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Slama L, Barrett BW, Abraham AG, Palella FJ, Magnani JW, Viard JP, Lake JE, Brown TT. Incident Proteinuria by HIV Serostatus Among Men With Pre--Diabetes Mellitus: The Multicenter AIDS Cohort Study. Clin Infect Dis 2024; 79:469-476. [PMID: 38335094 PMCID: PMC11327777 DOI: 10.1093/cid/ciae065] [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: 10/02/2023] [Revised: 01/12/2024] [Accepted: 01/30/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND Pre-diabetes mellitus (DM) is associated with proteinuria, a risk factor for chronic kidney disease. While people with human immunodeficiency virus (HIV; PWH) have a higher risk of proteinuria than people without HIV (PWOH), it is unknown whether incident proteinuria differs by HIV serostatus among prediabetic persons. METHODS The urine protein-to-creatinine ratio was measured at semiannual visits among men in the Multicenter AIDS Cohort Study since April 2006. Men with pre-DM on or after April 2006 and no prevalent proteinuria or use of antidiabetic medications were included. Pre-DM was defined as a fasting glucose level of 100-125 mg/dL confirmed within a year by a repeated fasting glucose or hemoglobin A1c measurement of 5.7%-6.4%. Incident proteinuria was defined as a urine protein-to-creatinine ratio (UPCR) >200 mg/g, confirmed within a year. We used Poisson regression models to determine whether incident proteinuria in participants with pre-DM differed by HIV serostatus and, among PWH, whether HIV-specific factors were related to incident proteinuria. RESULTS Between 2006 and 2019, among 1276 men with pre-DM, proteinuria developed in 128 of 613 PWH (21%) and 50 of 663 PWOH (8%) over a median 10-year follow-up. After multivariable adjustment, the incidence of proteinuria in PWH with pre-DM was 3.3 times (95% confidence interval, 2.3-4.8 times) greater than in PWOH (P < .01). Among PWH, current CD4 cell count <50/µL (P < .01) and current use of protease inhibitors (P = .03) were associated with incident proteinuria, while lamivudine and integrase inhibitor use were associated with a lower risk. CONCLUSIONS Among men with pre-DM, the risk of incident proteinuria was 3 times higher in PWH. Strategies to preserve renal function are needed in this population.
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Affiliation(s)
- Laurence Slama
- Infectious Diseases Unit, APHP, Hotel-Dieu Hospital, Paris, France
- University Paris Cité and University Sorbonne Paris Nord, INSERM, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Paris, France
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Benjamin W Barrett
- Division of Endocrinology, Diabetes, and Metabolism, Johns Hopkins University, Baltimore, Maryland, USA
| | - Alison G Abraham
- Department of Epidemiology, Colorado School of Public Health, Aurora, Colorado, USA
| | - Frank J Palella
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Jared W Magnani
- School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Jean Paul Viard
- Infectious Diseases Unit, APHP, Hotel-Dieu Hospital, Paris, France
| | - Jordan E Lake
- Department of Internal Medicine, UTHealth Houston, Houston, Texas, USA
| | - Todd T Brown
- Division of Endocrinology, Diabetes, and Metabolism, Johns Hopkins University, Baltimore, Maryland, USA
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Borges-Canha M, Neves JS, Silva MM, Mendonça F, Moreno T, Ribeiro S, Vale C, Gonçalves J, Ferreira HU, Gil-Santos S, Calheiros R, Meira I, Menino J, Guerreiro V, Pedro J, Sande A, Souto SB, da Costa EL, Carvalho D, Freitas P. Prediabetes remission after bariatric surgery: a 4-years follow-up study. BMC Endocr Disord 2024; 24:7. [PMID: 38200480 PMCID: PMC10782579 DOI: 10.1186/s12902-024-01537-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 01/03/2024] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Bariatric surgery leads to weight loss and to cardiometabolic risk improvement. Although prediabetes remission after bariatric surgery is biologically plausible, data on this topic is scarce. We aimed to assess prediabetes remission rate and clinical predictors of remission in a 4 year follow up period. METHODS Observational longitudinal study including patients with obesity and prediabetes who had undergone bariatric surgery in our centre. Prediabetes was defined as having a baseline glycated haemoglobin (A1c) between 5.7% and 6.4% and absence of anti-diabetic drug treatment. We used logistic regression models to evaluate the association between the predictors and prediabetes remission rate. RESULTS A total of 669 patients were included, 84% being female. The population had a mean age of 45.4 ± 10.1 years-old, body mass index of 43.8 ± 5.7 kg/m2, and median A1c of 5.9 [5.8, 6.1]%. After bariatric surgery, prediabetes remission rate was 82%, 73%, 66%, and 58%, respectively in the 1st, 2nd, 3rd, and 4th years of follow-up. Gastric sleeve (GS) surgery was associated with higher prediabetes remission rate than Roux-en-Y gastric bypass surgery in the 3rd year of follow-up. Men had a higher remission rate than women, in the 1st and 3nd years of follow-up in the unadjusted analysis. Younger patients presented a higher remission rate comparing to older patients in the 3rd year of follow-up. CONCLUSION We showed a high prediabetes remission rate after bariatric surgery. The remission rate decreases over the follow-up period, although most of the patients maintain the normoglycemia. Prediabetes remission seems to be more significant in patients who had undergone GS, in male and in younger patients.
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Affiliation(s)
- Marta Borges-Canha
- Serviço de Endocrinologia, Diabetes e Metabolismo do Centro Hospitalar Universitário de São João, Porto, Portugal.
- Departamento de Cirurgia e Fisiologia, Faculdade de Medicina da Universidade do Porto, Porto, Portugal.
| | - João Sérgio Neves
- Serviço de Endocrinologia, Diabetes e Metabolismo do Centro Hospitalar Universitário de São João, Porto, Portugal
- Departamento de Cirurgia e Fisiologia, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Maria Manuel Silva
- Serviço de Endocrinologia, Diabetes e Metabolismo do Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Fernando Mendonça
- Serviço de Endocrinologia, Diabetes e Metabolismo do Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Telma Moreno
- Serviço de Endocrinologia, Diabetes e Metabolismo do Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Sara Ribeiro
- Serviço de Endocrinologia, Diabetes e Metabolismo do Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Catarina Vale
- Departamento de Cirurgia e Fisiologia, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
- Serviço de Medicina Interna do Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Juliana Gonçalves
- Serviço de Endocrinologia, Diabetes e Metabolismo do Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Helena Urbano Ferreira
- Serviço de Endocrinologia, Diabetes e Metabolismo do Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Sara Gil-Santos
- Serviço de Endocrinologia do Instituto Português de Oncologia do Porto, Porto, Portugal
| | - Raquel Calheiros
- Serviço de Endocrinologia do Instituto Português de Oncologia do Porto, Porto, Portugal
| | - Inês Meira
- Serviço de Endocrinologia, Diabetes e Metabolismo do Centro Hospitalar Universitário de São João, Porto, Portugal
| | - João Menino
- Serviço de Endocrinologia, Diabetes e Metabolismo do Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Vanessa Guerreiro
- Serviço de Endocrinologia, Diabetes e Metabolismo do Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Jorge Pedro
- Serviço de Endocrinologia, Diabetes e Metabolismo do Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Ana Sande
- Serviço de Endocrinologia, Diabetes e Metabolismo do Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Selma B Souto
- Serviço de Endocrinologia, Diabetes e Metabolismo do Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Eduardo Lima da Costa
- Serviço de Cirurgia Geral do Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Davide Carvalho
- Serviço de Endocrinologia, Diabetes e Metabolismo do Centro Hospitalar Universitário de São João, Porto, Portugal
- Instituto de Investigação e Inovação em Saúde (i3s), Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Paula Freitas
- Serviço de Endocrinologia, Diabetes e Metabolismo do Centro Hospitalar Universitário de São João, Porto, Portugal
- Instituto de Investigação e Inovação em Saúde (i3s), Faculdade de Medicina da Universidade do Porto, Porto, Portugal
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Pereira PR, Pereira J, Braga PC, Pereira SS, Nora M, Guimarães M, Monteiro MP, Rodrigues A. Renal Dysfunction Phenotypes in Patients Undergoing Obesity Surgery. Biomolecules 2023; 13:biom13050790. [PMID: 37238660 DOI: 10.3390/biom13050790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 04/30/2023] [Accepted: 05/02/2023] [Indexed: 05/28/2023] Open
Abstract
Obesity surgery candidates are at an increased risk of kidney injury, but pre-operative evaluation usually neglects kidney function assessment. This study aimed to identify renal dysfunction in candidates for bariatric surgery. To reduce the sources of bias, subjects with diabetes, prediabetes under metformin treatment, neoplastic or inflammatory diseases were excluded. Patients' (n = 192) average body mass index was 41.7 ± 5.4 kg/m2. Among these, 51% (n = 94) had creatinine clearance over 140 mL/min, 22.4% (n = 43) had proteinuria over 150 mg/day and 14.6% (n = 28) albuminuria over 30 mg/day. A creatinine clearance higher than 140 mL/min was associated with higher levels of proteinuria and albuminuria. Univariate analysis identified sex, glycated hemoglobin, uric acid, HDL and VLDL cholesterol as being associated with albuminuria, but not with proteinuria. On multivariate analysis, glycated hemoglobin and creatinine clearance as continuous variables were significantly associated with albuminuria. In summary, in our patient population prediabetes, lipid abnormalities and hyperuricemia were associated with albuminuria, but not with proteinuria, suggesting different disease mechanisms might be implicated. Data suggest that in obesity-associated kidney disease, tubulointerstitial injury precedes glomerulopathy. A significant proportion of obesity surgery candidates present clinically relevant albuminuria and proteinuria along with renal hyperfiltration, suggesting that routine pre-operative assessment of these parameters should be considered.
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Affiliation(s)
- Pedro R Pereira
- Department of Nephrology, Centro Hospitalar de Trás-os-Montes e Alto Douro (CHTMAD), 5000-508 Vila Real, Portugal
- UMIB-Unit for Multidisciplinary Research in Biomedicine, ICBAS-School of Medicine and Biomedical Sciences, University of Porto, Rua Jorge Viterbo Ferreira 228, 4050-313 Porto, Portugal
- ITR-Laboratory of Integrative and Translocation Research in Population Health, Rua das Taipas 135, 4050-600 Porto, Portugal
| | - João Pereira
- UMIB-Unit for Multidisciplinary Research in Biomedicine, ICBAS-School of Medicine and Biomedical Sciences, University of Porto, Rua Jorge Viterbo Ferreira 228, 4050-313 Porto, Portugal
- ITR-Laboratory of Integrative and Translocation Research in Population Health, Rua das Taipas 135, 4050-600 Porto, Portugal
| | - Patrícia C Braga
- UMIB-Unit for Multidisciplinary Research in Biomedicine, ICBAS-School of Medicine and Biomedical Sciences, University of Porto, Rua Jorge Viterbo Ferreira 228, 4050-313 Porto, Portugal
- ITR-Laboratory of Integrative and Translocation Research in Population Health, Rua das Taipas 135, 4050-600 Porto, Portugal
| | - Sofia S Pereira
- UMIB-Unit for Multidisciplinary Research in Biomedicine, ICBAS-School of Medicine and Biomedical Sciences, University of Porto, Rua Jorge Viterbo Ferreira 228, 4050-313 Porto, Portugal
- ITR-Laboratory of Integrative and Translocation Research in Population Health, Rua das Taipas 135, 4050-600 Porto, Portugal
| | - Mário Nora
- Department of General Surgery, Hospital São Sebastião, Centro Hospitalar de Entre o Douro e Vouga, Rua Dr. Cândido Pinho, 4050-220 Santa Maria da Feira, Portugal
| | - Marta Guimarães
- UMIB-Unit for Multidisciplinary Research in Biomedicine, ICBAS-School of Medicine and Biomedical Sciences, University of Porto, Rua Jorge Viterbo Ferreira 228, 4050-313 Porto, Portugal
- ITR-Laboratory of Integrative and Translocation Research in Population Health, Rua das Taipas 135, 4050-600 Porto, Portugal
- Department of General Surgery, Hospital São Sebastião, Centro Hospitalar de Entre o Douro e Vouga, Rua Dr. Cândido Pinho, 4050-220 Santa Maria da Feira, Portugal
| | - Mariana P Monteiro
- UMIB-Unit for Multidisciplinary Research in Biomedicine, ICBAS-School of Medicine and Biomedical Sciences, University of Porto, Rua Jorge Viterbo Ferreira 228, 4050-313 Porto, Portugal
- ITR-Laboratory of Integrative and Translocation Research in Population Health, Rua das Taipas 135, 4050-600 Porto, Portugal
| | - Anabela Rodrigues
- UMIB-Unit for Multidisciplinary Research in Biomedicine, ICBAS-School of Medicine and Biomedical Sciences, University of Porto, Rua Jorge Viterbo Ferreira 228, 4050-313 Porto, Portugal
- ITR-Laboratory of Integrative and Translocation Research in Population Health, Rua das Taipas 135, 4050-600 Porto, Portugal
- Department of Nephrology, Centro Hospitalar Universitário de Santo António, 4099-001 Porto, Portugal
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Ford JH, Lage MJ, Boye KS, Bae JP, Terrell KA, Bunck MC. Five-year morbidity and mortality rates in a U.S. population with obesity with and without prediabetes. J Diabetes Complications 2023; 37:108454. [PMID: 37004499 DOI: 10.1016/j.jdiacomp.2023.108454] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 02/15/2023] [Accepted: 03/09/2023] [Indexed: 03/18/2023]
Abstract
AIMS This research examines the prevalence of morbidity and mortality among people with obesity with or without prediabetes. METHODS This observational study uses Optum® Market Clarity deidentified data from 2007 to 2020. Individuals with obesity without prediabetes (obesity only) were matched 1:1 to adults with prediabetes plus obesity based upon age, sex, race, ethnicity, and region. Age and sex adjusted prevalence rates and 95 % CIs were calculated for morbidity and mortality for each 365-day period post index date and over the entire 5-year post-period. RESULTS After 5-years, the adjusted mortality rate was 10.1 % for adults with obesity plus prediabetes and 6.9 % for adults with obesity only (p < 0.05). Five years post index date, the prevalence of type 2 diabetes was 25.3 % for people with obesity plus prediabetes and 9.2 % for people with obesity only (p < 0.05). Prevalence rates after 5 years for atherosclerotic cardiovascular disease (13.1 % v 8.1 %), composite cardiovascular outcome (7.0 % v 4.4 %) and composite cardio-renal outcome (8.9 % v 5.0 %) were significantly higher for adults with obesity plus prediabetes compared to adults with obesity only (all p < 0.05). CONCLUSIONS Results of this study indicate that the presence of prediabetes contributes to the development of additional morbidity and mortality in adults with obesity.
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Affiliation(s)
- Janet H Ford
- Value, Evidence and Outcomes, Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN 36255, United States of America.
| | - Maureen J Lage
- HealthMetrics Outcomes Research, 17 Benton's Knoll, Guilford, CT 06437, United States of America.
| | - Kristina S Boye
- Value, Evidence and Outcomes, Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN 36255, United States of America.
| | - Jay P Bae
- Value, Evidence and Outcomes, Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN 46226, United States of America.
| | - Kendra A Terrell
- Value, Evidence and Outcomes, Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN 46226, United States of America.
| | - Mathijs C Bunck
- Medical Development, Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN 46226, United States of America.
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Ghannam N, Alahmed S, Aldahash R, Aljohani N, Alshammary A, Amir A, Kamal A, Khader S, Salah M, Shalabi H, Abdallah A, Elboghdady A. Addressing the Continuum of Dysglycaemia and Vascular Complications in Prediabetes and Type 2 Diabetes: Need for Early and Intensive Treatment. Diabetes Metab Syndr Obes 2023; 16:105-115. [PMID: 36760588 PMCID: PMC9844108 DOI: 10.2147/dmso.s396621] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 12/23/2022] [Indexed: 01/18/2023] Open
Abstract
The onset of type 2 diabetes increases the risk of vascular complications and death. We know now that that this risk begins long before the diabetes diagnosis. Prediabetes and type 2 diabetes are not separate entities in practice and exist within a continuum of dysglycaemia and vascular risk that increases in severity over time. This excess risk requires early intervention with lifestyle therapy supported with pharmacologic antidiabetic therapy, intensified promptly where necessary throughout the duration of the diabetes continuum. Metformin is an evidence-based treatment for preventing prediabetes and improves cardiovascular outcomes in people with type 2 diabetes from diagnosis onwards. Newer agents (SGLT2 inhibitors and GLP-1 agonists) are appropriate for people presenting with type 2 diabetes and significant cardiovascular comorbidity. Additional therapies should be used without delay to achieve patients' individualised HbA1c goals and to minimise cardiovascular risk.
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Affiliation(s)
- Nadia Ghannam
- Ghannam Clinic, Jeddah, Saudi Arabia
- Correspondence: Nadia Ghannam, Ghannam Clinic, King Abdulaziz Road, Jeddah, 21411, Saudi Arabia, Email
| | | | - Raed Aldahash
- Ministry of National Guard (Health Affairs) and King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | | | - Afaf Alshammary
- Ministry of National Guard (Health Affairs), King Abdulaziz Medical City, Riyadh and King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Ashraf Amir
- Family Medicine International Medical Center, Jeddah, Saudi Arabia
| | | | - Said Khader
- Dr. Sulaiman Al Habib Medical Group, Riyadh, Saudi Arabia
| | - Mohammed Salah
- Cairo University, Cairo, Egypt and GNP Hospital, Jeddah, Saudi Arabia
| | - Hani Shalabi
- University of Jeddah, Jeddah, Saudi Arabia
- Dr. Soliman Fakeeh Hospital, Jeddah, Saudi Arabia
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Liang R, Feng X, Shi D, Yang M, Yu L, Liu W, Zhou M, Wang X, Qiu W, Fan L, Wang B, Chen W. The global burden of disease attributable to high fasting plasma glucose in 204 countries and territories, 1990-2019: An updated analysis for the Global Burden of Disease Study 2019. Diabetes Metab Res Rev 2022; 38:e3572. [PMID: 36001650 DOI: 10.1002/dmrr.3572] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 05/30/2022] [Accepted: 07/16/2022] [Indexed: 11/11/2022]
Abstract
AIMS High fasting plasma glucose (HFPG) is an independent risk factor for several adverse health outcomes and has become a serious public health problem. We aimed to evaluate the spatial pattern and temporal trend of disease burden attributed to HFPG from 1990 to 2019 using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. MATERIALS AND METHODS Using data from GBD 2019, we estimated the numbers and age-standardized rates of deaths and disability-adjusted life years (DALYs) attributed to HFPG by calendar year, age, gender, country, region, Socio-demographic Index (SDI), and specific causes. The joinpoint regression analysis was used to assess the temporal trends of deaths and DALYs from 1990 to 2019. RESULTS In 2019, globally, the numbers of deaths and DALYs attributable to HFPG were approximately 6.50 million and 172.07 million, respectively, with age-standardized rates of 83.00 per 100,000 people and 2104.26 per 100,000 people, respectively. From 1990 to 2019, the global numbers of deaths and DALYs attributed to HFPG have over doubled. The age-standardized rate of DALYs showed an increasing trend, particularly in males and in regions with middle SDI or below. The leading causes of the global disease burden attributable to HFPG in 2019 were diabetes mellitus, ischaemic heart disease, stroke, and chronic kidney disease. CONCLUSIONS HFPG is an important contributor to increasing the global and regional disease burden. Necessary measures should be taken to curb the growing burden attributed to HFPG, particularly in males and in regions with middle SDI or below.
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Affiliation(s)
- Ruyi Liang
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xiaobing Feng
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Da Shi
- Food and Human Nutritional Science, Faculty of Agriculture and Food Science, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Meng Yang
- Wuhan Children's Hospital (Wuhan Maternal and Child Health Care Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Linling Yu
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Wei Liu
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Min Zhou
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xing Wang
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Weihong Qiu
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Lieyang Fan
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Bin Wang
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Weihong Chen
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
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Gottwald-Hostalek U, Gwilt M. Vascular complications in prediabetes and type 2 diabetes: a continuous process arising from a common pathology. Curr Med Res Opin 2022; 38:1841-1851. [PMID: 35833523 DOI: 10.1080/03007995.2022.2101805] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
The term, "prediabetes", describes a state of hyperglycaemia that is intermediate between true normoglycaemia and the diagnostic cut-offs for indices of glycaemia that are used to diagnose type 2 diabetes. The presence of prediabetes markedly increases the risk of developing type 2 diabetes. Numerous randomized, controlled evaluations of various agents have demonstrated significant prevention or delay of the onset of type 2 diabetes in subjects with prediabetes. Intensive lifestyle interventions and metformin have been studied most widely, with the lifestyle intervention being more effective in the majority of subjects. The application of therapeutic interventions at the time of prediabetes to preserve long-term outcomes has been controversial, however, due to a lack of evidence relating to the pathogenic effects of prediabetes and the effectiveness of interventions to produce a long-term clinical benefit. Recent studies have confirmed that prediabetes, however defined, is associated with a significantly increased risk of macrovascular and microvascular complications essentially identical to those of diabetes, and also with subclinical derangements of the function of microvasculature and neurons that likely signify increased risk of compilations in future. Normoglycaemia, prediabetes and type 2 diabetes appear to be part of a continuum of increased risk of adverse outcomes. Long-term (25-30 years) post-trial follow up of two major diabetes prevention trials have shown that short-term interventions to prevent diabetes lead to long-term reductions in the risk of complications. These findings support the concept of therapeutic intervention to preserve long-term health in people with prediabetes before type 2 diabetes becomes established.
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Buysschaert M, Bergman M, Valensi P. 1-h post-load plasma glucose for detecting early stages of prediabetes. DIABETES & METABOLISM 2022; 48:101395. [PMID: 36184047 DOI: 10.1016/j.diabet.2022.101395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 09/28/2022] [Accepted: 09/28/2022] [Indexed: 06/16/2023]
Abstract
Prediabetes is a very prevalent condition associated with an increased risk of developing diabetes and/or other chronic complications, in particular cardiovascular disorders. Early detection is therefore mandatory since therapeutic interventions may limit the development of these complications. Diagnosis of prediabetes is currently based on glycemic criteria (fasting plasma glucose (PG), and/or glycemia at 120 min during a 75 g oral glucose tolerance test (OGTT) and/or glycated hemoglobin (HbA1c). Accumulating longitudinal evidence suggests that a 1-hour PG ≥155 mg/dl (8.6 mmol/l) during the OGTT is an earlier marker of prediabetes than fasting PG, 2-h post-load PG, or HbA1c. There is substantial evidence demonstrating that the 1-h post-load PG is a more sensitive predictor of type 2 diabetes, cardiovascular disease, microangiopathy and mortality compared with conventional glucose criteria. The aim of this review is to highlight the paramount importance of detecting prediabetes early in its pathophysiological course. Accordingly, as recommended by an international panel in a recent petition, 1-h post-load PG could replace current criteria for diagnosing early stages of "prediabetes" before prediabetes evolves as conventionally defined.
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Affiliation(s)
- M Buysschaert
- Service d'Endocrinologie et Nutrition, Cliniques universitaires UCLouvain Saint-Luc, B-1200 Brussels, Belgium.
| | - M Bergman
- NYU Grossman School of Medicine, Division of Endocrinology, Diabetes and Metabolism, New York, NY, USA
| | - P Valensi
- Unit of Endocrinology-Diabetology-Nutrition. Jean Verdier Hospital, APHP, Paris 13 University, Sorbonne Paris Cité, CINFO, CRNH-IdF. Bondy, France
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9
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Scharf P, Rizzetto F, Xavier LF, Farsky SHP. Xenobiotics Delivered by Electronic Nicotine Delivery Systems: Potential Cellular and Molecular Mechanisms on the Pathogenesis of Chronic Kidney Disease. Int J Mol Sci 2022; 23:10293. [PMID: 36142207 PMCID: PMC9498982 DOI: 10.3390/ijms231810293] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 09/01/2022] [Accepted: 09/05/2022] [Indexed: 11/20/2022] Open
Abstract
Chronic kidney disease (CKD) is characterized as sustained damage to the renal parenchyma, leading to impaired renal functions and gradually progressing to end-stage renal disease (ESRD). Diabetes mellitus (DM) and arterial hypertension (AH) are underlying diseases of CKD. Genetic background, lifestyle, and xenobiotic exposures can favor CKD onset and trigger its underlying diseases. Cigarette smoking (CS) is a known modified risk factor for CKD. Compounds from tobacco combustion act through multi-mediated mechanisms that impair renal function. Electronic nicotine delivery systems (ENDS) consumption, such as e-cigarettes and heated tobacco devices, is growing worldwide. ENDS release mainly nicotine, humectants, and flavorings, which generate several byproducts when heated, including volatile organic compounds and ultrafine particles. The toxicity assessment of these products is emerging in human and experimental studies, but data are yet incipient to achieve truthful conclusions about their safety. To build up the knowledge about the effect of currently employed ENDS on the pathogenesis of CKD, cellular and molecular mechanisms of ENDS xenobiotic on DM, AH, and kidney functions were reviewed. Unraveling the toxic mechanisms of action and endpoints of ENDS exposures will contribute to the risk assessment and implementation of proper health and regulatory interventions.
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Affiliation(s)
| | | | | | - Sandra Helena Poliselli Farsky
- Department of Clinical and Toxicological Analyses, School of Pharmaceutical Sciences, University of Sao Paulo, São Paulo 05508-220, Brazil
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10
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Manouchehri M, Cea-Soriano L, Franch-Nadal J, Ruiz A, Goday A, Villanueva R, Diez-Espino J, Mata-Cases M, Giraldez-García C, Regidor E. Heterogeneity in the association between prediabetes categories and reduction on glomerular filtration rate in a 5-year follow-up. Sci Rep 2022; 12:7373. [PMID: 35513560 PMCID: PMC9072306 DOI: 10.1038/s41598-022-11392-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 04/04/2022] [Indexed: 11/09/2022] Open
Abstract
Prediabetes and not just diabetes can cause kidney damage. This study assess the association of prediabetes with development of impaired renal function (IRF). We used data from PREDAPS prospective study a cohort of 1072 subjects with prediabetes and another cohort of 772 subjects without prediabetes were follow-up from 2012 to 2017. Prediabetes was defined according to American Association of Diabetes criteria. IRF was defined as having a glomerular filtration rate < 60 mL/min/1.73 m2. Incidence rates of IRF in both cohorts and in different categories of prediabetes, based on impaired glycosylated hemoglobin (HbA1c) and/or fasting plasma glucose (FPG), were calculated. Hazard ratios (HR) for the association of the prediabetes with IRF, adjusting for potential confounders, were estimated by Cox regression models. Incidence rates of IRF per 100 person-years were 1.72 (95% confidence interval [CI]: 1.34-2.21) and 1.79 (95%CI: 1.45-2.20) for those without and with prediabetes, respectively .The HR of IRF in subjects with prediabetes with respect to subjects without prediabetes was 0.76 (95% CI: 0. 54-1.07). Corresponding HRs for type of prediabetes was 0.68 (95%CI: 0.40-1.15) for those with both altered parameters, 0.68 (95%CI: 00.40-1.15) for those with only impaired HbA1c and 1.12 (95%CI: 0.68-1.85) for those with only impaired FPG. The present study reflects an overall trend towards a slightly decreased risk of IRF onset associated to prediabetes except for individuals with only isolated impaired FPG. Further studies are warranted to fully assess the renal progression of each group.
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Affiliation(s)
| | - Lucía Cea-Soriano
- Department of Public Health and Maternal and Child Health, Faculty of Medicine, Universidad Complutense de Madrid, Pza. Ramón y Cajal, s/n. Ciudad Universitaria, 28040, Madrid, Spain.
- Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain.
- redGDPS Foundation, Madrid, Spain.
| | - Josep Franch-Nadal
- redGDPS Foundation, Madrid, Spain
- Barcelona City Research Support Unit, University Institute for Research in Primary Care Jordi Gol, Barcelona, Spain
- CIBER Diabetes Y Enfermedades Metabólicas Asociadas, Madrid, Spain
- Department of Medicine, Universidad de Barcelona, Barcelona, Spain
| | - Antonio Ruiz
- redGDPS Foundation, Madrid, Spain
- Centro de Salud Universitario Pinto, Madrid, Spain
- Universidad Europea de Madrid, Madrid, Spain
| | - Albert Goday
- Servicio de Endocrinología, Hospital del Mar, IMIM, Barcelona, Spain
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
- CIBER Fisiopatología de La Obesidad Y Nutrición, Madrid, Spain
| | - Rosa Villanueva
- Department of Public Health and Maternal and Child Health, Faculty of Medicine, Universidad Complutense de Madrid, Pza. Ramón y Cajal, s/n. Ciudad Universitaria, 28040, Madrid, Spain
| | - Javier Diez-Espino
- redGDPS Foundation, Madrid, Spain
- CIBER Fisiopatología de La Obesidad Y Nutrición, Madrid, Spain
- Tafalla Health Center, Navarra, Spain
- Instituto de Investigación Sanitaria de Navarra (IDiSNA), Pamplona, Spain
| | - Manel Mata-Cases
- redGDPS Foundation, Madrid, Spain
- Barcelona City Research Support Unit, University Institute for Research in Primary Care Jordi Gol, Barcelona, Spain
| | | | - Enrique Regidor
- Department of Public Health and Maternal and Child Health, Faculty of Medicine, Universidad Complutense de Madrid, Pza. Ramón y Cajal, s/n. Ciudad Universitaria, 28040, Madrid, Spain
- Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
- redGDPS Foundation, Madrid, Spain
- CIBER Epidemiología Y Salud Pública (CIBERESP), Madrid, Spain
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11
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Hoffmann AP, Honigberg MC. Glycated Hemoglobin as an Integrator of Cardiovascular Risk in Individuals Without Diabetes: Lessons from Recent Epidemiologic Studies. Curr Atheroscler Rep 2022; 24:435-442. [PMID: 35386092 DOI: 10.1007/s11883-022-01024-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2022] [Indexed: 12/19/2022]
Abstract
PURPOSE OF REVIEW Prediabetes, or dysglycemia in the absence of diabetes, is a prevalent condition typically defined by a glycated hemoglobin (HgbA1c) of 5.7- < 6.5%. This article reviews current contemporary data examining the association between prediabetes and cardiovascular disease (CVD) as well as HgbA1c as a continuous measure of cardiovascular risk across the glycemic spectrum. RECENT FINDINGS Dysglycemia in the prediabetic range is associated with an increased risk of both subclinical and clinical CVD, including atherosclerotic CVD, chronic kidney disease, and heart failure. Several recent large, prospective studies demonstrate roughly linear risk with increasing HgbA1c, even below the threshold for prediabetes. "High-risk" patients with prediabetes have similar CVD risk as those with diabetes. HgbA1c below the threshold for diabetes stratifies CVD risk. Use of HgbA1c as a continuous measure, rather than simply dichotomized, may inform current and future prevention strategies. Given the high population attributable risk associated with prediabetes, targeted prevention strategies in this population warrant dedicated study.
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Affiliation(s)
- Alexander P Hoffmann
- Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
| | - Michael C Honigberg
- Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA.
- Cardiovascular Research Center, Massachusetts General Hospital, 185 Cambridge Street, Boston, MA, 02114, USA.
- Cardiology Division, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, MA, Boston, 02114, USA.
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12
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Di Sessa A, Russo MC, Arienzo MR, Umano GR, Cozzolino D, Cirillo G, Guarino S, Miraglia del Giudice E, Marzuillo P. PNPLA3 I148M polymorphism influences renal function in children with obesity and prediabetes. J Ren Nutr 2022; 32:670-676. [DOI: 10.1053/j.jrn.2022.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 11/28/2021] [Accepted: 01/10/2022] [Indexed: 11/11/2022] Open
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13
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Wang X, Huang C, Liu Y, Han Y, Hu H. Association of estimated glomerular filtration rate and incident pre-diabetes: A secondary 5-year longitudinal cohort study in Chinese people. Front Endocrinol (Lausanne) 2022; 13:965545. [PMID: 36387884 PMCID: PMC9648615 DOI: 10.3389/fendo.2022.965545] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 10/14/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE There is still limited evidence regarding the relationship between the estimated glomerular filtration rate (eGFR) and pre-diabetes. For that reason, our research aims to survey the association of eGFR with pre-diabetes. METHODS This study was a retrospective cohort study, which consecutively and non-selectively collected a total of 173301 participants from Rich Healthcare Group in China from January 2010 to 2016. We then used the Cox proportional-hazards regression model to explore the relationship between baseline eGFR and pre-diabetes risk. Using a Cox proportional hazards regression with cubic spline function and smooth curve fitting (cubical spline smoothing), we were able to determine the non-linear relationship between eGFR and pre-diabetes. Additionally, we also conducted a series of sensitivity analyses and subgroup analyses. The DATADRYAD website was updated with data. RESULTS The mean age of the included individuals was 40.95 ± 11.94 years old, and 92318 (53.27%) were male. The mean baseline eGFR was 111.40 ± 14.77 ml/min per 1.73 m2. During a median follow-up time of 3.0 years, 18333 (10.58%) people experienced pre-diabetes. As a result of adjusting for covariates, eGFR had a negative association with incident pre-diabetes (HR=0.993, 95%CI: 0.992-0.995). There was also a U-shaped curve relationship between eGFR and pre-diabetes, and the inflection point of eGFR was 129.793 ml/min per 1.73 m2. HRs on the left and right sides of the inflection point were respectively 0.993 (0.991-0.994) and 1.023 (1.010- 1.037). Our results were robust in the sensitivity analysis. Subgroup analyses indicated that eGFR was strongly associated with the risk of pre-diabetes among participants who were younger than 30 years and 40-70 years, as well as among those who had never smoked. In contrast, the association of eGFR with the risk of pre-diabetes was attenuated among participants who were 30-40 years of age and 70 years of age or older, and among those who currently smoked. CONCLUSION This study demonstrates a negative and U-shaped curve association between eGFR and the risk of pre-diabetes among the general Chinese population. Either reduced renal function or glomerular hyperperfusion status may be associated with an increased risk of prediabetes.
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Affiliation(s)
- Xiaoyu Wang
- Department of Nephrology, Hechi People’s Hospital, Hechi, Guangxi Zhuang Autonomous Region, China
| | - Cheng Huang
- Department of Nephrology, Hechi People’s Hospital, Hechi, Guangxi Zhuang Autonomous Region, China
| | - Yufei Liu
- Department of Neurosurgery, Shenzhen Second People’s Hospital, Shenzhen, Guangdong, China
- Department of Neurosurgery, The First Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong, China
- Shenzhen University Health Science Center, Shenzhen University, Shenzhen, Guangdong, China
| | - Yong Han
- Shenzhen University Health Science Center, Shenzhen University, Shenzhen, Guangdong, China
- Department of Emergency, Shenzhen Second People’s Hospital, Shenzhen, Guangdong, China
- Department of Emergency, The First Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong, China
- *Correspondence: Yong Han, ; Haofei Hu,
| | - Haofei Hu
- Shenzhen University Health Science Center, Shenzhen University, Shenzhen, Guangdong, China
- Department of Nephrology, Shenzhen Second People’s Hospital, Shenzhen, Guangdong, China
- Department of Nephrology, The First Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong, China
- *Correspondence: Yong Han, ; Haofei Hu,
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14
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Pammer LM, Lamina C, Schultheiss UT, Kotsis F, Kollerits B, Stockmann H, Lipovsek J, Meiselbach H, Busch M, Eckardt KU, Kronenberg F. Association of the metabolic syndrome with mortality and major adverse cardiac events: A large chronic kidney disease cohort. J Intern Med 2021; 290:1219-1232. [PMID: 34342064 DOI: 10.1111/joim.13355] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Metabolic syndrome with its key components insulin resistance, central obesity, dyslipidaemia, and hypertension is associated with a high risk for cardiovascular events and all-cause mortality in the general population. However, evidence that these findings apply to patients with chronic kidney disease (CKD) with moderately reduced estimated glomerular filtration rate and/or albuminuria is limited. OBJECTIVES We aimed to investigate the association between metabolic syndrome and its components with all-cause mortality and cardiovascular outcomes in CKD patients. METHODS Prospective observation of a cohort of 5110 CKD patients from the German Chronic Kidney Disease study with 3284 (64.3%) of them having a metabolic syndrome at baseline. RESULTS During the follow-up of 6.5 years, 605 patients died and 650 patients experienced major cardiovascular events. After extended data adjustment, patients with a metabolic syndrome had a higher risk for all-cause mortality (hazard ratio [HR] = 1.26, 95% confidence interval [CI]: 1.04-1.54) and cardiovascular events (HR = 1.48, 95% CI: 1.22-1.79). The risk increased steadily with a growing number of metabolic syndrome components (increased waist circumference, glucose, triglycerides, hypertension and decreased HDL cholesterol): HR per component = 1.09 (95% CI: 1.02-1.17) for all-cause mortality and 1.23 (95% CI: 1.15-1.32) for cardiovascular events. This resulted in hazard ratios between 1.50 and 2.50 in the case when four or five components are present. An analysis of individual components of metabolic syndrome showed that the glucose component led to the highest increase in risk for all-cause mortality (HR = 1.68, 95% CI: 1.38-2.03) and cardiovascular events (HR = 1.81, 95% CI: 1.51-2.18), followed by the HDL cholesterol and triglyceride components. CONCLUSIONS We observed a high prevalence of metabolic syndrome among patients with moderate CKD. Metabolic syndrome increases the risk for all-cause mortality and cardiovascular events. The glucose and lipid components seem to be the main drivers for the association with outcomes.
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Affiliation(s)
- Lorenz M Pammer
- Department of Genetics and Pharmacology, Institute of Genetic Epidemiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Claudia Lamina
- Department of Genetics and Pharmacology, Institute of Genetic Epidemiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Ulla T Schultheiss
- Faculty of Medicine and Medical Center, Institute of Genetic Epidemiology, University of Freiburg, Freiburg, Germany.,Department of Medicine IV-Nephrology and Primary Care, Faculty of Medicine and Medical Center-University of Freiburg, Freiburg, Germany
| | - Fruzsina Kotsis
- Faculty of Medicine and Medical Center, Institute of Genetic Epidemiology, University of Freiburg, Freiburg, Germany.,Department of Medicine IV-Nephrology and Primary Care, Faculty of Medicine and Medical Center-University of Freiburg, Freiburg, Germany
| | - Barbara Kollerits
- Department of Genetics and Pharmacology, Institute of Genetic Epidemiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Helena Stockmann
- Department of Nephrology and Medical Intensive Care, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Jan Lipovsek
- Faculty of Medicine and Medical Center, Institute of Genetic Epidemiology, University of Freiburg, Freiburg, Germany
| | - Heike Meiselbach
- Department of Nephrology and Hypertension, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Martin Busch
- Department of Internal Medicine III, Friedrich Schiller University Jena, Jena, Germany
| | - Kai-Uwe Eckardt
- Department of Nephrology and Medical Intensive Care, Charité-Universitätsmedizin Berlin, Berlin, Germany.,Department of Nephrology and Hypertension, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Florian Kronenberg
- Department of Genetics and Pharmacology, Institute of Genetic Epidemiology, Medical University of Innsbruck, Innsbruck, Austria
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- Department of Genetics and Pharmacology, Institute of Genetic Epidemiology, Medical University of Innsbruck, Innsbruck, Austria
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15
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Suarilah I, Lin CC. Factors influencing self-management among Indonesian patients with early-stage chronic kidney disease: A cross-sectional study. J Clin Nurs 2021; 31:703-715. [PMID: 34405484 DOI: 10.1111/jocn.15930] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 05/18/2021] [Accepted: 06/09/2021] [Indexed: 01/10/2023]
Abstract
AIMS AND OBJECTIVES The purpose of this study was to explore the self-management of patients with early-stage chronic kidney disease (CKD) and its influencing factors. METHODS A convenient sample of 226 patients with early-stage CKD was recruited from 63 Public Health Centers in Indonesia, from June to September 2020. Demographic characteristics, health literacy, illness perception, self-efficacy and self-management were assessed using self-reported questionnaires. Stepwise multiple linear regression analysis was performed to identify the factors influencing self-management. This study adhered to the EQUATOR checklist, STROBE. RESULTS The mean estimated glomerular filtration rate was 63.45 ml/min/1.73 m2 (standard deviation [SD] = 15.34). The average scores for health literacy, illness perception, self-efficacy and self-management were 32.11 (SD = 4.46), 4.57 (SD = 1.46), 183.64 (SD = 38.23) and 76.92 (SD = 9.45), respectively. The influencing factors were education level, monthly income, family history of comorbidity, health literacy and self-efficacy, which accounted for 45% of total self-management score. CONCLUSIONS Indonesian patients with early-stage CKD showed low level of health literacy, but positive illness perception and self-efficacy; these factors significantly affected CKD self-management. Health literacy was found to influence all dimensions of self-management: self-integration, problem-solving, seeking social support and adherence to the recommended regimen. RELEVANCE TO CLINICAL PRACTICE Adherence to the recommended regimen is the most challenging dimension of CKD self-management. Health literacy was found to be a major determinant of self-management. Improving health literacy and motivation of patients with early-stage CKD may help sustain positive illness perception and self-efficacy, and improve self-management.
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Affiliation(s)
- Ira Suarilah
- School of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan.,Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia
| | - Chiu-Chu Lin
- School of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Renal Care, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
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16
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Roumeliotis S, Liakopoulos V, Roumeliotis A, Stamou A, Panagoutsos S, D’Arrigo G, Tripepi G. Prognostic Factors of Fatal and Nonfatal Cardiovascular Events in Patients With Type 2 Diabetes: The Role of Renal Function Biomarkers. Clin Diabetes 2021; 39:188-196. [PMID: 33986571 PMCID: PMC8061536 DOI: 10.2337/cd20-0067] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
In this study, 158 patients with different degrees of renal function were followed for 7 years to assess the prognostic value of various risk factors, including carotid intima-media thickness (cIMT) and biomarkers of renal function, for incident cardiovascular morbidity and mortality in patients with type 2 diabetes. The investigators found that estimated glomerular filtration rate, albuminuria, and history of cardiovascular disease (CVD) can be used for prognosis of CVD, whereas cIMT adds little to the accuracy of this prediction.
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Affiliation(s)
- Stefanos Roumeliotis
- Division of Nephrology and Hypertension, 1 Department of Internal Medicine, AHEPA Hospital, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
- Institute of Clinical Physiology (IFC-CNR), Clinical Epidemiology and Physiopathology of Renal Diseases and Hypertension, Reggio Calabria, Italy
| | - Vassilios Liakopoulos
- Division of Nephrology and Hypertension, 1 Department of Internal Medicine, AHEPA Hospital, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Athanasios Roumeliotis
- Division of Nephrology and Hypertension, 1 Department of Internal Medicine, AHEPA Hospital, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Aikaterini Stamou
- Department of Microbiology, AHEPA Hospital, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Stylianos Panagoutsos
- Department of Nephrology, School of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
| | - Graziella D’Arrigo
- Institute of Clinical Physiology (IFC-CNR), Clinical Epidemiology and Physiopathology of Renal Diseases and Hypertension, Reggio Calabria, Italy
| | - Giovanni Tripepi
- Institute of Clinical Physiology (IFC-CNR), Clinical Epidemiology and Physiopathology of Renal Diseases and Hypertension, Reggio Calabria, Italy
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17
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Baranowska-Jurkun A, Matuszewski W, Bandurska-Stankiewicz E. Chronic Microvascular Complications in Prediabetic States-An Overview. J Clin Med 2020; 9:E3289. [PMID: 33066307 PMCID: PMC7602111 DOI: 10.3390/jcm9103289] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 09/01/2020] [Accepted: 09/08/2020] [Indexed: 12/12/2022] Open
Abstract
A prediabetic state is a major risk factor for the development of diabetes, and, because of an identical pathophysiological background of both conditions, their prevalence increases parallelly and equally fast. Long-term hyperglycemia is the main cause inducing chronic complications of diabetes, yet the range of glucose levels at which they start has not been yet unequivocally determined. The current data show that chronic microvascular complications of diabetes can be observed in patients with abnormal glucose metabolism in whom glycaemia is higher than optimal but below diagnostic criteria for diabetes. Prediabetes is a heterogenous nosological unit in which particular types are differently characterized and show different correlations with particular kinds of complications. Analysis of the latest research results shows the need to continue studies in a larger population and can imply the need to verify the currently employed criteria of diagnosing diabetes and chronic complications of diabetes in people with prediabetes.
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Affiliation(s)
- Angelika Baranowska-Jurkun
- Clinic of Endocrinology, Diabetology and Internal Medicine, Department of Internal Medicine, School of Medicine, Collegium Medicum, University of Warmia and Mazury, Żołnierska 18, 10-561 Olsztyn, Poland; (W.M.); (E.B.-S.)
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18
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Kim H, Park S, Kwon SH, Jeon JS, Han DC, Noh H. Impaired fasting glucose and development of chronic kidney disease in non-diabetic population: a Mendelian randomization study. BMJ Open Diabetes Res Care 2020; 8:8/1/e001395. [PMID: 32457053 PMCID: PMC7252970 DOI: 10.1136/bmjdrc-2020-001395] [Citation(s) in RCA: 2] [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] [Received: 03/25/2020] [Revised: 04/27/2020] [Accepted: 05/04/2020] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION Diabetes mellitus is a risk factor of chronic kidney disease (CKD); however, the relationship between fasting glucose and CKD remains controversial in non-diabetic population. This study aimed to assess causal relationship between genetically predicted fasting glucose and incident CKD. RESEARCH DESIGN AND METHODS This study included 5909 participants without diabetes and CKD from the Korean Genome Epidemiology Study. The genetic risk score (GRS9) was calculated using nine genetic variants associated with fasting glucose in previous genome-wide association studies. Incident CKD was defined as estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 and/or proteinuria (≥1+). The causal relationship between fasting glucose and CKD was evaluated using the Mendelian randomization (MR) approach. RESULTS The GRS9 was strongly associated with fasting glucose (β, 1.01; p<0.001). During a median follow-up of 11.6 years, 490 (8.3%) CKD events occurred. However, GRS9 was not significantly different between participants with CKD events and those without. After adjusting for confounding factors, fasting glucose was not associated with incident CKD (OR 0.990; 95% CI 0.977 to 1.002; p=0.098). In the MR analysis, GRS9 was not associated with CKD development (OR per 1 SD increase, 1.179; 95% CI 0.819 to 1.696; p=0.376). Further evaluation using various other MR methods and strict CKD criteria (decrease in the eGFR of ≥30% to a value of <60 mL/min/1.73 m2) found no significant relationship between GRS9 and incident CKD. CONCLUSIONS Fasting glucose was not causally associated with CKD development in non-diabetic population.
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Affiliation(s)
- Hyoungnae Kim
- Division of Nephrology, Department of Internal Medicine, Soon Chun Hyang University Hospital, Seoul, South Korea
- Hyonam Kidney Laboratory, Soon Chun Hyang University, Seoul, South Korea
| | - Suyeon Park
- Department of Biostatistics, Soon Chun Hyang University Hospital, Seoul, South Korea
| | - Soon Hyo Kwon
- Division of Nephrology, Department of Internal Medicine, Soon Chun Hyang University Hospital, Seoul, South Korea
| | - Jin Seok Jeon
- Division of Nephrology, Department of Internal Medicine, Soon Chun Hyang University Hospital, Seoul, South Korea
- Hyonam Kidney Laboratory, Soon Chun Hyang University, Seoul, South Korea
| | - Dong Cheol Han
- Division of Nephrology, Department of Internal Medicine, Soon Chun Hyang University Hospital, Seoul, South Korea
- Hyonam Kidney Laboratory, Soon Chun Hyang University, Seoul, South Korea
| | - Hyunjin Noh
- Division of Nephrology, Department of Internal Medicine, Soon Chun Hyang University Hospital, Seoul, South Korea
- Hyonam Kidney Laboratory, Soon Chun Hyang University, Seoul, South Korea
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19
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Kim SH. A Nuanced Relationship Between Prediabetes and Chronic Kidney Disease. J Clin Endocrinol Metab 2020; 105:5748205. [PMID: 32086934 DOI: 10.1210/clinem/dgaa079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 02/11/2020] [Indexed: 11/19/2022]
Affiliation(s)
- Sun H Kim
- Division of Endocrinology, Gerontology and Metabolism, Department of Medicine, Stanford University School of Medicine, Stanford, CA; and Stanford Diabetes Research Center, Stanford University School of Medicine, Stanford, CA
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