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Pei YF, Li XD, Liu QY, Zhang CW, Wang YH, Chen MR, Chen HS. A nomogram for predicting cerebral white matter lesions in elderly men. Front Neurol 2024; 15:1343654. [PMID: 38751887 PMCID: PMC11094237 DOI: 10.3389/fneur.2024.1343654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Accepted: 04/17/2024] [Indexed: 05/18/2024] Open
Abstract
Objective This study aimed to develop a nomogram tool to predict cerebral white matter lesions (WMLs) in elderly men. Methods Based on a retrospective cohort from January 2017 to December 2019, a multivariate logistic analysis was performed to construct a nomogram for predicting WMLs. The nomogram was further validated using a follow-up cohort between January 2020 and December 2022. The calibration curve, receiver operating characteristics (ROC) curves, and the decision curves analysis (DCA) were used to evaluate discrimination and calibration of this nomogram. Result A total of 436 male patients were enrolled in this study, and all 436 patients were used as the training cohort and 163 follow-up patients as the validation cohort. A multivariate logistic analysis showed that age, cystatin C, uric acid, total cholesterol, platelet, and the use of antiplatelet drugs were independently associated with WMLs. Based on these variables, a nomogram was developed. The nomogram displayed excellent predictive power with the area under the ROC curve of 0.951 [95% confidence interval (CI), 0.929-0.972] in the training cohort and 0.915 (95% CI, 0.864-0.966) in the validation cohort. The calibration of the nomogram was also good, as indicated by the Hosmer-Lemeshow test with p-value of 0.594 in the training cohort and 0.178 in the validation cohort. The DCA showed that the nomogram holds good clinical application value. Conclusion We have developed and validated a novel nomogram tool for identifying elderly men at high risk of WMLs, which exhibits excellent predictive power, discrimination, and calibration.
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Affiliation(s)
| | | | | | | | | | | | - Hui-Sheng Chen
- Department of Neurology, General Hospital of Northern Theater Command, Shenyang, China
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Wang X, Han Y, Liu Y, Hu H. Association between serum uric acid-to-creatinine ratio and non-alcoholic fatty liver disease: a cross-sectional study in Chinese non-obese people with a normal range of low-density lipoprotein cholesterol. BMC Gastroenterol 2022; 22:419. [PMID: 36104672 PMCID: PMC9472393 DOI: 10.1186/s12876-022-02500-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 09/09/2022] [Indexed: 11/10/2022] Open
Abstract
Objective Evidence regarding the relationship between serum uric acid-to-creatinine (SUA/Scr) ratio and non-alcoholic fatty liver disease (NAFLD) in Chinese non-obese people is still limited. Therefore, the present study was undertaken to analyze the association between the SUA/Scr ratio and NAFLD.
Methods This study was a cross-sectional study that non-selectively and consecutively collected 182,320 non-obese individuals with a normal range of low-density lipoprotein cholesterol in a Chinese hospital from January 2010 to December 2014. A binary logistic regression model was used to evaluate the independent association between the SUA/Scr ratio and NAFLD. A generalized additive model (GAM) and smooth curve fitting (penalized spline method) was conducted to explore the exact shape of the curve between them. A series of sensitivity analyses were used to ensure the robustness of the results. Moreover, subgroup analyses were conducted. In addition, the diagnostic value of the SUA/Scr ratio for NAFLD was evaluated based on the area under the receiver-operating characteristic curve (AUROC). It was stated that the data had been uploaded to the DATADRYAD website. Results The average participants' age was 40.96 ± 14.05 years old, and 90,305 (49.5%) were male. The prevalence of NAFLD was 13.7%, and the mean SUA/Scr was 3.62 ± 0.92. After adjusting covariates, the results showed that SUA/Scr ratio was positively associated with NAFLD (OR = 1.424, 95%CI: 1.396, 1.454). There was also a non-linear relationship between SUA/Scr ratio and NAFLD in participants with normal kidney function, and the inflection point of the SUA/Scr ratio was 4.425. The effect sizes (OR) on the left and right sides of the inflection point were 1.551 (1.504, 1.599) and 1.234 (1.179, 1.291), respectively. And the sensitive analysis demonstrated the robustness of the results. Subgroup analysis showed a stronger association between SUA/Scr ratio and NAFLD in females and the population with age < 50 years, FPG ≤ 6.1 mmol/L, BMI < 24 kg/m2, and HDL-c ≥ 1 mmol/L. In contrast, the weaker association was probed in males and the population with age ≥ 50 years, BMI ≥ 24 kg/m2, FPG > 6.1 mmol/L, and HDL-c < 1 mmol/L. The SUA/Scr ratio had an AUC of 0.6624 (95% CI 0.6589, 0.6660) for diagnosing NAFLD. Based on the best cut-off value of 3.776, the negative predictive value of the SUA/Scr ratio for identifying NAFLD was 91.0%. Conclusion This study demonstrates an independent positive association between SUA/Scr ratio and NAFLD in Chinese non-obese people with a normal range of low-density lipoprotein cholesterol. There is also a non-linear relationship between the SUA/Scr ratio and NAFLD in participants with normal kidney function, and the SUA/Scr ratio is strongly related to NAFLD when SUA/Scr ratio is less than 4.425. The SUA/Scr ratio has a certain reference value for determining NAFLD. When the SUA/Scr ratio is lower than 3.776, identifying NAFLD patients with low risk is a great reference. Supplementary Information The online version contains supplementary material available at 10.1186/s12876-022-02500-w.
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He M, Zheng J, Liu H, Wu Y, Xue X, Wu C, Li H. Decreased serum uric acid in patients with traumatic brain injury or after cerebral tumor surgery. ACTA ACUST UNITED AC 2021; 26:36-44. [PMID: 33530042 PMCID: PMC8015494 DOI: 10.17712/nsj.2021.1.20200089] [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] [Received: 06/05/2020] [Accepted: 08/08/2020] [Indexed: 02/05/2023]
Abstract
Objectives: To investigate changes in sUA in patients with TBI or patients after cerebral tumor surgery and the possible mechanism of these changes. Methods: This prospective cohort study enrolled patients with TBI or underwent cerebral tumor surgery at West China Hospital, China, from November 2014 to May 2018. Serum UA (sUA) levels, urine excretion, UA oxidant product allantoin and other clinical parameters were assessed. Results: 100 patients were enrolled for analysis. sUA in patients with TBI or underwent cerebral tumor surgery started to decline from day 1 after injury or surgery compared to control. This decreasing trend continued from day 3 (143.2±59.3 μmol/L, 188.8±49.4 μmol/L vs 287.3±80.2 μmol/L, p<0.0001) until day 7. No difference in urinary UA excretion was found in the TBI group or cerebral tumor surgery group. Urine allantoin and the allantoin to sUA ratio of the TBI group decreased on day 3 compared with the control group. The structural equation model showed that the sUA level was related to the Glasgow coma score (GCS) (r=0.5383, p<0.0001), suggesting the potential association of UA with consciousness level, as well as serum protein and electrolytes including albumin, calcium and phosphate. Conclusion: The sUA was decreased in patients with TBI or underwent cerebral tumor surgery.
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Affiliation(s)
- Miao He
- From the Department of Anesthesiology (He, Zheng, Wu), Department of Neurosurgery (Liu), Department of Neurology (Wu), Department of Critical Care Medicine (Xue), West China Hospital of Sichuan University, Sichuan, China
| | - Jianqiao Zheng
- From the Department of Anesthesiology (He, Zheng, Wu), Department of Neurosurgery (Liu), Department of Neurology (Wu), Department of Critical Care Medicine (Xue), West China Hospital of Sichuan University, Sichuan, China
| | - Hao Liu
- From the Department of Anesthesiology (He, Zheng, Wu), Department of Neurosurgery (Liu), Department of Neurology (Wu), Department of Critical Care Medicine (Xue), West China Hospital of Sichuan University, Sichuan, China
| | - Ying Wu
- From the Department of Anesthesiology (He, Zheng, Wu), Department of Neurosurgery (Liu), Department of Neurology (Wu), Department of Critical Care Medicine (Xue), West China Hospital of Sichuan University, Sichuan, China
| | - Xinsheng Xue
- From the Department of Anesthesiology (He, Zheng, Wu), Department of Neurosurgery (Liu), Department of Neurology (Wu), Department of Critical Care Medicine (Xue), West China Hospital of Sichuan University, Sichuan, China
| | - Chaoran Wu
- From the Department of Anesthesiology (He, Zheng, Wu), Department of Neurosurgery (Liu), Department of Neurology (Wu), Department of Critical Care Medicine (Xue), West China Hospital of Sichuan University, Sichuan, China
| | - Huiping Li
- From the Department of Anesthesiology (He, Zheng, Wu), Department of Neurosurgery (Liu), Department of Neurology (Wu), Department of Critical Care Medicine (Xue), West China Hospital of Sichuan University, Sichuan, China
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Abstract
OBJECTIVE In our study, the aim was to identify the serum uric acid levels, a marker of oxidative stress, according to migraine subtypes (aura/without aura and episodic/chronic migraine). METHOD The study included 300 migraine patients and 150 healthy controls for a total of 450 individuals. Migraine and subtypes were diagnosed according to International Classification of Headache Disorders-2013 criteria. Patients were evaluated during attendance at the neurology clinic. RESULTS Our patient group was 77.0% female and disease duration was 9.2 ± 7.2 years. Our control group comprised 77.3% females. The age intervals in the patient and control groups were 36.4 ± 10.4 years and 36.0 ± 8.1 years. There was no statistically significant difference between our control and patient groups in terms of age and gender (p = .937 and p = .655). The serum UA, ferritin, and urea levels in our patient group were found to be significantly low compared to the healthy control group (p < .001). The serum UA levels in the migraine and control groups were 3.7 ± 0.7 and 4.6 ± 0.7 mg/dL, respectively (p < .001). There were no statistically significant differences observed between serum uric acid levels and other blood parameters between aura/without aura and episodic/chronic migraine subtypes (p > .05). CONCLUSION Our study supports the hypothesis that the oxidative stress marker of serum uric acid levels may be associated with migraine diagnosis, concluding that serum uric acid levels were not significant for migraine subtypes.
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Piao X, Wu G, Yang P, Shen J, De A, Wu J, Qu Q. Association between Homocysteine and Cerebral Small Vessel Disease: A Meta-Analysis. J Stroke Cerebrovasc Dis 2018; 27:2423-2430. [PMID: 29801814 DOI: 10.1016/j.jstrokecerebrovasdis.2018.04.035] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 04/26/2018] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND This study aimed to evaluate whether elevated homocysteine levels is associated with risk of different subtypes of cerebral small vessel disease (CSVD) by using meta-analysis. MATERIALS AND METHODS Electronic databases were systematically searched up to April 2018 for collecting the studies reporting homocysteine levels in CSVD or CSVD subtypes. After an inclusion and exclusion criteria, the data was extracted. All data was analyzed using Stata software v.12.0 (Stata Corp LP, College Station, TX). The standardized mean difference (SMD) and 95% confidence interval (CI) were used to compare continuous variables. RESULTS Eighteen studies met eligibility criteria with 5088 participants (1987 patients with CSVD and 3101 controls) included in the meta-analysis. Meta-analysis revealed that, compared with the controls group, the CSVD group had significantly higher homocysteine levels, with the SMD of .50 and 95% CI (.36-.64). Subgroup analyses suggested white matter lesion had significantly higher levels of homocysteine compared with controls (SMD = .56, 95% CI .39-.73), followed by silent brain infarction (SMD = .33, 95% CI .24-.42) and lacunar infarction (SMD = .17, 95% CI -.06 to .40). CONCLUSIONS This meta-analysis found that CSVD or CSVD subtypes have a significantly higher homocysteine levels than in controls. Further prospective population-based studies are needed to longitudinally evaluate the association between homocysteine levels and progression of different CSVD subtypes.
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Affiliation(s)
- Xiangyu Piao
- Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Guangyao Wu
- Department of Radiology, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
| | - Pei Yang
- Department of Radiology, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
| | - Jing Shen
- Department of Radiology, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
| | - Ailing De
- Department of Radiology, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
| | - Jianlin Wu
- Department of Radiology, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
| | - Qiumin Qu
- Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
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Lin Q, Huang WQ, Ma QL, Lu CX, Tong SJ, Ye JH, Lin HN, Gu L, Yi KH, Cai LL, Tzeng CM. Incidence and risk factors of leukoaraiosis from 4683 hospitalized patients: A cross-sectional study. Medicine (Baltimore) 2017; 96:e7682. [PMID: 28953609 PMCID: PMC5626252 DOI: 10.1097/md.0000000000007682] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Leukoaraiosis (LA) refers to white matter hyperintensities or white matter lesions (WMLs) on magnetic resonance imaging (MRI) scans of the brain; this disease is associated with an increased risk of stroke, dementia, and cognitive decline. The aims of the study are to assess the incidence of LA and its associated risk factors in a Chinese population.A hospital-based cross-sectional study was conducted that included 4683 patients who were 40 years or older. Data collected included age, sex, hypertension, diabetes, smoking, drinking, homocysteine (HCY), and low-density lipoprotein cholesterol (LDL-C) levels in the blood in addition to brain MRI information. We examined the relationship of those putative risk factors with LA, LA occurrence, and LA progression through single-factor and multivariate analyses.Of the total subjects, 58.3% (2731/4683 cases) suffered from LA. LA was more frequent amongst elderly females, particularly in those older than 60, compared to men. The incidence of LA increased with age. Age, sex, hypertension, diabetes, smoking, and HCY levels all were risk factors for LA. Amongst those risk factors, both smoking and high HCY levels were associated with the onset process of LA. Moreover, the multivariate logistic analysis revealed that both drinking and abnormal LDL-C levels were positive regulators in the progression process of LA.This study revealed that the incidence of LA is high in hospitalized patients in China; moreover, age, sex, hypertension, diabetes mellitus, smoking, drinking, and abnormal HCY and LDL-C levels were found to be associated with overall LA risk, LA onset, or LA progression. These results provide insight into strategies for the prevention and treatment of LA.
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Affiliation(s)
- Qing Lin
- Department of Neurology, The First Affiliated Hospital of Xiamen University
- Translational Medicine Research Center (TMRC), School of Pharmaceutical Sciences, Xiamen University, Xiamen
- First Clinical Medical College of Fujian Medical University, Fuzhou
| | - Wen-Qing Huang
- Translational Medicine Research Center (TMRC), School of Pharmaceutical Sciences, Xiamen University, Xiamen
- Key Laboratory for Cancer T-Cell Theranostics and Clinical Translation (CTCTCT), School of Pharmaceutical Sciences, Xiamen University, Xiamen, Fujian
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, Guangdong
| | - Qi-Lin Ma
- Department of Neurology, The First Affiliated Hospital of Xiamen University
- First Clinical Medical College of Fujian Medical University, Fuzhou
| | - Cong-Xia Lu
- Department of Neurology, The First Affiliated Hospital of Xiamen University
| | - Sui-Jun Tong
- Department of Neurology, The First Affiliated Hospital of Xiamen University
| | - Jin-Hu Ye
- Department of Neurology, The First Affiliated Hospital of Xiamen University
| | - Hui-Nuan Lin
- Translational Medicine Research Center (TMRC), School of Pharmaceutical Sciences, Xiamen University, Xiamen
- Key Laboratory for Cancer T-Cell Theranostics and Clinical Translation (CTCTCT), School of Pharmaceutical Sciences, Xiamen University, Xiamen, Fujian
| | - Long Gu
- Translational Medicine Research Center (TMRC), School of Pharmaceutical Sciences, Xiamen University, Xiamen
- Key Laboratory for Cancer T-Cell Theranostics and Clinical Translation (CTCTCT), School of Pharmaceutical Sciences, Xiamen University, Xiamen, Fujian
| | - Ke-Hui Yi
- Department of Neurology, The First Affiliated Hospital of Xiamen University
- First Clinical Medical College of Fujian Medical University, Fuzhou
| | - Liang-Liang Cai
- Translational Medicine Research Center (TMRC), School of Pharmaceutical Sciences, Xiamen University, Xiamen
- Key Laboratory for Cancer T-Cell Theranostics and Clinical Translation (CTCTCT), School of Pharmaceutical Sciences, Xiamen University, Xiamen, Fujian
| | - Chi-Meng Tzeng
- Translational Medicine Research Center (TMRC), School of Pharmaceutical Sciences, Xiamen University, Xiamen
- Key Laboratory for Cancer T-Cell Theranostics and Clinical Translation (CTCTCT), School of Pharmaceutical Sciences, Xiamen University, Xiamen, Fujian
- INNOVA Clinics and TRANSLA Health Group, Yangzhou, Jiangsu, China
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