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Sehtman-Shachar DR, Yanuv I, Schechter M, Fishkin A, Aharon-Hananel G, Leibowitz G, Rozenberg A, Mosenzon O. Normoalbuminuria-is it normal? The association of urinary albumin within the 'normoalbuminuric' range with adverse cardiovascular and mortality outcomes: A systematic review and meta-analysis. Diabetes Obes Metab 2024. [PMID: 39021242 DOI: 10.1111/dom.15752] [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: 03/17/2024] [Revised: 06/04/2024] [Accepted: 06/14/2024] [Indexed: 07/20/2024]
Abstract
AIM To assess the association between urinary albumin-to-creatinine ratio (UACR) categories within the normal range with mortality and adverse cardiovascular outcomes. MATERIALS AND METHODS PubMed and Embase were systematically searched for real-world evidence studies. Studies were manually evaluated according to predefined eligibility criteria. We included prospective and retrospective cohort studies of the association between UACR categories <30 mg/g and cardiovascular outcomes or mortality. Published information regarding study design, participants, UACR categorization, statistical methods, and results was manually collected. Two UACR categorization approaches were defined: a two-category (UACR <10 mg/g vs. 10-30 mg/g) and a three-category division (UACR <5 mg/g vs. 5-10 and 10-30 mg/g). A random effects meta-analysis was performed on studies eligible for the meta-analysis. RESULTS In total, 22 manuscripts were identified for the systematic review, 15 of which were eligible for the meta-analysis. The results suggest an association between elevated UACR within the normal to mildly increased range and higher risks of all-cause mortality, cardiovascular death, and coronary heart disease, particularly in the range of 10-30 mg/g. Compared with UACR <10 mg/g, the hazard ratio [HR (95% confidence interval, CI)] for UACR between 10 and 30 mg/g was 1.41 (1.15, 1.74) for all-cause mortality and 1.56 (1.23, 1.98) for coronary heart disease. Compared with UACR <5 mg/g, the risk of cardiovascular mortality for UACR between 10 and 30 mg/g was more than twofold [HR (95% CI): 2.12 (1.61, 2.80)]. Intermediate UACR (5-10 mg/g) was also associated with a higher risk of all-cause mortality [HR (95% CI): 1.14 (1.05, 1.24)] and cardiovascular mortality [HR (95% CI): 1.50 (1.14, 1.99)]. CONCLUSIONS We propose considering higher UACR within the normoalbuminuric range as a prognostic factor for cardiovascular morbidity and mortality. Our findings underscore the clinical significance of even mild increases in albuminuria.
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Affiliation(s)
- Dvora R Sehtman-Shachar
- Diabetes Unit, Department of Endocrinology and Metabolism, Hadassah Medical Centre, Jerusalem, Israel
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Ilan Yanuv
- Diabetes Unit, Department of Endocrinology and Metabolism, Hadassah Medical Centre, Jerusalem, Israel
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Meir Schechter
- Diabetes Unit, Department of Endocrinology and Metabolism, Hadassah Medical Centre, Jerusalem, Israel
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Alisa Fishkin
- Diabetes Unit, Department of Endocrinology and Metabolism, Hadassah Medical Centre, Jerusalem, Israel
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Genya Aharon-Hananel
- Diabetes Unit, Department of Endocrinology and Metabolism, Hadassah Medical Centre, Jerusalem, Israel
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
- Endocrinology and Metabolism Service, Department of Medicine, Hadassah-Hebrew University Medical Centre, Jerusalem, Israel
| | - Gil Leibowitz
- Diabetes Unit, Department of Endocrinology and Metabolism, Hadassah Medical Centre, Jerusalem, Israel
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
- Endocrinology and Metabolism Service, Department of Medicine, Hadassah-Hebrew University Medical Centre, Jerusalem, Israel
| | - Aliza Rozenberg
- Diabetes Unit, Department of Endocrinology and Metabolism, Hadassah Medical Centre, Jerusalem, Israel
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Ofri Mosenzon
- Diabetes Unit, Department of Endocrinology and Metabolism, Hadassah Medical Centre, Jerusalem, Israel
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
- Regeneron Pharmaceuticals, Tarrytown, New York, USA
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Chen L, Wu L, Li Q, Ma H, Liu T, Li J, Pan B, Hu Y, Lin H, Gao X. Lower urinary albumin-to-creatinine ratio predicted all-cause and cardiovascular mortality in Chinese population with diabetes and prediabetes-The Shanghai Changfeng cohort study. J Diabetes 2024; 16:e13497. [PMID: 37986707 PMCID: PMC10925882 DOI: 10.1111/1753-0407.13497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 09/30/2023] [Accepted: 10/25/2023] [Indexed: 11/22/2023] Open
Abstract
INTRODUCTION Elevated urinary albumin-to-creatinine ratio (UACR) was associated with increased mortality in general population and diabetic patients. However, whether the association remains similar in the subjects with different status of glucose metabolism was unclear. The optimal level of UACR in predicting mortality also remained unknown. This study aims to investigate the relationship between UACR with all-cause and cardiovascular mortality in population with different status of glucose metabolism and explore the predictive cutoff point of UACR. METHODS Six thousand three hundred and eighty-six community-dwelling individuals aged ≥45 years were enrolled and followed for an average of 5.3 years. Cox proportional hazards model was performed to analysis the association of baseline UACR and all-cause as well as cardiovascular mortality according to the status of glucose metabolism. Receiver operating characteristic curve was plotted to explore the optimal predictive cutoff point of UACR. RESULTS With UACR increasing, both the prevalence of all-cause and cardiovascular death increased. Cox analyses showed baseline UACR independently predicted the risk of all-cause and cardiovascular mortality in the patients with prediabetes mellitus (pre-DM) and diabetes mellitus (DM) but not in subjects with normal glucose tolerance (NGT). When divided by quartiles of UACR, the cumulative survival rate decreased acrossing the quartiles. Compared to the subjects with lowest quartile of UACR, participants with UACR ≥7.40 mg/gCr had a higher risk of all-cause mortality, and participants with UACR ≥16.60 mg/gCr had an increased risk of cardiovascular mortality in all hyperglycemia subjects. The optimal predictive cutoff point of UACR was about 17 mg/gCr. CONCLUSION UACR was an independent predictor of all-cause and cardiovascular mortality in population with pre-DM and DM but not in the subjects with NGT. The optimal predictive cutoff point of UACR is about 17 mg/gCr, which was far below the diagnostic cutoff point of microalbuminuria. Earlier interventions of albuminuria should be initiated from very early stage of hyperglycemia to reduce the burden of death in all patients whose glucose metabolism are impaired.
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Affiliation(s)
- Lingyan Chen
- Department of Geriatrics, Zhongshan HospitalFudan UniversityShanghaiChina
| | - Li Wu
- Department of Endocrinology and Metabolism, Zhongshan HospitalFudan UniversityShanghaiChina
| | - Qian Li
- Department of Endocrinology and Metabolism, Zhongshan HospitalFudan UniversityShanghaiChina
| | - Hui Ma
- Department of Geriatrics, Zhongshan HospitalFudan UniversityShanghaiChina
| | - Ting Liu
- Department of Endocrinology and Metabolism, Zhongshan HospitalFudan UniversityShanghaiChina
| | - Jing Li
- Department of Endocrinology and Metabolism, Zhongshan HospitalFudan UniversityShanghaiChina
| | - Baisheng Pan
- Clinical Laboratory, Zhongshan HospitalFudan UniversityShanghaiChina
| | - Yu Hu
- Department of Geriatrics, Zhongshan HospitalFudan UniversityShanghaiChina
| | - Huandong Lin
- Department of Endocrinology and Metabolism, Zhongshan HospitalFudan UniversityShanghaiChina
| | - Xin Gao
- Department of Endocrinology and Metabolism, Zhongshan HospitalFudan UniversityShanghaiChina
- Fudan Institute for Metabolic DiseasesShanghaiChina
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Cai S, Cheng B, Li K, Li Y, Zhang A, Sun J, Su Y, Li M, Bao Q, Zhang Y, Ma S, Zhu P, Wang S. Association of cognitive impairment and diabetes on survival in Chinese older people with hypertension: a 10-year prospective study. BMC Geriatr 2023; 23:582. [PMID: 37735635 PMCID: PMC10515062 DOI: 10.1186/s12877-023-04214-4] [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: 04/29/2022] [Accepted: 08/03/2023] [Indexed: 09/23/2023] Open
Abstract
BACKGROUND Older people with hypertension may have more complex multisystem problems and a higher risk of morbidity and mortality. We aimed to examine the association of cognitive impairment (CI) and diabetes mellitus (DM) on all-cause mortality in the aged with hypertension (HTN). METHODS This is a prospective cohort study with a sample of 1017 older people with hypertension aged 60 years or older who completed baseline examinations in 2009-2010 and followed up for ten years in 2020. The endpoint was death from any cause. Subjects were categorized as HTN only, HTN + DM, HTN + CI, and HTN + DM + CI. Cox regression model was used to determine the association of comorbidities on all-cause mortality. RESULTS During the 10-year follow-up period, 196 deaths occurred. After adjusted for covariates, risk of death from any cause was significantly increased in the older people with increased comorbidities (P = 0.003). Compared with the HTN only, with HTN + CI, and HTN + DM + CI, the HRs (95% confidence intervals) for all-cause mortality were 1.61(1.13-2.30) and 1.79(1.07-2.99), respectively. In stratified analyses, the relationship between comorbidities level and the risk of all-cause mortality persisted. CONCLUSION All-cause mortality risks increased with increasing the comorbidities. This study emphasizes the importance of comprehensive management of the older people with HTN in clinical practice and public health policy.
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Affiliation(s)
- Shuang Cai
- Department of Geriatrics, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, 100853, China
- Medical School of Chinese PLA, Beijing, 100853, China
| | - Bokai Cheng
- Department of Geriatrics, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, 100853, China
- Medical School of Chinese PLA, Beijing, 100853, China
| | - Kailiang Li
- Department of Geriatric Cardiology, The Second Medical Center, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China
| | - Yun Li
- Department of Emergency, The Fifth Medical Center, Chinese PLA General Hospital, Beijing, 100853, China
| | - Anhang Zhang
- Department of Geriatrics, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, 100853, China
- Medical School of Chinese PLA, Beijing, 100853, China
| | - Jin Sun
- Department of Geriatrics, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, 100853, China
- Medical School of Chinese PLA, Beijing, 100853, China
| | - Yongkang Su
- Department of Geriatrics, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, 100853, China
- Medical School of Chinese PLA, Beijing, 100853, China
| | - Man Li
- Department of Geriatrics, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, 100853, China
- Medical School of Chinese PLA, Beijing, 100853, China
| | - Qiligeer Bao
- Department of Geriatrics, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, 100853, China
- Medical School of Chinese PLA, Beijing, 100853, China
| | - Yan Zhang
- Department of Outpatient, The First Medical Center, Chinese PLA General Hospital, Beijing, 100853, China
| | - Shouyuan Ma
- Department of Emergency, The Fifth Medical Center, Chinese PLA General Hospital, Beijing, 100853, China
| | - Ping Zhu
- Department of Geriatrics, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, 100853, China.
- Medical School of Chinese PLA, Beijing, 100853, China.
| | - Shuxia Wang
- Department of Geriatrics, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, 100853, China.
- Medical School of Chinese PLA, Beijing, 100853, China.
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Yu F, Liu A, Deng Z, Gan S, Zhou Q, Long H. Association Between Chinese Visceral Adipose Index and Albuminuria in Chinese Adults: A Cross-Sectional Study. Int J Gen Med 2023; 16:2271-2283. [PMID: 37304903 PMCID: PMC10254699 DOI: 10.2147/ijgm.s411416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 05/30/2023] [Indexed: 06/13/2023] Open
Abstract
Purpose To explore the correlation between Chinese visceral adipose index (CVAI) and urinary microalbumin/creatinine ratio (UACR) and urinary albumin, and whether there is any difference in correlation between Han and Tujia ethnicity. Methods This cross-sectional study was conducted in Changde, Hunan, China from May 2021 to December 2021. Biochemical indicators including anthropometric parameters, blood pressure, blood glucose, blood lipids, and UACR of the participants were measured. Univariate analysis, multivariate analyses and multinomial logistic regression analysis were carried out to assess the association between CVAI and albuminuria. In addition, curve fitting and threshold effect analysis were used to explore the nonlinear association between CVAI and albuminuria, and to observe whether there were ethnic differences in this association. Results A total of 2026 adult residents were enrolled in this study, 500 of whom had albuminuria. Population-standardized prevalence of albuminuria is 19.06%. In the multivariable model adjusted for confounding factors, the odds ratio (OR) of albuminuria for pre-unit increase of CVAI and pre-SD increase of CVAI were 1.007 (1.003-1.010) and 1.298 (1.127-1.496), respectively. Multinomial logistic regression analysis confirmed the robustness and consistency of the results.The generalized additive model showed that CVAI and albuminuria had a nonlinear relationship with inflection point at 97.201 using the threshold effect. Compared with Han ethnic groups, the threshold between CVAI and albuminuria in Tujia people moved backward. The thresholds were 159.785 and 98.527, respectively. Conclusion There was a positive nonlinear dose-response relationship between increased CVAI and higher levels of albuminuria. Maintaining appropriate CVAI levels may be important for the prevention of albuminuria.
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Affiliation(s)
- Fang Yu
- Department of Endocrinology, The First People’s Hospital of Changde City, Changde, Hunan, People’s Republic of China
| | - Aizhong Liu
- Hunan Provincial Key Laboratory of Clinical Epidemiology, Xiangya School of Public Health, Central South University, Changsha, Hunan, People’s Republic of China
| | - Zhiming Deng
- Department of Endocrinology, The First People’s Hospital of Changde City, Changde, Hunan, People’s Republic of China
| | - Shenglian Gan
- Department of Endocrinology, The First People’s Hospital of Changde City, Changde, Hunan, People’s Republic of China
| | - Quan Zhou
- Department of Science and Education Section, The First People’s Hospital of Changde City, Changde, Hunan, People’s Republic of China
| | - Haowen Long
- Department of Radiology, The First People’s Hospital of Changde City, Changde, Hunan, People’s Republic of China
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Zhang A, Li Y, Ma S, Bao Q, Sun J, Cai S, Li M, Su Y, Cheng B, Dong J, Zhang Y, Wang S, Zhu P. Conicity-index predicts all-cause mortality in Chinese older people: a 10-year community follow-up. BMC Geriatr 2022; 22:971. [PMID: 36522628 PMCID: PMC9756661 DOI: 10.1186/s12877-022-03664-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 11/30/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Abdominal obesity (AO) has been regarded as the most dangerous type of obesity. The Conicity-index (C-index) had a high ability to discriminate underlying AO. The purpose of this study was to determine the ability of C-index to predict all-cause mortality among non-cancer Chinese older people. METHODS The participants were residents of the Wanshou Road community in Beijing, China. Receiver operating curve (ROC) curves were used to determine the sensitivity and specificity of the best cut-off values for different anthropometric measures for predicting all-cause mortality. The area under the curve (AUC) of the ROC curves were calculated to compare the relative ability of various anthropometric measures to correctly identify older people in the community where all-cause mortality occurs. Included subjects were grouped according to C-index tertiles. The association between C-index and all-cause mortality was verified using Kaplan-Meier survival analysis and different Cox regression models. RESULTS During a mean follow-up period of 9.87 years, 1821 subjects completed follow-up. The average age was 71.21 years, of which 59.4% were female. The ROC curve results showed that the AUC of the C-index in predicting all-cause mortality was 0.633. Kaplan-Meier survival curves showed a clear dose-response relationship between C-index and all-cause mortality. With the increase of C-index, the survival rate of the study population showed a significant downward trend (P < 0.05). Adjusted for age, gender, hip circumference, systolic blood pressure, diastolic blood pressure, fasting blood glucose (FBG), 2-h postprandial blood glucose (2hPG), glycosylated hemoglobin, high-density lipids protein (LDL), triglyceride, serum creatinine, serum uric acid, urine albumin-creatinine ratio (UACR), Mini-Mental State Examination (MMSE), smoking history, and drinking history, COX regression analysis showed that in the model adjusted for all covariates, the risk of all-cause mortality in tertile 3 was 1.505 times that in tertile 1, and the difference was statistically significant. CONCLUSIONS The C-index is an independent risk factor for all-cause mortality in the non-cancer Chinese older people.
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Affiliation(s)
- Anhang Zhang
- grid.414252.40000 0004 1761 8894Medical School of Chinese PLA & Chinese, PLA General Hospital, Beijing, 100853 China ,grid.414252.40000 0004 1761 8894Department of Geriatrics, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853 China
| | - Yingnan Li
- grid.414252.40000 0004 1761 8894Department of Gastroenterology, the Second Medical Center, Chinese PLA General Hospital, Beijing, 100853 China
| | - Shouyuan Ma
- grid.414252.40000 0004 1761 8894Department of Geriatric Cardiology, the Second Medical Center, Chinese PLA General Hospital, Beijing, 100853 China
| | - Qiligeer Bao
- grid.414252.40000 0004 1761 8894Medical School of Chinese PLA & Chinese, PLA General Hospital, Beijing, 100853 China ,grid.414252.40000 0004 1761 8894Department of Geriatrics, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853 China
| | - Jin Sun
- grid.414252.40000 0004 1761 8894Medical School of Chinese PLA & Chinese, PLA General Hospital, Beijing, 100853 China ,grid.414252.40000 0004 1761 8894Department of Geriatrics, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853 China
| | - Shuang Cai
- grid.414252.40000 0004 1761 8894Medical School of Chinese PLA & Chinese, PLA General Hospital, Beijing, 100853 China ,grid.414252.40000 0004 1761 8894Department of Geriatrics, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853 China
| | - Man Li
- grid.414252.40000 0004 1761 8894Medical School of Chinese PLA & Chinese, PLA General Hospital, Beijing, 100853 China ,grid.414252.40000 0004 1761 8894Department of Geriatrics, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853 China
| | - Yongkang Su
- grid.414252.40000 0004 1761 8894Medical School of Chinese PLA & Chinese, PLA General Hospital, Beijing, 100853 China ,grid.414252.40000 0004 1761 8894Department of Geriatrics, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853 China
| | - Bokai Cheng
- grid.414252.40000 0004 1761 8894Medical School of Chinese PLA & Chinese, PLA General Hospital, Beijing, 100853 China ,grid.414252.40000 0004 1761 8894Department of Geriatrics, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853 China
| | - Jing Dong
- grid.414252.40000 0004 1761 8894Department of Geriatrics, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853 China
| | - Yan Zhang
- grid.414252.40000 0004 1761 8894Department of Outpatient, the First Medical Center, Chinese PLA General Hospital, Beijing, 100853 China
| | - Shuxia Wang
- grid.414252.40000 0004 1761 8894Medical School of Chinese PLA & Chinese, PLA General Hospital, Beijing, 100853 China ,grid.414252.40000 0004 1761 8894Department of Geriatrics, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853 China
| | - Ping Zhu
- grid.414252.40000 0004 1761 8894Medical School of Chinese PLA & Chinese, PLA General Hospital, Beijing, 100853 China ,grid.414252.40000 0004 1761 8894Department of Geriatrics, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853 China
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Zhang A, Liu Y, Ma S, Bao Q, Sun J, Su Y, Cai S, Cheng B, Li M, Zhang Y, Tao T, Qiu J, Dong J, Song G, Zhu P, Wang S. Effects of ankle-brachial index and brachial-ankle pulse wave velocity on all-cause mortality in a community-based elderly population. Front Cardiovasc Med 2022; 9:883651. [PMID: 36176985 PMCID: PMC9513615 DOI: 10.3389/fcvm.2022.883651] [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: 03/08/2022] [Accepted: 07/12/2022] [Indexed: 11/25/2022] Open
Abstract
Background Ankle-brachial index (ABI) and brachial-ankle pulse wave velocity (baPWV) are both important indicators of arterial stiffness and vascular injury. At present, most studies on the relationship between ABI and baPWV and all-cause mortality in community-based elderly are analyzing ABI or baPWV alone, and will focus on a single special population such as diabetes and stroke. The purpose of this study was to evaluate the relationship between ABI and baPWV in a Chinese community-based elderly population, and to analyze their impact on all-cause mortality in a community-based population through a follow-up of nearly 10 years. Methods Participants were residents of the Wanshou Road community in Beijing, China. A total of 2,162 people in the community were included, with an average age of 71.48 years. During a mean follow-up period of 9.87 years, 1,826 subjects completed follow-up. Kaplan-Meier survival analysis and different Cox regression models were used to verify the association of ABI and baPWV with all-cause mortality. The selected subjects were divided into two groups according to ABI and baPWV, and ABI was divided into two groups with 0.90 as the cut-off point (group 1: 0.9 < ABI ≤ 1.3; group 2: ABI ≤ 0.9); according to the level of baPWV, they were divided into three groups (Tertile 1: baPWV <1761.5 cm/s; Tertile 2: 1761.5 ≤ baPWV <2121.5 cm/s; Tertile 3: baPWV ≥2121.5 cm/s). Results 1,826 people were included in the statistical analysis, and the total mortality rate was 181.3/1000. The 10-year all-cause mortality rate of the abnormal ABI group (group 2) was 44.7%, and that of the normal ABI group (group 1) was 17.0%; The 10-year all-cause mortality rates from low to high in the baPWV tertile were 10.0%, 18.7%, and 26.4%. In the Cox proportional hazards model, after adjusting for possible confounders, the effect of baPWV on all-cause mortality was significant, with the 3rd tertile having a 1.647-fold higher risk of all-cause mortality than the 1st tertile (P = 0.014 ). Conclusions ABI and baPWV are risk factors affecting all-cause mortality in the elderly community population, and baPWV is an independent predictor of all-cause mortality in the elderly community population.
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Affiliation(s)
- Anhang Zhang
- Medical School of Chinese PLA & Chinese PLA General Hospital, Beijing, China
- Department of Geriatrics, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Yupeng Liu
- Medical School of Chinese PLA & Chinese PLA General Hospital, Beijing, China
- Department of Geriatrics, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Shouyuan Ma
- Department of Geriatric Cardiology, The Second Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Qiligeer Bao
- Medical School of Chinese PLA & Chinese PLA General Hospital, Beijing, China
- Department of Geriatrics, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Jin Sun
- Medical School of Chinese PLA & Chinese PLA General Hospital, Beijing, China
- Department of Geriatrics, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Yongkang Su
- Medical School of Chinese PLA & Chinese PLA General Hospital, Beijing, China
- Department of Geriatrics, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Shuang Cai
- Medical School of Chinese PLA & Chinese PLA General Hospital, Beijing, China
- Department of Geriatrics, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Bokai Cheng
- Medical School of Chinese PLA & Chinese PLA General Hospital, Beijing, China
- Department of Geriatrics, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Man Li
- Medical School of Chinese PLA & Chinese PLA General Hospital, Beijing, China
- Department of Geriatrics, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Yan Zhang
- Department of Outpatient, The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Tianqi Tao
- Department of Geriatrics, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Jiaojiao Qiu
- Department of Geriatrics, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Jing Dong
- Department of Geriatrics, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Ge Song
- Department of Geriatrics, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Ping Zhu
- Medical School of Chinese PLA & Chinese PLA General Hospital, Beijing, China
- Department of Geriatrics, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
- *Correspondence: Ping Zhu
| | - Shuxia Wang
- Medical School of Chinese PLA & Chinese PLA General Hospital, Beijing, China
- Department of Geriatrics, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
- Shuxia Wang
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Cai S, Zhou L, Zhang Y, Cheng B, Zhang A, Sun J, Li M, Su Y, Bao Q, Zhang Y, Ma S, Zhu P, Wang S. Association of the Weight-Adjusted-Waist Index With Risk of All-Cause Mortality: A 10-Year Follow-Up Study. Front Nutr 2022; 9:894686. [PMID: 35694172 PMCID: PMC9174751 DOI: 10.3389/fnut.2022.894686] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 05/06/2022] [Indexed: 01/06/2023] Open
Abstract
Background To explore the relationship between weight-adjusted-waist index (WWI) and the risk of all-cause mortality in one urban community-dwelling population in China. Methods This is a prospective cohort study with a sample of 1,863 older adults aged 60 years or over in Beijing who completed baseline examinations in 2009-2010 and a 10-year follow-up in 2020. WWI was calculated as waist circumference (cm) divided by the square root of weight (kg). Cox regression analysis was performed to investigate the significance of the association of WWI with all-cause mortality. The area under the receiver operating characteristic (ROC) curves were used to compare the ability of each obesity index to predict mortality. Results During a median follow-up of 10.8 years (1.0 to 11.3 years), 339 deaths occurred. After adjusted for covariates, the hazard ratios (HRs) for all-cause mortality progressively increased across the tertile of WWI. Compared with the lowest WWI category (tertile1 <10.68 cm/√kg), with WWI 10.68 to 11.24cm/√kg, and≥11.25 cm/√kg, the HRs (95% confidence intervals (CIs)) for all-cause mortality were 1.58 (1.12-2.22), and 2.66 (1.80-3.92), respectively. In stratified analyses, the relationship between WWI and the risk of all-cause mortality persisted. The area under ROC for WWI was higher for all-cause mortality than BMI, WHtR, and WC. Conclusion WWI was associated with a higher risk for all-cause mortality, and the association was more robust with the highest WWI category.
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Affiliation(s)
- Shuang Cai
- Department of Geriatrics, the 2nd Medical Center, Chinese PLA General Hospital, Beijing, China
- Medical School of Chinese PLAl, Beijing, China
| | - Lin Zhou
- Department of Geriatrics, the 2nd Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Yue Zhang
- Department of Geriatrics, the 2nd Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Bokai Cheng
- Department of Geriatrics, the 2nd Medical Center, Chinese PLA General Hospital, Beijing, China
- Medical School of Chinese PLAl, Beijing, China
| | - Anhang Zhang
- Department of Geriatrics, the 2nd Medical Center, Chinese PLA General Hospital, Beijing, China
- Medical School of Chinese PLAl, Beijing, China
| | - Jin Sun
- Department of Geriatrics, the 2nd Medical Center, Chinese PLA General Hospital, Beijing, China
- Medical School of Chinese PLAl, Beijing, China
| | - Man Li
- Department of Geriatrics, the 2nd Medical Center, Chinese PLA General Hospital, Beijing, China
- Medical School of Chinese PLAl, Beijing, China
| | - Yongkang Su
- Department of Geriatrics, the 2nd Medical Center, Chinese PLA General Hospital, Beijing, China
- Medical School of Chinese PLAl, Beijing, China
| | - Qiligeer Bao
- Department of Geriatrics, the 2nd Medical Center, Chinese PLA General Hospital, Beijing, China
- Medical School of Chinese PLAl, Beijing, China
| | - Yan Zhang
- Department of Outpatient, the First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Shouyuan Ma
- Department of Geriatrics, the 2nd Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Ping Zhu
- Department of Geriatrics, the 2nd Medical Center, Chinese PLA General Hospital, Beijing, China
- Medical School of Chinese PLAl, Beijing, China
| | - Shuxia Wang
- Department of Geriatrics, the 2nd Medical Center, Chinese PLA General Hospital, Beijing, China
- Medical School of Chinese PLAl, Beijing, China
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