1
|
Ding J, Shi Q, Tao Q, Su H, Du Y, Pan T, Zhong X. Correlation between long-term glycemic variability and cognitive function in middle-aged and elderly patients with type 2 diabetes mellitus: a retrospective study. PeerJ 2023; 11:e16698. [PMID: 38144199 PMCID: PMC10748480 DOI: 10.7717/peerj.16698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 11/29/2023] [Indexed: 12/26/2023] Open
Abstract
Objective To investigate the correlation between long-term glycemic variability and cognitive function in middle-aged and elderly patients with type 2 diabetes mellitus (T2DM). Methods This retrospective analysis includes 222 patients hospitalized at Second Affiliated Hospital of Anhui Medical University from June 2021 to June 2023. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE). All patients were categorized into the MCI group and the non-MCI group based on their MoCA score. Long-term blood glucose fluctuations were measured using glycated hemoglobin A1c standard deviation (HbA1c-SD) and fasting plasma glucose standard deviation (FPG-SD). The study compared general clinical data, blood biochemical indicators, and glycemic variability indicators between the two groups. The differences between the groups were compared using t-test, Chi-Square Test, or Mann-Whitney U test. Kendall's correlation analysis, multivariate logistic regression analysis and ROC curve correlation analysis were further used to analyze the correlation and diagnostic power. Results The differences in age, MoCA scores, MMSE scores, HOMA-β, HbA1c-M, HbA1c-SD, FPG-M, FPG-SD, eGFR, Smoking, GLP-1RA and SGLT-2i usage were statistically significant between the two groups (P < 0.05). Kendall's correlation analysis showed that age, HbA1c-M, HbA1c-SD, FPG-M, and FPG-SD was negatively correlated with MoCA scores; meanwhile, the HOMA-β, and eGFR was positively correlated with MoCA scores. Multiple logistic regression analysis revealed that HbA1c-SD, FPG-SD and Smoking were risk factors for cognitive dysfunction, while eGFR, GLP-1RA and SGLT-2i usage was a protective effect. The area under the curve (AUC) values for predicting MCI prevalence were 0.830 (95% CI [0.774-0.877], P < 0.001) for HbA1c-SD, 0.791 (95% CI [0.655-0.808], P < 0.001) for FPG-SD, and 0.698 (95% CI [0.633-0.757], P < 0.001) for eGFR. The optimal diagnostic values were 0.91, 1.32, and 74.81 ml/min/1.73 m2 for HbA1c-SD, FPG-SD, and eGFR, respectively. Conclusions Cognitive function in middle-aged and elderly T2DM patients is influenced by long-term blood glucose variability, with poorer cognitive function observed in individuals with higher blood glucose variability. The impact of HbA1c-SD on MCI exhibited a greater magnitude compared to that of PFG-SD and smoking. Additionally, renal function, GLP-1RA and SGLT-2i usage exert positive effects on cognitive function.
Collapse
Affiliation(s)
- JingCheng Ding
- Department of Endocrinology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China
| | - Qian Shi
- Department of Endocrinology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China
| | - Qian Tao
- Department of Endocrinology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China
| | - Hong Su
- Department of Epidemiology and Health Statistics, Anhui Medical University, Hefei, Anhui Province, China
| | - Yijun Du
- Department of Endocrinology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China
| | - Tianrong Pan
- Department of Endocrinology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China
| | - Xing Zhong
- Department of Endocrinology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China
| |
Collapse
|
2
|
Zhang C, Xue G, Hou Y, Meng P, Gao H, Bai B, Li D. Association between kidney measurements and cognitive performance in patients with ischemic stroke. PLoS One 2023; 18:e0292506. [PMID: 38096197 PMCID: PMC10721055 DOI: 10.1371/journal.pone.0292506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 11/30/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND Individuals with chronic kidney disease (CKD) are at a substantially higher risk for stroke, which may predispose individuals to cognitive impairment. However, the association of low estimated glomerular filtration rate (eGFR) and albuminuria with poorer cognitive performance in patients with stroke is not fully understood, and the current evidence for this association is contradictory. Our aim was to retrospectively investigate whether low eGFR and albuminuria, as indicated by the urine albumin-creatinine ratio (UACR), are independently or jointly associated with worse cognitive performance in patients with ischemic stroke. METHODS This retrospective study included 608 patients with acute ischemic stroke. Their UACR and eGFR values were obtained from inpatient medical records. Global cognitive function was assessed with the mini-mental state exam (MMSE) and Montreal Cognitive Assessment (MoCA) one month after hospital discharge. The relationship between renal measures and cognitive performance was assessed using univariate and multiple linear regression analyses. Potential confounders included age, gender, BMI, education, diabetes and hypertension history, NIHSS score, smoking and alcohol consumption status, serum total cholesterol, triglyceride, fasting glucose, uric acid, homocysteine, systolic blood pressure, and either eGFR or UACR. RESULTS Patients had an average age of 66.6±4.1 years, and 48% were females. Average eGFR and UACR were 88.4±12.9 ml/min/1.73m2 and 83.6±314.2 mg/g, respectively. The number of patients with eGFR ≥90, 60-89, and <60 ml/min/1.73 m2 was 371 (61%), 207 (34%), and 30 (5%), respectively, and the percentage of patients with UACR <30 mg/g, 30-300 mg/g, and >300 mg/g was 56%, 39%, and 5%, respectively. Multivariate adjusted models showed that eGFR was independently associated with MMSE (β = -0.4; 95% CI = -0.5,-0.4; p <0.001) and MoCA (β = -0.6; 95% CI = -0.7,-0.5; p <0.001). However, UACR was not significantly correlated with MMSE or MoCA. CONCLUSION In patients with ischemic stroke, reduced eGFR but not albuminuria was associated with lower cognitive performance. These results show that the eGFR decline could be an effective indicator of cognitive impairment after a stroke. Therefore, regular monitoring and early detection of mild renal dysfunction in patients with acute ischemic stroke might be needed.
Collapse
Affiliation(s)
- Chunyan Zhang
- Department of Neurology, Second Hospital, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Guofang Xue
- Department of Neurology, Second Hospital, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Yanjuan Hou
- Department of Nephrology, Second Hospital, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Pengfei Meng
- Department of Neurology, Second Hospital, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Huizhong Gao
- Department of Neurology, Second Hospital, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Bo Bai
- Department of Neurology, Second Hospital, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Dongfang Li
- Department of Neurology, Second Hospital, Shanxi Medical University, Taiyuan, Shanxi, China
| |
Collapse
|
3
|
Batsis JA, Batchek DJ, Petersen CL, Gross DC, Lynch DH, Spangler HB, Cook SB. Protein Supplementation May Dampen Positive Effects of Exercise on Glucose Homeostasis: A Pilot Weight Loss Intervention. Nutrients 2023; 15:4947. [PMID: 38068805 PMCID: PMC10707998 DOI: 10.3390/nu15234947] [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: 10/27/2023] [Revised: 11/23/2023] [Accepted: 11/24/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND The role of protein in glucose homeostasis has demonstrated conflicting results. However, little research exists on its impact following weight loss. This study examined the impact of protein supplementation on glucose homeostasis in older adults >65 years with obesity seeking to lose weight. METHODS A 12-week, nonrandomized, parallel group intervention of protein (PG) and nonprotein (NPG) arms for 28 older rural adults (body mass index (BMI) ≥ 30 kg/m2) was conducted at a community aging center. Both groups received twice weekly physical therapist-led group strength training classes. The PG consumed a whey protein supplement three times per week, post-strength training. Primary outcomes included pre/post-fasting glucose, insulin, inflammatory markers, and homeostasis model assessment of insulin resistance (HOMA-IR). RESULTS Mean age and baseline BMI were 72.9 ± 4.4 years and 37.6 ± 6.9 kg/m2 in the PG and 73.0 ± 6.3 and 36.6 ± 5.5 kg/m2 in the NPG, respectively. Mean weight loss was -3.45 ± 2.86 kg in the PG and -5.79 ± 3.08 kg in the NPG (p < 0.001). There was a smaller decrease in pre- vs. post-fasting glucose levels (PG: -4 mg ± 13.9 vs. NPG: -12.2 ± 25.8 mg/dL; p = 0.10), insulin (-7.92 ± 28.08 vs. -46.7 ± 60.8 pmol/L; p = 0.01), and HOMA-IR (-0.18 ± 0.64 vs. -1.08 ± 1.50; p = 0.02) in the PG compared to the NPG. CONCLUSIONS Protein supplementation during weight loss demonstrated a smaller decrease in insulin resistance compared to the NPG, suggesting protein may potentially mitigate beneficial effects of exercise on glucose homeostasis.
Collapse
Affiliation(s)
- John A. Batsis
- Division of Geriatric Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC 27599, USA; (D.H.L.); (H.B.S.)
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; (D.J.B.); (D.C.G.)
- The Dartmouth Institute for Health Policy, Dartmouth College, Hanover, NH 03755, USA;
- Center for Aging and Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Dakota J. Batchek
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; (D.J.B.); (D.C.G.)
| | - Curtis L. Petersen
- The Dartmouth Institute for Health Policy, Dartmouth College, Hanover, NH 03755, USA;
- Geisel School of Medicine at Dartmouth, Dartmouth College, Hanover, NH 03755, USA
| | - Danae C. Gross
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; (D.J.B.); (D.C.G.)
- Center for Aging and Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - David H. Lynch
- Division of Geriatric Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC 27599, USA; (D.H.L.); (H.B.S.)
- Center for Aging and Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Hillary B. Spangler
- Division of Geriatric Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC 27599, USA; (D.H.L.); (H.B.S.)
- Center for Aging and Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Summer B. Cook
- Department of Kinesiology, University of New Hampshire, Durham, NH 03824, USA;
| |
Collapse
|
4
|
Feng L, Wu D, Ping P, Lin J, Zhao Y, Yao Y, Zhang P, Fu S. Age Related Cognitive Function Was Positively Associated with Diastolic Pressure and Negatively Associated with Antibody Expression in Chinese Oldest-Old and Centenarian Adults. J Inflamm Res 2022; 15:6675-6682. [DOI: 10.2147/jir.s344105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 05/16/2022] [Indexed: 12/14/2022] Open
|
5
|
Tang X, Han YP, Chai YH, Gong HJ, Xu H, Patel I, Qiao YS, Zhang JY, Cardoso MA, Zhou JB. Association of kidney function and brain health: A systematic review and meta-analysis of cohort studies. Ageing Res Rev 2022; 82:101762. [PMID: 36374833 DOI: 10.1016/j.arr.2022.101762] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 10/07/2022] [Accepted: 10/14/2022] [Indexed: 01/31/2023]
Abstract
OBJECTIVE This study aimed to evaluate the bidirectional association between the kidney dysfunction and the brain health, including structural and functional abnormalities. DESIGN Systematic review and meta-analysis with network meta-analysis for outcomes with different estimated glomerular filtration rate (eGFR) ranges. DATA SOURCES PubMed, Embase database, Cochrane library and Web of Science (up to Dec. 2021). ELIGIBILITY CRITERIA FOR SELECTING STUDIES Longitudinal studies that provided evidence of the impact of kidney function estimated from eGFR and urine albumin-to-creatinine ratio (UACR) or chronic kidney disease (CKD) on structural and functional brain abnormalities, and those that provided evidence of the opposite relationship. Studies with study population mean age under 18 years old were excluded. MAIN OUTCOME MEASURES Two independent reviewers screened the included studies, extracted the data, and assessed the risk of bias. We performed a random-effects meta-analysis and a network meta-analysis for outcomes with compatible data. We assessed the risk of bias using the Newcastle-Ottawa Quality Assessment Scale criteria (NOS). Subgroup and sensitivity analyses were conducted to explore heterogeneity in the meta-analyses. Inconsistency analyses using the node-splitting method were performed to confirm the results of network meta-analysis. RESULTS A total of 53 studies with 3037,357 participants were included in the current systematic review. Among these, 16 provided evidence of structural brain abnormalities, and 38 provided evidence of cognitive impairment and dementia. Analysis of evidence of categorical kidney function showed a positive association between kidney dysfunction and cerebral small vessel disease (cSVD) (relative risk (RR) 1.77, 95% confidence interval (CI) 1.40-2.24, I2 = 0.0%), but such results were not found in the analyses of evidence where the kidney function was measured as a continuous variable. Meanwhile, analysis of 28 prior longitudinal studies with 194 compatible sets of data showed that the worse kidney function as categorical variables was related to a greater risk of global brain cognitive disorder (RR 1.28, 95% CI 1.20-1.36, I2 = 82.5%). CONCLUSIONS In this systematic review and meta-analysis, we found a positive association between CKD and functional brain disorders. However, the relationship between the kidney dysfunction and structural abnormalities in the brain remains controversial. As for the opposite relationship, structural brain abnormalities, especially cerebral microbleeds and silent infarction, but not functional brain abnormalities, are associated with worse renal function. In addition, a higher UACR, but not a lower eGFR, was associated with a higher risk of Alzheimer's disease and vascular dementia.
Collapse
Affiliation(s)
- Xingyao Tang
- Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Yi-Peng Han
- Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Yin-He Chai
- Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Hong-Jian Gong
- Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Hui Xu
- Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Ikramulhaq Patel
- Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Yu-Shun Qiao
- Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Jin-Yan Zhang
- Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Marly Augusto Cardoso
- Department of Nutrition, School of Public Health, University of Sao Paulo, Sao Paulo, Brazil
| | - Jian-Bo Zhou
- Beijing Tongren Hospital, Capital Medical University, Beijing, China; Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
| |
Collapse
|
6
|
Cong X, Zhang J, Sun R, Pu Y. Indoor unclean fuel cessation linked with adult cognitive performance in China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 775:145518. [PMID: 33621876 DOI: 10.1016/j.scitotenv.2021.145518] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 01/03/2021] [Accepted: 01/26/2021] [Indexed: 06/12/2023]
Abstract
Both indoor unclean fuel use and CVD associates with cognitive function. Indoor fuel has transitioned from the use of unclean fuel to clean fuel in recent years in China. The aim of this study was to evaluate the association between adult cognitive function and such a transition and to investigate the potential role of CVD in this association. 7112 participants (26- to 98-years of age) with 12,676 observations living in twelve provinces of China from 1997 to 2015 were extracted based on having complete data. The associations, combined effects, and further mediation effects between indoor unclean fuel use and its transition, CVD, and cognitive function were tested using regression models, stratified analyses, the relative excess risk due to interaction (RERI), mediation analysis methods, and sensitivity analyses. Between 1997 and 2015, cooking fuel use coal and wood went down a lot in China, from a baseline of 26.9% to 6.1%, from 30.1% to 11.5%, respectively. Such a transition showed a positive association with delayed verbal recall (B = 0.288, p < 0.01), especially in rural area, subjects with age ≥ 65 years old, and women (all P < 0.05). The combined effect of the presence of hypertension during a baseline visit and such a transition on changes in delayed verbal recall was antagonistic (RERI = -0.529, p < 0.05). Moreover, the development of hypertension explained more than 50% of such a fuel transition-related decline of verbal memory. The transition of household energy to clean fuel was associated with a higher adult cognitive function. The presence or the development of CVD appeared to affect the association between indoor air pollution and cognitive function, which suggests a need to further optimize prevention of concurrent CVD and risk factor control in adults at higher risk for cognitive impairment and with indoor unclean cooking fuel, especially in potentially susceptible subgroups.
Collapse
Affiliation(s)
- Xiaowei Cong
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, Jiangsu, China
| | - Juan Zhang
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, Jiangsu, China.
| | - Rongli Sun
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, Jiangsu, China
| | - Yuepu Pu
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, Jiangsu, China.
| |
Collapse
|
7
|
Wang M, Ding D, Zhao Q, Wu W, Xiao Z, Liang X, Luo J, Chen J. Kidney function and dementia risk in community-dwelling older adults: the Shanghai Aging Study. Alzheimers Res Ther 2021; 13:21. [PMID: 33430940 PMCID: PMC7798296 DOI: 10.1186/s13195-020-00729-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 11/23/2020] [Indexed: 01/06/2023]
Abstract
BACKGROUND Association between kidney dysfunction and dementia has been studied in western cohorts, but with inconsistent conclusions which may be due to the different measurements of kidney function. We aim to verify the hypothesis that lower levels of kidney function would be associated with increased risk of incident dementia in Chinese elderly. METHODS One thousand four hundred twelve dementia-free participants aged 60 years or older from the Shanghai Aging Study were enrolled and followed up for 5.3 years on average. Glomerular filtration rate (GFR) was calculated by using combined creatinine-cystatin C CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration) equation. Diagnoses of incident dementia and Alzheimer's disease (AD) were established using DSM-IV and NINCDS-ADRDA criteria based on medical, neurological, and neuropsychological examinations to each participant. Cox proportional regression was used to analyze the association of baseline GFRcrcys levels with incident dementia/AD, adjusting age, gender, education years, APOE-ε4, diabetes, hypertension, baseline Mini-Mental State Examination score, and proteinuria. RESULTS A total of 113 (8%) and 84 (7%) participants developed dementia and AD. Comparing to participants with high GFRcrcys (≥ 80 ml/min/1.73 m2), participants with low (< 67 ml/min/1.73 m2) and moderate GFRcrcys (67 ≤ GFR < 80 ml/min/1.73 m2) had increased risk of incident dementia with hazard ratios (HRs) of 1.87 (95% CI 1.02-3.44) and 2.19 (95% CI 1.21-3.95) after adjustment for confounders, respectively. Low (HR = 2.27 [95%CI 1.10-4.68]) and moderate (HR = 2.14 [95% CI 1.04-4.40]) GFRcrcys at baseline was also independently associated with incident AD after adjustments when comparing to high GFRcrcys. The significant association between GFRcrcys and dementia risk was observed in female but not in male participants. CONCLUSIONS GFRcrcys may be considered as a marker of an individual's vulnerability to the increased risk of cognitive decline.
Collapse
Affiliation(s)
- Mengjing Wang
- Department of Nephrology, National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, 12 Middle Wurumuqi Road, Shanghai, 200040, China
- National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, 12 Middle Wurumuqi Road, Shanghai, 200040, China
| | - Ding Ding
- National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, 12 Middle Wurumuqi Road, Shanghai, 200040, China.
- Institute of Neurology, Huashan Hospital, Fudan University, Shanghai, China.
| | - Qianhua Zhao
- National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, 12 Middle Wurumuqi Road, Shanghai, 200040, China
- Institute of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Wanqing Wu
- Institute of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Zhenxu Xiao
- Institute of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Xiaoniu Liang
- Institute of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Jianfeng Luo
- Department of Biostatistics, School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety of Ministry of Education (Fudan University), Shanghai, China
| | - Jing Chen
- Department of Nephrology, National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, 12 Middle Wurumuqi Road, Shanghai, 200040, China.
- National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, 12 Middle Wurumuqi Road, Shanghai, 200040, China.
| |
Collapse
|
8
|
Tseng TJ, Yen YT, Yang YH, Chen YH, Chan TC. Association between the occurrence of albuminuria and the risk of early dementia among older people upon health examination: a community-based cohort study in Taiwan. BMJ Open 2020; 10:e041664. [PMID: 33293399 PMCID: PMC7725074 DOI: 10.1136/bmjopen-2020-041664] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES This study aimed to investigate the associations between biochemical markers, renal function, health behaviours and dementia among older people. DESIGN A retrospective cohort study. SETTING Community-based health examination database from Taipei city. PARTICIPANTS In total, 35 434 older people were included from February 2005 to December 2012. To assess changes in renal function, we selected participants who attended health examinations at least twice and responded to the AD8 questionnaire in 2012. We excluded those with dementia at baseline. PRIMARY OUTCOME MEASURES Early dementia was assessed using the AD8 questionnaire in 2012. Explanatory variables included demographic factors, health behaviours, biochemical markers and renal function. We used a Cox proportional hazard model to estimate the HR for early dementia onset. RESULTS Individuals with mild albuminuria (HR 1.228; 95% CI 1.066 to 1.414), lower eGFR (HR 1.549; 95% CI 1.319 to 1.820) and higher age (HR 1.022; 95% CI 1.015 to 1.028) were associated with a high risk of early dementia. Older people with no alcohol intake (HR 0.872; 95% CI 0.794 to 0.958), and higher education levels (HR 0.647; 95% CI 0.589 to 0.710) were at a low risk of early dementia. CONCLUSIONS Elevated mild albuminuria and low eGFR were associated with a high risk of early dementia in this community-based cohort. Routine health examinations for older people can help screen out the high-risk population, and clinical management might reduce or delay the risk of early dementia.
Collapse
Affiliation(s)
- Tzu-Jung Tseng
- Research Center for Humanities and Social Sciences, Academia Sinica, Taipei, Taiwan
| | - Yun-Ting Yen
- Research Center for Humanities and Social Sciences, Academia Sinica, Taipei, Taiwan
| | - Yuan-Han Yang
- Department of Neurology, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Neurology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan
- Neuroscience Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yen-Hsu Chen
- Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan
- School of Medicine, Graduate Institute of Medicine, Sepsis Research Center, Center of Tropical Medicine and Infectious Diseases, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Biological Science and Technology, College of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan
| | - Ta-Chien Chan
- Research Center for Humanities and Social Sciences, Academia Sinica, Taipei, Taiwan
- Institute of Public Health, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| |
Collapse
|
9
|
Wu JJ, Weng SC, Liang CK, Lin CS, Lan TH, Lin SY, Lin YT. Effects of kidney function, serum albumin and hemoglobin on dementia severity in the oldest old people with newly diagnosed Alzheimer's disease in a residential aged care facility: a cross-sectional study. BMC Geriatr 2020; 20:391. [PMID: 33028210 PMCID: PMC7541276 DOI: 10.1186/s12877-020-01789-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 09/24/2020] [Indexed: 01/09/2023] Open
Abstract
Background Chronic kidney disease (CKD), low serum albumin, and anemia are known risk factors for cognitive decline in older people. We investigated the association between kidney function and cognitive impairment severity in oldest-old people with a diagnosis of Alzheimer’s disease (AD). Methods A cross-sectional study of patients aged 80 years and older was conducted at a veterans’ home in Taiwan between 2012 and 2016. Their estimated glomerular filtration rate (eGFR) was determined using the Modification of Diet in Renal Diseases (MDRD) equation. Cognitive function was evaluated with the Mini-Mental State Examination (MMSE) and Clinical Dementia Rating (CDR). Results A total of 84 patients (age mean ± SD, 86.6 ± 3.9 years) had MMSE scores of 10.1 ± 6.7, and CDR scores of 1.6 ± 0.7. The average eGFR was 61.7 ± 21.5 mL/min/1.73m2. The mean hemoglobin concentration was 12.7 ± 1.7 g/dl, and the mean albumin concentration was 4.5 ± 4.8 g/dl. Multivariate regression analyses showed that scores of CDR were significantly correlated with eGFR after adjustment for potential confounders. The scores of MMSE were significantly correlated with serum albumin and hemoglobin after adjustment for potential confounders. Conclusions We found dementia severity was significantly associated with kidney function, serum albumin, and hemoglobin in the oldest-old with AD. We recommend that oldest-old people with a diagnosis of AD be evaluated to determine kidney function, as well as nutritional and hematological status. Further study is needed to establish whether prevention of CKD deterioration, and correction of malnutrition and anemia may help to slow cognitive decline in oldest-old people with dementia.
Collapse
Affiliation(s)
- Jia-Jyun Wu
- Center for Geriatrics and Gerontology, Taichung Veterans General Hospital, Taichung, Taiwan.,Department of Family Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Shuo-Chun Weng
- Center for Geriatrics and Gerontology, Taichung Veterans General Hospital, Taichung, Taiwan.,Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.,Division of Nephrology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Chih-Kuang Liang
- Center for Geriatrics and Gerontology, Division of Neurology, Department of Medicine, Kaohsiung Veterans General Hospital, No.386, Dazhong 1st Rd., Zuoying Dist, Kaohsiung, Taiwan
| | - Chu-Sheng Lin
- Center for Geriatrics and Gerontology, Taichung Veterans General Hospital, Taichung, Taiwan.,Department of Family Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Tsuo-Hung Lan
- Tsaotun Psychiatric Center, Ministry of Health and Welfare, Nantou, Taiwan.,Department of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Center for Neuropsychiatric Research, National Health Research Institutes, Miaoli, Taiwan
| | - Shih-Yi Lin
- Center for Geriatrics and Gerontology, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Yu-Te Lin
- Center for Geriatrics and Gerontology, Division of Neurology, Department of Medicine, Kaohsiung Veterans General Hospital, No.386, Dazhong 1st Rd., Zuoying Dist, Kaohsiung, Taiwan.
| |
Collapse
|
10
|
Bai K, Chen R, Lu F, Zhao Y, Pan Y, Wang F, Zhang L. Blood Pressure is Associated with Rapid Kidney Function Decline in a Very Elderly Hypertensive Chinese Population. Clin Interv Aging 2020; 15:1317-1323. [PMID: 32848372 PMCID: PMC7428315 DOI: 10.2147/cia.s255640] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 07/19/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose In prior analyses, blood pressure (BP) was related to rapid kidney function decline (RKFD). However, studies of this relationship in populations of advanced age are lacking. In the present study, we therefore examined the relationship between BP and RKFD in a population of 284 hypertensive Chinese individuals over the age of 80. Patients and Methods All study participants were diagnosed with hypertension (systolic BP [SBP] 160–200 mmHg; diastolic BP [DBP] <110 mmHg). RKFD was defined based upon a decline in estimated glomerular filtration rate (eGFR) >5mL/min per 1.73 m2 per year during follow-up. The Cox regression models (competing risk models) were used for calculating hazard ratios (HRs) to examine the relationship between SBP, DBP, pulse pressure (PP) and RKFD. Results Over a 3.3-year median follow-up period, 68 study participants (23.9%) were diagnosed with RKFD, while 35 (12.3%) died. After adjusting for confounding variables, we determined that each 10 mmHg rise in SBP and PP was associated with a 34% and 110% increase, respectively, in RKFD risk (adjusted HR: 1.34, 95% confidence interval [CI]: 1.05–1.71 for SBP, p=0.02; HR: 2.10, 95% CI: 0.87–5.08 for PP, p=0.10). In addition, we determined that each 10 mmHg increase in DBP was linked to a 10% reduction in RKFD risk (adjusted HR: 0.90, 95% CI: 0.70–1.14, p=0.37). Conclusion Our results indicate that SBP, but not DBP or PP, is positively correlated with RKFD risk in a very elderly hypertensive Chinese population.
Collapse
Affiliation(s)
- Kunhao Bai
- Department of Endoscopy, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, People's Republic of China.,Renal Division, Department of Medicine, Peking University First Hospital, Beijing, People's Republic of China
| | - Rui Chen
- Renal Division, Department of Medicine, Peking University First Hospital, Beijing, People's Republic of China
| | - Fanghong Lu
- Cardio-Cerebrovascular Control and Research Center, Institute of Basic Medicine, Shandong Academy of Medical Sciences, Jinan, Shandong, People's Republic of China
| | - Yingxin Zhao
- Cardio-Cerebrovascular Control and Research Center, Institute of Basic Medicine, Shandong Academy of Medical Sciences, Jinan, Shandong, People's Republic of China
| | - Yujing Pan
- Renal Division, Department of Medicine, Peking University International Hospital, Beijing, China
| | - Fang Wang
- Renal Division, Department of Medicine, Peking University First Hospital, Beijing, People's Republic of China
| | - Luxia Zhang
- Renal Division, Department of Medicine, Peking University First Hospital, Beijing, People's Republic of China.,National Institute of Health Data Science at Peking University, Beijing, People's Republic of China.,Peking University, Center for Data Science in Health and Medicine, Beijing, People's Republic of China
| |
Collapse
|
11
|
Di Rosa M, D’Alia S, Guarasci F, Soraci L, Pierpaoli E, Lenci F, Ricci M, Onder G, Volpato S, Ruggiero C, Cherubini A, Corsonello A, Lattanzio F. Cognitive Impairment, Chronic Kidney Disease, and 1-Year Mortality in Older Patients Discharged from Acute Care Hospital. J Clin Med 2020; 9:E2202. [PMID: 32664677 PMCID: PMC7408778 DOI: 10.3390/jcm9072202] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 07/09/2020] [Accepted: 07/10/2020] [Indexed: 02/01/2023] Open
Abstract
The prognostic interaction between chronic kidney disease (CKD) and cognitive impairment is still to be elucidated. We investigated the potential interaction of overall cognitive impairment or defective constructional praxis and CKD in predicting 1-year mortality among 646 older patients discharged from hospital. The estimated glomerular filtration rate (eGFR) was calculated using the Berlin Initiative Study (BIS) equation. Cognitive impairment was assessed by the Mini Mental State Exam (MMSE) and defective constructional praxis was ascertained by the inherent MMSE item. The study outcome was 1-year mortality. Statistical analysis was carried out using Cox regression. After adjusting for potential confounders, the co-occurrence of eGFR <30 and overall cognitive impairment (Hazard Ratio (HR) = 3.12, 95% Confidence Interval (CI) = 1.26-7.77) and defective constructional praxis (HR = 2.50, 95% CI = 1.08-5.77) were associated with the outcome. No significant prognostic interaction of eGFR < 30 with either overall cognitive impairment (HR = 1.99, 95% CI = 0.38-10.3) or constructional apraxia (HR = 1.68, 95% CI = 0.33-8.50) was detectable, while only cognitive deficits were found significantly associated with the outcome in the interaction models (HR = 3.12, 95% CI = 1.45-6.71 for overall cognitive impairment and HR = 2.16, 95% CI = 1.05-4.45 for constructional apraxia). Overall cognitive impairment and defective constructional praxis may be associated with increased risk of 1-year mortality among older hospitalized patients with severe CKD. However, no significant prognostic interaction between CKD and cognitive impairment could be observed.
Collapse
Affiliation(s)
- Mirko Di Rosa
- Unit of Geriatric Pharmacoepidemiology and Biostatistics, IRCCS INRCA, 60124 Ancona, Italy; (M.D.R.); (S.D.A.); (F.G.); (A.C.)
| | - Sonia D’Alia
- Unit of Geriatric Pharmacoepidemiology and Biostatistics, IRCCS INRCA, 60124 Ancona, Italy; (M.D.R.); (S.D.A.); (F.G.); (A.C.)
| | - Francesco Guarasci
- Unit of Geriatric Pharmacoepidemiology and Biostatistics, IRCCS INRCA, 60124 Ancona, Italy; (M.D.R.); (S.D.A.); (F.G.); (A.C.)
| | - Luca Soraci
- Unit of Geriatric Pharmacoepidemiology and Biostatistics, IRCCS INRCA, 60124 Ancona, Italy; (M.D.R.); (S.D.A.); (F.G.); (A.C.)
- Department of Clinical and Experimental Medicine, University of Messina, 98124 Messina, Italy
| | - Elisa Pierpaoli
- Advanced Technology Center for Aging Research, Scientific Technological Area, IRCCS INRCA, 60124 Ancona, Italy;
| | - Federica Lenci
- Unit of Nephrology and Dialysis, IRCCS INRCA, 60124 Ancona, Italy; (F.L.); (M.R.)
| | - Maddalena Ricci
- Unit of Nephrology and Dialysis, IRCCS INRCA, 60124 Ancona, Italy; (F.L.); (M.R.)
| | - Graziano Onder
- Department of Cardiovascular and Endocrine-Metabolic Diseases and Aging, Istituto Superiore di Sanità, 00161 Rome, Italy;
| | - Stefano Volpato
- Department of Medical Sciences, University of Ferrara, 44121 Ferrara, Italy;
| | - Carmelinda Ruggiero
- Section of Gerontology and Geriatrics, Department of Medicine, University of Perugia, 06132 Perugia, Italy;
| | - Antonio Cherubini
- Geriatria Accettazione Geriatrica e Centro di Ricerca per l’Invecchiamento, IRCCS INRCA, 60124 Ancona, Italy;
| | - Andrea Corsonello
- Unit of Geriatric Pharmacoepidemiology and Biostatistics, IRCCS INRCA, 60124 Ancona, Italy; (M.D.R.); (S.D.A.); (F.G.); (A.C.)
- Unit of Geriatric Medicine, IRCSS INRCA, 60124 Ancona, Italy
| | | |
Collapse
|
12
|
Chen R, Bai K, Lu F, Zhao Y, Pan Y, Wang F, Zhang L. Electrocardiographic left ventricular hypertrophy and mortality in an oldest-old hypertensive Chinese population. Clin Interv Aging 2019; 14:1657-1662. [PMID: 31571845 PMCID: PMC6756150 DOI: 10.2147/cia.s218106] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Accepted: 08/29/2019] [Indexed: 01/19/2023] Open
Abstract
Purpose Previous studies have identified that electrocardiographic pattern of left ventricular hypertrophy (ECG LVH) is associated with mortality, but studies of its correlation in the oldest-old hypertensive population is extremely limited. We investigated the correlation between ECG LVH and mortality in a hypertensive Chinese population aged 80 years and older. Patients and methods In this study, we included 284 Chinese participants older than 80 years. All included participants with hypertension (sitting systolic blood pressure [BP] 160 to 200 mmHg; sitting diastolic BP <110 mmHg) were ascertained at the baseline. ECG LVH was defined as a Sokolow-Lyon voltage calculated as the amplitude of SV1+ (max RV5 or RV6) greater than 3.5 mV. We categorized participants into two groups by the status of baseline ECG LVH. We used Cox regression models to calculate hazard ratio (HRs) for mortality due to ECG LVH, including cardiovascular mortality and all-cause mortality. Results In this study, with a 28-month median follow-up, a total of 35 (12.3%) patients died; 21 of those died due to cardiovascular causes. Compared with participants without ECG LVH, there was an increased risk of cardiovascular mortality in participants with ECG LVH (adjusted HR 4.25 [95% confidence interval [CI], 1.50–12.06]) but ECG LVH did not predict all-cause mortality (adjusted HR 2.31 [95% CI, 0.93–5.72]). Conclusion Our study shows that ECG LVH predicts the risk of cardiovascular mortality in an oldest-old hypertensive Chinese population.
Collapse
Affiliation(s)
- Rui Chen
- Renal Division, Department of Medicine, Peking University First Hospital, Beijing, People's Republic of China
| | - Kunhao Bai
- Department of Endoscopy, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, People's Republic of China
| | - Fanghong Lu
- Cardio-Cerebrovascular Control and Research Center, Institute of Basic Medicine, Shandong Academy of Medical Sciences, Jinan, Shandong, People's Republic of China
| | - Yingxin Zhao
- Cardio-Cerebrovascular Control and Research Center, Institute of Basic Medicine, Shandong Academy of Medical Sciences, Jinan, Shandong, People's Republic of China
| | - Yujing Pan
- Renal Division, Department of Medicine, Peking University International Hospital, Beijing, People's Republic of China
| | - Fang Wang
- Renal Division, Department of Medicine, Peking University First Hospital, Beijing, People's Republic of China
| | - Luxia Zhang
- Renal Division, Department of Medicine, Peking University First Hospital, Beijing, People's Republic of China.,National Institute of Health Data Science at Peking University, Beijing, People's Republic of China.,Center for Data Science in Health and Medicine, Peking University, Beijing, People's Republic of China
| |
Collapse
|
13
|
Mandelli S, Riva E, Tettamanti M, Detoma P, Giacomin A, Lucca U. Association of renal function with cognition, functional ability and mood in the oldest‐old: The ‘Health and Anemia study’. Nephrology (Carlton) 2019; 25:48-54. [DOI: 10.1111/nep.13579] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/25/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Sara Mandelli
- Laboratory of Geriatric NeuropsychiatryIstituto di Ricerche Farmacologiche Mario Negri IRCCS Milan Italy
| | - Emma Riva
- Laboratory of Geriatric NeuropsychiatryIstituto di Ricerche Farmacologiche Mario Negri IRCCS Milan Italy
| | - Mauro Tettamanti
- Laboratory of Geriatric NeuropsychiatryIstituto di Ricerche Farmacologiche Mario Negri IRCCS Milan Italy
| | - Paolo Detoma
- Laboratory of AnalysesOspedale Degli Infermi Biella Italy
| | | | - Ugo Lucca
- Laboratory of Geriatric NeuropsychiatryIstituto di Ricerche Farmacologiche Mario Negri IRCCS Milan Italy
| |
Collapse
|
14
|
Bai K, Pan Y, Lu F, Zhao Y, Wang F, Zhang L. Cognitive function and 3-year mortality in the very elderly Chinese population with chronic kidney disease. Clin Interv Aging 2018; 13:2055-2060. [PMID: 30425460 PMCID: PMC6201991 DOI: 10.2147/cia.s173696] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Background Cognitive function has been suggested to be correlated with mortality, while studies regarding the association among the very elderly population with chronic kidney disease (CKD) are extremely limited. Aim To explore the association between cognitive function and mortality among the very elderly Chinese population with CKD. Methods This prospective study included 163 Chinese participants aged 80 years or older with CKD. CKD was defined as an estimated glomerular filtration rate <60 mL/min/1.73 m2. Cognitive function was evaluated using the mini-mental state examination (MMSE) at baseline. Participants were divided into three groups based on the MMSE score. Cox proportional hazard models were used to assess the contribution of cognitive function to mortality. Results During a median follow-up of 28 months, 24 (14.7%) participants died, and 14 of the events were cardiovascular death. After making adjustment for potential confounders, every 1-point increase of MMSE score was associated with 29% decreased risk of all-cause mortality (adjusted hazards ratio [HR], 0.71; 95% CI, 0.58–0.87) and 39% decreased risk of cardiovascular mortality (adjusted HR, 0.61; 95% CI, 0.44–0.83). Compared with participants with top category of MMSE score, the adjusted HRs for all-cause mortality and cardiovascular mortality among those with bottom category of MMSE score were 8.18 (95% CI, 2.05–32.54) and 14.72 (95% CI, 1.65–131.16). Conclusion Cognitive function was associated with all-cause mortality and cardiovascular mortality among the very elderly population with CKD.
Collapse
Affiliation(s)
- Kunhao Bai
- Renal Division, Department of Medicine, Peking University First Hospital, Beijing, People's Republic of China, .,Department of Endoscopy, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, People's Republic of China
| | - Yujing Pan
- Renal Division, Department of Medicine, Peking University International Hospital, Beijing, People's Republic of China
| | - Fanghong Lu
- Cardio-Cerebrovascular Control and Research Center, Institute of Basic Medicine, Shandong Academy of Medical Sciences, Jinan, Shandong, People's Republic of China
| | - Yingxin Zhao
- Cardio-Cerebrovascular Control and Research Center, Institute of Basic Medicine, Shandong Academy of Medical Sciences, Jinan, Shandong, People's Republic of China
| | - Fang Wang
- Renal Division, Department of Medicine, Peking University First Hospital, Beijing, People's Republic of China, .,Peking University Institute of Nephrology, Peking University Health Science Center, Beijing, People's Republic of China,
| | - Luxia Zhang
- Renal Division, Department of Medicine, Peking University First Hospital, Beijing, People's Republic of China, .,Peking University Institute of Nephrology, Peking University Health Science Center, Beijing, People's Republic of China, .,Center for Data Science in Health and Medicine, Peking University, Beijing, People's Republic of China,
| |
Collapse
|
15
|
Kobayashi H, Otsuka H, Yanai M, Hara M, Hishiki M, Soma M, Abe M. Adiponectin Receptor gene Polymorphisms are Associated with Kidney Function in Elderly Japanese Populations. J Atheroscler Thromb 2018; 26:328-339. [PMID: 30135333 PMCID: PMC6456456 DOI: 10.5551/jat.45609] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Aim: Adiponectin exhibits its biological effects through adiponectin receptors (AdipoR1 and AdipoR2), which are distributed in the kidneys, and activation of those receptors could prevent or ameliorate diabetic nephropathy. This study aimed to evaluate the associations between AdipoR single nucleotide polymorphisms (SNPs) and kidney function in an elderly Japanese population. Methods: A total of 271 elderly Japanese volunteers underwent anthropometric and laboratory tests (cystatin C-based eGFR and total and high molecular weight adiponectin levels at baseline and a follow-up visit). Genotype data were obtained for the selected 7 and 5 AdipoR1 and AdipoR2 SNPs, respectively. Results: In a cross-sectional analysis at baseline, we found a significant association between the AdipoR2 SNP rs12230440 and kidney function; eGFRcys tended to increase as the number of carriers of T alleles increased after adjustment for covariates and Bonferroni correction, although the association of the SNP and annual eGFR decline could not be identified in the longitudinal data. Regarding the variants rs16850797, rs11061925, and rs10773983, each of the allele G, allele C, and allele G showed nominally significant associations with higher eGFRcys. However, this failed to reach significance after Bonferroni correction. Conclusion: Here, an AdipoR2 SNP was associated with kidney function, suggesting that the effects of this polymorphism on adiponectin receptor may affect kidney function in the elderly Japanese population.
Collapse
Affiliation(s)
- Hiroki Kobayashi
- Division of Nephrology, Hypertension and Endocrinology, Department of Internal Medicine, Nihon University School of Medicine
| | - Hiromasa Otsuka
- Division of General Medicine, Department of Internal Medicine, Nihon University School of Medicine
| | - Mitsuru Yanai
- Division of General Medicine, Department of Internal Medicine, Nihon University School of Medicine
| | - Motohiko Hara
- Department of Nursing, School of Health and Social Services, Saitama Prefectural University
| | - Mikano Hishiki
- Department of Diabetes and Endocrinology, Tokyo Metropolitan Hiroo Hospital
| | - Masayoshi Soma
- Division of General Medicine, Department of Internal Medicine, Nihon University School of Medicine
| | - Masanori Abe
- Division of Nephrology, Hypertension and Endocrinology, Department of Internal Medicine, Nihon University School of Medicine
| |
Collapse
|
16
|
Xu X, Parker D, Shi Z, Byles J, Hall J, Hickman L. Dietary Pattern, Hypertension and Cognitive Function in an Older Population: 10-Year Longitudinal Survey. Front Public Health 2018; 6:201. [PMID: 30079333 PMCID: PMC6062638 DOI: 10.3389/fpubh.2018.00201] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Accepted: 06/29/2018] [Indexed: 01/01/2023] Open
Abstract
Background: There is a paucity of studies that have explored the association between dietary pattern and cognitive function, and whether there is an interaction between dietary pattern and hypertension in relation to older people's cognitive functioning. Methods: We analyzed data from the China Health and Nutrition (CHNS) survey. Dietary data have been collected since 1991, and cognitive function interview data were collected between 1997 and 2006. We analyzed ten years of data, including 4,847 participants with 10,658 observations (aged ≥55 years). Exploratory factor analysis was used to identify dietary patterns. Cognitive function measures include cognitive global scores and verbal memory scores. Linear mixed models were used to investigate the association between dietary patterns, hypertension and cognitive function. Results: Three dietary patterns were identified by factor analysis, named "Traditional Chinese," "Protein-rich," and "Starch-rich" dietary pattern. A Protein-rich dietary pattern (high intake of milk, eggs and soymilk) was significantly associated with higher cognitive global scores and verbal memory scores, while the starch-rich dietary pattern (high intake of salted vegetable and legumes) was significantly associated with lower cognitive global and verbal memory scores. In addition, we found that participants with hypertension were independently associated with significant low cognitive function. Conclusion: The study reinforces the importance of diet in preventing cognitive decline among the older population. Identification of older populations who had hypertension should be targeted in intervention studies to maintain their cognitive health.
Collapse
Affiliation(s)
- Xiaoyue Xu
- Faculty of Health, University of Technology, Sydney, NSW, Australia
- Priority Research Centre for Generational, Health and Ageing, School of Medicine and Public Health, Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW, Australia
| | - Deborah Parker
- Faculty of Health, University of Technology, Sydney, NSW, Australia
| | - Zumin Shi
- Human Nutrition Department, Qatar University, Doha, Qatar
- School of Medicine, University of Adelaide, Adelaide, SA, Australia
| | - Julie Byles
- Priority Research Centre for Generational, Health and Ageing, School of Medicine and Public Health, Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW, Australia
| | - John Hall
- School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Louise Hickman
- Faculty of Health, University of Technology, Sydney, NSW, Australia
| |
Collapse
|