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Wang C, Xin Q, Li J, Wang J, Yao S, Wang M, Zhao M, Chen S, Wu S, Xue H. Association of Estimated Glomerular Filtration Rate Trajectories with Atrial Fibrillation Risk in Populations with Normal or Mildly Impaired Renal Function. KIDNEY DISEASES (BASEL, SWITZERLAND) 2024; 10:274-283. [PMID: 39131881 PMCID: PMC11309754 DOI: 10.1159/000539289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 05/06/2024] [Indexed: 08/13/2024]
Abstract
Introduction The association between the longitudinal patterns of estimated glomerular filtration rate (eGFR) and risk of atrial fibrillation (AF) in populations with normal or mildly impaired renal function is not well characterized. We sought to explore the eGFR trajectories in populations with normal or mildly impaired renal function and their association with AF. Methods This prospective cohort study included 62,407 participants who were free of AF, cardiovascular diseases, and moderate to severe renal insufficiency (eGFR <60 mL/min/1.73 m2) before 2010. The eGFR trajectories were developed using latent mixture modeling based on examination data in 2006, 2008, and 2010. Incident AF cases were identified in biennial electrocardiogram assessment and a review of medical insurance data and discharge registers. We used Cox regression models to estimate the hazard ratios and 95% confidence intervals (CIs) for incident AF. Results According to survey results for the range and changing pattern of eGFR during 2006-2010, four trajectories were identified: high-stable (range, 107.47-110.25 mL/min/1.73 m2; n = 11,719), moderate-increasing (median increase from 83.83 to 100.37 mL/min/1.73 m2; n = 22,634), high-decreasing (median decrease from 101.72 to 89.10 mL/min/1.73 m2; n = 7,943), and low-stable (range, 73.48-76.78 mL/min/1.73 m2; n = 20,111). After an average follow-up of 9.63 years, a total of 485 cases of AF were identified. Compared with the high-stable trajectory, the adjusted hazard ratios of AF were 1.70 (95% CI, 1.09-2.66) for the moderate-increasing trajectory, 1.92 (95% CI, 1.18-3.13) for the high-decreasing trajectory, and 2.28 (95% CI, 1.46-3.56) for the low-stable trajectory. The results remained consistent across a number of sensitivity analyses. Conclusion The trajectories of eGFR were associated with subsequent AF risk in populations with normal or mildly impaired renal function.
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Affiliation(s)
- Chi Wang
- Department of Cardiology, The Sixth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Qian Xin
- Department of Cardiology, The Sixth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Junjuan Li
- Department of Nephrology, Kailuan General Hospital, Tangshan, China
| | - Jianli Wang
- Department of Rehabilitation, Kailuan General Hospital, Tangshan, China
| | - Siyu Yao
- Department of Cardiology, The Sixth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Miao Wang
- Department of Cardiology, The Sixth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Maoxiang Zhao
- Department of Cardiology, The Sixth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Shuohua Chen
- Department of Cardiology, Kailuan General Hospital, Tangshan, China
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, Tangshan, China
| | - Hao Xue
- Department of Cardiology, The Sixth Medical Center of Chinese PLA General Hospital, Beijing, China
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Dong Y, Chen S, Yu Y, Li W, Xu Z, Du J, Huang S, Wu S, Cai Y. Association between Urine Specific Gravity as a Measure of Hydration Status and Risk of Type 2 Diabetes: The Kailuan Prospective Cohort Study. Nutrients 2024; 16:1643. [PMID: 38892576 PMCID: PMC11174895 DOI: 10.3390/nu16111643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 05/07/2024] [Accepted: 05/23/2024] [Indexed: 06/21/2024] Open
Abstract
Diabetes, especially type 2 diabetes (T2D), poses an unprecedented challenge to global public health. Hydration status also plays a fundamental role in human health, especially in people with T2D, which is often overlooked. This study aimed to explore the longitudinal associations between hydration status and the risk of T2D among the Chinese population. This study used data from the large community-based Kailuan cohort, which included adults who attended physical examinations from 2006 to 2007 and were followed until 2020. A total of 71,526 participants who eventually met the standards were divided into five hydration-status groups based on their levels of urine specific gravity (USG). Multivariable and time-dependent Cox proportional hazards models were employed to evaluate the associations of baseline and time-dependent hydration status with T2D incidence. Restricted cubic splines (RCS) analysis was used to examine the dose-response relationship between hydration status and the risk of T2D. Over a median 12.22-year follow-up time, 11,804 of the participants developed T2D. Compared with the optimal hydration-status group, participants with dehydration and severe dehydration had a significantly increased risk of diabetes, with adjusted hazard ratios (95% CI) of 1.30 (1.04-1.63) and 1.38 (1.10-1.74). Time-dependent analyses further confirmed the adverse effects of impending dehydration, dehydration, and severe dehydration on T2D incidence by 16%, 26%, and 33% compared with the reference group. Inadequate hydration is significantly associated with increased risks of T2D among Chinese adults. Our findings provided new epidemiological evidence and highlighted the potential role of adequate hydration status in the early prevention of T2D development.
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Affiliation(s)
- Yinqiao Dong
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China;
- Public Health Department, Hongqiao International Institute of Medicine, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200335, China
| | - Shuohua Chen
- Department of Cardiology, Kailuan General Hospital, North China University of Science and Technology, Tangshan 063000, China;
| | - Yaohui Yu
- School of Public Health, North China University of Science and Technology, Tangshan 063210, China;
| | - Wenjuan Li
- School of Clinical Medicine, North China University of Science and Technology, Tangshan 063210, China;
| | - Zhongqing Xu
- Department of General Practice, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200335, China;
| | - Juan Du
- Endocrinology Department, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200335, China;
| | - Shan Huang
- Endocrinology Department, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200335, China;
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, North China University of Science and Technology, Tangshan 063000, China;
| | - Yong Cai
- Public Health Department, Hongqiao International Institute of Medicine, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200335, China
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Zhou L, Hu W, Liu S, Qiao Y, He D, Xiong S, Peng L, Cao L, Wu Y, Sun N, Han Q, Chu J, Chen X, Li T, Feng Z, He Q, Ke C, Shen Y. Cohort profile: the Liyang cohort study on chronic diseases and risk factors monitoring in China (Liyang Study). BMJ Open 2022; 12:e060978. [PMID: 35851009 PMCID: PMC9297217 DOI: 10.1136/bmjopen-2022-060978] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
PURPOSE The Liyang cohort study on chronic diseases and risk factors monitoring in China (Liyang Study) is a prospective population-based study which aims to investigate and identify the determinants of the most prevalent chronic non-communicable diseases (NCDs) and to evaluate the impact of demographic characteristics, lifestyle, dietary habits, cognition, disability and NCDs on the health-related quality of life. PARTICIPANTS Between March 2019 and June 2020, 10 056 individuals aged ≥18 years were administered a baseline survey through a multistage cluster random sampling in Liyang City, southern Jiangsu Province, China. FINDINGS TO DATE The Liyang Study included detailed sociodemographic, anthropometric and health-related behaviour, common NCDs and blood sample information. Moreover, the study gathered a series of data on specific scales including the activities of daily living, instrumental activities of daily living, abbreviated mental test, Food Frequency Questionnaire and EuroQol 5-Dimensions 5-Levels Scale. Of the 10 056 participants, 52.92% (n=5322) were female and 92.26% (n=9278) came from rural areas. The mean age was 49.9±16.2 years. Men were more likely to have a higher level of education, annual income and a paid job than women (p<0.05). The top three overall most prevalent NCDs in the study were hypertension (18.06%, n=1815), digestive diseases (7.88%, n=791), and arthritis or rheumatism (5.28%, n=530). Women had a significantly higher prevalence of diabetes (5.46%, n=290 vs 4.42%, n=209, p=0.016) and arthritis (6.04%, n=321 vs 4.42%, n=209, p<0.001) than men, while the opposite was true for chronic lung diseases such as chronic obstructive pulmonary disease (1.37%, n=65 vs 0.92%, n=49, p=0.032) and chronic hepatic diseases (0.80%, n=38 vs 0.47%, n=25, p=0.035). FUTURE PLANS The current study will give valuable insights into the association between sociodemographic factors, health-related behaviour, diet, cognition, disability and genetic factors and the most prevalent NCDs among local community residents. Starting from 2022, a follow-up survey will be conducted every 3 years to further explore the causal relationship between the above factors and NCDs.
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Affiliation(s)
- Liang Zhou
- Liyang Center for Disease Control and Prevention, Liyang Health Bureau, Liyang, China
| | - Wei Hu
- Department of Epidemiology and Biostatistics, Soochow University Medical College, Suzhou, China
| | - Siyuan Liu
- Department of Epidemiology and Biostatistics, Soochow University Medical College, Suzhou, China
| | - Yanan Qiao
- Department of Epidemiology and Biostatistics, Soochow University Medical College, Suzhou, China
| | - Dingliu He
- Department of Epidemiology and Biostatistics, Soochow University Medical College, Suzhou, China
| | - Shuting Xiong
- Department of Epidemiology and Biostatistics, Soochow University Medical College, Suzhou, China
| | - Liuming Peng
- Liyang Center for Disease Control and Prevention, Liyang Health Bureau, Liyang, China
| | - Lei Cao
- Liyang Center for Disease Control and Prevention, Liyang Health Bureau, Liyang, China
| | - Ying Wu
- Liyang Center for Disease Control and Prevention, Liyang Health Bureau, Liyang, China
| | - Na Sun
- Department of Epidemiology and Biostatistics, Soochow University Medical College, Suzhou, China
| | - Qiang Han
- Department of Epidemiology and Biostatistics, Soochow University Medical College, Suzhou, China
| | - Jiadong Chu
- Department of Epidemiology and Biostatistics, Soochow University Medical College, Suzhou, China
| | - Xuanli Chen
- Department of Epidemiology and Biostatistics, Soochow University Medical College, Suzhou, China
| | - Tongxing Li
- Department of Epidemiology and Biostatistics, Soochow University Medical College, Suzhou, China
| | - Zhaolong Feng
- Department of Epidemiology and Biostatistics, Soochow University Medical College, Suzhou, China
| | - Qida He
- Department of Epidemiology and Biostatistics, Soochow University Medical College, Suzhou, China
| | - Chaofu Ke
- Department of Epidemiology and Biostatistics, Soochow University Medical College, Suzhou, China
| | - Yueping Shen
- Department of Epidemiology and Biostatistics, Soochow University Medical College, Suzhou, China
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Wang A, Zhang J, Li J, Li H, Zuo Y, Lv W, Chen S, Li J, Meng X, Wu S, Zhao X, Wang Y. Relationship Between Time-Dependent Proteinuria and Risk of Stroke in Population With Different Glucose Tolerance Status. J Am Heart Assoc 2020; 9:e015776. [PMID: 32536236 PMCID: PMC7670539 DOI: 10.1161/jaha.120.015776] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Background Proteinuria often changes and is known as a “time‐dependent exposure.” The effect of time‐dependent proteinuria on the risk of future stroke remains unclear. Proteinuria is often detected in patients with diabetes mellitus. The present study was designed to evaluate the association between time‐dependent proteinuria and the risk of stroke in a patient cohort with different glucose tolerance status. Methods and Results A total of 82 938 participants, who were free of myocardial infarction or stroke and underwent fasting blood glucose and urinary protein measurements at baseline in the Kailuan study, were enrolled. Proteinuria was determined using urine dipstick tests at baseline and subsequent follow‐ups. Time‐dependent proteinuria was defined as the status of urine protein updated through the follow‐up examinations, separately. Time‐dependent Cox regression models were used to analyze the relationship between time‐dependent proteinuria and the risk of stroke. During a median follow‐up of 8.37 years, 2538 participants developed stroke. After adjusting for confounding factors, the hazard ratio (95% CI) for stroke in time‐dependent proteinuria among all participants, and the normoglycemia, prediabetes, and diabetes mellitus populations were 1.68 (1.49–1.89), 1.73 (1.47–2.05), 2.15 (1.70–2.72), and 1.30 (1.03–1.65), respectively. There were interaction effects in patients with normoglycemia and prediabetes compared with those with diabetes mellitus. Findings were similar for ischemic and hemorrhagic strokes and were confirmed in sensitivity analyses. Conclusions Time‐dependent proteinuria is an independent risk factor of stroke, especially in the normoglycemia and prediabetes populations.
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Affiliation(s)
- Anxin Wang
- China National Clinical Research Center for Neurological Diseases Beijing Tiantan Hospital Capital Medical University Beijing China.,Department of Neurology Beijing Tiantan Hospital Capital Medical University Beijing China
| | - Jia Zhang
- China National Clinical Research Center for Neurological Diseases Beijing Tiantan Hospital Capital Medical University Beijing China.,Department of Neurology Beijing Tiantan Hospital Capital Medical University Beijing China
| | - Jingjing Li
- Department of Neurology Yangquan Coalmine Group General Hospital Yangquan China
| | - Haibin Li
- School of Public Health Capital Medical University Beijing China
| | - Yingting Zuo
- China National Clinical Research Center for Neurological Diseases Beijing Tiantan Hospital Capital Medical University Beijing China.,Department of Neurology Beijing Tiantan Hospital Capital Medical University Beijing China
| | - Wei Lv
- China National Clinical Research Center for Neurological Diseases Beijing Tiantan Hospital Capital Medical University Beijing China.,Department of Neurology Beijing Tiantan Hospital Capital Medical University Beijing China
| | - Shuohua Chen
- Department of Cardiology Kailuan Hospital North China University of Science and Technology Tangshan China
| | - Junjuan Li
- Department of Nephrology Kailuan Hospital North China University of Science and Technology Tangshan China
| | - Xia Meng
- China National Clinical Research Center for Neurological Diseases Beijing Tiantan Hospital Capital Medical University Beijing China.,Department of Neurology Beijing Tiantan Hospital Capital Medical University Beijing China
| | - Shouling Wu
- Department of Cardiology Kailuan Hospital North China University of Science and Technology Tangshan China
| | - Xingquan Zhao
- China National Clinical Research Center for Neurological Diseases Beijing Tiantan Hospital Capital Medical University Beijing China.,Department of Neurology Beijing Tiantan Hospital Capital Medical University Beijing China
| | - Yongjun Wang
- China National Clinical Research Center for Neurological Diseases Beijing Tiantan Hospital Capital Medical University Beijing China.,Department of Neurology Beijing Tiantan Hospital Capital Medical University Beijing China
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Alsanani A, Shapiro JI. Effects of Short‐Term Proteinuria on the Incidence of Stroke in Patients With Different Glucose Tolerance Status. J Am Heart Assoc 2020; 9:e017288. [PMID: 32538236 PMCID: PMC7670507 DOI: 10.1161/jaha.120.017288] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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