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Wang X, Hao G, Chen L, Yang Y, Zhou H, Kang Y, Shaver L, Chen Z, Zheng C, Zhang L, Li S, Wang Z, Gao R. Hypertension-mediated organ damage and established cardiovascular disease in patients with hypertension: the China Hypertension Survey, 2012-2015. J Hum Hypertens 2022; 36:1092-1098. [PMID: 34799686 PMCID: PMC9734033 DOI: 10.1038/s41371-021-00635-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 10/29/2021] [Accepted: 11/04/2021] [Indexed: 01/25/2023]
Abstract
Hypertension is a major health burden worldwide. However, there is limited data on the status of hypertension-mediated organ damage (HMOD) and established cardiovascular (CV) disease in Chinese hypertensive patients. The aim of this study is to determine the prevalence of HMOD and established CV disease in a nationally representative population in China. A stratified multistage random sampling method was used in the China Hypertension Survey and 21,243 participants aged 35 or older were eligible for analysis in this study. For each participant, the demographic information and a self-reported medical history were acquired. Blood pressure was measured with the electronic device 3 times on the right arm, supported at heart level, after the participant was sitting at rest for 5 min. Samples of blood and urine were tested. 2-D and Doppler echocardiography were used to assess the heart's function and structures. Sampling weights were calculated based on the 2010 China population census data. Overall, the weighted prevalence of asymptomatic HMOD was 22.1%, 28.9%, 23.1%, 6.4%, and 6.2% for wide pulse pressure, left ventricular hypertrophy, microalbuminuria, chronic kidney disease, and abnormal ankle-brachial index, respectively. For the established CV disease, the weighted prevalence was 1.8%, 1.3%, 2.0%, and 1.1% for stroke, coronary artery disease, heart failure, and atrial fibrillation, respectively. The prevalence of asymptomatic HMOD and established CV disease was greater with higher blood pressure level (P < 0.05), rather than ankle-brachial index. Compared to those with uncontrolled hypertension, the prevalence of asymptomatic HMOD was lower in patients with controlled hypertension. In summary, the prevalence of HMOD in Chinese people aged 35 or older was very common, indicating a substantial future burden of both morbidity and mortality from hypertension in China. Clinical trial registration number: ChiCTR-ECS-14004641.
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Affiliation(s)
- Xin Wang
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research center of Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Guang Hao
- Department of Epidemiology, School of Medicine, Jinan University, Guangzhou, China
| | - Lu Chen
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research center of Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Ying Yang
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research center of Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Haoqi Zhou
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research center of Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Yuting Kang
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research center of Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Lance Shaver
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Zuo Chen
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research center of Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Congyi Zheng
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research center of Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Linfeng Zhang
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research center of Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Suning Li
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research center of Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Zengwu Wang
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research center of Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China.
| | - Runlin Gao
- Department of Cardiology, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
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Zhou Z, Jin H, Ju H, Sun M, Chen H, Li L. Circulating Trimethylamine-N-Oxide and Risk of All-Cause and Cardiovascular Mortality in Patients With Chronic Kidney Disease: A Systematic Review and Meta-Analysis. Front Med (Lausanne) 2022; 9:828343. [PMID: 35433743 PMCID: PMC9012260 DOI: 10.3389/fmed.2022.828343] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 03/09/2022] [Indexed: 12/25/2022] Open
Abstract
Background Trimethylamine-N-oxide (TMAO) is expected to be a prognostic biomarker among patients suffering from chronic kidney disease (CKD). However, investigations on the association between TMAO and CKD prognosis are conflicting. In the present article, we aimed to assess the relationship of circulating TMAO with the risk of all-cause and cardiovascular mortality among CKD patients by a meta-analysis. Methods Data were collected from PubMed, EMBASE, and Web of Science for systematically searching related literature (last update: February 2022). The multivariable-adjusted hazard risks (HR) and their 95% confidence intervals (CI) were pooled using random effects models. Results Eleven prospective cohort studies covering 7,899 CKD patients were enrolled in this meta-analysis. When comparing individuals in the top and bottom baseline TMAO levels thirds, the multivariate adjusted pooled HR was 1.29 (95% CI 1.11–1.51, P = 0.001) for all-cause mortality, and 1.45 (95% CI 1.01–2.09, P = 0.043) for cardiovascular death. For continuous variables, per 1 unit increase of circulating TMAO levels was associated with a 3% higher all-cause mortality (HR 1.03, 95% CI 1.00–1.06, P = 0.032), but not significantly associated with cardiovascular death (HR 1.08, 95% CI 0.92–1.27, P = 0.346). Stratified analyses revealed that the positive relationship between TMAO and all-cause mortality remained significant after adjusting for diabetes, blood pressure, blood lipid, renal function, or inflammatory parameters. Conclusion Higher circulating TMAO was associated with an increased mortality risk among patients with CKD, and this relationship may be dependent on TMAO dose and independent of renal function, inflammation, diabetes, hypertension, and dyslipidemia. Systematic Review Registration [https://www.INPLASY.COM], identifier [INPLASY2021100049].
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Affiliation(s)
- Zhongwei Zhou
- Department of Clinical Laboratory, Yancheng Third People’s Hospital, The Sixth Affiliated Hospital of Nantong University, Yancheng, China
| | - Hao Jin
- Department of Blood Transfusion, Yancheng Third People’s Hospital, The Sixth Affiliated Hospital of Nantong University, Yancheng, China
| | - Huixiang Ju
- Department of Clinical Laboratory, Yancheng Third People’s Hospital, The Sixth Affiliated Hospital of Nantong University, Yancheng, China
| | - Mingzhong Sun
- Department of Clinical Laboratory, Yancheng Third People’s Hospital, The Sixth Affiliated Hospital of Nantong University, Yancheng, China
| | - Hongmei Chen
- Department of Clinical Laboratory, Yancheng Third People’s Hospital, The Sixth Affiliated Hospital of Nantong University, Yancheng, China
| | - Li Li
- Department of Clinical Laboratory, Binhai County People’s Hospital, Yancheng, China
- *Correspondence: Li Li,
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Smoking Is a Risk Factor of Coronary Heart Disease through HDL-C in Chinese T2DM Patients: A Mediation Analysis. JOURNAL OF HEALTHCARE ENGINEERING 2020; 2020:8876812. [PMID: 32774825 PMCID: PMC7407009 DOI: 10.1155/2020/8876812] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 06/10/2020] [Accepted: 07/09/2020] [Indexed: 01/25/2023]
Abstract
Objective To investigate associations between smoking and cardiovascular and cerebrovascular complications in type 2 diabetes mellitus (T2DM) patients. Methods This is a cross-sectional study. Of 971 T2DM patients aged 14–93 years old in this study, 182 had ever smoked and 789 never smoked. Propensity score matching (PSM) reduced the confounding bias between groups. Logistic regression analysis was performed on matched data to evaluate coronary heart disease (CHD) and stroke risk. In addition, the mediation analysis was conducted among smoking exposure, HDL-C, and CHD. Results A total of 139 pairs of patients who had never and ever smoked were matched. Logistic regression analysis showed that compared with patients who never smoked, those who smoked > 20 cigarettes per day (CPD) had a higher risk of CHD (odds ratio [OR]: 3.09, 95% confidence interval [CI]: 1.21–7.89). Additionally, after adjusting for age, sex, origin, occupation, smoking status, body mass index, waist circumference, and diabetes duration, the OR for CHD with >20 years of cumulative smoking (pack-years) was 2.21 (95% CI: 1.05–4.65). Furthermore, we observed a significant dose-response relationship between CPD and lower high-density lipoprotein cholesterol (HDL-C) (P < 0.001). Moreover, the mediation analysis showed that the indirect effect mediated by HDL-C accounted for 86% (effect = 0.0187, 95% CI: 0.0100–0.0316). Conclusions Smoking may be a risk factor for CHD in T2DM patients. T2DM patients should stop smoking or reduce the CPD to prevent the onset of CHD. Moreover, to prevent CHD complications, monitoring HDL-C levels in T2DM patients who smoke may be necessary.
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Li F, Chen QX, Chen Y, Wang G, Peng B, Yao T. Prevalence and risk factors of microalbuminuria in patients with lacunar infarction. Postgrad Med 2019; 131:342-347. [PMID: 31032695 DOI: 10.1080/00325481.2019.1613119] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Objectives: To investigate the prevalence and risk factors for microalbuminuria in patients with lacunar infarction. Methods: 702 lacunar infarction patients and 234 controls were recruited in this study, the concentration of urinary albumin and clinical characteristics were collected for each participant. We analyzed the prevalence of microalbuminuria in lacunar infarction patients, as well as the risk factors of microalbuminuria in patients with lacunar infarction. Results: The prevalence of microalbuminuria in patients with lacunar infarction was 32.8%, which was significantly higher than that in controls (9.8%, P<0.001). Multiple linear regression analysis indicated that age, alcohol abuse, fasting blood glucose, systolic blood pressure, and triglyceride were positively associated with albumin/creatinine ratio levels. Multiple logistic regression analysis indicated that age (odds ratio [OR] = 1.067, 95% confidence interval [CI] = 1.029 to 1.105), alcohol abuse (OR = 3.001, 95% CI = 1.668 to 5.398), fasting blood glucose (OR = 2.014, 95% CI = 1.794 to 2.260), and systolic blood pressure (OR = 1.033, 95% CI = 1.010 to 1.056) were the independent risk factors for microalbuminuria in acute lacunar infarction patients, with high sensitivity, specificity, positive predictive value, and negative predictive value. Receiver operating characteristic curve analysis showed that the area under the curve for age, systolic blood pressure, and fasting blood glucose were 0.618 (cutoff value, 63.5 years; sensitivity, 54.8%; and specificity, 62.9%), 0.736 (cutoff level, 149.5 mmHg; sensitivity, 78.3%; and specificity, 61.2%) and 0.893 (cutoff value, 7 mmol/L; sensitivity, 92.2%; and specificity, 86%), respectively. Conclusion: Lacunar infarction was associated with higher microalbuminuria prevalence. Age, alcohol abuse, fasting blood glucose, and systolic blood pressure were individually significant and correlated factors of microalbuminuria in patients with lacunar infarction. More attention should be provided to this group of patients.
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Affiliation(s)
- Fei Li
- a Department of Neurosurgery , Renmin Hospital of Wuhan University , Wuhan , Hubei , China
| | - Qian-Xue Chen
- a Department of Neurosurgery , Renmin Hospital of Wuhan University , Wuhan , Hubei , China
| | - Yan Chen
- b Department of Neurology , Renmin Hospital of Wuhan University , Wuhan , Hubei , China
| | - Guan Wang
- b Department of Neurology , Renmin Hospital of Wuhan University , Wuhan , Hubei , China
| | - Bo Peng
- b Department of Neurology , Renmin Hospital of Wuhan University , Wuhan , Hubei , China
| | - Tao Yao
- b Department of Neurology , Renmin Hospital of Wuhan University , Wuhan , Hubei , China
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Chen J, Zhou X, Zhang H, Liu Y, Cao C, Dong R, Yuan Y, Wang M, Lu Y, Wu M, Li S, Chen B. Association between urinary concentration of phthalate metabolites and impaired renal function in Shanghai adults. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2019; 245:149-162. [PMID: 30415034 DOI: 10.1016/j.envpol.2018.10.044] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 09/16/2018] [Accepted: 10/08/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Exposure to phthalates is reported to be associated with increased incidence of microalbuminuria and low-grade albuminuria in children and adolescents. However, this phenomenon of phthalate-related nephrotoxicity is unknown in adults. METHODS Urine samples of 1663 adults from the 2012 Shanghai Food Consumption Survey (SHFCS) were measured for 10 metabolites of 6 phthalates and for renal function parameters. Their associations were explored by linear and logistic regression models. RESULTS Multivariate linear regression analysis showed that all three renal function parameters (albumin-to-creatinine ratio (ACR), β2-microglobulin (B2M), and N-acetyl-β-d-glucosaminidase (NAG)) are positively associated with six metabolites, including mono-benzylphthalate (MBzP), mono-2-ethylhexylphthalate (MEHP), mono-2-ethyl-5-oxohexyphthalate (MEOHP), mono-2-ethyl-5-hydroxyhexylphthalate (MEHHP), mono-2-ethyl-5-carboxypentylphthalate (MECPP), and mono-2-carboxymethyl-hexyl phthalate (MCMHP) (P < 0.05). Logistic analysis showed that the prevalence of hyperALBuria, hyperB2Muria, hyperNAGuria, or potentially impaired renal function (PIRF) were positively associated with urinary levels of MBzP, MEOHP, and MECPP, respectively (P < 0.05). Co-exposure to identified risk metabolites monoethylphthalate (MEP), MBzP, MEHP, MEOHP, MECPP, MEHHP, and MCMHP increased the risk of having impaired renal function. CONCLUSION Certain metabolites of phthalates, including bis (2-ethylhexyl) phthalate (DEHP) and benzyle butyl phthalate (BBzP), were associated with impaired renal function in Shanghai adults.
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Affiliation(s)
- Jingsi Chen
- Key Laboratory of Public Health Safety of the Ministry of Education, School of Public Health, Fudan University, Shanghai, China.
| | - Xiaofeng Zhou
- Key Laboratory of Public Health Safety of the Ministry of Education, School of Public Health, Fudan University, Shanghai, China.
| | - Han Zhang
- Key Laboratory of Public Health Safety of the Ministry of Education, School of Public Health, Fudan University, Shanghai, China.
| | - Yueming Liu
- Shanghai Entry-Exit Inspection and Quarantine Bureau, Shanghai, China.
| | - Chen Cao
- Shanghai Entry-Exit Inspection and Quarantine Bureau, Shanghai, China.
| | - Ruihua Dong
- Key Laboratory of Public Health Safety of the Ministry of Education, School of Public Health, Fudan University, Shanghai, China.
| | - Yaqun Yuan
- Key Laboratory of Public Health Safety of the Ministry of Education, School of Public Health, Fudan University, Shanghai, China.
| | - Min Wang
- Shanghai Entry-Exit Inspection and Quarantine Bureau, Shanghai, China.
| | - Yuanan Lu
- Environmental Health Laboratory, Department of Public Health, University of Hawaii at Manoa, Honolulu, USA.
| | - Min Wu
- Key Laboratory of Public Health Safety of the Ministry of Education, School of Public Health, Fudan University, Shanghai, China.
| | - Shuguang Li
- Key Laboratory of Public Health Safety of the Ministry of Education, School of Public Health, Fudan University, Shanghai, China.
| | - Bo Chen
- Key Laboratory of Public Health Safety of the Ministry of Education, School of Public Health, Fudan University, Shanghai, China.
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Yang S, Wang S, Yang B, Zheng J, Cai Y, Yang Z. Alcohol Consumption Is a Risk Factor for Lower Extremity Arterial Disease in Chinese Patients with T2DM. J Diabetes Res 2017; 2017:8756978. [PMID: 28761879 PMCID: PMC5518525 DOI: 10.1155/2017/8756978] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Revised: 05/22/2017] [Accepted: 05/28/2017] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To investigate the relationship between alcohol consumption and diabetic lower extremity arterial disease (LEAD) in hospitalized patients with type 2 diabetes mellitus (T2DM). METHODS We evaluated 138 hospitalized patients with T2DM who consumed alcohol and 833 who did not. We used propensity score matching to reduce the confounding bias between groups. Additionally, a logistic regression analysis was performed with the matched data to evaluate the LEAD risk. RESULTS In total, 119 pairs of patients who did and did not consume alcohol were matched. According to the logistic regression analysis, patients who consumed >8 U of alcohol/day had a higher risk of LEAD (odds ratio (OR): 6.35, 95% confidence interval (CI): 1.78-22.65) than patients who did not consume alcohol. Additionally, after adjusting for age, gender, region, occupation, smoking status, body mass index, weight change, and duration of diabetes, the OR of peripheral artery disease after >20 years of alcohol consumption was 3.48 (95% CI: 1.09-11.15). Furthermore, we observed a significant dose-response relationship between alcohol consumption and LEAD. CONCLUSIONS Alcohol consumption may be a risk factor of LEAD in patients with T2DM. Patients with T2DM should be advised to stop drinking, to prevent the onset of LEAD.
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Affiliation(s)
- Shanshan Yang
- Institute of Geriatrics, Beijing Key Laboratory of Ageing and Geriatrics, State Key Laboratory of Kidney Disease, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China
- Jinan Military Area CDC, Jinan, Shandong 250014, China
| | - Shuang Wang
- Department of Nephrology and Endocrinology, PLA 148th Hospital, Zibo 255300, China
| | - Bo Yang
- Department of Nephrology and Endocrinology, PLA 148th Hospital, Zibo 255300, China
| | - Jinliang Zheng
- Department of Nephrology and Endocrinology, PLA 148th Hospital, Zibo 255300, China
| | - Yuping Cai
- Department of Nephrology and Endocrinology, PLA 148th Hospital, Zibo 255300, China
| | - Zhengguo Yang
- Department of Nephrology and Endocrinology, PLA 148th Hospital, Zibo 255300, China
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Wu B, Zhang S, Lin H, Mou S. Prevention of renal failure in Chinese patients with newly diagnosed type 2 diabetes: A cost-effectiveness analysis. J Diabetes Investig 2017; 9:152-161. [PMID: 28296280 PMCID: PMC5754528 DOI: 10.1111/jdi.12653] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Revised: 02/08/2017] [Accepted: 03/02/2017] [Indexed: 02/06/2023] Open
Abstract
Aims/Introduction Diabetic kidney disease (DKD) is the second leading cause (16.4%) of end‐stage renal disease in China. The current study assessed the cost‐effectiveness of preventing DKD in patients with newly diagnosed type 2 diabetes from the Chinese healthcare perspective. Materials and Methods A lifetime Markov decision model was developed according to the disease course of DKD. Patients with newly diagnosed type 2 diabetes might receive treatment according to one of the following three strategies: (i) “do nothing” strategy (control strategy); (ii) treatment with angiotensin‐converting enzyme inhibitors and angiotensin II receptor blockers (universal strategy); (iii) or screening for microalbuminuria followed by angiotensin‐converting enzyme inhibitor/angiotensin II receptor blocker treatment (screening strategy). Clinical and utility data were obtained from the published literature. Direct medical costs and resource utilization in the Chinese healthcare setting were considered. Sensitivity analyses were undertaken to test the impact of a range of variables and assumptions on the results. Results Compared with the control strategy, both the screening and universal strategies were cost‐saving options that showed lower costs and better health benefits. The incremental cost‐effectiveness ratio of the universal strategy over the screening strategy was US $30,087 per quality‐adjusted life‐year, which was higher than the cost‐effectiveness threshold of China. The sensitivity analyses showed robust results, except for the probability of developing macroalbuminuria from microalbuminuria. Conclusions Screening for microalbuminuria could be a cost‐saving option for the prevention of DKD in the Chinese setting.
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Affiliation(s)
- Bin Wu
- Medical Decision and Economic Group, Department of Pharmacy, Ren Ji Hospital, South Campus, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Suhua Zhang
- Department of Nephrology, Ren Ji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Houwen Lin
- Medical Decision and Economic Group, Department of Pharmacy, Ren Ji Hospital, South Campus, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Shan Mou
- Department of Nephrology, Ren Ji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
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Yang S, Wang S, Yang B, Zheng J, Cai Y, Yang Z. Weight loss before a diagnosis of type 2 diabetes mellitus is a risk factor for diabetes complications. Medicine (Baltimore) 2016; 95:e5618. [PMID: 27930591 PMCID: PMC5266063 DOI: 10.1097/md.0000000000005618] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Our goal was to investigate the relationship between weight loss before a diagnosis of type 2 diabetes mellitus (T2DM) and diabetic complications among hospitalized patients with T2DM.We conducted a cross-sectional study and evaluated 347 and 642 hospitalized patients with T2DM who experienced and did not experienced weight loss before T2DM diagnosis, respectively. We used propensity score matching to reduce the confounding bias between the groups. In addition, a logistic regression analysis of the matched data was performed to evaluate the risk of diabetic complications.A total of 339 patients who experienced weight loss were matched to 339 patients who did not experience weight loss. After adjusting for age, gender, origin, occupation, smoking history, alcohol use, and duration of diabetes, the logistic regression analysis showed that compared with patients who did not experience weight loss, patients who lost ≤5 kg had a higher risk of diabetic nephropathy (DN) (odds ratio [OR]: 2.05, 95% confidence interval [CI]: 1.35-3.10) and diabetic retinopathy (OR: 1.79, 95% CI: 1.11-2.87). However, we did not observe a dose-response relationship in terms of weight loss.We found that weight loss before a diagnosis of T2DM might serve as a risk factor for DN and diabetic retinopathy. Our findings demonstrate that we should strengthen the management and prevention of complications in patients who experience weight loss of ≤5 kg prior to a T2DM diagnosis, particularly those who are centrally obese.
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Affiliation(s)
- Shanshan Yang
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, State Key Laboratory of Kidney Disease, Chinese PLA General Hospital, Beijing
- Jinan Military Area CDC, Jinan, Shandong
| | - Shuang Wang
- Department of Nephrology and Endocrinology, PLA 148th Hospital, Zibo, China
| | - Bo Yang
- Department of Nephrology and Endocrinology, PLA 148th Hospital, Zibo, China
| | - Jinliang Zheng
- Department of Nephrology and Endocrinology, PLA 148th Hospital, Zibo, China
| | - Yuping Cai
- Department of Nephrology and Endocrinology, PLA 148th Hospital, Zibo, China
| | - Zhengguo Yang
- Department of Nephrology and Endocrinology, PLA 148th Hospital, Zibo, China
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Zheng T, Baskota A, Gao Y, Tian H, Yang F. Increased plasma dipeptidyl peptidase 4 activities predict new-onset microalbuminuria in association with its proinflammatory effects in Chinese without diabetes: a four-year prospective study. Nephrol Dial Transplant 2014; 30:460-6. [DOI: 10.1093/ndt/gfu312] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
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Liu J, Kou Z, Tian Y. Diffuse axonal injury after traumatic cerebral microbleeds: an evaluation of imaging techniques. Neural Regen Res 2014; 9:1222-30. [PMID: 25206786 PMCID: PMC4146289 DOI: 10.4103/1673-5374.135330] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/01/2014] [Indexed: 12/11/2022] Open
Abstract
Previous neuropathological studies regarding traumatic brain injury have primarily focused on changes in large structures, for example, the clinical prognosis after cerebral contusion, intracerebral hematoma, and epidural and subdural hematoma. In fact, many smaller injuries can also lead to severe neurological disorders. For example, cerebral microbleeds result in the dysfunction of adjacent neurons and the disassociation between cortex and subcortical structures. These tiny changes cannot be adequately visualized on CT or conventional MRI. In contrast, gradient echo sequence-based susceptibility-weighted imaging is very sensitive to blood metabolites and microbleeds, and can be used to evaluate traumatic cerebral microbleeds with high sensitivity and accuracy. Cerebral microbleed can be considered as an important imaging marker for diffuse axonal injury with potential relevance for prognosis. For this reason, based on experimental and clinical studies, this study reviews the role of imaging data showing traumatic cerebral microbleeds in the evaluation of cerebral neuronal injury and neurofunctional loss.
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Affiliation(s)
- Jun Liu
- Department of Radiology, Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China ; Department of Biomedical Engineering and Radiology, School of Medicine, Wayne State University, 3990 John R St, Detroit, MI, USA ; School of Public Administration, Central South University, Changsha, Hunan Province, China
| | - Zhifeng Kou
- Department of Biomedical Engineering and Radiology, School of Medicine, Wayne State University, 3990 John R St, Detroit, MI, USA
| | - Yongquan Tian
- School of Public Administration, Central South University, Changsha, Hunan Province, China
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