+)/iAS(+) (OR = 5.22, P < 0.01). CONCLUSION Based on the heterogeneous influences of MetS-related risk factors on MAU and iAS, these influences could be selectively targeted to identify different types of vascular injuries.
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Affiliation(s)
- Rujia Miao
- Department of Health Management, the Third Xiangya Hospital, Central South University, Tongzipo Road 138, Changsha, 410013, Hunan Province, China
| | - Liuxin Wu
- Institute of Aviation Medicine, Beijing, China
| | - Ping Ni
- Statistics Department, Public Health Academy, Central South University, Changsha, Hunan, China
| | - Yue Zeng
- Department of Health Management, the Third Xiangya Hospital, Central South University, Tongzipo Road 138, Changsha, 410013, Hunan Province, China
| | - Zhiheng Chen
- Department of Health Management, the Third Xiangya Hospital, Central South University, Tongzipo Road 138, Changsha, 410013, Hunan Province, China.
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Abstract
: The burden of chronic kidney disease (CKD) is rising both in this country and worldwide. An estimated 10% to 15% of U.S. adults are currently living with CKD. Reducing the CKD burden requires a systematic, interdisciplinary approach to care. The greatest opportunities to reduce the impact of CKD arise early, when most patients are being followed in primary care; yet many clinicians are inadequately educated on this disease. Nurses are well positioned to facilitate the implementation of collaborative care. This two-part article aims to provide nurses with the basic information necessary to assess and manage patients with CKD. Part 1 offers an overview of the disease, describes identification and etiology, and discusses ways to slow disease progression. Part 2, which will appear next month, addresses disease complications and treatment of kidney failure.
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Toulis KA, Jiang CQ, Hemming K, Nirantharakumar K, Cheng KK, Lam TH, Thomas GN. Glycated Hemoglobin, Albuminuria and Surrogate Markers of Macrovascular Disease in Adults Without Diabetes: The Guangzhou Biobank Cohort Study, Cardiovascular Disease Subcohort. Can J Diabetes 2017; 42:245-250.e1. [PMID: 28689704 DOI: 10.1016/j.jcjd.2017.06.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Revised: 06/05/2017] [Accepted: 06/05/2017] [Indexed: 01/19/2023]
Abstract
OBJECTIVES To explore the clinical utility of glycated hemoglobin (A1C) levels as an early marker of albuminuria, macrovascular disease and subclinical cardiovascular disease in comparison to fasting and postprandial glucose levels in a well-characterized Chinese population with no history of diabetes. METHODS The study population consisted of 1223 individuals who were enrolled in the Guangzhou Biobank Cohort Study, Cardiovascular Disease Subcohort, and who had undergone oral glucose tolerance tests. The associations between each glycemic measure and albuminuria, carotid intima-media thickness (CIMT) and CIMT-based presence of carotid plaques and aortic arch calcification were assessed by chest radiographs. RESULTS The overall prevalence of albuminuria, carotid plaque and any aortic arch calcification was 20.6%, 22.8% and 25.8%, respectively. All 3 glycemia indices were significantly associated with albuminuria, but only 1 (fasting glucose) was associated with carotid plaques. No significant difference was detected among them in the area under the curve for albuminuria (chi-square test; p=0.84), carotid plaques (p=0.28) or calcifications (p=0.29). In sensitivity analysis, adjusted for age and sex, the above findings remained unchanged. CONCLUSIONS Although there was evidence suggesting differential associations, the performance of the glycemic indices was similar, and their association with macrovascular disease and albuminuria was modest.
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Affiliation(s)
- Konstantinos A Toulis
- Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom; Department of Endocrinology, 424 General Military Hospital, Thessaloniki, Greece
| | - Chao Q Jiang
- Guangzhou Occupational Disease Prevention and Treatment Centre, Guangzhou No. 12 Hospital, Guangzhou, China
| | - Karla Hemming
- Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
| | | | - Kar K Cheng
- Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
| | - Tai H Lam
- Department of Community Medicine, University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - G Neil Thomas
- Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom.
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Li Y, Shi J, Huang X, Wang R, Gu B, Liang P, Zhao S, Sun Y, Liu W, Deng Y, Xi L, Zhao D, Song D, Cao Y, Zhang Y, Gu W, Hong J. Glycated Hemoglobin is Independently Associated with Albuminuria in Young Nondiabetic People with Obesity: A Cross-Sectional Study. Med Sci Monit 2017; 23:2612-2618. [PMID: 28553987 PMCID: PMC5461886 DOI: 10.12659/msm.902450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background The aim of this study was to explore the association between glycated hemoglobin (HbA1c) level and albuminuria in young nondiabetic people with obesity. Material/Methods A total of 537 young nondiabetic people with obesity were enrolled in this cross-sectional study, which was approved by the Rui-jin Hospital Ethics Committee. Albuminuria was defined as a urinary albumin-to-creatinine ratio (ACR) ≥30 mg/g. Multivariate logistic regression was used to analyze the association between HbA1c level and albuminuria. Results Urinary ACR progressively increased across the tertiles of HbA1c level (P for trend <0.05). HbA1c levels were positively associated with the risk of albuminuria in the logistic regression analysis after adjustment for confounding factors. The adjusted odds ratio (OR) for albuminuria was 3.72 (95% confidence interval [CI], 1.25–11.00; P=0.017) when comparing between the highest (≥5.7%) and lowest tertiles of HbA1c level (≤5.3%). Moreover, an increment of 1 SD in HbA1c level increased the risk of albuminuria in a fully adjusted model (OR, 1.73; 95% CI, 1.25–2.46). Conclusions These data suggest that HbA1c level was independently associated with albuminuria in young nondiabetic people with obesity.
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Affiliation(s)
- Yanli Li
- Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Key Laboratory for Endocrine Tumors, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China (mainland)
| | - Juan Shi
- Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Key Laboratory for Endocrine Tumors, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China (mainland)
| | - Xiaolin Huang
- Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Key Laboratory for Endocrine Tumors, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China (mainland)
| | - Rui Wang
- Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Key Laboratory for Endocrine Tumors, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China (mainland)
| | - Bin Gu
- Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Key Laboratory for Endocrine Tumors, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China (mainland)
| | - Peiwen Liang
- Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Key Laboratory for Endocrine Tumors, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China (mainland)
| | - Shaoqian Zhao
- Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Key Laboratory for Endocrine Tumors, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China (mainland)
| | - Yingkai Sun
- Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Key Laboratory for Endocrine Tumors, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China (mainland)
| | - Wen Liu
- Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Key Laboratory for Endocrine Tumors, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China (mainland)
| | - Yuying Deng
- Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Key Laboratory for Endocrine Tumors, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China (mainland)
| | - Liuqing Xi
- Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Key Laboratory for Endocrine Tumors, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China (mainland)
| | - Dandan Zhao
- Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Key Laboratory for Endocrine Tumors, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China (mainland)
| | - Dalong Song
- Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Key Laboratory for Endocrine Tumors, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China (mainland)
| | - Yanan Cao
- Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Key Laboratory for Endocrine Tumors, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China (mainland)
| | - Yifei Zhang
- Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Key Laboratory for Endocrine Tumors, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China (mainland)
| | - Weiqiong Gu
- Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Key Laboratory for Endocrine Tumors, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China (mainland)
| | - Jie Hong
- Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Key Laboratory for Endocrine Tumors, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China (mainland)
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Quintanilla AE, Taype-Rondan Á, Lazo-Porras M, Herrera-Añazco P. Obesity markers associated to albuminuria in a primary care center in Lima, Perú. ACTA ACUST UNITED AC 2017; 64:295-302. [PMID: 28604339 DOI: 10.1016/j.endinu.2017.03.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2016] [Revised: 03/06/2017] [Accepted: 03/29/2017] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To evaluate the association between three obesity markers, body mass index (BMI), abdominal circumference (AC), waist to height ratio (WHtR), and albuminuria in adults seen in a primary health care center specialized in chronic diseases in Lima, Perú. METHODS A cross-sectional, descriptive, retrospective study in adults who attended a primary health care center specialized in chronic diseases in 2011. Patients were divided into four categories: healthy subjects and patients with high blood pressure, with type 2 diabetes mellitus (T2DM), and with both diseases (HBP+T2DM). The main outcome was presence of albuminuria, defined as urine albumin levels higher than 30mg/day. Exposure variables included the following obesity markers: body mass index (BMI), waist-to-height ratio (WHtR), and abdominal circumference (AC). Other covariates considered included sex and age. Crude and adjusted Poisson regressions were performed to estimate prevalence ratios (PRs) and their respective 95% confidence intervals (95% CIs). Areas under the curve were calculated for each indicator, stratified by sex. RESULTS Data from 1,214 patients, 41% of them male, were analyzed, and albuminuria was found in 14.2%. Albuminuria was found to be associated to AC and WHtR, but not to BMI. All three parameters assessed had similar areas under the curve. The optimum cut-off points found for BMI and AC in females were higher than conventional (32.7kg/m2 and 93cm respectively), while the values in males were lower than conventional (27.9kg/m2 and 100cm respectively). For WHtR, however, the optimum cut-off point was higher in both sexes. The higher index in females was for BMI, followed by AC and WHtR. In males, the higher index was for WHtR, followed by AC and BMI. CONCLUSIONS AC and WHtR were found to be directly associated to albuminuria, while BMI was not associated to albuminuria. Areas under the curve were similar for all three markers. The optimum cut-off points for BMI and AC were higher than the conventional ones in females and lower in males.
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Affiliation(s)
- Alberto E Quintanilla
- Centro de Atención Integral de Diabetes e Hipertensión (CEDHI)-EsSalud, Lima, Perú; Facultad de Salud Pública y Administración, Universidad Peruana Cayetano Heredia, Lima, Perú.
| | - Álvaro Taype-Rondan
- CRONICAS Centro de Excelencia de Enfermedades Crónicas, Universidad Peruana Cayetano Heredia, Lima, Perú
| | - María Lazo-Porras
- CRONICAS Centro de Excelencia de Enfermedades Crónicas, Universidad Peruana Cayetano Heredia, Lima, Perú; Unidad de Conocimiento y Evidencia (CONEVID - Universidad Peruana Cayetano Heredia), Lima, Perú
| | - Percy Herrera-Añazco
- Hospital Nacional Dos de Mayo, Lima, Perú; Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Perú
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21
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Fink HA, Vo TN, Langsetmo L, Barzilay JI, Cauley JA, Schousboe JT, Orwoll ES, Canales MT, Ishani A, Lane NE, Ensrud KE. Association of Increased Urinary Albumin With Risk of Incident Clinical Fracture and Rate of Hip Bone Loss: the Osteoporotic Fractures in Men Study. J Bone Miner Res 2017; 32:1090-1099. [PMID: 28012217 PMCID: PMC5413394 DOI: 10.1002/jbmr.3065] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Revised: 12/06/2016] [Accepted: 12/15/2016] [Indexed: 12/29/2022]
Abstract
Prior studies suggest that increased urine albumin is associated with a heightened fracture risk in women, but results in men are unclear. We used data from Osteoporotic Fractures in Men (MrOS), a prospective cohort study of community-dwelling men aged ≥65 years, to evaluate the association of increased urine albumin with subsequent fractures and annualized rate of hip bone loss. We calculated albumin/creatinine ratio (ACR) from urine collected at the 2003-2005 visit. Subsequent clinical fractures were ascertained from triannual questionnaires and centrally adjudicated by review of radiographic reports. Total hip BMD was measured by DXA at the 2003-2005 visit and again an average of 3.5 years later. We estimated risk of incident clinical fracture using Cox proportional hazards models, and annualized BMD change using ANCOVA. Of 2982 men with calculable ACR, 9.4% had ACR ≥30 mg/g (albuminuria) and 1.0% had ACR ≥300 mg/g (macroalbuminuria). During a mean of 8.7 years of follow-up, 20.0% of men had an incident clinical fracture. In multivariate-adjusted models, neither higher ACR quintile (p for trend 0.75) nor albuminuria (HR versus no albuminuria, 0.89; 95% CI, 0.65 to 1.20) was associated with increased risk of incident clinical fracture. Increased urine albumin had a borderline significant, multivariate-adjusted, positive association with rate of total hip bone loss when modeled in ACR quintiles (p = 0.06), but not when modeled as albuminuria versus no albuminuria. Macroalbuminuria was associated with a higher rate of annualized hip bone loss compared to no albuminuria (-1.8% more annualized loss than in men with ACR <30 mg/g; p < 0.001), but the limited prevalence of macroalbuminuria precluded reliable estimates of its fracture associations. In these community-dwelling older men, we found no association between urine albumin levels and risk of incident clinical fracture, but found a borderline significant, positive association with rate of hip bone loss. © 2016 American Society for Bone and Mineral Research.
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Affiliation(s)
- Howard A. Fink
- Geriatric Research Education & Clinical Center, Veterans Affairs Health Care System, Minneapolis, MN
- Center for Chronic Disease Outcomes Research, Veterans Affairs Health Care System, Minneapolis, MN
- Department of Medicine, University of Minnesota, Minneapolis, MN
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Tien N. Vo
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Lisa Langsetmo
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Joshua I. Barzilay
- Division of Endocrinology, Kaiser Permanente of Georgia, Atlanta, GA
- Division of Endocrinology, Emory University School of Medicine, Atlanta, GA
| | - Jane A. Cauley
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA
| | - John T. Schousboe
- Park Nicollet Institute, Minneapolis, MN
- Division of Health Policy and Management, University of Minnesota, Minneapolis, MN
| | - Eric S. Orwoll
- Bone and Mineral Unit, Oregon Health & Science University, Portland, OR
| | - Muna T. Canales
- Department of Medicine (Nephrology), College of Public Health and Health Professions & College of Medicine, University of Florida, Gainesville, FL
| | - Areef Ishani
- Department of Medicine, University of Minnesota, Minneapolis, MN
| | | | - Kristine E. Ensrud
- Center for Chronic Disease Outcomes Research, Veterans Affairs Health Care System, Minneapolis, MN
- Department of Medicine, University of Minnesota, Minneapolis, MN
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
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22
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Yang SK, Liu J, Yi B, Mao J, Zhang XM, Liu Y, Lei DD, Gui M, Zhang H. Elevated High Sensitivity C-Reactive Protein Increases the Risk of Microalbuminuria in Subjects With Cardiovascular Disease Risk Factors. Ther Apher Dial 2017; 21:387-394. [PMID: 28322017 DOI: 10.1111/1744-9987.12530] [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: 06/07/2016] [Revised: 12/26/2016] [Accepted: 01/03/2017] [Indexed: 12/19/2022]
Abstract
Microalbuminuria is an early biomarker of kidney injury, the aim of this study was to investigate the impact of high sensitivity C-reactive protein (hs-CRP) on microalbuminuria in adults with cardiovascular disease (CVD) risk factors. A total of 5667 subjects who voluntarily attended annual health screenings in the Third Xiangya Hospital of Central South University were included in the study. Logistic regression was used to determine the validity of hs-CRP to predict the presence of microalbuminuria. In the unadjusted regression analysis, male gender (OR 2.23), age (OR 1.71), smoking status (OR 1.48), obesity (OR 2.41), hypertension(OR 4.03), diabetes (OR 4.61), hyperuricemia (OR 1.83), and high hs-CRP(OR 1.61) were associated with microalbuminuria. Multivariate logistic regression analysis showed that the adjusted odds ratios (OR) of diabetes, hypertension, male, abdominal obesity, and high hs-CRP for microalbuminuria were 2.71, 2.57, 1.51, 1.28 and 1.41 in all subjects, respectively (P < 0.01). ROC analysis indicated that the cut-off for hs-CRP with better properties for screening of microalbuminuria was identified as ≥0.85 mg/L. The ORs of microalbuminuria were 1.97, 1.49, 1.32 and 1.71 times in male, abdominal obesity, diabetes and hypertension subjects with hs-CRP ≥ 0.85 mg/L, respectively, compared with those without elevated hs-CRP (P < 0.01). Elevated hs-CRP level was associated with microalbuminuria independent of cardiovascular risk factors. In addition, elevated hs-CRP increased the risk of developing microalbuminuria in subjects with CVD risk factors, indicating that chronic inflammation could amplify the deterioration of kidney by effect of CVD risk factors.
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Affiliation(s)
- Shi-Kun Yang
- Department of Nephrology, Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Jun Liu
- Department of Nephrology, Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Bin Yi
- Department of Nephrology, Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Juan Mao
- Department of Nephrology, Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Xian-Ming Zhang
- Department of Nephrology, Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yan Liu
- Department of Nephrology, Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Dan-Dan Lei
- Department of Nephrology, Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Ming Gui
- Department of Nephrology, Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Hao Zhang
- Department of Nephrology, Third Xiangya Hospital, Central South University, Changsha, Hunan, China
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23
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Yoon HE, Nam Y, Kang E, Hwang HS, Shin SJ, Hong YS, Kang KY. Gender-Specific Associations between Low Skeletal Muscle Mass and Albuminuria in the Middle-Aged and Elderly Population. Int J Med Sci 2017; 14:1054-1064. [PMID: 29104458 PMCID: PMC5666535 DOI: 10.7150/ijms.20286] [Citation(s) in RCA: 5] [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: 03/27/2017] [Accepted: 07/24/2017] [Indexed: 12/21/2022] Open
Abstract
Objective This study assessed gender-specific associations between low muscle mass (LMM) and albuminuria. Methods Data from the Korea National Health and Nutrition Examination Survey 2011 were employed. The study consisted of 1,087 subjects (≥50 years old). Skeletal muscle index (SMI) was defined as the weight-adjusted appendicular skeletal muscle mass. Mild LMM and severe LMM were defined as SMI that were 1-2 and >2 standard deviations below the sex-specific mean appendicular skeletal muscle mass of young adults, respectively. Increased albuminuria was defined as albumin-to-creatinine ratio ≥30mg/g Results Men with mild and severe LMM were significantly more likely to have increased albuminuria (15.2% and 45.45%, respectively) than men with normal SMI (9.86%, P<0.0001), but not women. Severe LMM associated independently with increased albuminuria in men (OR=7.661, 95% CI=2.72-21.579) but not women. Severe LMM was an independent predictor of increased albuminuria in hypertensive males (OR=11.449, 95% CI=3.037-43.156), non-diabetic males (OR=8.782, 95% CI=3.046-25.322), and males without metabolic syndrome (MetS) (OR=8.183, 95% CI=1.539-43.156). This was not observed in males without hypertension, males with diabetes or MetS, and all female subgroups. Conclusion Severe LMM associated with increased albuminuria in men, especially those with hypertension and without diabetes or MetS.
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Affiliation(s)
- Hye Eun Yoon
- Division of Nephrology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea.,Department of Internal Medicine, Incheon St. Mary's Hospital
| | - Yunju Nam
- Division of Nephrology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea.,Department of Internal Medicine, Incheon St. Mary's Hospital
| | - Eunjin Kang
- Division of Nephrology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea.,Department of Internal Medicine, Incheon St. Mary's Hospital
| | - Hyeon Seok Hwang
- Division of Nephrology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea.,Department of Internal Medicine, Daejeon St. Mary's Hospital
| | - Seok Joon Shin
- Division of Nephrology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea.,Department of Internal Medicine, Incheon St. Mary's Hospital
| | - Yeon Sik Hong
- Department of Internal Medicine, Incheon St. Mary's Hospital.,Division of Rheumatology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea
| | - Kwi Young Kang
- Department of Internal Medicine, Incheon St. Mary's Hospital.,Division of Rheumatology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea
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24
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Lin L, Lu J, Huang X, Ding L, Huang Y, Wang P, Peng K, Zhang D, Xu Y, Xu M, Chen Y, Bi Y, Wang W, Xu Y. Nonalcoholic fatty liver disease is associated with low-grade albuminuria in Chinese adults (change not displayed). QJM 2016; 109:737-743. [PMID: 27317608 DOI: 10.1093/qjmed/hcw070] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Revised: 03/24/2016] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Nonalcoholic fatty liver disease (NAFLD) was associated with higher risk of cardiovascular disease (CVD). Low-grade albuminuria was recognized as an early indicator of CVD. Epidemiological studies investigating the association between NAFLD and low-grade albuminuria were limited. AIM To determine whether NAFLD is independently associated with the presence of low-grade albuminuria in Chinese adults. DESIGN A cross-sectional community-based population study was performed in 8270 Chinese adults aged 40 years or older. METHODS A first-voided early morning spot urine sample was obtained for urinary albumin and creatinine measurements. The highest quartile of urinary albumin-to-creatinine ratio was defined as low-grade albuminuria, after excluding the participants with micro- or macroalbuminuria. NAFLD was diagnosed by using ultrasonography findings after the exclusion of alcohol abuse and other liver diseases. RESULTS The prevalence of low-grade albuminuria was significantly higher in participants with NAFLD than in those without NAFLD (33.6% vs. 21.3% in men and 30.4% vs. 22.8% in women, respectively). Multivariate-adjusted logistic regression analysis revealed that NAFLD was significantly associated with increased odds ratio of low-grade albuminuria in men (odds ratio, 1.47; 95% CI, 1.16-1.87) after adjusting for multiple confounders. The significant association was not detected in women. CONCLUSIONS NAFLD was significantly associated with an increased risk of present low-grade albuminuria in middle-aged and elderly Chinese men.
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Affiliation(s)
- L Lin
- From the State Key Laboratory of Medical Genomics, National Clinical Research Center for Metabolic Diseases, Collaborative Innovation Center of Systems Biomedicine, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai 200025, China
- Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrine and Metabolic Diseases Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai 200025, China
| | - J Lu
- From the State Key Laboratory of Medical Genomics, National Clinical Research Center for Metabolic Diseases, Collaborative Innovation Center of Systems Biomedicine, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai 200025, China
- Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrine and Metabolic Diseases Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai 200025, China
| | - X Huang
- From the State Key Laboratory of Medical Genomics, National Clinical Research Center for Metabolic Diseases, Collaborative Innovation Center of Systems Biomedicine, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai 200025, China
- Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrine and Metabolic Diseases Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai 200025, China
| | - L Ding
- From the State Key Laboratory of Medical Genomics, National Clinical Research Center for Metabolic Diseases, Collaborative Innovation Center of Systems Biomedicine, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai 200025, China
- Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrine and Metabolic Diseases Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai 200025, China
| | - Y Huang
- From the State Key Laboratory of Medical Genomics, National Clinical Research Center for Metabolic Diseases, Collaborative Innovation Center of Systems Biomedicine, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai 200025, China
- Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrine and Metabolic Diseases Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai 200025, China
| | - P Wang
- From the State Key Laboratory of Medical Genomics, National Clinical Research Center for Metabolic Diseases, Collaborative Innovation Center of Systems Biomedicine, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai 200025, China
- Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrine and Metabolic Diseases Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai 200025, China
| | - K Peng
- From the State Key Laboratory of Medical Genomics, National Clinical Research Center for Metabolic Diseases, Collaborative Innovation Center of Systems Biomedicine, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai 200025, China
- Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrine and Metabolic Diseases Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai 200025, China
| | - D Zhang
- From the State Key Laboratory of Medical Genomics, National Clinical Research Center for Metabolic Diseases, Collaborative Innovation Center of Systems Biomedicine, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai 200025, China
- Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrine and Metabolic Diseases Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai 200025, China
| | - Y Xu
- From the State Key Laboratory of Medical Genomics, National Clinical Research Center for Metabolic Diseases, Collaborative Innovation Center of Systems Biomedicine, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai 200025, China
- Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrine and Metabolic Diseases Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai 200025, China
| | - M Xu
- From the State Key Laboratory of Medical Genomics, National Clinical Research Center for Metabolic Diseases, Collaborative Innovation Center of Systems Biomedicine, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai 200025, China
- Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrine and Metabolic Diseases Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai 200025, China
| | - Y Chen
- From the State Key Laboratory of Medical Genomics, National Clinical Research Center for Metabolic Diseases, Collaborative Innovation Center of Systems Biomedicine, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai 200025, China
- Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrine and Metabolic Diseases Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai 200025, China
| | - Y Bi
- From the State Key Laboratory of Medical Genomics, National Clinical Research Center for Metabolic Diseases, Collaborative Innovation Center of Systems Biomedicine, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai 200025, China
- Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrine and Metabolic Diseases Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai 200025, China
| | - W Wang
- From the State Key Laboratory of Medical Genomics, National Clinical Research Center for Metabolic Diseases, Collaborative Innovation Center of Systems Biomedicine, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai 200025, China
- Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrine and Metabolic Diseases Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai 200025, China
| | - Y Xu
- From the State Key Laboratory of Medical Genomics, National Clinical Research Center for Metabolic Diseases, Collaborative Innovation Center of Systems Biomedicine, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai 200025, China
- Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrine and Metabolic Diseases Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai 200025, China
- Department of Research and Development, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai 200025, China
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25
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Lee SH, Kim DH, Kim YH, Roh YK, Ju SY, Nam HY, Nam GE, Choi JS, Lee JE, Sang JE, Han K, Park YG. Relationship Between Dyslipidemia and Albuminuria in Hypertensive Adults: A Nationwide Population-Based Study. Medicine (Baltimore) 2016; 95:e3224. [PMID: 27100412 PMCID: PMC4845816 DOI: 10.1097/md.0000000000003224] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
This study aimed to estimate the relationship between various lipid abnormalities and albuminuria in hypertensive Korean adults. Data obtained from the Korea National Health and Nutrition Examination Survey in 2011 to 2012 were analyzed. The study included 2330 hypertensive participants. Total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) levels were measured. Dyslipidemia parameters were defined as high TG ≥200 mg/dL, low HDL-C as HDL-C <40 mg/dL, high TC/HDL-C as TC/HDL-C ratio ≥4, high TG/HDL-C as TG/HDL-C ratio ≥3.8, and high LDL-C/HDL-C as LDL-C/HDL-C ratio ≥2.5. Albuminuria was defined as a urine albumin to creatinine ratio (ACR) ≥30 mg/g. Women with albuminuria showed significantly higher levels of TG, TC/HDL-C, and TG/HDL-C and a lower level of HDL-C than women without albuminuria (all P < 0.05). LogTG, TC/HDL-C, and logTG/HDL-C were positively correlated with ACR in both men and women; however, HDL-C was negatively correlated with ACR in women and non-HDL-C was positively correlated with ACR in men. In men, there was no association between ACR and lipid parameters. However, in women, higher values for logTG, TC/HDL-C, and logTG/HDL-C were associated with an increased odds ratio (OR) for albuminuria (OR [95% confidence interval]: 1.53 [1.06-2.21], 1.21 [1.02-1.45], and 1.78 [1.21-2.63], respectively) and HDL-C with a decreased OR for albuminuria (0.78 [0.67-0.92]) after adjusting for all covariates. LogTG, TC/HDL-C, and logTG/HDL-C were associated with an increased prevalence of albuminuria in hypertensive women. Screening and treatment for dyslipidemia may be necessary for hypertensive women to address potential albuminuria.
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Affiliation(s)
- Sung-Ho Lee
- From the Department of Family Medicine, Korea University, College of Medicine, Seoul (S-HL, DHK, Y-HK, H-YN, G-EN, J-SC, J-EL, J-ES); Department of Family Medicine, Hallym University, College of Medicine, Chunchon (YKR); Department of Family Medicine, Catholic University (SYJ); and Department of Biostatistics, The Catholic University of Korea, College of Medicine, Seoul (KDH, Y-GP), Republic of Korea
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Okumiya K, Sakamoto R, Ishimoto Y, Kimura Y, Fukutomi E, Ishikawa M, Suwa K, Imai H, Chen W, Kato E, Nakatsuka M, Kasahara Y, Fujisawa M, Wada T, Wang H, Dai Q, Xu H, Qiao H, Ge RL, Norboo T, Tsering N, Kosaka Y, Nose M, Yamaguchi T, Tsukihara T, Ando K, Inamura T, Takeda S, Ishine M, Otsuka K, Matsubayashi K. Glucose intolerance associated with hypoxia in people living at high altitudes in the Tibetan highland. BMJ Open 2016; 6:e009728. [PMID: 26908520 PMCID: PMC4769430 DOI: 10.1136/bmjopen-2015-009728] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES To clarify the association between glucose intolerance and high altitudes (2900-4800 m) in a hypoxic environment in Tibetan highlanders and to verify the hypothesis that high altitude dwelling increases vulnerability to diabetes mellitus (DM) accelerated by lifestyle change or ageing. DESIGN Cross-sectional epidemiological study on Tibetan highlanders. PARTICIPANTS We enrolled 1258 participants aged 40-87 years. The rural population comprised farmers in Domkhar (altitude 2900-3800 m) and nomads in Haiyan (3000-3100 m), Ryuho (4400 m) and Changthang (4300-4800 m). Urban area participants were from Leh (3300 m) and Jiegu (3700 m). MAIN OUTCOME MEASURE Participants were classified into six glucose tolerance-based groups: DM, intermediate hyperglycaemia (IHG), normoglycaemia (NG), fasting DM, fasting IHG and fasting NG. Prevalence of glucose intolerance was compared in farmers, nomads and urban dwellers. Effects of dwelling at high altitude or hypoxia on glucose intolerance were analysed with the confounding factors of age, sex, obesity, lipids, haemoglobin, hypertension and lifestyle, using multiple logistic regression. RESULTS The prevalence of DM (fasting DM)/IHG (fasting IHG) was 8.9% (6.5%)/25.1% (12.7%), respectively, in all participants. This prevalence was higher in urban dwellers (9.5% (7.1%)/28.5% (11.7%)) and in farmers (8.5% (6.1%)/28.5% (18.3%)) compared with nomads (8.2% (5.7%)/15.7% (9.7%)) (p=0.0140/0.0001). Dwelling at high altitude was significantly associated with fasting IHG+fasting DM/fasting DM (ORs for >4500 and 3500-4499 m were 3.59/4.36 and 2.07/1.76 vs <3500 m, respectively). After adjusting for lifestyle change, hypoxaemia and polycythaemia were closely associated with glucose intolerance. CONCLUSIONS Socioeconomic factors, hypoxaemia and the effects of altitudes >3500 m play a major role in the high prevalence of glucose intolerance in highlanders. Tibetan highlanders may be vulnerable to glucose intolerance, with polycythaemia as a sign of poor hypoxic adaptation, accelerated by lifestyle change and ageing.
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Affiliation(s)
- Kiyohito Okumiya
- Research Department, Research Institute for Humanity and Nature, Kyoto, Japan
- Center for Southeast Asian Studies, Kyoto University, Kyoto, Japan
| | - Ryota Sakamoto
- Center for Southeast Asian Studies, Kyoto University, Kyoto, Japan
- Hakubi Center for Advanced Research, Kyoto University, Kyoto, Japan
| | - Yasuko Ishimoto
- Faculty of Medicine, Public Health Nursing, School of Nursing, Mie University, Tsu, Mie, Japan
| | - Yumi Kimura
- Center for Southeast Asian Studies, Kyoto University, Kyoto, Japan
| | - Eriko Fukutomi
- Center for Southeast Asian Studies, Kyoto University, Kyoto, Japan
| | - Motonao Ishikawa
- Department of Medicine, Tokyo Women's Medical University, Medical Center East, Tokyo, Japan
| | - Kuniaki Suwa
- Department of Medicine, Tokyo Women's Medical University, Medical Center East, Tokyo, Japan
| | - Hissei Imai
- Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Wenling Chen
- Center for Southeast Asian Studies, Kyoto University, Kyoto, Japan
| | - Emiko Kato
- Center for Southeast Asian Studies, Kyoto University, Kyoto, Japan
| | | | - Yoriko Kasahara
- College of Nursing, Kanto Gakuin University, Yokohama, Japan
| | - Michiko Fujisawa
- Center for Southeast Asian Studies, Kyoto University, Kyoto, Japan
| | - Taizo Wada
- Center for Southeast Asian Studies, Kyoto University, Kyoto, Japan
| | - Hongxin Wang
- Affiliated Hospital of Qinghai University, Xining, Qinghai, China
| | - Qingxiang Dai
- Affiliated Hospital of Qinghai University, Xining, Qinghai, China
| | - Huining Xu
- Affiliated Hospital of Qinghai University, Xining, Qinghai, China
| | - Haisheng Qiao
- Qinghai Academy of Animal and Veterinary Sciences, Xining, Qinghai, China
| | - Ri-Li Ge
- Research Center for High Altitude Medicine, Qinghai University, Xining, Qinghai, China
| | | | | | - Yasuyuki Kosaka
- Graduate School of Asian and African Area Studies, Kyoto University, Kyoto, Japan
| | - Mitsuhiro Nose
- Center for Southeast Asian Studies, Kyoto University, Kyoto, Japan
| | | | - Toshihiro Tsukihara
- Faculty of Education and Regional Studies, University of Fukui, Fukui, Japan
| | - Kazuo Ando
- Center for Southeast Asian Studies, Kyoto University, Kyoto, Japan
| | | | - Shinya Takeda
- Graduate School of Asian and African Area Studies, Kyoto University, Kyoto, Japan
| | | | - Kuniaki Otsuka
- Department of Medicine, Tokyo Women's Medical University, Medical Center East, Tokyo, Japan
- Chronomics & Gerontology, Tokyo Women's Medical University, Tokyo, Japan
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Guo M, Niu JY, Li SR, Ye XW, Fang H, Zhao YP, Gu Y. Gender differences in the association between hyperuricemia and diabetic kidney disease in community elderly patients. J Diabetes Complications 2015; 29:1042-9. [PMID: 26387809 DOI: 10.1016/j.jdiacomp.2015.08.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Revised: 08/20/2015] [Accepted: 08/20/2015] [Indexed: 01/23/2023]
Abstract
AIMS To investigate gender differences of the associations between hyperuricemia and diabetic kidney disease (DKD) in elderly patients with type 2 diabetes mellitus (T2DM) based on electronic health records (EHR). METHODS A total of 20,207 older diabetic patients (mean age 71±7years) were investigated based on the EHR from 2012 to 2013 in the Minhang District of Shanghai-China. The status of hyperuricemia, albuminuric DKD and the odds ratios of DKD relative to hyperuricemia were analyzed among 8541 men and 11,666 women. RESULTS The overall rate of hyperuricemia was 20.5% (males: 17.2%, females: 23.0%) and that of albuminuric DKD was 36.2% (males: 32.2%, female: 39.1%) in these diabetic patients. Hyperuricemia was independently associated with increased risk of reduced renal function and albuminuria (p<0.001) in both genders. After adjustment of traditional DKD risk factors, hyperuricemia had a stronger association with albuminuric DKD in males (OR 1.67, 95% CI: 1.48-1.88) than in females (OR 1.23, 95% CI: 1.12-1.35). CONCLUSIONS This study showed an independent association of hyperuricemia with albuminuric DKD that was stronger in elderly males for the first time in China based on EHR. The level of uric acid should be monitored and managed in older diabetic patients.
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Affiliation(s)
- Mei Guo
- Fifth People's Hospital, Fudan University, No. 128 Ruili Road,Minhang District, Shanghai 200240, China
| | - Jian-Ying Niu
- Fifth People's Hospital, Fudan University, No. 128 Ruili Road,Minhang District, Shanghai 200240, China
| | - She-Ran Li
- Fifth People's Hospital, Fudan University, No. 128 Ruili Road,Minhang District, Shanghai 200240, China
| | - Xian-Wu Ye
- Fifth People's Hospital, Fudan University, No. 128 Ruili Road,Minhang District, Shanghai 200240, China
| | - Hong Fang
- Center for Disease Prevention and Control of Minhang District, No. 965 Zhongyi Road, Shanghai 201101, China
| | - Yan-Ping Zhao
- Fifth People's Hospital, Fudan University, No. 128 Ruili Road,Minhang District, Shanghai 200240, China
| | - Yong Gu
- Fifth People's Hospital, Fudan University, No. 128 Ruili Road,Minhang District, Shanghai 200240, China; Department of Nephrology, Huashan Hospital, Fudan University, No. 12 Wulumuqi Road, Shanghai 200040, China.
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28
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Chen F, Yang W, Weng J, Jia W, Ji L, Xiao J, Shan Z, Liu J, Tian H, Ji Q, Zhu D, Ge J, Lin L, Chen L, Guo X, Zhao Z, Li Q, Zhou Z, Shan G, Lu J. Albuminuria: Prevalence, associated risk factors and relationship with cardiovascular disease. J Diabetes Investig 2014; 5:464-71. [PMID: 25411608 PMCID: PMC4210073 DOI: 10.1111/jdi.12172] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2013] [Revised: 09/20/2013] [Accepted: 09/25/2013] [Indexed: 02/05/2023] Open
Abstract
AIMS/INTRODUCTION To investigate the prevalence and associated risk factors of microalbuminuria, and to explore the relationship between albuminuria and cardiovascular disease (CVD). MATERIALS AND METHODS A nationally representative sample of 38,203 Chinese participants was categorized by different levels of urinary albumin-to-creatinine ratio (ACR; 0 -10 mg/g, 10 -20 mg/g, 20 -30 mg/g, 30 -300 mg/g). The prevalence of albuminuria was compared by using a single urinary ACR cut-off point and by sex-specific ACR cut-off points. Factors associated with the presence of albuminuria, and the relationship between albuminuria and CVD were analyzed by logistic regression. RESULTS Prevalence of albuminuria as measured by a single ACR cut-point was significantly lower for men compared with women (13.9% vs 19.1% in the normal glucose tolerance group; 20.8% vs 26.8% in the impaired glucose tolerance group, P < 0.01). The prevalence of albuminuria, as measured by sex-specific ACR cut-points, was higher for men than women (31.4% vs 29.6% in the normal glucose tolerance group; 42.2% vs 39.3% in the impaired glucose tolerance group, P < 0.01). The independent risk factors for the presence of albuminuria were aging, female sex, hypertension, hyperglycemia, obesity, dyslipidemia, insulin resistance and metabolic syndrome. The subdivided normal ACR group did not show a linear or statistically significant relationship with CVD after adjusting for conventional CVD risk factors (P > 0.05). CONCLUSIONS The prevalence of albuminuria was high in the general Chinese population. Aging, female sex, hypertension, hyperglycemia, dyslipidemia, insulin resistance, obesity and metabolic syndrome were all independent risk factors for albuminuria. The causal relationship between ACR and CVD might require further follow-up investigation.
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Affiliation(s)
- Fang Chen
- Department of Endocrinology and Metabolism Chinese PLA General Hospital Beijing China
| | | | - Jianping Weng
- Sun Yat-sen University Third Hospital Guangzhou China
| | - Weiping Jia
- Shanghai Jiao Tong University Affiliated Sixth People's Hospital Shanghai China
| | - Linong Ji
- Peking University People's Hospital Beijing China
| | | | - Zhongyan Shan
- First Affiliated Hospital Chinese Medical University Shenyang Liaoning China
| | - Jie Liu
- Shanxi Province People's Hospital Taiyuan Shanxi China
| | - Haoming Tian
- West China Hospital, Sichuan University Chengdu Sichuan China
| | - Qiuhe Ji
- Xijing Hospital Fourth Military Medical University Xi'an Shaanxi China
| | - Dalong Zhu
- The Affiliated Drum Tower Hospital of Nanjing University Medical School Nanjing Jiangsu China
| | - Jiapu Ge
- Xinjiang Uygur Autonomous Region's Hospital Urmqi Xinjiang China
| | - Lixiang Lin
- Fujian Provincial Hospital Fuzhou Fujiang China
| | - Li Chen
- Qilu Hospital of Shandong University Jinan Shandong China
| | - Xiaohui Guo
- Peking University First Hospital Beijing China
| | - Zhigang Zhao
- Henan Province People's Hospital Zhengzhou Henan China
| | - Qiang Li
- Second Affiliated Hospital of Harbin Medical University Harbin Heilongjiang China
| | | | - Guangliang Shan
- Department of Epidemiology and Statistics Institute of Basic Medical Sciences Chinese Academy of Medical Sciences School of Basic Medicine Peking Union Medical College Beijing China
| | - Juming Lu
- Department of Endocrinology and Metabolism Chinese PLA General Hospital Beijing China
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