1
|
Wang C, Xin Q, Li J, Wang J, Yao S, Wang M, Zhao M, Chen S, Wu S, Xue H. Association of Estimated Glomerular Filtration Rate Trajectories with Atrial Fibrillation Risk in Populations with Normal or Mildly Impaired Renal Function. KIDNEY DISEASES (BASEL, SWITZERLAND) 2024; 10:274-283. [PMID: 39131881 PMCID: PMC11309754 DOI: 10.1159/000539289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 05/06/2024] [Indexed: 08/13/2024]
Abstract
Introduction The association between the longitudinal patterns of estimated glomerular filtration rate (eGFR) and risk of atrial fibrillation (AF) in populations with normal or mildly impaired renal function is not well characterized. We sought to explore the eGFR trajectories in populations with normal or mildly impaired renal function and their association with AF. Methods This prospective cohort study included 62,407 participants who were free of AF, cardiovascular diseases, and moderate to severe renal insufficiency (eGFR <60 mL/min/1.73 m2) before 2010. The eGFR trajectories were developed using latent mixture modeling based on examination data in 2006, 2008, and 2010. Incident AF cases were identified in biennial electrocardiogram assessment and a review of medical insurance data and discharge registers. We used Cox regression models to estimate the hazard ratios and 95% confidence intervals (CIs) for incident AF. Results According to survey results for the range and changing pattern of eGFR during 2006-2010, four trajectories were identified: high-stable (range, 107.47-110.25 mL/min/1.73 m2; n = 11,719), moderate-increasing (median increase from 83.83 to 100.37 mL/min/1.73 m2; n = 22,634), high-decreasing (median decrease from 101.72 to 89.10 mL/min/1.73 m2; n = 7,943), and low-stable (range, 73.48-76.78 mL/min/1.73 m2; n = 20,111). After an average follow-up of 9.63 years, a total of 485 cases of AF were identified. Compared with the high-stable trajectory, the adjusted hazard ratios of AF were 1.70 (95% CI, 1.09-2.66) for the moderate-increasing trajectory, 1.92 (95% CI, 1.18-3.13) for the high-decreasing trajectory, and 2.28 (95% CI, 1.46-3.56) for the low-stable trajectory. The results remained consistent across a number of sensitivity analyses. Conclusion The trajectories of eGFR were associated with subsequent AF risk in populations with normal or mildly impaired renal function.
Collapse
Affiliation(s)
- Chi Wang
- Department of Cardiology, The Sixth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Qian Xin
- Department of Cardiology, The Sixth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Junjuan Li
- Department of Nephrology, Kailuan General Hospital, Tangshan, China
| | - Jianli Wang
- Department of Rehabilitation, Kailuan General Hospital, Tangshan, China
| | - Siyu Yao
- Department of Cardiology, The Sixth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Miao Wang
- Department of Cardiology, The Sixth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Maoxiang Zhao
- Department of Cardiology, The Sixth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Shuohua Chen
- Department of Cardiology, Kailuan General Hospital, Tangshan, China
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, Tangshan, China
| | - Hao Xue
- Department of Cardiology, The Sixth Medical Center of Chinese PLA General Hospital, Beijing, China
| |
Collapse
|
2
|
Ran Z, Zheng Y, Yu L, Zhang Y, Zhang Z, Li H, Li X, Song J, Zhang L, Zhang R, Lu C, Gong Y, Gong J. Linking artificial sweetener intake with kidney function: insights from NHANES 2003-2006 and findings from Mendelian randomization research. Front Nutr 2024; 11:1387676. [PMID: 38873559 PMCID: PMC11169671 DOI: 10.3389/fnut.2024.1387676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Accepted: 04/29/2024] [Indexed: 06/15/2024] Open
Abstract
Background The current investigation examines the association between artificial sweetener (AS) consumption and the likelihood of developing chronic kidney disease (CKD), along with its impact on kidney function. Methods We utilized data from the National Health and Nutrition Examination Survey from 2003-2006 to conduct covariance analysis and weighted adjusted logistic regression, aiming to assess the association between artificial sweetener intake and CKD risk, as well as kidney function indicators. Subsequently, we employed Mendelian randomization methods to validate the causal relationship between the intake of artificial sweeteners, CKD risk, and kidney function indicators. Instrumental variable analysis using inverse-variance weighting and Robust adjusted profile score were the primary analytical methods employed. Results A total of 20,470 participants were included in the study, with 1,257 participants ultimately included in the analysis. In all adjusted logistic regression models, no significant association was found between the intake of artificial sweeteners and CKD risk. Similarly, the summary odds ratios (OR) for each unit change in genetically predicted CKD risk were 2.14 (95% CI: 0.83, 5.21, p = 0.092), 1.41 (95% CI: 0.54, 3.63, p = 0.482), and 1.50 (95% CI: 0.50, 4.52, p = 0.468) for the impact of artificial sweeteners added to cereals, tea, and coffee, respectively. It was only observed that adding artificial sweeteners to coffee was associated with a modest reduction in urinary albumin-to-creatinine ratio (OR = 0.94, 95% CI: -0.108, -0.022, p = 0.003), the effect appeared to be relatively small and may not directly impact the individual level. Conclusion Our study does not support a causal relationship between artificial sweetener intake and the risk of CKD. However, due to the limitations and potential confounding factors, these findings need to be further validated through larger sample sizes in observational studies and Mendelian randomization analyses.
Collapse
Affiliation(s)
- Zhuoling Ran
- Research Group of Jian Gong on Pharmacoepidemiology and Clinical Drug Evaluation, School of Life Science and Biopharmaceutics, Shenyang Pharmaceutical University, Shenyang, China
| | - Yuxuan Zheng
- Research Group of Jian Gong on Pharmacoepidemiology and Clinical Drug Evaluation, School of Life Science and Biopharmaceutics, Shenyang Pharmaceutical University, Shenyang, China
| | - Lin Yu
- Research Group of Jian Gong on Pharmacoepidemiology and Clinical Drug Evaluation, School of Life Science and Biopharmaceutics, Shenyang Pharmaceutical University, Shenyang, China
| | - Yuxian Zhang
- Research Group of Jian Gong on Pharmacoepidemiology and Clinical Drug Evaluation, School of Life Science and Biopharmaceutics, Shenyang Pharmaceutical University, Shenyang, China
| | - Zhenjiang Zhang
- Research Group of Jian Gong on Pharmacoepidemiology and Clinical Drug Evaluation, School of Life Science and Biopharmaceutics, Shenyang Pharmaceutical University, Shenyang, China
| | - Huijie Li
- Research Group of Jian Gong on Pharmacoepidemiology and Clinical Drug Evaluation, School of Life Science and Biopharmaceutics, Shenyang Pharmaceutical University, Shenyang, China
| | - Xuhan Li
- Research Group of Jian Gong on Pharmacoepidemiology and Clinical Drug Evaluation, School of Life Science and Biopharmaceutics, Shenyang Pharmaceutical University, Shenyang, China
| | - Jing Song
- Research Group of Jian Gong on Pharmacoepidemiology and Clinical Drug Evaluation, School of Life Science and Biopharmaceutics, Shenyang Pharmaceutical University, Shenyang, China
| | - Li Zhang
- Research Group of Jian Gong on Pharmacoepidemiology and Clinical Drug Evaluation, School of Life Science and Biopharmaceutics, Shenyang Pharmaceutical University, Shenyang, China
| | - Ran Zhang
- Research Group of Jian Gong on Pharmacoepidemiology and Clinical Drug Evaluation, School of Life Science and Biopharmaceutics, Shenyang Pharmaceutical University, Shenyang, China
| | - Chang Lu
- Research Group of Jian Gong on Pharmacoepidemiology and Clinical Drug Evaluation, School of Life Science and Biopharmaceutics, Shenyang Pharmaceutical University, Shenyang, China
| | - Yang Gong
- McWilliams School of Biomedical Informatics, University of Texas Health Science Center, Houston, TX, United States
| | - Jian Gong
- Research Group of Jian Gong on Pharmacoepidemiology and Clinical Drug Evaluation, School of Life Science and Biopharmaceutics, Shenyang Pharmaceutical University, Shenyang, China
| |
Collapse
|
3
|
Fu Y, Xiang Y, Wei Q, Ilatovskaya D, Dong Z. Rodent models of AKI and AKI-CKD transition: an update in 2024. Am J Physiol Renal Physiol 2024; 326:F563-F583. [PMID: 38299215 PMCID: PMC11208034 DOI: 10.1152/ajprenal.00402.2023] [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: 12/13/2023] [Revised: 01/29/2024] [Accepted: 01/29/2024] [Indexed: 02/02/2024] Open
Abstract
Despite known drawbacks, rodent models are essential tools in the research of renal development, physiology, and pathogenesis. In the past decade, rodent models have been developed and used to mimic different etiologies of acute kidney injury (AKI), AKI to chronic kidney disease (CKD) transition or progression, and AKI with comorbidities. These models have been applied for both mechanistic research and preclinical drug development. However, current rodent models have their limitations, especially since they often do not fully recapitulate the pathophysiology of AKI in human patients, and thus need further refinement. Here, we discuss the present status of these rodent models, including the pathophysiologic compatibility, clinical translational significance, key factors affecting model consistency, and their main limitations. Future efforts should focus on establishing robust models that simulate the major clinical and molecular phenotypes of human AKI and its progression.
Collapse
Affiliation(s)
- Ying Fu
- Department of Nephrology, Institute of Nephrology, The Second Xiangya Hospital at Central South University, Changsha, People's Republic of China
| | - Yu Xiang
- Department of Nephrology, Institute of Nephrology, The Second Xiangya Hospital at Central South University, Changsha, People's Republic of China
| | - Qingqing Wei
- Department of Cellular Biology and Anatomy, Medical College of Georgia at Augusta University and Charlie Norwood Veterans Affairs Medical Center, Augusta, Georgia, United States
| | - Daria Ilatovskaya
- Department of Physiology, Medical College of Georgia at Augusta University, Augusta, Georgia, United States
| | - Zheng Dong
- Department of Nephrology, Institute of Nephrology, The Second Xiangya Hospital at Central South University, Changsha, People's Republic of China
- Department of Cellular Biology and Anatomy, Medical College of Georgia at Augusta University and Charlie Norwood Veterans Affairs Medical Center, Augusta, Georgia, United States
- Research Department, Charlie Norwood Veterans Affairs Medical Center, Augusta, Georgia, United States
| |
Collapse
|
4
|
Israel E, Borko UD, Mota K, Tesfaw M, Feleke T, Abraham A, Akako B, Samuel B, Aynalem A. Out of sight: chronic kidney diseases among diabetic patients attending care and follow up. Findings from pastoralist health facilities of Southern Ethiopia. Front Public Health 2024; 12:1326011. [PMID: 38439761 PMCID: PMC10910120 DOI: 10.3389/fpubh.2024.1326011] [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: 10/22/2023] [Accepted: 02/05/2024] [Indexed: 03/06/2024] Open
Abstract
Background In Ethiopia, the prevalence of chronic kidney disease (CKD) among the adult population ranges to 19.1%. The disease's impact has increased in low-resource settings due to a lack of knowledge about the condition and its risk factors. Diabetes is one of the numerous causes of CKD. Despite this, little was known in Ethiopia, particularly in the study area. This study aimed to identify the determinants of CKD among diabetic patients enrolled in care and follow up at pastoralist health facility of Jinka General Hospital (JGH), Southern Ethiopia, 2023. Methods An institutional-based cross-sectional study design was conducted among 626 diabetic patients recruited through a systematic random sampling. Data was collected using a structured interviewer-administered questionnaire and entered into Epi data version 7.2 and then exported to the Statistical Package for Social Sciences (SPSS) version 25 for further analysis. Bivariate and multivariate logistic regression analyses were conducted to find eligible variables for the later analysis. Variables with p < 0.25 at bivariate logistic regression were selected for multivariate logistic regression analysis. The variables with p < 0.05 at the multivariate analysis were taken as statically significant in the final model. Results The prevalence of CKD was 2.7% (95% CI: 1.12-6.01%). Place of residence (AOR: 4.84; 95% CI: 1.51-15.40), presence of hypertension (AOR: 5.69; 95% CI: 1.58-20.51) and family history of CKD (AOR: 6.20; 95% CI: 1.40-15.49) were factors associated with CKD among diabetes patients. Conclusion The prevalence found in this study was low when compared with the local studies. Provision of health education to diabetic patients on preventative measures such as physical exercise is cost-effective approach. Factors associated with CKD among diabetics can be significantly mitigated by strengthening the existing NCDs prevention packages in the study area particularly and in Ethiopia generally.
Collapse
Affiliation(s)
- Eskinder Israel
- School of Public Health, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Ushula Deboch Borko
- School of Medicine, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Kuma Mota
- Department of Public Health, Marie-stopes International (MSI) Ethiopia Reproductive Choices, Hawassa, Ethiopia
| | - Mihret Tesfaw
- Department of Public Health, Marie-stopes International (MSI) Ethiopia Reproductive Choices, Hawassa, Ethiopia
| | - Tihun Feleke
- Department of Nursing, Hawassa College of Health Science, Hawassa, Ethiopia
| | - Awoke Abraham
- Division of Maternal and Child Health, Wolaita Zone Health Department, Wolaita Sodo, Ethiopia
| | - Bereket Akako
- School of Medicine, College of Medicine and Health Science, Hawassa University, Hawassa, Ethiopia
| | - Beniyam Samuel
- Department of Midwifery, College of Health Science and Medicine, Dilla University, Dilla, Ethiopia
| | - Amdehiwot Aynalem
- School of Nursing, College of Medicine and Health Science, Hawassa University, Hawassa, Ethiopia
| |
Collapse
|
5
|
Feng L, Bee YM, Fu X, Kwek JL, Chan CM, Jafar TH. Kidney function trajectories, associated factors, and outcomes in multiethnic Asian patients with type 2 diabetes. J Diabetes 2024. [PMID: 38169157 DOI: 10.1111/1753-0407.13523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 11/02/2023] [Accepted: 12/05/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND We examined the trajectory of estimated glomerular filtrate rate (eGFR), associated risk factors, and its relationship with end-stage kidney disease (ESKD) among a multiethnic patient population with type 2 diabetes in Singapore. METHODS A follow-up study included 62 080 individuals with type 2 diabetes aged ≥18 years in a multi-institutional SingHealth Diabetes Registry between 2013 and 2019. eGFR trajectories were analyzed using latent class linear mixed models. Factors associated with eGFR trajectories were evaluated using multinomial logistic regression. The association of eGFR trajectories with ESKD was assessed via competing risk models. RESULTS Trajectory of kidney function, determined by eGFR, was nonlinear. The trajectory pattern was classified as stable initially then gradual decline (75%), progressive decline (21.9%), and rapid decline (3.1%). Younger age, female sex, Malay ethnicity, lower-income housing type, current smoking, higher glycated hemoglobin, lower low-density lipoprotein, higher triglyceride, uncontrolled blood pressure, albuminuria, cardiovascular disease, hypertension, and higher eGFR levels each were associated with progressive or rapid decline. Compared with the trajectory of stable initially then gradual eGFR decline, progressive decline increased the hazard of ESKD by 6.14-fold (95% confidence interval [CI]: 4.96-7.61)) and rapid decline by 82.55 folds (95% CI: 55.90-121.89). CONCLUSIONS Three nonlinear trajectory classes of kidney function were identified among multiethnic individuals with type 2 diabetes in Singapore. About one in four individuals had a progressive or rapid decline in eGFR. Our results suggest that eGFR trajectories are correlated with multiple social and modifiable risk factors and inform the risk of ESKD.
Collapse
Affiliation(s)
- Liang Feng
- Program in Health Services & Systems Research, Duke-NUS Medical School, Singapore, Singapore
| | - Yong Mong Bee
- Department of Endocrinology, Singapore General Hospital, Singapore, Singapore
| | - Xiuju Fu
- Institute of High Performance Computing, A*STAR, Singapore, Singapore
| | - Jia Liang Kwek
- Department of Renal Medicine, Singapore General Hospital, Singapore, Singapore
| | - Choong Meng Chan
- Department of Renal Medicine, Singapore General Hospital, Singapore, Singapore
| | - Tazeen H Jafar
- Program in Health Services & Systems Research, Duke-NUS Medical School, Singapore, Singapore
- Duke Global Health Institute, Durham, North Carolina, USA
| |
Collapse
|
6
|
Khater MH, Abd El-Hassib DM, Sabry JH, Elkilany RM, Ameen SG. Association Between Renalase Gene Polymorphism (rs2296545) and Hypertension in Egyptian Chronic Kidney Disease Patients. Cureus 2023; 15:e47903. [PMID: 37905164 PMCID: PMC10613451 DOI: 10.7759/cureus.47903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/29/2023] [Indexed: 11/02/2023] Open
Abstract
Background Renalase gene polymorphisms are associated with an increased risk of essential hypertension, chronic kidney disease (CKD), heart disease, diabetes, and stroke. One of these polymorphisms is a common missense (rs2296545) polymorphism, which was reported to be related to hypertension. The aim of this work was to investigate the possible relation between renalase gene polymorphism (rs2296545) and hypertension in patients with CKD patients. Subjects and methods Ninety patients were included in this case-control study: 30 normotensive CKD patients, 30 hypertensive CKD patients, and 30 apparently healthy controls. Genomic deoxyribonucleic acid (DNA) was extracted from peripheral whole blood, and renalase gene (rs2296545) polymorphism was genotyped in all patients and controls by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Odds ratios (OR) and their 95% CIs were calculated. Results We found that the CC genotype and the C allele renalase (rs2296545) were statistically associated with the risk of CKD (OR= 9.4; 95%CI 1.2-7.2; P= 0.036) and (OR= 3.78; 95%CI 1.57-9.08; P= 0.003), respectively. There was a statistically significant difference between the hypertensive CKD patients and the controls regarding the CC genotypes and the C allele, (26.7% versus 3.3%, P= 0.018) and (40% versus 11.7%, P< 0.001) for the CC genotype and the C allele, respectively. The mean values of systolic and diastolic blood pressure were higher in the normotensive CKD patients with the CC genotype compared to other genotypes (P= 0.014 and P= 0.022, respectively) and also were higher in hypertensive CKD patients with the CC genotype when compared to other genotypes (P= 0.001 for both). Conclusion This study demonstrated a statistically significant increase in the renalase gene (rs2296545) CC genotype and the C allele in CKD patients, especially hypertensive CKD.
Collapse
Affiliation(s)
- Mohamed H Khater
- General Surgery, Nile Health Insurance Hospital, Shubra El-Kheima, EGY
- General Surgery, Northwick Park Hospital, Harrow, GBR
| | | | - Jehan H Sabry
- Clinical and Chemical Pathology, Faculty of Medicine Benha University, Benha, EGY
| | - Rania M Elkilany
- Clinical and Chemical Pathology, Faculty of Medicine Benha University, Benha, EGY
| | - Seham G Ameen
- Clinical and Chemical Pathology, Faculty of Medicine Benha University, Benha, EGY
| |
Collapse
|
7
|
Tu J, Xu Y, Guo X, Zhang J, Xu D, Han L, Wang Y, Zhang B, Sun H. No causal association between plasma cystatin C and cardiovascular diseases: Mendelian randomization analyses in UK biobank. Front Med (Lausanne) 2023; 10:1191675. [PMID: 37663661 PMCID: PMC10472449 DOI: 10.3389/fmed.2023.1191675] [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: 03/22/2023] [Accepted: 08/07/2023] [Indexed: 09/05/2023] Open
Abstract
Background We aimed to determine whether the plasma cystatin C is a causal risk factor for cardiovascular events, stroke, myocardial infarction (MI), and cardiovascular disease (CVD) mortality by conducting Mendelian randomization (MR) designs. Methods Our study included 277,057 individuals free of CVDs or cancer at baseline in the UK Biobank. The genetic scores of plasma cystatin C comprising 67 single-nucleotide polymorphisms were calculated on the basis of data from a large genome-wide association study. By stratifying the genetic score, we conducted cox regression to assess the relationship between plasma cystatin C and CVDs. In this study, linear MR analysis was used to estimate the causal association between plasma cystatin C and CVDs. Results Observational analyses showed that plasma cystatin C concentrations were associated with the risk of CVDs [hazard ratios (HR) per standard deviation (SD) 1.09, 95% confidence interval (CI); 1.07-1.10] and CVD mortality (1.14, 1.11-1.17). Among CVDs, plasma cystatin C were associated with stroke (1.10, 1.08-1.11) and MI (1.08, 1.07-1.10). Linear MR analysis did not provide evidence of a causal association between plasma cystatin C and the risk of CVDs [odds ratio (OR) per SD 0.96, 95% CI;0.90-1.03], stroke (0.96, 0.93-1.01), MI (0.97, 0.91-1.03), and CVD mortality (0.98, 0.96-1.01), with consistent estimates from sensitivity analyses. Conclusion Observational findings indicated that higher plasma cystatin C is associated with a higher risk of CVDs; According to MR studies, there is no causal association between plasma cystatin C and the risk of CVDs and CVD mortality.
Collapse
Affiliation(s)
- Jingjing Tu
- Department of Rehabilitation Medicine, Ningbo No.2 Hospital, Ningbo, China
| | - Ying Xu
- School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Xu Guo
- Department of Rehabilitation Medicine, Ningbo No.2 Hospital, Ningbo, China
| | - Jiayu Zhang
- School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Duo Xu
- Department of Global Health, Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo, Zhejiang, China
| | - Liyuan Han
- Department of Global Health, Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo, Zhejiang, China
| | - Yue Wang
- Department of Global Health, Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo, Zhejiang, China
| | - Boya Zhang
- School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Hongpeng Sun
- Department of Global Health, Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo, Zhejiang, China
| |
Collapse
|
8
|
De Beer D, Mels CMC, Schutte AE, Delles C, Mary S, Mullen W, Latosinska A, Mischak H, Kruger R. Identifying a urinary peptidomics profile for hypertension in young adults: The African-PREDICT study: Urinary peptidomics and hypertension: Urinary peptidomics and hypertension. Proteomics 2023; 23:e2200444. [PMID: 36943111 DOI: 10.1002/pmic.202200444] [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: 10/24/2022] [Revised: 01/27/2023] [Accepted: 03/02/2023] [Indexed: 03/23/2023]
Abstract
Hypertension is one of the most important and complex risk factors for cardiovascular diseases (CVDs). By using urinary peptidomics analyses, we aimed to identify peptides associated with hypertension, building a framework for future research towards improved prediction and prevention of premature development of CVD. We included 78 hypertensive and 79 normotensive participants from the African-PREDICT study (aged 20-30 years), matched for sex (51% male) and ethnicity (49% black and 51% white). Urinary peptidomics data were acquired using capillary-electrophoresis-time-of-flight-mass-spectrometry. Hypertension-associated peptides were identified and combined into a support vector machine-based multidimensional classifier. When comparing the peptide data between the normotensive and hypertensive groups, 129 peptides were nominally differentially abundant (Wilcoxon p < 0.05). Nonetheless, only three peptides, all derived from collagen alpha-1(III), remained significantly different after rigorous adjustments for multiple comparisons. The 37 most significant peptides (all p ≤ 0.001) served as basis for the development of a classifier, with 20 peptides being combined into a unifying score, resulting in an AUC of 0.85 in the ROC analysis (p < 0.001), with 83% sensitivity at 80% specificity. Our study suggests potential value of urinary peptides in the classification of hypertension, which could enable earlier diagnosis and better understanding of the pathophysiology of hypertension and premature cardiovascular disease development.
Collapse
Affiliation(s)
- Dalene De Beer
- Hypertension in Africa Research Team (HART), North-West University (Potchefstroom Campus), Potchefstroom, South Africa
| | - Catharina M C Mels
- Hypertension in Africa Research Team (HART), North-West University (Potchefstroom Campus), Potchefstroom, South Africa
- MRC Research Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa
| | - Aletta E Schutte
- Hypertension in Africa Research Team (HART), North-West University (Potchefstroom Campus), Potchefstroom, South Africa
- MRC Research Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa
- School of Population Health, The George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - Christian Delles
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Sheon Mary
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - William Mullen
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | | | | | - Ruan Kruger
- Hypertension in Africa Research Team (HART), North-West University (Potchefstroom Campus), Potchefstroom, South Africa
- MRC Research Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa
| |
Collapse
|
9
|
Pitzer Mutchler A, Huynh L, Patel R, Lam T, Bain D, Jamison S, Kirabo A, Ray EC. The role of dietary magnesium deficiency in inflammatory hypertension. Front Physiol 2023; 14:1167904. [PMID: 37293263 PMCID: PMC10244581 DOI: 10.3389/fphys.2023.1167904] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 05/10/2023] [Indexed: 06/10/2023] Open
Abstract
Nearly 30% of adults consume less than the estimated average daily requirement of magnesium (Mg2+), and commonly used medications, such as diuretics, promote Mg2+ deficiency. Higher serum Mg2+ levels, increased dietary Mg2+ in-take, and Mg2+ supplementation are each associated with lower blood pressure, suggesting that Mg2+-deficiency contributes to the pathogenesis of hypertension. Antigen-presenting cells, such as monocytes and dendritic cells, are well-known to be involved in the pathogenesis of hypertension. In these cells, processes implicated as necessary for increased blood pressure include activation of the NLRP3 inflammasome, IL-1β production, and oxidative modification of fatty acids such as arachidonic acid, forming isolevuglandins (IsoLGs). We hypothesized that increased blood pressure in response to dietary Mg2+-depletion leads to increased NLRP3, IL-1β, and IsoLG production in antigen presenting cells. We found that a Mg2+-depleted diet (0.01% Mg2+ diet) increased blood pressure in mice compared to mice fed a 0.08% Mg2+ diet. Mg2+-depleted mice did not exhibit an increase in total body fluid, as measured by quantitative magnetic resonance. Plasma IL-1β concentrations were increased (0.13 ± 0.02 pg/mL vs. 0.04 ± 0.02 pg/mL). Using flow cytometry, we observed increased NLRP3 and IL-1β expression in antigen-presenting cells from spleen, kidney, and aorta. We also observed increased IsoLG production in antigen-presenting cells from these organs. Primary culture of CD11c+ dendritic cells confirmed that low extracellular Mg2+ exerts a direct effect on these cells, stimulating IL-1β and IL-18 production. The present findings show that NLRP3 inflammasome activation and IsoLG-adduct formation are stimulated when dietary Mg2+ is depleted. Interventions and increased dietary Mg2+ consumption may prove beneficial in decreasing the prevalence of hypertension and cardiovascular disease.
Collapse
Affiliation(s)
- Ashley Pitzer Mutchler
- Vanderbilt University Department of Medicine, Division of Clinical Pharmacology, Nashville, TN, United States
| | - Linh Huynh
- University of Pittsburgh Department of Medicine, Renal-Electrolyte Division, Pittsburgh, PA, United States
| | - Ritam Patel
- University of Pittsburgh Department of Medicine, Renal-Electrolyte Division, Pittsburgh, PA, United States
| | - Tracey Lam
- University of Pittsburgh Department of Medicine, Renal-Electrolyte Division, Pittsburgh, PA, United States
| | - Daniel Bain
- University of Pittsburgh Department of Geology, Pittsburgh, PA, United States
| | - Sydney Jamison
- Meharry Medical College Nashville, Nashville, TN, United States
| | - Annet Kirabo
- Vanderbilt University Department of Medicine, Division of Clinical Pharmacology, Nashville, TN, United States
| | - Evan C. Ray
- University of Pittsburgh Department of Medicine, Renal-Electrolyte Division, Pittsburgh, PA, United States
| |
Collapse
|
10
|
Hypertension and cardiomyopathy associated with chronic kidney disease: epidemiology, pathogenesis and treatment considerations. J Hum Hypertens 2023; 37:1-19. [PMID: 36138105 PMCID: PMC9831930 DOI: 10.1038/s41371-022-00751-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 08/09/2022] [Accepted: 08/31/2022] [Indexed: 01/31/2023]
Abstract
Chronic kidney disease (CKD) is a complex condition with a prevalence of 10-15% worldwide. An inverse-graded relationship exists between cardiovascular events and mortality with kidney function which is independent of age, sex, and other risk factors. The proportion of deaths due to heart failure and sudden cardiac death increase with progression of chronic kidney disease with relatively fewer deaths from atheromatous, vasculo-occlusive processes. This phenomenon can largely be explained by the increased prevalence of CKD-associated cardiomyopathy with worsening kidney function. The key features of CKD-associated cardiomyopathy are increased left ventricular mass and left ventricular hypertrophy, diastolic and systolic left ventricular dysfunction, and profound cardiac fibrosis on histology. While these features have predominantly been described in patients with advanced kidney disease on dialysis treatment, patients with only mild to moderate renal impairment already exhibit structural and functional changes consistent with CKD-associated cardiomyopathy. In this review we discuss the key drivers of CKD-associated cardiomyopathy and the key role of hypertension in its pathogenesis. We also evaluate existing, as well as developing therapies in the treatment of CKD-associated cardiomyopathy.
Collapse
|
11
|
Association of plasma cystatin C with all-cause and cause-specific mortality among middle-aged and elderly individuals: a prospective community-based cohort study. Sci Rep 2022; 12:22265. [PMID: 36564420 PMCID: PMC9789032 DOI: 10.1038/s41598-022-24722-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 11/18/2022] [Indexed: 12/24/2022] Open
Abstract
We investigated the associations of plasma cystatin C with all-cause and cause-specific mortality risk and identified potential modifying factors affecting these associations in middle-aged and elderly people (≥ 50 years). This community-based prospective cohort study included 13,913 individuals aged ≥ 50 years from the Health and Retirement Study. Cox proportional hazard models were used to estimate the associations between cystatin C concentrations and the risk of all-cause and cardiovascular and cancer mortality after adjustment for sociodemographic characteristics, lifestyle factors, self-reported medical history, and other potential confounding factors. During a total of 71,988 person-years of follow-up (median: 5.8 years; interquartile range 3.3-7.6 years), 1893 all-cause deaths were documented, including 714 cardiovascular-related and 406 cancer-related deaths. The comparisons of the groups with the highest (quartile 4) and lowest (quartile 1) cystatin C concentrations revealed that the adjusted hazard ratios and 95% confidence intervals were 1.92 (1.62-2.28) for all-cause mortality, 1.98 (1.48-2.65) for cardiovascular mortality, and 1.62 (1.13-2.32) for cancer mortality. The associations of cystatin C concentrations with all-cause, cardiovascular and cancer mortality did not differ substantially when participants were stratified by sex, age, BMI, current smoking status, current alcohol consumption, and regular exercise (all P for interactions > 0.05). Our study indicates that an elevated plasma cystatin C concentration is associated with an increased risk of all-cause, cardiovascular and cancer mortality both men and women among the middle-aged and elderly individuals.
Collapse
|
12
|
Cardiometabolic Biomarkers and Habitual Caffeine Consumption Associate with the Adverse Ambulatory Blood Pressure Response to Strenuous Physical Exertion among Firefighters. Nutrients 2022; 14:nu14194025. [PMID: 36235676 PMCID: PMC9572770 DOI: 10.3390/nu14194025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 09/21/2022] [Accepted: 09/26/2022] [Indexed: 11/16/2022] Open
Abstract
Caffeine has beneficial effects on firefighter job performance reducing fatigue and improving psychomotor vigilance. However, excessive caffeine intake may raise blood pressure (BP) following a bout of acute exercise among adults with elevated BP. The influence of caffeine intake on the ambulatory BP (ABP) response to vigorous physical exertion among firefighters has not been studied. In this sub-study we conducted secondary statistical analyses from a larger clinical trial (NCT04514354) that included examining the influence of habitual caffeine intake, and cardiometabolic biomarkers shown to influence BP, on the ABP response following a bout of sudden vigorous exertion over 19 h among firefighters. Previously, we found high amounts of calcium and sodium intake raised BP following a bout of acute exercise among adults with elevated BP. Thus, other secondary aims were to examine the influence of habitual calcium and sodium intake, and cardiometabolic biomarkers have shown to influence BP, on the ABP response following sudden vigorous exertion over 19 h among firefighters. Firefighters (n = 15) completed a Food-Frequency Questionnaire assessing habitual dietary intake over the past year. They randomly completed a maximal graded exercise stress test (GEST) and non-exercise CONTROL on separate non-workdays leaving the laboratory wearing an ABP monitor for 19 h. Prior to and immediately after the GEST, fasting venous blood was collected to measure lipid-lipoproteins, c-reactive protein, and blood glucose. Height and weight were taken to calculate body mass index. Repeated measures ANCOVA tested if the ABP response differed after GEST vs. CONTROL. Linear mixed models examined the relationships among caffeine, calcium, sodium, cardiometabolic biomarkers, and the ABP response following GEST vs. CONTROL. Firefighters were middle-aged (40.2 ± 9.5 year), overweight (29.0 ± 3.9 kg/m2) men with elevated BP (124.1 ± 10.3/79.6 ± 11.5 mmHg) who consumed 542.0 ± 348.9 mg of caffeine/day, about ~50% more than the dietary reference intake. Unexpectedly, systolic ABP was higher by 18.0 ± 6.7 mmHg and diastolic ABP by 9.1 ± 5.4 mmHg (ps < 0.01) over 19 h following GEST vs. CONTROL. We found 24% of the variance in the adverse ABP response to maximal physical exertion was explained by caffeine intake, and when combined with c-reactive protein, non-high-density lipoprotein-cholesterol, body mass index, blood glucose, and resting heart rate, up to 74% of the variability in the ABP response was explained. Additionally, we found calcium (ps < 0.001) and sodium (p < 0.0001) intake each explained up to 24% of the ABP response. Further investigation is needed in a larger, more diverse sample of firefighters to better establish how caffeine contributes to the adverse BP response to strenuous physical exertion.
Collapse
|
13
|
Nielsen VW, Yao Y, Holm JG, Jørgensen AHR, Ring HC, Hornum M, Thomsen SF. Decreased glomerular function is associated with disease severity in patients with hidradenitis suppurativa. Health Sci Rep 2022; 5:e535. [PMID: 35284649 PMCID: PMC8902810 DOI: 10.1002/hsr2.535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 01/02/2022] [Accepted: 01/04/2022] [Indexed: 12/04/2022] Open
Affiliation(s)
- Valdemar W Nielsen
- Department of Dermato-Venereology and Wound Healing Centre Bispebjerg Hospital Copenhagen Denmark
| | - Yiqiu Yao
- Department of Dermato-Venereology and Wound Healing Centre Bispebjerg Hospital Copenhagen Denmark
| | - Jesper G Holm
- Department of Dermato-Venereology and Wound Healing Centre Bispebjerg Hospital Copenhagen Denmark
| | | | - Hans C Ring
- Department of Dermato-Venereology and Wound Healing Centre Bispebjerg Hospital Copenhagen Denmark
| | - Mads Hornum
- Department of Nephrology, Rigshospitalet University of Copenhagen Copenhagen Denmark.,Department of Clinical Medicine University of Copenhagen Copenhagen Denmark
| | - Simon F Thomsen
- Department of Dermato-Venereology and Wound Healing Centre Bispebjerg Hospital Copenhagen Denmark.,Department of Biomedical Sciences University of Copenhagen Copenhagen Denmark
| |
Collapse
|
14
|
Renoprotective Effect of KLF2 on Glomerular Endothelial Dysfunction in Hypertensive Nephropathy. Cells 2022; 11:cells11050762. [PMID: 35269384 PMCID: PMC8909753 DOI: 10.3390/cells11050762] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 02/18/2022] [Accepted: 02/18/2022] [Indexed: 11/17/2022] Open
Abstract
Kruppel-like factor 2 (KLF2) regulates endothelial cell metabolism; endothelial dysfunction is associated with hypertension and is a predictor of atherosclerosis development and cardiovascular events. Here, we investigated the role of KLF2 in hypertensive nephropathy by regulating KLF2 expression in human primary glomerular endothelial cells (hPGECs) and evaluating this expression in the kidney tissues of a 5/6 nephrectomy mouse model as well as patients with hypertension. Hypertension-mimicking devices and KLF2 siRNA were used to downregulate KLF2 expression, while the expression of KLF2 was upregulated by administering simvastatin. After 4 mmHg of pressure was applied on hPGECs for 48 h, KLF2 mRNA expression decreased, while alpha-smooth muscle actin (αSMA) mRNA expression increased. Apoptosis and fibrosis rates were increased under pressure, and these phenomena were aggravated following KLF2 knockdown, but were alleviated after simvastatin treatment; additionally, these changes were observed in angiotensin II, angiotensin type-1 receptor (AT1R) mRNA, and interleukin-18 (IL-18), but not in angiotensin type-2 receptor mRNA. Reduced expression of KLF2 in glomerular endothelial cells due to hypertension was found in both 5/6 nephrectomy mice and patients with hypertensive nephropathy. Thus, our study demonstrates that the pressure-induced apoptosis and fibrosis of glomerular endothelial cells result from angiotensin II, AT1R activation, and KLF2 inhibition, and are associated with IL-18.
Collapse
|
15
|
Zhu C, Zhang H, Shen Z, Chen J, Gu Y, Lv S, Li Y, Zhu B, Ding X, Zhang X. OUP accepted manuscript. Clin Kidney J 2022; 15:1322-1332. [PMID: 35756734 PMCID: PMC9217656 DOI: 10.1093/ckj/sfac070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Indexed: 11/14/2022] Open
Abstract
Background Methods Results Conclusions
Collapse
Affiliation(s)
| | | | - Ziyan Shen
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China
- Shanghai Medical Center of Kidney Disease, Shanghai, China
- Shanghai Institute of Kidney and Dialysis, Shanghai, China
| | - Jing Chen
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China
- Shanghai Medical Center of Kidney Disease, Shanghai, China
- Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China
| | - Yulu Gu
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China
- Shanghai Medical Center of Kidney Disease, Shanghai, China
- Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China
| | - Shiqi Lv
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China
- Shanghai Medical Center of Kidney Disease, Shanghai, China
- Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China
| | - Yang Li
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China
- Shanghai Medical Center of Kidney Disease, Shanghai, China
- Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China
| | - Bowen Zhu
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China
- Shanghai Medical Center of Kidney Disease, Shanghai, China
- Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China
| | | | | |
Collapse
|
16
|
Jung E, Ro YS, Ryu HH, Kong SY, Shin SD, Hwang SO. Cystatin C and mortality risk in the general population: systematic review and dose response meta-analysis. Biomarkers 2021; 27:222-229. [PMID: 34847805 DOI: 10.1080/1354750x.2021.1989489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Affiliation(s)
- Eujene Jung
- Department of Emergency medicine, Chonnam National University Hospital, South Korea
| | - Young Sun Ro
- Department of Emergency Medicine, Seoul National University College of Medicine, South Korea
| | - Hyun Ho Ryu
- Department of Emergency medicine, Chonnam National University Hospital, South Korea.,Chonnam National University College of Medicine, South Korea
| | | | - Sang Do Shin
- Department of Emergency Medicine, Seoul National University College of Medicine, South Korea
| | - Sung Oh Hwang
- Department of Emergency Medicine, Yonsei University Wonju College of Medicine, South Korea
| |
Collapse
|
17
|
Liu J, Cheng NN, Zhou ZY, Zhang Y, Yang J, Liu LS, Song Y, Huang X, Tang GF, Wang BY, Qin XH, Xu XP, Kong XQ. Effect of fasting blood glucose on risk of new-onset hypertension in rural Chinese population: a 15-year follow-up cohort. BMC Cardiovasc Disord 2021; 21:531. [PMID: 34749652 PMCID: PMC8573915 DOI: 10.1186/s12872-021-02336-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 10/20/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The purpose of this study was to examine the correlation between fasting blood glucose and new-onset hypertension and examine any synergistically effect modification with multiple risk factors. METHODS We conducted post-hoc analyses of repeated-measures data in the original Dongzhi osteoporosis cohort study. In total, 3985 participants without hypertension aged 25-64 years were included in the current analyses. Generalized estimating equation models were used to assess the relationship between fasting blood glucose and risk of new-onset hypertension after adjusting for pertinent covariates and autocorrelations among siblings. RESULTS 393 men (19.4%) and 398 women (20.3%) without hypertension at the baseline developed hypertension by the end of the study period. Compared to lower baseline fasting blood glucose levels (Q1-Q3: < 5.74 mmol/L; clinical cut points: < 5.6 mmol/L), higher baseline fasting blood glucose levels (Q4: ≥ 5.74 mmol/L; clinical cut points: ≥ 5.6 mmol/L and < 7.0 mmol/L) increased the risk of new-onset hypertension significantly [(OR: 1.54, 95% CI 1.19-1.98, P < 0.001); (OR: 1.38, 95% CI 1.09-1.75, P = 0.008)] in women. Additionally, a stronger significant association was found in women with elevated fasting blood glucose on risk of new-onset of hypertension with higher total cholesterol (≥ 5.2 mmol/L) [(OR: 2.76; 95% CI: (1.54, 4.96), P < 0.001)]. However, no association was found between fasting blood glucose and risk of new-onset hypertension in men. CONCLUSIONS High fasting blood glucose may be significantly associated with risk of new-onset hypertension in Chinese women, especially in women with higher total cholesterol. Further randomized studies are needed to confirm our findings.
Collapse
Affiliation(s)
- Jing Liu
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu, People's Republic of China
| | - Nan N Cheng
- State Key Laboratory of Natural Medicines, Research Center of Biostatistics and Computational Pharmacy, China Pharmaceutical University, Nanjing, 210009, People's Republic of China
| | - Zi Y Zhou
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, People's Republic of China
| | - Yue Zhang
- State Key Laboratory of Natural Medicines, Research Center of Biostatistics and Computational Pharmacy, China Pharmaceutical University, Nanjing, 210009, People's Republic of China
| | - Jie Yang
- State Key Laboratory of Natural Medicines, Research Center of Biostatistics and Computational Pharmacy, China Pharmaceutical University, Nanjing, 210009, People's Republic of China
| | - Li S Liu
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, People's Republic of China
| | - Yun Song
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, People's Republic of China.,School of Health Administration, Anhui Medical University, Hefei, People's Republic of China
| | - Xiao Huang
- Department of Cardiovascular Medicine, Second Affiliated Hospital of Nanchang University, Nanchang, People's Republic of China
| | - Gen F Tang
- School of Health Administration, Anhui Medical University, Hefei, People's Republic of China
| | - Bin Y Wang
- School of Health Administration, Anhui Medical University, Hefei, People's Republic of China
| | - Xian H Qin
- National Clinical Research Study Center for Kidney Disease, The State Key Laboratory for Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, People's Republic of China
| | - Xi P Xu
- National Clinical Research Study Center for Kidney Disease, The State Key Laboratory for Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, People's Republic of China
| | - Xiang Q Kong
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu, People's Republic of China.
| |
Collapse
|
18
|
Association between socioeconomic position and cystatin C in the Heinz Nixdorf Recall Study. Sci Rep 2021; 11:19387. [PMID: 34588554 PMCID: PMC8481271 DOI: 10.1038/s41598-021-98835-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 09/15/2021] [Indexed: 11/21/2022] Open
Abstract
Social inequalities in health and disease are well studied. Less information is available on inequalities in biomarker levels indicating subclinical stages of disease such as cystatin C, an early diagnostic marker of renal dysfunction and predictor for cardiovascular disease. We evaluated the relationship between cystatin C, socioeconomic position (SEP) and established cardiovascular risk factors in a population-based study. In 4475 men and women aged 45–75 years participating in the baseline examination of the Heinz Nixdorf Recall Study cystatin C was measured from serum samples with a nephelometric assay. SEP was assessed by education and household income. Linear regression models were used to analyse the association between SEP and cystatin C as well as the impact of cardiovascular risk factors (i.e., body mass index, blood pressure, blood glucose, diabetes mellitus, blood lipids, C-reactive protein, smoking) on this association. After adjustment for age and sex cystatin C decreased by 0.019 mg/l (95% confidence interval (CI) − 0.030 to − 0.008) per five years of education. While using a categorical education variable cystatin C presented 0.039 mg/l (95% CI 0.017–0.061) higher in men and women in the lowest educational category (≤ 10 years of education) compared to the highest category (≥ 18 years). Concerning income, cystatin C decreased by 0.014 mg/l (95% CI − 0.021 to − 0.006) per 1000 € after adjustment for age and sex. For men and women in the lowest income quartile cystatin C was 0.024 mg/l (95% CI 0.009–0.038) higher compared to the highest income quartile. After adjusting for established cardiovascular risk factors the observed associations were substantially diminished. Social inequalities seem to play a role in subclinical stages of renal dysfunction, which are also related to development of cardiovascular disease. Adjustment for traditional cardiovascular risk factors showed that these risk factors largely explain the association between SEP and cystatin C.
Collapse
|
19
|
Wang H, Ji X, Wang AY, Wu PK, Liu Z, Dong L, Liu J, Duan M. Epidemiology of Sepsis-Associated Acute Kidney Injury in Beijing, China: A Descriptive Analysis. Int J Gen Med 2021; 14:5631-5649. [PMID: 34548815 PMCID: PMC8449640 DOI: 10.2147/ijgm.s320768] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 08/20/2021] [Indexed: 12/12/2022] Open
Abstract
Background Sepsis is the most common contributing factor towards development of acute kidney injury (AKI), which is strongly associated to poor prognostic outcomes. There are numerous epidemiological studies about sepsis-associated acute kidney injury (S-AKI), however current literature is limited with the majority of studies being conducted only in the intensive care unit (ICU) setting. The aim of this study was to assess the epidemiology of S-AKI in all hospitalized in-patients. Methods This was a retrospective population-based study using a large regional population database in Beijing city from January, 2005 to December, 2017. It included patients with S-AKI. Patients with pre-existing end-stage kidney disease (ESKD), previous history of kidney transplantation, or being pregnant were excluded. Patients’ demographic characteristics, incidence, risk factors and outcomes of S-AKI were analyzed. The contrast between different time periods, different levels of hospitals, and types of the hospitals (traditional Chinese medicine hospitals (TCMHs) and western medicine hospitals (WMHs)) was also compared using Mann–Whitney U-test. Results A total of 19,579 patients were included. The overall incidence of S-AKI in all in-patients was 48.1%. The significant risk factors by multivariate analysis for AKI included: age, male, being treated in a level-II hospital, pre-existing hypertension, chronic kidney disease (CKD), cirrhosis, atrial fibrillation (AF), ischemic heart disease (IHD), being admitted from emergency room, ICU admission, shock, pneumonia, intra-abdominal infection, bloodstream infection, respiratory insufficiency, acute liver injury, disseminated intravascular coagulation (DIC) and metabolic encephalopathy. The overall mortality rate in this cohort was 55%. The multivariate analysis showed that the significant risk factors for mortality included: age, being treated in a level-II hospital and TCMHs, being admitted from emergency room, pre-existing comorbidities (CKD, malignancy, cirrhosis and AF), shock, pneumonia, intra-abdominal infection, bloodstream infection, central nervous system (CNS) infection and respiratory insufficiency. Conclusion AKI is a common complication in patients with sepsis, and its incidence increases over time, especially when ICU admission is required. Exploring interventional strategies to address modifiable risk factors will be important to reduce incidence and mortality of S-AKI.
Collapse
Affiliation(s)
- Haiman Wang
- Department of Intensive Care Unit, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, People's Republic of China
| | - Xiaojun Ji
- Department of Intensive Care Unit, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, People's Republic of China
| | - Amanda Ying Wang
- Division of the Renal and Metabolic, George Institute for Global Health, The University of New South Wales, Sydney, New South Wales, Australia.,Concord Clinical School, the University of Sydney, Sydney, Australia.,Department of Renal Medicine, Concord Repatriation General Hospital, Concord, Australia
| | | | - Zhuang Liu
- Department of Intensive Care Unit, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, People's Republic of China
| | - Lei Dong
- Department of Intensive Care Unit, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, People's Republic of China
| | - Jingfeng Liu
- Department of Intensive Care Unit, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, People's Republic of China
| | - Meili Duan
- Department of Intensive Care Unit, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, People's Republic of China
| |
Collapse
|
20
|
Zheng X, She HD, Zhang QX, Si T, Wu KS, Xiao YX. Cystatin C predicts the risk of incident cerebrovascular disease in the elderly: A meta-analysis on survival date studies. Medicine (Baltimore) 2021; 100:e26617. [PMID: 34260548 PMCID: PMC8284707 DOI: 10.1097/md.0000000000026617] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Revised: 05/26/2021] [Accepted: 06/22/2021] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Stroke is the third leading cause of global year of life lost in all-age and second-ranked cause of disability adjusted life years in middle-aged and elder population. Therefore, it is critical to study the relationship between vascular-related risk factors and cerebrovascular diseases. Several cross-sectional studies have shown that Cystatin C (Cys C) is an independent risk factor for cerebrovascular diseases and levels of Cys C are significantly higher in stroke patients than in healthy individuals. In this meta-analysis, we introduce a Cox proportional hazards model to evaluate the causality between Cys C and the risk of cerebrovascular accident in the elderly. METHODS We searched PubMed, EMBASE, the Web of Science, and the Cochrane Library from 1985 to 2019 for studies on the relationship between serum Cys C and incidence stroke with Cox proportional hazards models. We conducted a subgroup analysis of the selected studies to determine a connection between atherosclerosis and stroke. Finally, 7 research studies, including 26,768 patients without a history of cerebrovascular, were studied. RESULTS After comparing the maximum and minimum Cys C levels, the hazard ratio for all types of stroke, including ischemic and hemorrhagic stroke, was 1.18 (95% confidence interval 1.04-1.31) with moderate heterogeneity (I2 = 43.0%; P = .119) in a fixed-effect model after pooled adjustment for other potential risk factors. In the subgroup analysis, the hazard ratio and 95% confidence interval for Cys C stratified by atherosclerosis was 1.85 (0.97-2.72). As shown in Egger linear regression test, there was no distinct publication bias (P = .153). CONCLUSION Increased serum Cys C is significantly associated with future stroke events in the elderly, especially in patients with carotid atherosclerosis. Thus, serum levels of Cys C could serve as a predicted biomarker for stroke attack.
Collapse
Affiliation(s)
- Xin Zheng
- Department of Neurology, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong
| | - Hong-da She
- Department of Neurology, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong
| | - Qiao-xin Zhang
- Department of Neurology, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong
| | - Tong Si
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing
| | - Ku-sheng Wu
- Department of Public and preventive medicine, Shantou University Medical College, Shantou, Guangdong, China
| | - Ying-xiu Xiao
- Department of Neurology, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong
| |
Collapse
|
21
|
Jin H, Zhou J, Wu C. Prevalence and health correlates of reduced kidney function among community-dwelling Chinese older adults: the China Health and Retirement Longitudinal Study. BMJ Open 2020; 10:e042396. [PMID: 33303467 PMCID: PMC7733173 DOI: 10.1136/bmjopen-2020-042396] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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 We aimed to understand the prevalence of reduced kidney function in China by sociodemographics and geographical region, and to examine health correlates of reduced kidney function. DESIGN Cross-sectional study. SETTING AND PARTICIPANTS Participants were 6706 adults ≥60 years from the 2015-2016 wave of the China Health and Retirement Longitudinal Study. OUTCOME MEASURES Reduced kidney function was defined as an estimated glomerular filtration rate of less than 60 mL/min per 1.73 m². The estimated glomerular filtration rate was calculated with the creatinine-cystatin C equation developed by the Chronic Kidney Disease Epidemiology Collaboration in 2012. The associations between reduced kidney function and potential risk factors were analysed using multivariable regression models. RESULTS The prevalence of reduced kidney function was 10.3% (95% CI: 9.3% to 11.2%), corresponding to approximately 20 million older adults. Multivariable analysis showed that older adults with hypertension (β=-3.61, 95% CI: -4.42 to 2.79), cardiac disease (β=-1.90, 95% CI: -2.93 to 0.86), who had a stroke (β=-3.75, 95% CI: -6.35 to 1.15), kidney disease (β=-3.88, 95% CI: -5.62 to 2.13), slow gait speed (β=-2.23, 95% CI: -3.27 to 1.20), and living in the South (β=-4.38, 95% CI: -5.95 to 2.80) and South Central (β=-1.85, 95% CI: -3.15 to 0.56) were more significantly likely to have reduced kidney function. CONCLUSIONS Kidney function screening should be performed, especially in patients with hypertension, cardiac disease and who had a stroke. More efforts should be paid to improve the kidney function of older adults living in the South and South Central parts of China.
Collapse
Affiliation(s)
- Haiyu Jin
- Global Health Research Center, Duke Kunshan University, Kunshan, Jiangsu, China
| | - Jingyi Zhou
- Kidney Disease Center, Zhejiang University School of Medicine First Affiliated Hospital, Hangzhou, Zhejiang, China
| | - Chenkai Wu
- Global Health Research Center, Duke Kunshan University, Kunshan, Jiangsu, China
| |
Collapse
|
22
|
Cystatin C and uncontrolled hypertension. Anatol J Cardiol 2020; 24:309-315. [PMID: 33122483 PMCID: PMC7724385 DOI: 10.14744/anatoljcardiol.2020.78974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Objective: Increased serum level of cystatin C, a sensitive biomarker for renal function, seems to predict adverse cardiovascular events. We investigated the predictive value of serum cystatin C for controlling hypertension in an observational study. Methods: We screened 1037 adults residing in both rural and urban communities. They were grouped based on their diagnosis and control of hypertension. Results: Serum cystatin C levels in patients with uncontrolled hypertension were higher than those in patients with controlled hypertension (0.98±0.23 mg/L vs. 0.89±0.19 mg/L, p=0.001). However, serum creatinine levels were similar between these groups (0.72±0.20 mg/dL vs. 0.70±0.18 mg/dL, p=0.89). Serum cystatin C levels increased the probability of uncontrolled hypertension independent from confounding factors (odds ratio, 1.48; 95% confidence interval, 1.09–5.64; p=0.03). Conclusion: Subtle kidney dysfunction may be detected using serum cystatin C concentrations among patients with poor blood pressure control and normal serum creatinine levels.
Collapse
|
23
|
Liu CS, Li CI, Guo YC, Lin CH, Lin WY, Liu CH, Wang MC, Yang CW, Yang SY, Li TC, Lin CC. Independent associations of urinary albumin-to-creatinine ratio and serum cystatin C with carotid intima-media thickness in community-living Taiwanese adults. BMC Nephrol 2020; 21:454. [PMID: 33129312 PMCID: PMC7603773 DOI: 10.1186/s12882-020-02123-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 10/26/2020] [Indexed: 11/29/2022] Open
Abstract
Background Renal function is a key factor of cardiovascular disease. Carotid intima-media thickness (IMT) has been widely used as a marker of early subclinical atherosclerosis. The determinants of cystatin C, a novel marker of renal function, have not been extensively studied in the Asian population. This study aimed to assess the determinants of cystatin C and explore whether carotid thickening was associated with urinary albumin-creatinine ratio and cystatin C in community-living Taiwanese adults. Methods A cross-sectional study was conducted on participants from Taichung City, Taiwan. All the participants underwent carotid ultrasonography. Carotid IMT-mean and IMT-maximum were derived. Kidney biomarkers were measured on the basis of urinary albumin-to-creatinine ratio (ACR) and cystatin C. Multiple linear regression analysis was used. Results A total of 1032 individuals were recruited, and 469 (45.44%) of them were men. An increased cystatin C level was significantly associated with older age, male gender, lack of physical activity, low HDL cholesterol, abdominal obesity, high hs-CRP, and high ACR. The multivariate-adjusted mean carotid IMT-mean and IMT-maximum values significantly increased by 80.49 and 195.23 μm for every one unit of increase in cystatin C level and by 0.07 and 0.14 μm for every one unit of increase in ACR, respectively (all p < 0.001 except ACR on IMT-maximum with p < 0.01). Lack of physical activity, low HDL, abdominal obesity, high hs-CRP, and high ACR were the determinants of cystatin C. Conclusion Cystatin C and ACR were strongly and linearly associated with carotid thickening, a marker of subclinical atherosclerosis. Supplementary Information The online version contains supplementary material available at 10.1186/s12882-020-02123-x.
Collapse
Affiliation(s)
- Chiu-Shong Liu
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.,Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Chia-Ing Li
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.,Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Yuh-Cherng Guo
- Department of Neurology, China Medical University Hospital, Taichung, Taiwan
| | - Chih-Hsueh Lin
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.,Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Wen-Yuan Lin
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.,Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Chung-Hsiang Liu
- Department of Neurology, China Medical University Hospital, Taichung, Taiwan
| | - Mu-Cyun Wang
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.,Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Chuan-Wei Yang
- Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Shing-Yu Yang
- Department of Public Health, College of Public Health, China Medical University, 91 Hsueh-Shih Road, Taichung, 40421, Taiwan
| | - Tsai-Chung Li
- Department of Public Health, College of Public Health, China Medical University, 91 Hsueh-Shih Road, Taichung, 40421, Taiwan. .,Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan.
| | - Cheng-Chieh Lin
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.,Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan.,Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| |
Collapse
|
24
|
Zhao M, Che Q, Zhang Y, Qian X, Huang T. Expression and clinical significance of serum cystatin C in patients with hypertension and coronary heart disease. Medicine (Baltimore) 2020; 99:e20029. [PMID: 32481372 DOI: 10.1097/md.0000000000020029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
The aim of this study is to explore the potential association between cystatin C (Cys-c) and coronary heart disease (CHD) in hypertensive patients.In this study, circulating levels of Cys-c in 62 essential hypertension (EH) patients, 147 hypertension with coronary heart disease (EH + CHD) patients, and 60 healthy volunteers were investigated using immunoturbidimetry. Then, we analyzed the correlations between Cys-C and other clinical parameters.Serum Cys-C level was significantly higher in the EH and EH + CHD groups than in the control group, and higher in the EH + CHD group than in the EH group. Receiver operating characteristic curve (ROC) analysis showed that the diagnostic value of Cys-C for patients with hypertension combined CHD was 0.871(95% CI: 0.818-0.913). Serum Cys-C level was significantly higher in the double-vessel disease group and multi-vessel disease group than in the single-vessel disease group, and higher in the multi-vessel disease group than in the double-vessel disease group. Urinary albumin and CRP correlated positively with Cys-C, and HDL correlated negatively with Cys-C. Cys-C was an independent risk factor for CHD in hypertensive patients.Our results suggested that circulating Cys-C levels was up-regulated in patients with hypertension and CHD, and had correlation with the severity of coronary artery disease. As one of the important risk factors for CHD, Cys-C can predict the occurrence of CHD in patients with hypertension.
Collapse
Affiliation(s)
| | | | | | | | - Tong Huang
- NingBo First Hospital, Ningbo, Zhejiang, China
| |
Collapse
|
25
|
Yu Z, Coresh J, Qi G, Grams M, Boerwinkle E, Snieder H, Teumer A, Pattaro C, Köttgen A, Chatterjee N, Tin A. A bidirectional Mendelian randomization study supports causal effects of kidney function on blood pressure. Kidney Int 2020; 98:708-716. [PMID: 32454124 DOI: 10.1016/j.kint.2020.04.044] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 03/12/2020] [Accepted: 04/09/2020] [Indexed: 12/11/2022]
Abstract
Blood pressure and kidney function have a bidirectional relation. Hypertension has long been considered as a risk factor for kidney function decline. However, whether intensive blood pressure control could promote kidney health has been uncertain. The kidney is known to have a major role in affecting blood pressure through sodium extraction and regulating electrolyte balance. This bidirectional relation makes causal inference between these two traits difficult. Therefore, to examine the causal relations between these two traits, we performed two-sample Mendelian randomization analyses using summary statistics of large-scale genome-wide association studies. We selected genetic instruments more likely to be specific for kidney function using meta-analyses of complementary kidney function biomarkers (glomerular filtration rate estimated from serum creatinine [eGFRcr], and blood urea nitrogen from the CKDGen Consortium). Systolic and diastolic blood pressure summary statistics were from the International Consortium for Blood Pressure and UK Biobank. Significant evidence supported the causal effects of higher kidney function on lower blood pressure. Based on the mode-based Mendelian randomization method, the effect estimates for one standard deviation (SD) higher in log-transformed eGFRcr was -0.17 SD unit (95 % confidence interval: -0.09 to -0.24) in systolic blood pressure and -0.15 SD unit (95% confidence interval: -0.07 to -0.22) in diastolic blood pressure. In contrast, the causal effects of blood pressure on kidney function were not statistically significant. Thus, our results support causal effects of higher kidney function on lower blood pressure and suggest preventing kidney function decline can reduce the public health burden of hypertension.
Collapse
Affiliation(s)
- Zhi Yu
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA; Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, Maryland, USA
| | - Josef Coresh
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA; Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, Maryland, USA
| | - Guanghao Qi
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Morgan Grams
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, Maryland, USA; Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Eric Boerwinkle
- Human Genetics Center, University of Texas Health Science Center at Houston, Houston, Texas, USA; Human Genome Sequencing Center, Baylor College of Medicine, Houston, Texas, USA
| | - Harold Snieder
- Department of Epidemiology, University Medical Centre Groningen, Groningen, The Netherlands
| | - Alexander Teumer
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany; DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, Greifswald, Germany
| | - Cristian Pattaro
- Eurac Research, Institute for Biomedicine (affiliated to the University of Lübeck), Bolzano, Italy
| | - Anna Köttgen
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA; Institute of Genetic Epidemiology, Department of Biometry, Epidemiology and Medical Bioinformatics, Faculty of Medicine and Medical Centre - University of Freiburg, Freiburg, Germany
| | - Nilanjan Chatterjee
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA; Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Adrienne Tin
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA; Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, Maryland, USA; Division of Nephrology, Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA.
| |
Collapse
|
26
|
Abstract
Chronic kidney disease (CKD) is an increasingly prevalent condition globally and is strongly associated with incident cardiovascular disease (CVD). Hypertension is both a cause and effect of CKD and affects the vast majority of CKD patients. Control of hypertension is important in those with CKD as it leads to slowing of disease progression as well as reduced CVD risk. Existing guidelines do not offer a consensus on optimal blood pressure (BP) targets. Therefore, an understanding of the evidence used to create these guidelines is vital when considering how best to manage individual patients. Non-pharmacological interventions are useful in reducing BP in CKD but are rarely sufficient to control BP adequately. Patients with CKD and hypertension will often require a combination of antihypertensive medications to achieve target BP. Certain pharmacological therapies provide additional BP-independent renoprotective and/or cardioprotective action and this must be considered when instituting therapy. Managing hypertension in the context of haemodialysis and following kidney transplantation presents further challenges. Novel therapies may enhance treatment in the near future. Importantly, a personalised and evidence-based management plan remains key to achieving BP targets, reducing CVD risk and slowing progression of CKD.
Collapse
Affiliation(s)
- Dan Pugh
- University/BHF Centre for Cardiovascular Science, The Queen's Medical Research Institute, University of Edinburgh, 47 Little France Crescent, Edinburgh, EH16 4TJ, Scotland, UK.,Department of Renal Medicine, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - Peter J Gallacher
- University/BHF Centre for Cardiovascular Science, The Queen's Medical Research Institute, University of Edinburgh, 47 Little France Crescent, Edinburgh, EH16 4TJ, Scotland, UK
| | - Neeraj Dhaun
- University/BHF Centre for Cardiovascular Science, The Queen's Medical Research Institute, University of Edinburgh, 47 Little France Crescent, Edinburgh, EH16 4TJ, Scotland, UK. .,Department of Renal Medicine, Royal Infirmary of Edinburgh, Edinburgh, UK.
| |
Collapse
|
27
|
Shen Y, Zhang Y, Xiong S, Zhu X, Ke C. High-sensitivity C-reactive protein and cystatin C independently and jointly predict all-cause mortality among the middle-aged and elderly Chinese population. Clin Biochem 2019; 65:7-14. [DOI: 10.1016/j.clinbiochem.2018.12.012] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 12/22/2018] [Accepted: 12/24/2018] [Indexed: 02/05/2023]
|
28
|
Cystatin C and risk of new-onset depressive symptoms among individuals with a normal creatinine-based estimated glomerular filtration rate: A prospective cohort study. Psychiatry Res 2019; 273:75-81. [PMID: 30640054 DOI: 10.1016/j.psychres.2019.01.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2018] [Revised: 01/02/2019] [Accepted: 01/02/2019] [Indexed: 01/09/2023]
Abstract
The association between cystatin C and depressive symptoms in the general population has not been thoroughly elucidated to date. We investigated the association of cystatin C with new-onset depressive symptoms among individuals with normal creatinine-based estimated glomerular filtration rates (eGFR). In the China Health and Retirement Longitudinal Study, 5111 participants without depressive symptoms or renal dysfunction (eGFR < 60 ml/min/1.73 m2) were included. The outcome was new-onset depressive symptoms over 4 years, defined as a score of ≥12 on the 10-item Center for Epidemiologic Studies Depressive Symptoms Scale. The incidence risk ratio (IRR) and 95% confidence interval (CI) were calculated using modified Poisson regression models. During a 4-year follow-up period, 1746 (34.16%) incidents of depressive symptoms occurred. In a multivariable-adjusted model, the risk of incident depressive symptoms was 1.07 (95% CI 1.02-1.11) per-SD change in cystatin C. A greater cystatin C level was associated with a higher risk of new-onset depressive symptoms among subjects with relatively normal renal function.
Collapse
|
29
|
Ku E, Vittinghoff E, Jacobs DR, Lewis CE, Allen NB, Bibbins-Domingo K, Shlipak M, Kramer H, Peralta CA. Changes in Blood Pressure During Young Adulthood and Subsequent Kidney Function Decline: Findings From the Coronary Artery Risk Development in Young Adulthood (CARDIA) Study. Am J Kidney Dis 2018; 72:243-250. [PMID: 29510922 PMCID: PMC6057820 DOI: 10.1053/j.ajkd.2017.12.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Accepted: 12/22/2017] [Indexed: 11/11/2022]
Abstract
BACKGROUND Many studies have focused on the association between a single blood pressure (BP) measurement and risk for adverse outcomes. However, the association of BP trajectories during young adulthood with subsequent decline in kidney function has not been well defined. STUDY DESIGN Observational cohort study. SETTING & PARTICIPANTS 3,429 participants in the Coronary Artery Risk Development in Young Adulthood (CARDIA) Study enrolled between the ages of 18 and 30 years. PREDICTORS BP slope during the first 10 years of participation in CARDIA, derived from linear mixed models incorporating all repeated BP measures. OUTCOME Decline in estimated glomerular filtration rate (eGFR) during the interval between years 10 and 20 of CARDIA participation using cystatin C measured at years 10, 15, and 20. RESULTS Mean age of CARDIA participants at year 0 was 25.1 years, 56% were women, and 53% were white. Every 10-mmHg higher level of systolic (SBP) and diastolic BP (DBP) in year 10 was associated with change in eGFR of -0.09 (95% CI, -0.13 to -0.06) and -0.07 (95% CI, -0.12 to -0.03) mL/min/1.73m2 per year, respectively. Every 10-mmHg increase in SBP slope between years 0 and 10 was associated with a subsequent -0.52 (95% CI, -1.02 to -0.03) mL/min/1.73m2 per year change in kidney function after adjustment for comorbid conditions and SBP at year 10. Similarly, every 10-mmHg increase in DBP slope between years 0 and 10 was associated with a subsequent change in kidney function of -0.65 (95% CI, -1.23 to -0.07) mL/min/1.73m2 per year, after adjustment for comorbid conditions and DBP in year 10. LIMITATIONS Observational design. CONCLUSIONS During young adulthood, increasing SBP and DBP are associated with a higher rate of subsequent kidney function decline, independent of BP measured at the beginning of eGFR assessment.
Collapse
Affiliation(s)
- Elaine Ku
- Division of Nephrology, Department of Medicine, University of California, San Francisco, CA; Division of Pediatric Nephrology, Department of Pediatrics, University of California, San Francisco, CA.
| | - Eric Vittinghoff
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA
| | - David R Jacobs
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, MN
| | - Cora E Lewis
- Division of Preventive Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL
| | - Norrina B Allen
- Department of Preventive Medicine and Medicine, Northwestern University, Chicago, IL
| | - Kirsten Bibbins-Domingo
- Division of General Internal Medicine, Departments of Medicine and Epidemiology and Biostatistics, San Francisco General Hospital, San Francisco, CA
| | - Michael Shlipak
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA; Division of General Internal Medicine, San Francisco Veterans Affair Medical Center, San Francisco, CA; and Department of Medicine and Kidney Health Research Collaborative
| | - Holly Kramer
- Division of Nephrology, Department of Medicine, Loyola Medicine, Chicago, IL
| | - Carmen A Peralta
- Division of Nephrology, Department of Medicine, University of California, San Francisco, CA; Department of Epidemiology and Biostatistics, University of California, San Francisco, CA; Division of General Internal Medicine, San Francisco Veterans Affair Medical Center, San Francisco, CA; and Department of Medicine and Kidney Health Research Collaborative
| |
Collapse
|
30
|
Vakili H, Mohamadian A, Naderian M, Khaheshi I. Cystatin C may not be a precious predictor for coronary artery disease and its severity: an area of uncertainty. ACTA BIO-MEDICA : ATENEI PARMENSIS 2018; 89:209-213. [PMID: 29957753 PMCID: PMC6179010 DOI: 10.23750/abm.v89i2.5495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Accepted: 06/23/2016] [Indexed: 11/23/2022]
Abstract
Background and Aim: Cystatin C, an endogenous indicator for kidney function, may be also an original indicator for coronary atherosclerosis. In the current study, we intended to assess its role in establishing the existence of coronary artery disease. We also attempted to present the best cut off point for Cystatin C to discriminate coronary disease from normal coronary condition. Methods: 147 consecutive patients who were candidate for coronary angiography were included into the study. Cystatin C was measured using Auto-analyzer system and by Gentian kit with enzyme calorimetric method. Results: The mean level of Cystatin C in the patients with and without coronary artery disease was 0.97±0.51 mg/l and 1.02±0.40 mg/l with no significant difference (p=0.564). In multivariate logistic regression model, the serum level of Cystatin C could not predict coronary artery disease (OR=1.199, 95% CI: 0.531 to 1.706, p=0.662). According to the area under the ROC curve, Cystatin C was not a good indicator to discriminate coronary artery disease from normal coronary condition (AUC=0.465, 95% CI: 0.372 to 0.559, p=0.470). Considering cut of points of 0.85 and 0.94 for Cystatin C, the sensitivity of this test for predicting coronary artery disease in comparison with coronary angiography was 65% and 51%, respectively. In assessing relationship between serum level of Cystatin C and other chemical biomarkers, Cystatin C was only correlated with serum triglyceride level (r=0.207, p=0.012). Conclusions: Cystatin C measurement may not be a suitable predictor for coronary artery disease and severity of the coronary involvement. Future studies with large sample size are necessitated to demarcate distinct role of Cystatin C in coronary artery disease. (www.actabiomedica.it)
Collapse
Affiliation(s)
- Hossein Vakili
- Cardiovascular Research Center, Modarres hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran..
| | - Abdollah Mohamadian
- Cardiovascular Research Center, Modarres hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran..
| | - Mohammadreza Naderian
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran..
| | - Isa Khaheshi
- Cardiovascular Research Center, Modarres hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran..
| |
Collapse
|
31
|
Yang W, Zhang S, Zhang S, Zhu Y. Relation between serum cystatin C level and brachial-ankle pulse wave velocity in Chinese general population. Clin Exp Hypertens 2018; 40:203-206. [PMID: 29485915 DOI: 10.1080/10641963.2016.1248769] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND The purpose of the study is to evaluate whether serum cystatin C level is associated with arterial stiffness independent of other risk factors in Chinese general population. HYPOTHESIS Cystatin C is a predictable marker of arterial stiffness in Chinese general population. METHODS Subjects are 748 persons (mean age, 38.8years) who attended a health checkup in Beijing, China. We measured brachial-ankle PWV (baPWV) by using an automatic oscillometric method, and the concentration of serum cystatin C was quantified. RESULTS The level of baPWV showed a significantly positive correlation with BMI, SBP, DBP, TG, TC, cystatin C (r = 0.251, p < 0.001), and a negative correlation with HDL-C. And when adjustment for age, BMI, and cigarette smoking, these correlations remain significantly. CONCLUSION Arterial stiffness increases with an increase in serum cystatin C level in Chinese general population with normal renal function.
Collapse
Affiliation(s)
- Wei Yang
- a China Rehabilitation Research Center , Beijing , China
| | - Shuyang Zhang
- b Peking Union Medical College Hospital, Dongcheng-qu , China
| | - Shengyu Zhang
- b Peking Union Medical College Hospital, Dongcheng-qu , China
| | - Yuanyuan Zhu
- b Peking Union Medical College Hospital, Dongcheng-qu , China
| |
Collapse
|
32
|
Saik OV, Demenkov PS, Ivanisenko TV, Bragina EY, Freidin MB, Goncharova IA, Dosenko VE, Zolotareva OI, Hofestaedt R, Lavrik IN, Rogaev EI, Ivanisenko VA. Novel candidate genes important for asthma and hypertension comorbidity revealed from associative gene networks. BMC Med Genomics 2018; 11:15. [PMID: 29504915 PMCID: PMC6389037 DOI: 10.1186/s12920-018-0331-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Hypertension and bronchial asthma are a major issue for people's health. As of 2014, approximately one billion adults, or ~ 22% of the world population, have had hypertension. As of 2011, 235-330 million people globally have been affected by asthma and approximately 250,000-345,000 people have died each year from the disease. The development of the effective treatment therapies against these diseases is complicated by their comorbidity features. This is often a major problem in diagnosis and their treatment. Hence, in this study the bioinformatical methodology for the analysis of the comorbidity of these two diseases have been developed. As such, the search for candidate genes related to the comorbid conditions of asthma and hypertension can help in elucidating the molecular mechanisms underlying the comorbid condition of these two diseases, and can also be useful for genotyping and identifying new drug targets. RESULTS Using ANDSystem, the reconstruction and analysis of gene networks associated with asthma and hypertension was carried out. The gene network of asthma included 755 genes/proteins and 62,603 interactions, while the gene network of hypertension - 713 genes/proteins and 45,479 interactions. Two hundred and five genes/proteins and 9638 interactions were shared between asthma and hypertension. An approach for ranking genes implicated in the comorbid condition of two diseases was proposed. The approach is based on nine criteria for ranking genes by their importance, including standard methods of gene prioritization (Endeavor, ToppGene) as well as original criteria that take into account the characteristics of an associative gene network and the presence of known polymorphisms in the analysed genes. According to the proposed approach, the genes IL10, TLR4, and CAT had the highest priority in the development of comorbidity of these two diseases. Additionally, it was revealed that the list of top genes is enriched with apoptotic genes and genes involved in biological processes related to the functioning of central nervous system. CONCLUSIONS The application of methods of reconstruction and analysis of gene networks is a productive tool for studying the molecular mechanisms of comorbid conditions. The method put forth to rank genes by their importance to the comorbid condition of asthma and hypertension was employed that resulted in prediction of 10 genes, playing the key role in the development of the comorbid condition. The results can be utilised to plan experiments for identification of novel candidate genes along with searching for novel pharmacological targets.
Collapse
Affiliation(s)
- Olga V. Saik
- Institute of Cytology and Genetics, Siberian Branch, Russian Academy of Sciences, Novosibirsk, Russia
| | - Pavel S. Demenkov
- Institute of Cytology and Genetics, Siberian Branch, Russian Academy of Sciences, Novosibirsk, Russia
| | - Timofey V. Ivanisenko
- Institute of Cytology and Genetics, Siberian Branch, Russian Academy of Sciences, Novosibirsk, Russia
| | - Elena Yu Bragina
- Research Institute of Medical Genetics, Tomsk NRMC, Tomsk, Russia
| | - Maxim B. Freidin
- Research Institute of Medical Genetics, Tomsk NRMC, Tomsk, Russia
| | | | | | - Olga I. Zolotareva
- Bielefeld University, International Research Training Group “Computational Methods for the Analysis of the Diversity and Dynamics of Genomes”, Bielefeld, Germany
| | - Ralf Hofestaedt
- Bielefeld University, Technical Faculty, AG Bioinformatics and Medical Informatics, Bielefeld, Germany
| | - Inna N. Lavrik
- Department of Translational Inflammation, Institute of Experimental Internal Medicine, Otto von Guericke University, Magdeburg, Germany
| | - Evgeny I. Rogaev
- Institute of Cytology and Genetics, Siberian Branch, Russian Academy of Sciences, Novosibirsk, Russia
- University of Massachusetts Medical School, Worcester, MA USA
- Department of Genomics and Human Genetics, Institute of General Genetics, Russian Academy of Sciences, Moscow, Russia
- Center for Genetics and Genetic Technologies, Faculty of Biology, Faculty of Bioengineering and Bioinformatics, Lomonosov Moscow State University, Moscow, Russia
| | - Vladimir A. Ivanisenko
- Institute of Cytology and Genetics, Siberian Branch, Russian Academy of Sciences, Novosibirsk, Russia
| |
Collapse
|
33
|
Chen TK, Estrella MM, Vittinghoff E, Lin F, Gutierrez OM, Kramer H, Lewis CE, Kopp JB, Allen NB, Winkler CA, Bibbins-Domingo KB, Peralta CA. APOL1 genetic variants are not associated with longitudinal blood pressure in young black adults. Kidney Int 2017; 92:964-971. [PMID: 28545715 PMCID: PMC5610603 DOI: 10.1016/j.kint.2017.03.028] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 03/08/2017] [Accepted: 03/16/2017] [Indexed: 01/13/2023]
Abstract
Whether APOL1 polymorphisms contribute to the excess risk of hypertension among blacks is unknown. To assess this we evaluated whether self-reported race and, in blacks, APOL1 risk variants (high-risk [2 risk alleles] versus low-risk [0-1 risk allele]) were associated with longitudinal blood pressure. Blood pressure trajectories were determined using linear mixed-effects (slope) and latent class models (5 distinct groups) during 25 years of follow-up in the Coronary Artery Risk Development in Young Adults Study. Associations of race and APOL1 genotypes with blood pressure change, separately, using linear mixed-effects and multinomial logistic regression models, adjusting for demographic, socioeconomic, and traditional hypertension risk factors, anti-hypertensive medication use, and kidney function were evaluated. Among 1700 whites and 1330 blacks (13% APOL1 high-risk, mean age 25 years; 46% male) mean mid-, ([systolic + diastolic blood pressure]/2), systolic, and diastolic blood pressures were 89, 110, and 69 mm Hg, respectively. One percent of participants used anti-hypertensive medications at baseline. Compared to whites, blacks, regardless of APOL1 genotype, had significantly greater increases in mid-blood pressure and were more likely to experience significantly increasing mid-blood pressure trajectories with adjusted relative risk ratios of 5.21 and 7.27 for moderate-increasing and elevated-increasing versus low-stable blood pressure, respectively. Among blacks, longitudinal mid-blood pressure changes and mid-blood pressure trajectory classification were similar by APOL1 risk status. Modeling systolic and diastolic blood pressure as outcomes yielded similar findings. From young adulthood to mid-life, blacks have greater blood pressure increases versus whites that are not fully explained by traditional risk factors. Thus APOL1 variants are not associated with longitudinal blood pressure in blacks.
Collapse
Affiliation(s)
- Teresa K Chen
- Division of Nephrology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
| | - Michelle M Estrella
- Kidney Health Research Collaborative, Department of Medicine, University of California, San Francisco, California, USA; San Francisco VA Medical Center, San Francisco, California, USA
| | - Eric Vittinghoff
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
| | - Feng Lin
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
| | - Orlando M Gutierrez
- Division of Preventative Medicine, Department of Medicine, University of Alabama at Birmingham, Alabama, USA
| | - Holly Kramer
- Division of Nephrology, Department of Medicine, Loyola University, Maywood, Illinois, USA
| | - Cora E Lewis
- Division of Preventative Medicine, Department of Medicine, University of Alabama at Birmingham, Alabama, USA
| | - Jeffrey B Kopp
- Kidney Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland, USA
| | - Norrina B Allen
- Division of Epidemiology, Department of Preventative Medicine, Northwestern University, Chicago, Illinois, USA
| | - Cheryl A Winkler
- Basic Research Laboratory, Center for Cancer Research, National Cancer Institute, National Institutes of Health and Leidos Biomedical Research, Frederick National Laboratory, Frederick, Maryland, USA
| | - Kirsten B Bibbins-Domingo
- Kidney Health Research Collaborative, Department of Medicine, University of California, San Francisco, California, USA
| | - Carmen A Peralta
- Kidney Health Research Collaborative, Department of Medicine, University of California, San Francisco, California, USA; San Francisco VA Medical Center, San Francisco, California, USA
| |
Collapse
|
34
|
Munakata M, Hattori T, Konno S. Relationship between subtle urinary albumin excretion and risk of incident hypertension: modification by glomerular filtration rate. Hypertens Res 2017; 40:994-998. [PMID: 28933781 PMCID: PMC5746590 DOI: 10.1038/hr.2017.77] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Revised: 05/05/2017] [Accepted: 05/20/2017] [Indexed: 01/19/2023]
Abstract
It has been reported that an increase in urinary albumin excretion (UAE) within the normal range could be a risk factor for incident hypertension. However, it remains unclear how the subtle increases in UAE and renal function interact in the development of hypertension. We examined the modification of UAE as a risk factor for incident hypertension by glomerular filtration rate (GFR) in the Japanese population. We prospectively followed 1281 normotensive individuals from Watari town (34.3% men; mean age, 58.0±12.3 years old) whose UAE was <30 mg g−1· Cr. Hypertension was diagnosed as a systolic blood pressure (BP)⩾140 mm Hg and/or a diastolic BP⩾90 mm Hg, or antihypertensive medication use. The relationship between sex-specific quartiles of UAE and incident hypertension was examined with Cox proportional hazard analysis. During a mean follow-up of 3.7 years, 315 individuals developed hypertension. Multivariate Cox proportional hazard analysis revealed that a subtle increase in UAE was a risk factor for incident hypertension, but there was a significant interaction between UAE and estimated GFR (eGFR) (P=0.018). The risk of incident hypertension dose dependently increased in the highest eGFR quartile (⩾90 ml min−1 per 1.73 m2). Decline in renal function alone increased the risk of incident hypertension but the increased risk with a subtle increase in UAE became smaller and less clear in the lower eGFR quartiles. The present data suggest that UAE as a risk factor for incident hypertension is largely dependent on eGFR levels.
Collapse
Affiliation(s)
- Masanori Munakata
- Research Center for Lifestyle-Related Disease, Tohoku Rosai Hospital, Sendai, Japan
| | - Tomomi Hattori
- Research Center for Lifestyle-Related Disease, Tohoku Rosai Hospital, Sendai, Japan
| | - Satoshi Konno
- Research Center for Lifestyle-Related Disease, Tohoku Rosai Hospital, Sendai, Japan
| |
Collapse
|
35
|
Tanner RM, Shimbo D, Irvin MR, Spruill TM, Bromfield SG, Seals SR, Young BA, Muntner P. Chronic kidney disease and incident apparent treatment-resistant hypertension among blacks: Data from the Jackson Heart Study. J Clin Hypertens (Greenwich) 2017; 19:1117-1124. [PMID: 28921875 DOI: 10.1111/jch.13065] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 05/31/2017] [Accepted: 06/04/2017] [Indexed: 01/13/2023]
Abstract
It is unclear whether black patients with chronic kidney disease (CKD) vs those without CKD who take antihypertensive medication have an increased risk for apparent treatment-resistant hypertension (aTRH). The authors analyzed 1741 Jackson Heart Study participants without aTRH taking antihypertensive medication at baseline. aTRH was defined as uncontrolled blood pressure while taking three antihypertensive medication classes or taking four or more antihypertensive medication classes, regardless of blood pressure level. CKD was defined as an albumin to creatinine ratio ≥30 mg/g or estimated glomerular filtration rate <60 mL/min/1.73 m2 . Over 8 years, 20.1% of participants without CKD and 30.5% with CKD developed aTRH. The multivariable-adjusted hazard ratio for aTRH comparing participants with CKD vs those without CKD was 1.45 (95% CI, 1.12-1.86). Participants with an albumin to creatinine ratio ≥30 vs <30 mg/g (hazard ratio, 1.44; 95% CI, 1.04-2.00) and estimated glomerular filtration rate of 45 to 59 mL/min/1.73 m2 and <45 vs ≥60mL/min/1.73 m2 (hazard ratio, 1.60 [95% CI, 1.16-2.20] and 2.05 [95% CI, 1.28-3.26], respectively) were more likely to develop aTRH.
Collapse
Affiliation(s)
- Rikki M Tanner
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Daichi Shimbo
- Department of Medicine, Columbia University Medical Center, New York, NY, USA
| | - Marguerite R Irvin
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Tanya M Spruill
- Department of Population Health, New York University School of Medicine, New York, NY, USA
| | - Samantha G Bromfield
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Samantha R Seals
- Center of Biostatistics and Bioinformatics, University of Mississippi Medical Center, Jackson, MS, USA
| | - Bessie A Young
- Kidney Research Institute, University of Washington, Seattle, WA, USA
| | - Paul Muntner
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA
| |
Collapse
|
36
|
Zhao Y, Sun H, Wang B, Zhang M, Luo X, Ren Y, Zhou J, Han C, Wang C, Li L, Zhang L, Pang C, Yin L, Feng T, Zhao J, Hu D. Impaired fasting glucose predicts the development of hypertension over 6years in female adults: Results from the rural Chinese cohort study. J Diabetes Complications 2017; 31:1090-1095. [PMID: 28433447 DOI: 10.1016/j.jdiacomp.2017.04.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Revised: 03/17/2017] [Accepted: 04/06/2017] [Indexed: 12/28/2022]
Abstract
AIMS To investigate whether impaired fasting glucose (IFG) is an independent risk factor for incident hypertension in a rural Chinese population. METHODS We selected 9583 eligible participants 18 to 75years old, who were without hypertension and diabetes at baseline (from 2007 to 2008) and were from a rural area in the middle of China. Concentration of fasting glucose at baseline was assessed in quartiles to predict hypertension risk by gender. Odds ratios (ORs) and 95% confidence intervals (CIs) for IFG (fasting glucose of 100 to 125mg/dl) associated with hypertension were estimated by logistic regression models. RESULTS Risk of hypertension was increased for females with glucose levels in quartile 2 (90-96mg/dl), quartile 3 (96-102mg/dl), and quartile 4 (102-125mg/dl) versus quartile 1 (<90mg/dl): OR=1.27 (95% CI=1.01-1.60), 1.30 (1.04-1.63), and 1.55 (1.24-1.93), respectively. During the 6-year follow-up, the cumulative incidence of hypertension was greater for people with IFG than normal fasting glucose (NFG) at baseline (23.9% vs 18.4%, p<0.001 for males and 23.8% vs 16.4%, p<0.001 for females). Risk of incident hypertension was significantly increased for females with IFG versus NFG (OR=1.23 95% CI=1.05-1.45). CONCLUSIONS IFG may be an independent risk factor for hypertension in normotensive nondiabetic Chinese females.
Collapse
Affiliation(s)
- Yang Zhao
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China.
| | - Haohang Sun
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China.
| | - Bingyuan Wang
- The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China.
| | - Ming Zhang
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China.
| | - Xinping Luo
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China.
| | - Yongcheng Ren
- The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China.
| | - Junmei Zhou
- The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China.
| | - Chengyi Han
- The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China.
| | - Chongjian Wang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China.
| | - Linlin Li
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China.
| | - Lu Zhang
- The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China; Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong, People's Republic of China.
| | - Chao Pang
- Department of Prevention and Health Care, Military Hospital of Henan Province, Zhengzhou, Henan, People's Republic of China.
| | - Lei Yin
- Department of Prevention and Health Care, Military Hospital of Henan Province, Zhengzhou, Henan, People's Republic of China.
| | - Tianping Feng
- Department of Prevention and Health Care, Military Hospital of Henan Province, Zhengzhou, Henan, People's Republic of China.
| | - Jingzhi Zhao
- Department of Prevention and Health Care, Military Hospital of Henan Province, Zhengzhou, Henan, People's Republic of China.
| | - Dongsheng Hu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China.
| |
Collapse
|
37
|
Ascher SB, Scherzer R, Peralta CA, Tien PC, Grunfeld C, Estrella MM, Abraham A, Gustafson DR, Nowicki M, Sharma A, Cohen MH, Butch AW, Young MA, Bennett MR, Shlipak MG. Association of Kidney Function and Early Kidney Injury With Incident Hypertension in HIV-Infected Women. Hypertension 2016; 69:304-313. [PMID: 27993956 DOI: 10.1161/hypertensionaha.116.08258] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 08/16/2016] [Accepted: 11/23/2016] [Indexed: 12/17/2022]
Abstract
Subclinical kidney disease is associated with developing hypertension in the general population, but data are lacking among HIV-infected people. We examined associations of kidney function and injury with incident hypertension in 823 HIV-infected and 267 HIV-uninfected women in the Women's Interagency HIV Study, a multicenter, prospective cohort of HIV-infected and uninfected women in the United States. Baseline kidney biomarkers included estimated glomerular filtration rate using cystatin C, urine albumin-to-creatinine ratio, and 7 urine biomarkers of tubular injury: α-1-microglobulin, interleukin-18, kidney injury molecule-1, neutrophil gelatinase-associated lipocalin, liver fatty acid-binding protein, N-acetyl-β-d-glucosaminidase, and α1-acid-glycoprotein. We used multivariable Poisson regression to evaluate associations of kidney biomarkers with incident hypertension, defined as 2 consecutive visits of antihypertensive medication use. During a median follow-up of 9.6 years, 288 HIV-infected women (35%) developed hypertension. Among the HIV-infected women, higher urine albumin-to-creatinine ratio was independently associated with incident hypertension (relative risk =1.13 per urine albumin-to-creatinine ratio doubling, 95% confidence interval, 1.07-1.20), as was lower estimated glomerular filtration rate (relative risk =1.10 per 10 mL/min/1.73 m2 lower estimated glomerular filtration rate; 95% confidence interval, 1.04-1.17). No tubular injury and dysfunction biomarkers were independently associated with incident hypertension in HIV-infected women. In contrast, among the HIV-uninfected women, urine albumin-to-creatinine ratio was not associated with incident hypertension, whereas higher urine interleukin-18, α1-acid-glycoprotein, and N-acetyl-β-d-glucosaminidase levels were significantly associated with incident hypertension. These findings suggest that early glomerular injury and kidney dysfunction may be involved in the pathogenesis of hypertension in HIV-infected people. The associations of tubular markers with hypertension in HIV-uninfected women should be validated in other studies.
Collapse
Affiliation(s)
- Simon B Ascher
- From the Kidney Health Research Collaborative, Department of Medicine, San Francisco VA Medical Center (S.B.A., R.S., C.A.P., P.C.T., C.G., M.G.S.) and Department of Epidemiology and Biostatistics (C.A.P., P.C.T., C.G., M.G.S.), University of California, San Francisco; Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD (M.M.E., A.A.); Department of Medicine, SUNY Downstate Medical Center, Brooklyn, NY (D.R.G.); Department of Medicine, University of Southern California, Los Angeles (M.N.); Department of Medicine, Albert Einstein College of Medicine, Bronx, NY (A.S.); Department of Medicine, Stroger Hospital and Rush University, Chicago, IL (M.H.C.); Department of Pathology and Laboratory Medicine, UCLA Health System, Los Angeles, CA (A.W.B.); Georgetown University Medical Center, Washington, DC (M.A.Y.); and Division of Nephrology and Hypertension, Cincinnati Children's Hospital Medical Center, OH (M.R.B.)
| | - Rebecca Scherzer
- From the Kidney Health Research Collaborative, Department of Medicine, San Francisco VA Medical Center (S.B.A., R.S., C.A.P., P.C.T., C.G., M.G.S.) and Department of Epidemiology and Biostatistics (C.A.P., P.C.T., C.G., M.G.S.), University of California, San Francisco; Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD (M.M.E., A.A.); Department of Medicine, SUNY Downstate Medical Center, Brooklyn, NY (D.R.G.); Department of Medicine, University of Southern California, Los Angeles (M.N.); Department of Medicine, Albert Einstein College of Medicine, Bronx, NY (A.S.); Department of Medicine, Stroger Hospital and Rush University, Chicago, IL (M.H.C.); Department of Pathology and Laboratory Medicine, UCLA Health System, Los Angeles, CA (A.W.B.); Georgetown University Medical Center, Washington, DC (M.A.Y.); and Division of Nephrology and Hypertension, Cincinnati Children's Hospital Medical Center, OH (M.R.B.)
| | - Carmen A Peralta
- From the Kidney Health Research Collaborative, Department of Medicine, San Francisco VA Medical Center (S.B.A., R.S., C.A.P., P.C.T., C.G., M.G.S.) and Department of Epidemiology and Biostatistics (C.A.P., P.C.T., C.G., M.G.S.), University of California, San Francisco; Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD (M.M.E., A.A.); Department of Medicine, SUNY Downstate Medical Center, Brooklyn, NY (D.R.G.); Department of Medicine, University of Southern California, Los Angeles (M.N.); Department of Medicine, Albert Einstein College of Medicine, Bronx, NY (A.S.); Department of Medicine, Stroger Hospital and Rush University, Chicago, IL (M.H.C.); Department of Pathology and Laboratory Medicine, UCLA Health System, Los Angeles, CA (A.W.B.); Georgetown University Medical Center, Washington, DC (M.A.Y.); and Division of Nephrology and Hypertension, Cincinnati Children's Hospital Medical Center, OH (M.R.B.)
| | - Phyllis C Tien
- From the Kidney Health Research Collaborative, Department of Medicine, San Francisco VA Medical Center (S.B.A., R.S., C.A.P., P.C.T., C.G., M.G.S.) and Department of Epidemiology and Biostatistics (C.A.P., P.C.T., C.G., M.G.S.), University of California, San Francisco; Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD (M.M.E., A.A.); Department of Medicine, SUNY Downstate Medical Center, Brooklyn, NY (D.R.G.); Department of Medicine, University of Southern California, Los Angeles (M.N.); Department of Medicine, Albert Einstein College of Medicine, Bronx, NY (A.S.); Department of Medicine, Stroger Hospital and Rush University, Chicago, IL (M.H.C.); Department of Pathology and Laboratory Medicine, UCLA Health System, Los Angeles, CA (A.W.B.); Georgetown University Medical Center, Washington, DC (M.A.Y.); and Division of Nephrology and Hypertension, Cincinnati Children's Hospital Medical Center, OH (M.R.B.)
| | - Carl Grunfeld
- From the Kidney Health Research Collaborative, Department of Medicine, San Francisco VA Medical Center (S.B.A., R.S., C.A.P., P.C.T., C.G., M.G.S.) and Department of Epidemiology and Biostatistics (C.A.P., P.C.T., C.G., M.G.S.), University of California, San Francisco; Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD (M.M.E., A.A.); Department of Medicine, SUNY Downstate Medical Center, Brooklyn, NY (D.R.G.); Department of Medicine, University of Southern California, Los Angeles (M.N.); Department of Medicine, Albert Einstein College of Medicine, Bronx, NY (A.S.); Department of Medicine, Stroger Hospital and Rush University, Chicago, IL (M.H.C.); Department of Pathology and Laboratory Medicine, UCLA Health System, Los Angeles, CA (A.W.B.); Georgetown University Medical Center, Washington, DC (M.A.Y.); and Division of Nephrology and Hypertension, Cincinnati Children's Hospital Medical Center, OH (M.R.B.)
| | - Michelle M Estrella
- From the Kidney Health Research Collaborative, Department of Medicine, San Francisco VA Medical Center (S.B.A., R.S., C.A.P., P.C.T., C.G., M.G.S.) and Department of Epidemiology and Biostatistics (C.A.P., P.C.T., C.G., M.G.S.), University of California, San Francisco; Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD (M.M.E., A.A.); Department of Medicine, SUNY Downstate Medical Center, Brooklyn, NY (D.R.G.); Department of Medicine, University of Southern California, Los Angeles (M.N.); Department of Medicine, Albert Einstein College of Medicine, Bronx, NY (A.S.); Department of Medicine, Stroger Hospital and Rush University, Chicago, IL (M.H.C.); Department of Pathology and Laboratory Medicine, UCLA Health System, Los Angeles, CA (A.W.B.); Georgetown University Medical Center, Washington, DC (M.A.Y.); and Division of Nephrology and Hypertension, Cincinnati Children's Hospital Medical Center, OH (M.R.B.)
| | - Alison Abraham
- From the Kidney Health Research Collaborative, Department of Medicine, San Francisco VA Medical Center (S.B.A., R.S., C.A.P., P.C.T., C.G., M.G.S.) and Department of Epidemiology and Biostatistics (C.A.P., P.C.T., C.G., M.G.S.), University of California, San Francisco; Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD (M.M.E., A.A.); Department of Medicine, SUNY Downstate Medical Center, Brooklyn, NY (D.R.G.); Department of Medicine, University of Southern California, Los Angeles (M.N.); Department of Medicine, Albert Einstein College of Medicine, Bronx, NY (A.S.); Department of Medicine, Stroger Hospital and Rush University, Chicago, IL (M.H.C.); Department of Pathology and Laboratory Medicine, UCLA Health System, Los Angeles, CA (A.W.B.); Georgetown University Medical Center, Washington, DC (M.A.Y.); and Division of Nephrology and Hypertension, Cincinnati Children's Hospital Medical Center, OH (M.R.B.)
| | - Deborah R Gustafson
- From the Kidney Health Research Collaborative, Department of Medicine, San Francisco VA Medical Center (S.B.A., R.S., C.A.P., P.C.T., C.G., M.G.S.) and Department of Epidemiology and Biostatistics (C.A.P., P.C.T., C.G., M.G.S.), University of California, San Francisco; Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD (M.M.E., A.A.); Department of Medicine, SUNY Downstate Medical Center, Brooklyn, NY (D.R.G.); Department of Medicine, University of Southern California, Los Angeles (M.N.); Department of Medicine, Albert Einstein College of Medicine, Bronx, NY (A.S.); Department of Medicine, Stroger Hospital and Rush University, Chicago, IL (M.H.C.); Department of Pathology and Laboratory Medicine, UCLA Health System, Los Angeles, CA (A.W.B.); Georgetown University Medical Center, Washington, DC (M.A.Y.); and Division of Nephrology and Hypertension, Cincinnati Children's Hospital Medical Center, OH (M.R.B.)
| | - Marek Nowicki
- From the Kidney Health Research Collaborative, Department of Medicine, San Francisco VA Medical Center (S.B.A., R.S., C.A.P., P.C.T., C.G., M.G.S.) and Department of Epidemiology and Biostatistics (C.A.P., P.C.T., C.G., M.G.S.), University of California, San Francisco; Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD (M.M.E., A.A.); Department of Medicine, SUNY Downstate Medical Center, Brooklyn, NY (D.R.G.); Department of Medicine, University of Southern California, Los Angeles (M.N.); Department of Medicine, Albert Einstein College of Medicine, Bronx, NY (A.S.); Department of Medicine, Stroger Hospital and Rush University, Chicago, IL (M.H.C.); Department of Pathology and Laboratory Medicine, UCLA Health System, Los Angeles, CA (A.W.B.); Georgetown University Medical Center, Washington, DC (M.A.Y.); and Division of Nephrology and Hypertension, Cincinnati Children's Hospital Medical Center, OH (M.R.B.)
| | - Anjali Sharma
- From the Kidney Health Research Collaborative, Department of Medicine, San Francisco VA Medical Center (S.B.A., R.S., C.A.P., P.C.T., C.G., M.G.S.) and Department of Epidemiology and Biostatistics (C.A.P., P.C.T., C.G., M.G.S.), University of California, San Francisco; Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD (M.M.E., A.A.); Department of Medicine, SUNY Downstate Medical Center, Brooklyn, NY (D.R.G.); Department of Medicine, University of Southern California, Los Angeles (M.N.); Department of Medicine, Albert Einstein College of Medicine, Bronx, NY (A.S.); Department of Medicine, Stroger Hospital and Rush University, Chicago, IL (M.H.C.); Department of Pathology and Laboratory Medicine, UCLA Health System, Los Angeles, CA (A.W.B.); Georgetown University Medical Center, Washington, DC (M.A.Y.); and Division of Nephrology and Hypertension, Cincinnati Children's Hospital Medical Center, OH (M.R.B.)
| | - Mardge H Cohen
- From the Kidney Health Research Collaborative, Department of Medicine, San Francisco VA Medical Center (S.B.A., R.S., C.A.P., P.C.T., C.G., M.G.S.) and Department of Epidemiology and Biostatistics (C.A.P., P.C.T., C.G., M.G.S.), University of California, San Francisco; Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD (M.M.E., A.A.); Department of Medicine, SUNY Downstate Medical Center, Brooklyn, NY (D.R.G.); Department of Medicine, University of Southern California, Los Angeles (M.N.); Department of Medicine, Albert Einstein College of Medicine, Bronx, NY (A.S.); Department of Medicine, Stroger Hospital and Rush University, Chicago, IL (M.H.C.); Department of Pathology and Laboratory Medicine, UCLA Health System, Los Angeles, CA (A.W.B.); Georgetown University Medical Center, Washington, DC (M.A.Y.); and Division of Nephrology and Hypertension, Cincinnati Children's Hospital Medical Center, OH (M.R.B.)
| | - Anthony W Butch
- From the Kidney Health Research Collaborative, Department of Medicine, San Francisco VA Medical Center (S.B.A., R.S., C.A.P., P.C.T., C.G., M.G.S.) and Department of Epidemiology and Biostatistics (C.A.P., P.C.T., C.G., M.G.S.), University of California, San Francisco; Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD (M.M.E., A.A.); Department of Medicine, SUNY Downstate Medical Center, Brooklyn, NY (D.R.G.); Department of Medicine, University of Southern California, Los Angeles (M.N.); Department of Medicine, Albert Einstein College of Medicine, Bronx, NY (A.S.); Department of Medicine, Stroger Hospital and Rush University, Chicago, IL (M.H.C.); Department of Pathology and Laboratory Medicine, UCLA Health System, Los Angeles, CA (A.W.B.); Georgetown University Medical Center, Washington, DC (M.A.Y.); and Division of Nephrology and Hypertension, Cincinnati Children's Hospital Medical Center, OH (M.R.B.)
| | - Mary A Young
- From the Kidney Health Research Collaborative, Department of Medicine, San Francisco VA Medical Center (S.B.A., R.S., C.A.P., P.C.T., C.G., M.G.S.) and Department of Epidemiology and Biostatistics (C.A.P., P.C.T., C.G., M.G.S.), University of California, San Francisco; Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD (M.M.E., A.A.); Department of Medicine, SUNY Downstate Medical Center, Brooklyn, NY (D.R.G.); Department of Medicine, University of Southern California, Los Angeles (M.N.); Department of Medicine, Albert Einstein College of Medicine, Bronx, NY (A.S.); Department of Medicine, Stroger Hospital and Rush University, Chicago, IL (M.H.C.); Department of Pathology and Laboratory Medicine, UCLA Health System, Los Angeles, CA (A.W.B.); Georgetown University Medical Center, Washington, DC (M.A.Y.); and Division of Nephrology and Hypertension, Cincinnati Children's Hospital Medical Center, OH (M.R.B.)
| | - Michael R Bennett
- From the Kidney Health Research Collaborative, Department of Medicine, San Francisco VA Medical Center (S.B.A., R.S., C.A.P., P.C.T., C.G., M.G.S.) and Department of Epidemiology and Biostatistics (C.A.P., P.C.T., C.G., M.G.S.), University of California, San Francisco; Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD (M.M.E., A.A.); Department of Medicine, SUNY Downstate Medical Center, Brooklyn, NY (D.R.G.); Department of Medicine, University of Southern California, Los Angeles (M.N.); Department of Medicine, Albert Einstein College of Medicine, Bronx, NY (A.S.); Department of Medicine, Stroger Hospital and Rush University, Chicago, IL (M.H.C.); Department of Pathology and Laboratory Medicine, UCLA Health System, Los Angeles, CA (A.W.B.); Georgetown University Medical Center, Washington, DC (M.A.Y.); and Division of Nephrology and Hypertension, Cincinnati Children's Hospital Medical Center, OH (M.R.B.)
| | - Michael G Shlipak
- From the Kidney Health Research Collaborative, Department of Medicine, San Francisco VA Medical Center (S.B.A., R.S., C.A.P., P.C.T., C.G., M.G.S.) and Department of Epidemiology and Biostatistics (C.A.P., P.C.T., C.G., M.G.S.), University of California, San Francisco; Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD (M.M.E., A.A.); Department of Medicine, SUNY Downstate Medical Center, Brooklyn, NY (D.R.G.); Department of Medicine, University of Southern California, Los Angeles (M.N.); Department of Medicine, Albert Einstein College of Medicine, Bronx, NY (A.S.); Department of Medicine, Stroger Hospital and Rush University, Chicago, IL (M.H.C.); Department of Pathology and Laboratory Medicine, UCLA Health System, Los Angeles, CA (A.W.B.); Georgetown University Medical Center, Washington, DC (M.A.Y.); and Division of Nephrology and Hypertension, Cincinnati Children's Hospital Medical Center, OH (M.R.B.).
| |
Collapse
|
38
|
Swaminathan K, Veerasekar G, Veerasamy M, Mohanraj S, Sujatha K, Velmurugan G, Palaniswami NG. Cystatin levels in a rural South Indian population. APOLLO MEDICINE 2016. [DOI: 10.1016/j.apme.2016.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
|
39
|
Cystatin C Levels in Middle-Aged Patients with Obstructive Sleep Apnea Syndrome. Pulm Med 2016; 2016:8081723. [PMID: 27843647 PMCID: PMC5098092 DOI: 10.1155/2016/8081723] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Accepted: 09/27/2016] [Indexed: 11/17/2022] Open
Abstract
Background. Obstructive sleep apnea syndrome (OSAS) is associated with systemic inflammation and increased risk of cardiovascular and chronic kidney disease. Cystatin C (Cyst C) is a novel biomarker of both latent renal damage and cardiovascular disease. Aim of the study was to measure serum levels of Cyst C, as well as IL-8 and CRP, in otherwise healthy OSAS patients. Methods. 84 individuals examined with polysomnography for OSAS symptoms without known comorbidities were prospectively recruited. Results. According to apnea hypopnea index (AHI) subjects were divided in two groups: OSAS group (AHI > 5/hour, n = 64) and controls (AHI < 5/hour, n = 20), which were age- and BMI-matched. Cyst C levels were higher in OSAS patients versus controls (1176.13 ± 351.33 versus 938.60 ± 245.83 ng/mL, resp.; p = 0.017) while serum IL-8 and CRP levels did not differ significantly. Positive correlation was found between Cyst C levels and respiratory disturbance index (RDI) (r = 0.240, p = 0.039) and percentage of time with oxygen saturation <90% (r = 0.290, p = 0.02) and negative correlation was found between Cyst C levels and average oxygen saturation during sleep (r = -0.291, p = 0.012). After adjustment for age and BMI, RDI was the only independent predictor of Cyst C levels (β = 0.256, p = 0.039). Conclusion. Cyst C serum levels are increased in OSAS patients without comorbidities, suggesting an increased renal and cardiovascular disease risk.
Collapse
|
40
|
Mehta AJ, Zanobetti A, Bind MAC, Kloog I, Koutrakis P, Sparrow D, Vokonas PS, Schwartz JD. Long-Term Exposure to Ambient Fine Particulate Matter and Renal Function in Older Men: The Veterans Administration Normative Aging Study. ENVIRONMENTAL HEALTH PERSPECTIVES 2016; 124:1353-60. [PMID: 26955062 PMCID: PMC5010417 DOI: 10.1289/ehp.1510269] [Citation(s) in RCA: 138] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Revised: 09/15/2015] [Accepted: 02/23/2016] [Indexed: 05/07/2023]
Abstract
BACKGROUND It is unknown if ambient fine particulate matter (PM2.5) is associated with lower renal function, a cardiovascular risk factor. OBJECTIVE We investigated whether long-term PM2.5 exposure was associated with estimated glomerular filtration rate (eGFR) in a cohort of older men living in the Boston Metropolitan area. METHODS This longitudinal analysis included 669 participants from the Veterans Administration Normative Aging Study with up to four visits between 2000 and 2011 (n = 1,715 visits). Serum creatinine was measured at each visit, and eGFR was calculated according to the Chronic Kidney Disease Epidemiology Collaboration equation. One-year exposure to PM2.5 prior to each visit was assessed using a validated spatiotemporal model that utilized satellite remote-sensing aerosol optical depth data. eGFR was modeled in a time-varying linear mixed-effects regression model as a continuous function of 1-year PM2.5, adjusting for important covariates. RESULTS One-year PM2.5 exposure was associated with lower eGFRs; a 2.1-μg/m3 interquartile range higher 1-year PM2.5 was associated with a 1.87 mL/min/1.73 m2 lower eGFR [95% confidence interval (CI): -2.99, -0.76]. A 2.1 μg/m3-higher 1-year PM2.5 was also associated with an additional annual decrease in eGFR of 0.60 mL/min/1.73 m2 per year (95% CI: -0.79, -0.40). CONCLUSIONS In this longitudinal sample of older men, the findings supported the hypothesis that long-term PM2.5 exposure negatively affects renal function and increases renal function decline. CITATION Mehta AJ, Zanobetti A, Bind MC, Kloog I, Koutrakis P, Sparrow D, Vokonas PS, Schwartz JD. 2016. Long-term exposure to ambient fine particulate matter and renal function in older men: the VA Normative Aging Study. Environ Health Perspect 124:1353-1360; http://dx.doi.org/10.1289/ehp.1510269.
Collapse
Affiliation(s)
- Amar J. Mehta
- Exposure, Epidemiology and Risk Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Address correspondence to A.J. Mehta, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Landmark Center 4th floor, 401 Park Dr., Boston, MA 02215 USA. Telephone: (617) 384-8847. E-mail:
| | - Antonella Zanobetti
- Exposure, Epidemiology and Risk Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Marie-Abele C. Bind
- Exposure, Epidemiology and Risk Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Itai Kloog
- Department of Geography and Environmental Development, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Petros Koutrakis
- Exposure, Epidemiology and Risk Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - David Sparrow
- VA Normative Aging Study, Veterans Affairs Boston Healthcare System, Boston, Massachusetts, USA
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Pantel S. Vokonas
- VA Normative Aging Study, Veterans Affairs Boston Healthcare System, Boston, Massachusetts, USA
- Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Joel D. Schwartz
- Exposure, Epidemiology and Risk Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| |
Collapse
|
41
|
Mallikethi-Reddy S, Briasoulis A, Akintoye E, Afonso L. Novel biomarkers with potential for cardiovascular risk reclassification. Biomarkers 2016; 22:189-199. [DOI: 10.1080/1354750x.2016.1201540] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Sagar Mallikethi-Reddy
- Division of Cardiology, Detroit Medical Center, Wayne State University, Detroit, MI, USA
| | - Alexandros Briasoulis
- Division of Cardiology, Detroit Medical Center, Wayne State University, Detroit, MI, USA
| | - Emmanuel Akintoye
- Division of Cardiology, Detroit Medical Center, Wayne State University, Detroit, MI, USA
| | - Luis Afonso
- Division of Cardiology, Detroit Medical Center, Wayne State University, Detroit, MI, USA
| |
Collapse
|
42
|
Kaboré J, Metzger M, Helmer C, Berr C, Tzourio C, Massy ZA, Stengel B. Kidney Function Decline and Apparent Treatment-Resistant Hypertension in the Elderly. PLoS One 2016; 11:e0146056. [PMID: 26807712 PMCID: PMC4726557 DOI: 10.1371/journal.pone.0146056] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Accepted: 12/11/2015] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Cross-sectional studies show a strong association between chronic kidney disease and apparent treatment-resistant hypertension, but the longitudinal association of the rate of kidney function decline with the risk of resistant hypertension is unknown. METHODS The population-based Three-City included 8,695 participants older than 65 years, 4265 of them treated for hypertension. We estimated the odds ratios (OR) of new-onset apparent treatment-resistant hypertension, defined as blood pressure ≥ 140/90 mmHg despite use of 3 antihypertensive drug classes or ≥ 4 classes regardless of blood pressure, associated with the mean estimated glomerular filtration rate (eGFR) level and its rate of decline over 4 years, compared with both controlled hypertension and uncontrolled nonresistant hypertension with ≤ 2 drugs. GFR was estimated with three different equations. RESULTS Baseline prevalence of apparent treatment-resistant hypertension and of controlled and uncontrolled nonresistant hypertension, were 6.5%, 62.3% and 31.2%, respectively. During follow-up, 162 participants developed apparent treatment-resistant hypertension. Mean eGFR decline with the MDRD equation was 1.5±2.9 mL/min/1.73 m² per year: 27.7% of the participants had an eGFR ≥3 and 10.1% ≥ 5 mL/min/1.73 m² per year. After adjusting for age, sex, obesity, diabetes, and cardiovascular history, the ORs for new-onset apparent treatment-resistant hypertension associated with a mean eGFR level, per 15 mL/min/1.73 m² drop, were 1.23 [95% confidence interval 0.91-1.64] compared to controlled hypertension and 1.10 [0.83-1.45] compared to uncontrolled nonresistant hypertension; ORs associated with a decline rate ≥ 3 mL/min/1.73 m² per year were 1.89 [1.09-3.29] and 1.99 [1.19-3.35], respectively. Similar results were obtained when we estimated GFR with the CKDEPI and the BIS1 equations. ORs tended to be higher for an eGFR decline rate ≥ 5 mL/min/1.73 m² per year. CONCLUSION The speed of kidney function decline is associated more strongly than kidney function itself with the risk of apparent treatment-resistant hypertension in the elderly.
Collapse
Affiliation(s)
- Jean Kaboré
- Inserm U1018, CESP, Villejuif, France
- University Paris-Sud, University Paris-Saclay, Villejuif, France
- IRSS/Centre Muraz, Bobo-Dioulasso, Burkina Faso
| | - Marie Metzger
- Inserm U1018, CESP, Villejuif, France
- University Paris-Sud, University Paris-Saclay, Villejuif, France
| | - Catherine Helmer
- Inserm U897-Epidemiology-Biostatistic, Bordeaux, France
- University of Bordeaux, Bordeaux, France
- Clinical Investigation Center – Clinical Epidemiology, Bordeaux, France
| | - Claudine Berr
- Inserm U1061, Montpellier, France, University Montpellier I, Montpellier, France
| | - Christophe Tzourio
- Inserm U897-Epidemiology-Biostatistic, Bordeaux, France
- University of Bordeaux, Bordeaux, France
| | - Ziad A. Massy
- Inserm U1018, CESP, Villejuif, France
- Division of Nephrology, Ambroise Paré University Hospital, Boulogne Billancourt, France
- University Paris-Ouest-UVSQ, Paris, France
| | - Bénédicte Stengel
- Inserm U1018, CESP, Villejuif, France
- University Paris-Sud, University Paris-Saclay, Villejuif, France
| |
Collapse
|
43
|
Lambrinoudaki I, Tourlakis D, Armeni E, Kaparos G, Rizos D, Augoulea A, Alexandrou A, Kreatsa M, Deligeoroglou E, Stamatelopoulos K. Variations in glomerular filtration rate are associated with subclinical atherosclerosis in healthy postmenopausal women. Menopause 2015; 22:317-24. [PMID: 25072953 DOI: 10.1097/gme.0000000000000302] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
OBJECTIVE This study aims to evaluate the potential effects of renal function variations on vascular structure before the development of hypertension. METHODS This pilot study included 141 postmenopausal women without evidence of renal dysfunction or hypertension. Markers of renal function and levels of glomerular filtration rate (GFR)--using standard calculations (GFR based on levels of creatinine [GFR(epi)]) and newer creatinine and/or cystatin calculations (GFR based on levels of creatinine and cystatin [GFR(cr cystatin)] and GFR based on levels of cystatin [GFR(cystatin)])--were associated with hemodynamic parameters and markers of vascular structure (intima-media thickness [IMT] and presence of atheromatous plaques in carotid and femoral arteries). RESULTS Levels of GFR(epi), GFR(cr cystatin), and GFR(cystatin) exhibited a significant negative correlation with femoral artery IMT, whereas levels of GFR(epi) correlated significantly with mean carotid bulb (CB) IMT. Multivariate analysis showed that CB-IMT was predicted by GFR(epi) levels and age (β-coefficient = -0.212, P = 0.020), whereas femoral artery IMT was predicted by GFR(epi) levels (β-coefficient = -0.293, P = 0.001). GFR(epi) levels lower than the 25th percentile were associated with higher CB-IMT (P = 0.009), femoral artery IMT (P = 0.001), and combined IMT (P = 0.035) compared with higher GFR(epi) levels. Moreover, GFR(epi) levels greater than the 25th percentile were associated with lower odds for the presence of atherosclerotic plaques at the CB and carotid arteries combined (CB: odds ratio, 0.146; P = 0.006; combined: odds ratio, 0.249; P = 0.043) compared with lower GFR(epi) levels. CONCLUSIONS A mild decrease in renal function within normal limits of GFR is independently associated with the presence of subclinical atherosclerosis in a sample of apparently healthy young postmenopausal women. Assessment of GFR using creatinine (vs cystatin C) levels is a more sensitive marker of its association with IMT and atherosclerotic plaques in this postmenopausal population.
Collapse
Affiliation(s)
- Irene Lambrinoudaki
- From the 1Second Department of Obstetrics and Gynecology and 2Hormonal and Biochemical Laboratory, University of Athens, Aretaieio Hospital, Athens, Greece; and 3Department of Therapeutics, University of Athens, Alexandra Hospital, Athens, Greece
| | | | | | | | | | | | | | | | | | | |
Collapse
|
44
|
Xu H, Huang X, Risérus U, Cederholm T, Sjögren P, Lindholm B, Ärnlöv J, Carrero JJ. Albuminuria, renal dysfunction and circadian blood pressure rhythm in older men: a population-based longitudinal cohort study. Clin Kidney J 2015; 8:560-6. [PMID: 26413281 PMCID: PMC4581386 DOI: 10.1093/ckj/sfv068] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Accepted: 07/08/2015] [Indexed: 02/06/2023] Open
Abstract
Background Both albuminuria and kidney dysfunction may affect circadian blood pressure (BP) rhythm, while exacerbating each other's effects. We investigated associations and interactions of these two risk factors with circadian BP rhythm variation and non-dipper pattern progression in community-dwelling older men. Methods This was a cross-sectional and longitudinal analyses in the third and fourth cycles of the Uppsala Longitudinal Study of Adult Men, including 1051 men (age 71 years) with assessments on urinary albumin excretion rate (UAER), 24-h ambulatory BP monitoring (ABPM) and cystatin-C-estimated glomerular filtration rate (eGFR). Of these, 574 men attended re-examination after 6 years. Study outcomes were ABMP changes and non-dipping BP pattern (prevalence and progression). Results UAER associated with circadian BP rhythm both cross-sectionally and longitudinally. Longitudinally, significant interactions were observed between UAER and kidney dysfunction (eGFR < 60 mL/min/1.73 m2) in its association with the changes of both night-time systolic BP (SBP) and night–day SBP ratio. After stratification, UAER strongly predicted night–day SBP ratio change only in those with concurrent kidney dysfunction. At re-examination, 221 new cases of non-dipper were identified. In multivariable logistic models, high UAER associated with increased likelihood of non-dipper progression, but more strongly so among individuals with concurrent kidney dysfunction. These associations were evident also in the subpopulation of non-diabetics and in participants with normal range UAER. Conclusions UAER associates with circadian BP rhythm variation and non-dipper progression in elderly men. Concurrent renal dysfunction modifies and exacerbates these associations.
Collapse
Affiliation(s)
- Hong Xu
- Divisions of Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention and Technology , Karolinska Institutet , Stockholm , Sweden
| | - Xiaoyan Huang
- Divisions of Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention and Technology , Karolinska Institutet , Stockholm , Sweden ; Division of Nephrology , Peking University Shenzhen Hospital , Shenzhen , China
| | - Ulf Risérus
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism , Uppsala University , Uppsala , Sweden
| | - Tommy Cederholm
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism , Uppsala University , Uppsala , Sweden
| | - Per Sjögren
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism , Uppsala University , Uppsala , Sweden
| | - Bengt Lindholm
- Divisions of Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention and Technology , Karolinska Institutet , Stockholm , Sweden
| | - Johan Ärnlöv
- Department of Medical Sciences, Molecular Epidemiology , Uppsala University , Uppsala , Sweden ; School of Health and Social Studies , Dalarna University , Falun , Sweden
| | - Juan Jesús Carrero
- Divisions of Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention and Technology , Karolinska Institutet , Stockholm , Sweden ; Center for Molecular Medicine , Karolinska Institutet , Stockholm , Sweden
| |
Collapse
|
45
|
Luo J, Wang LP, Hu HF, Zhang L, Li YL, Ai LM, Mu HY, Kun-Wang. Cystatin C and cardiovascular or all-cause mortality risk in the general population: A meta-analysis. Clin Chim Acta 2015; 450:39-45. [PMID: 26192218 DOI: 10.1016/j.cca.2015.07.016] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Revised: 07/10/2015] [Accepted: 07/16/2015] [Indexed: 11/25/2022]
Abstract
BACKGROUND Elevated cystatin C level was associated with excessive risk of cardiovascular events and mortality in the highly cardiovascular risk populations. We conducted this meta-analysis to investigate the relationship between serum cystatin C level and cardiovascular or all-cause mortality risk in the general population. METHODS We searched for all relevant studies published through May 2015 using PubMed, Embase, and Cochrane Library. Prospective studies that assessed the relationship between serum cystatin C level and cardiovascular or all-cause mortality risk in the general population were selected. Pooled adjust hazard risk (HR) and the corresponding 95% confidence intervals (CI) were calculated for continuous and category of cystatin C level. RESULTS Nine studies composed of 38,854 participants were analyzed. Elevated serum cystatin C level was associated with excessive risk of all-cause mortality (HR 1.72; 95% CI 1.37-2.16) and cardiovascular mortality (HR 2.74; 95% CI 2.04-3.68) comparing the highest to lowest category of cystatin C. Each standard deviation increment in serum cystatin C level increased 32% all-cause (HR 1.32; 95% CI 1.12-1.55) and 57% cardiovascular mortality (HR 1.57; 95% CI 1.31-1.88) risk. CONCLUSIONS Elevated serum cystatin C level is independently associated with excessive cardiovascular and all-cause mortality risk in elderly persons.
Collapse
Affiliation(s)
- Jian Luo
- Department of Cardiology, The First Affiliated Hospital, Xinjiang Medical University, Urumqi 830000, China
| | - Ling-Peng Wang
- Department of Internal Medicine (VIP) of The First Affiliated Hospital, Xinjiang Medical University, Urumqi 830000, China
| | - Hai-Feng Hu
- Department of Heart and Renal of The Sixth People's Hospital in Xinjiang Uygur Autonomous Region, Urumqi 830000, China
| | - Li Zhang
- Department of Cardiology, The First Affiliated Hospital, Xinjiang Medical University, Urumqi 830000, China
| | - Ya-Li Li
- Department of Cardiology, The First Affiliated Hospital, Xinjiang Medical University, Urumqi 830000, China
| | - Li-Man Ai
- Department of Internal Medicine (VIP) of The First Affiliated Hospital, Xinjiang Medical University, Urumqi 830000, China
| | - Hu-Yati Mu
- Department of Internal Medicine (VIP) of The First Affiliated Hospital, Xinjiang Medical University, Urumqi 830000, China.
| | - Kun-Wang
- Department of Cardiology, The First Affiliated Hospital, Xinjiang Medical University, Urumqi 830000, China.
| |
Collapse
|
46
|
Wang Y, Su X, Zhang W, Yang W, Wang Y, He Y. Correlation between serum cystatin C level and elderly hypertensive patients combined coronary heart disease. Int J Clin Exp Med 2015; 8:6287-6290. [PMID: 26131241 PMCID: PMC4483934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2015] [Accepted: 03/17/2015] [Indexed: 06/04/2023]
Abstract
OBJECTIVES To explore the correlation between serum cystatin C level and elderly hypertension with coronary heart disease patients. METHODS 500 hypertensive patients combined coronary heart disease were selected by coronary angiography. 321 of them were elderly patients with hypertension (male 204, female 117), and 400 of them were elderly patients with coronary heart disease (male 257, female 143), The serum cystatin C level of all patients were detected by immunoturbidimetry, and analyzed the correlation between the serum cystatin C level and different degree of blood pressure and the degree of coronary artery stenosis in elderly patients. RESULTS The serum cystatin C level was closely related with the blood pressure and the degree of the coronary artery stenosis. The higher the blood pressure level and the more serious the coronary artery stenosis, the higher the serum cystatin C level; The serum cystatin C level of hypertensive patients with coronary heart disease patients (Group D) were markedly higher than the level of the patients without hypertension and coronary heart disease patients (Group A), and the level of the patients with coronary heart disease (Group B) and the hypertension group (Group C) (P < 0.05). CONCLUSION The serum cystatin C level of elderly patients with hypertension and coronary heart disease were closely related with the degree of blood pressure and coronary arteries stenosis. The serum cystatin C maybe a predictor of disease severity in elderly hypertensive patients with coronary heart disease.
Collapse
Affiliation(s)
- Ying Wang
- The Medicine School of Xi’an Jiaotong UniversityXi’an 710061, Shaanxi
- Department of Geriatric Cardiology, The Nuclear Industry 215 HospitalXianyang 712000, Shaanxi
| | - Xianming Su
- The Department of Geriatrics Cardiology, First Affiliated Hospital of Xi’an Jiaotong UniversityXi’an 710061, Shaanxi
| | - Wei Zhang
- The Department of Geriatrics Cardiology, First Affiliated Hospital of Xi’an Jiaotong UniversityXi’an 710061, Shaanxi
| | - Wei Yang
- The Department of Geriatrics Cardiology, First Affiliated Hospital of Xi’an Jiaotong UniversityXi’an 710061, Shaanxi
| | - Ying Wang
- The Department of Geriatrics Cardiology, First Affiliated Hospital of Xi’an Jiaotong UniversityXi’an 710061, Shaanxi
| | - Yajun He
- The First Department of Cardiology, The Nuclear Industry 215 HospitalXianyang 712000, Shaanxi
| |
Collapse
|
47
|
Takase H, Sugiura T, Ohte N, Dohi Y. Urinary albumin as a marker of future blood pressure and hypertension in the general population. Medicine (Baltimore) 2015; 94:e511. [PMID: 25674745 PMCID: PMC4602748 DOI: 10.1097/md.0000000000000511] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Revised: 12/22/2014] [Accepted: 01/07/2015] [Indexed: 01/18/2023] Open
Abstract
We investigated whether urinary albumin could predict the development of hypertension and future increases in blood pressure in the normotensive general population.Normotensive subjects who visited our hospital for a physical checkup (n = 6205, men 61.8%, 53.4 ± 11.4 years old) were enrolled in this study. Urine samples were collected for the measurement of albumin concentration, expressed as the ratio of urinary albumin to creatinine concentrations (UACR [mg/g Cr]). After the baseline examination, subjects were followed up for a median of 1089 days with the endpoint being the development of hypertension.Urinary albumin was in the normal range (UACR <30 mg/g Cr) in most subjects (97.5%). During the follow-up, hypertension developed in 1184 subjects (19.1%, 69.5 per 1000 person-years), with more men than women affected. The incidence of hypertension was increased across the quartiles of UACR by Kaplan-Meier analysis (log-rank, P < 0.0001) and the hazard ratio (lowest quartile [median UACR 1.14 mg/g Cr] as reference) was 1.53 (95% confidence intervals 1.30-1.80) in the highest quartile (median UACR 8.87 mg/g Cr). Multivariate Cox hazard analysis in which UACR was taken as a continuous variable identified UACR as a significant predictor of hypertension (hazard ratio 1.37, 95% CI 1.20-1.56). UACR was also an independent predictor of future increases in systolic blood pressure (P < 0.01).Urinary albumin is an independent predictor of hypertension and increases in blood pressure in the general population even in the normal range below the threshold defined for microalbuminuria.
Collapse
Affiliation(s)
- Hiroyuki Takase
- From the Department of Internal Medicine (HT), Enshu Hospital, Hamamatsu; and Department of Cardio-Renal Medicine and Hypertension (TS, NO, YD), Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | | | | | | |
Collapse
|
48
|
Vääräniemi K, Koskela J, Tahvanainen A, Tikkakoski A, Wilenius M, Kähönen M, Kööbi T, Niemelä O, Mustonen J, Pörsti I. Lower glomerular filtration rate is associated with higher systemic vascular resistance in patients without prevalent kidney disease. J Clin Hypertens (Greenwich) 2014; 16:722-8. [PMID: 25228202 PMCID: PMC8032143 DOI: 10.1111/jch.12405] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2014] [Revised: 07/29/2014] [Accepted: 07/29/2014] [Indexed: 01/22/2023]
Abstract
The authors examined the association between estimated glomerular filtration rate (eGFR), calculated using the Chronic Kidney Disease Epidemiology Collaboration creatinine-cystatin C equation, and hemodynamics in 556 normotensive or never-treated hypertensive patients without kidney disease (mean age, 46 years). Hemodynamic variables were recorded using pulse wave analysis and whole-body impedance cardiography. The mean eGFR was 98 mL/min/1.73 m(2) (range, 64-145 mL/min/1.73 m(2) and one third of the patients had values below 92, while none had proteinuria. In linear regression analyses adjusted for differences in age, weight:height ratio, low-density lipoprotein cholesterol, and sex, significant associations were found between lower eGFR and higher systolic (P=.001) and diastolic blood pressure (P<.001) and higher systemic vascular resistance (P=.001). There was no association between eGFR and cardiac output or extracellular volume. In the absence of clinical kidney disease, lower eGFR was associated with higher blood pressure and systemic vascular resistance. Therefore, early impairment in kidney function may be involved in the pathogenesis of essential hypertension.
Collapse
Affiliation(s)
- Kati Vääräniemi
- School of MedicineUniversity of TampereTampereFinland
- Department of Internal MedicineCentral Hospital of Central FinlandJyväskyläFinland
| | - Jenni Koskela
- School of MedicineUniversity of TampereTampereFinland
- Department of Internal MedicineTampere University HospitalTampereFinland
| | - Anna Tahvanainen
- School of MedicineUniversity of TampereTampereFinland
- Department of Internal MedicineTampere University HospitalTampereFinland
| | - Antti Tikkakoski
- School of MedicineUniversity of TampereTampereFinland
- Department of Clinical PhysiologyTampere University HospitalTampereFinland
| | - Matias Wilenius
- School of MedicineUniversity of TampereTampereFinland
- Department of Clinical PhysiologyTampere University HospitalTampereFinland
| | - Mika Kähönen
- School of MedicineUniversity of TampereTampereFinland
- Department of Clinical PhysiologyTampere University HospitalTampereFinland
| | - Tiit Kööbi
- Department of Clinical PhysiologyTampere University HospitalTampereFinland
| | - Onni Niemelä
- Laboratory and Medical Research UnitSeinäjoki Central HospitalSeinäjokiFinland
| | - Jukka Mustonen
- School of MedicineUniversity of TampereTampereFinland
- Department of Internal MedicineTampere University HospitalTampereFinland
| | - Ilkka Pörsti
- School of MedicineUniversity of TampereTampereFinland
- Department of Internal MedicineTampere University HospitalTampereFinland
| |
Collapse
|
49
|
Clinical analysis of the relationship between cystatin C and metabolic syndrome in the elderly. Rev Port Cardiol 2014; 33:411-6. [PMID: 25155006 DOI: 10.1016/j.repc.2014.01.019] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2013] [Revised: 12/29/2013] [Accepted: 01/02/2014] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE Studies have shown that both cystatin C and metabolic syndrome (MetS) are associated with inflammation. We set out to investigate the correlation between serum cystatin C levels and MetS in the elderly. METHODS This prospective study was conducted in 380 elderly individuals, including 135 patients with MetS, 142 patients with metabolic disturbance (MetD), and 103 healthy elderly individuals (control group). Waist-hip ratio, waist circumference, waist-height ratio, body mass index (BMI), fasting plasma glucose (FPG), hemoglobin A1c (HbA1c), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), high-density lipoprotein (HDL-C), systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure and cystatin C were measured and their mutual relations were analyzed. RESULTS The higher the MetS scores, the higher the serum cystatin C concentration in these patients. Serum cystatin C concentration was closely related to waist-hip ratio, waist circumference, waist-height ratio, BMI, TG, FPG, and blood pressure, not related to LDL-C levels, and negatively correlated with HDL-C levels. Logistic regression analysis indicated that cystatin C, waist-height ratio, waist circumference, FPG, TG, SBP and pulse pressure were significantly associated with MetS (OR between cystatin C and MetS 2.164, 95% CI 1.136-8.259). CONCLUSION Cystatin C was significantly associated with MetS in the elderly. As MetS scores rose, serum cystatin C levels increased.
Collapse
|
50
|
Huang M, Matsushita K, Sang Y, Ballew SH, Astor BC, Coresh J. Association of kidney function and albuminuria with prevalent and incident hypertension: the Atherosclerosis Risk in Communities (ARIC) study. Am J Kidney Dis 2014; 65:58-66. [PMID: 25151408 DOI: 10.1053/j.ajkd.2014.06.025] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Accepted: 06/12/2014] [Indexed: 12/20/2022]
Abstract
BACKGROUND Decreased kidney function and kidney damage may predate hypertension, but only a few studies have investigated both types of markers simultaneously, and these studies have obtained conflicting results. STUDY DESIGN Cross-sectional for prevalent and prospective observational study for incident hypertension. SETTING & PARTICIPANTS 9,593 participants from the ARIC (Atherosclerosis Risk in Communities) Study, aged 53-75 years in 1996-1998. PREDICTORS Several markers of kidney function (estimated glomerular filtration rate using serum creatinine and/or cystatin C and 2 novel markers [β-trace protein and β2-microglobulin]) and 1 marker of kidney damage (urinary albumin-creatinine ratio [ACR]). Every kidney marker was categorized by its quintiles (top quintile as a reference for estimated glomerular filtration rates and bottom quintile for the rest). OUTCOMES Prevalent and incident hypertension. MEASUREMENTS Prevalence ratios and HRs of hypertension based on modified Poisson regression and Cox proportional hazards models, respectively. RESULTS There were 4,378 participants (45.6%) with prevalent hypertension at baseline and 2,175 incident hypertension cases during a median follow-up of 9.8 years. Although all 5 kidney function markers were associated significantly with prevalent hypertension, prevalent hypertension was associated most notably with higher ACR (adjusted prevalence ratio, 1.60 [95% CI, 1.50-1.71] for the highest vs lowest ACR quintile). Similarly, ACR was associated consistently with incident hypertension in all models tested (adjusted HR, 1.28 [95% CI, 1.10-1.49] for top quintile), while kidney function markers demonstrated significant associations in some, but not all, models. Even mildly increased ACR (9.14-14.0mg/g) was associated significantly with incident hypertension. LIMITATIONS Self-reported use of antihypertensive medication for defining incident hypertension, single assessment of kidney markers, and relatively narrow age range. CONCLUSIONS Although all kidney markers were associated with prevalent hypertension, only elevated albuminuria was associated consistently with incident hypertension, suggesting that kidney damage is related more closely to hypertension than moderate reduction in overall kidney function.
Collapse
Affiliation(s)
- Minxuan Huang
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | | | - Yingying Sang
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Shoshana H Ballew
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Brad C Astor
- University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Josef Coresh
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| |
Collapse
|