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Lee S, Cho S, Nam GN, Cho J, Kim SG, Kim M, Huh H, Kang E, Park S, Paek JH, Park WY, Jin K, Han S, Joo KW, Han K, Kim DK, Kim Y. Impact of albuminuria on early-onset type 2 diabetes mellitus: a nationwide population-based study. Kidney Res Clin Pract 2023:j.krcp.22.278. [PMID: 38148130 DOI: 10.23876/j.krcp.22.278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 07/11/2023] [Indexed: 12/28/2023] Open
Abstract
Background Early-onset diabetes mellitus has a significant lifetime burden and is associated with higher morbidity and mortality. Since insulin resistance is one of the mechanisms of podocyte injury, we aimed to evaluate the effect of albuminuria on newly developed early-onset type 2 diabetes mellitus (T2DM). Methods We screened 6,891,399 subjects aged ≥20 and <40 years without a history of prediabetes or diabetes from the Korean National Health Insurance Service database between 2009 and 2012. A multivariate Cox proportional hazard model was used to identify the impact of albuminuria on early-onset T2DM. Results Among a total of 5,383,779 subjects, 62,148 subjects (1.2%) developed early-onset diabetes over 7.3 ± 1.2 years. Albuminuria was significantly associated with early-onset T2DM (adjusted hazard ratio [aHR], 1.62; 95% confidence interval [CI], 1.55-1.70) after adjustment for age, sex, anthropometric data, physical exercise status, serum glucose, and total cholesterol. The risk of early-onset T2DM increased more in subjects with more components of metabolic syndrome (MetS). Among each component of MetS, hypertriglyceridemia was prominently associated with early-onset T2DM (aHR, 2.02; 95% CI, 1.81-2.25) in subjects with albuminuria. Conclusion Dipstick albuminuria was significantly associated with early-onset T2DM in young adult populations. Close monitoring of albuminuria is warranted for disease risk modification, especially in subjects with MetS.
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Affiliation(s)
- Soojin Lee
- Department of Internal Medicine, Uijeongbu Eulji University Medical Center, Uijeongbu, Republic of Korea
| | - Semin Cho
- Department of Internal Medicine, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong, Republic of Korea
| | - Geum Nae Nam
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jeongmin Cho
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Seong Geun Kim
- Department of Internal Medicine, Inje University Sanggye Paik Hospital, Seoul, Republic of Korea
| | - Minsang Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Hyuk Huh
- Department of Internal Medicine, Inje University Busan Paik Hospital, Busan, Republic of Korea
| | - Eunjeong Kang
- Transplantation Center, Seoul National University Hospital, Seoul, Republic of Korea
| | - Sehoon Park
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jin Hyuk Paek
- Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Republic of Korea
| | - Woo Yeong Park
- Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Republic of Korea
| | - Kyubok Jin
- Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Republic of Korea
| | - Seungyeup Han
- Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Republic of Korea
| | - Kwon Wook Joo
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
| | - Dong Ki Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Yaerim Kim
- Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Republic of Korea
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2
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Corgie L, Huiban N, Janvier F, Darles C, Brocq FX, Dutasta F, Monteil M. Prevalence of leukocyturia in a cohort of French asymptomatic aircrews. Clin Microbiol Infect 2021:S1198-743X(21)00547-4. [PMID: 34607000 DOI: 10.1016/j.cmi.2021.09.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 09/01/2021] [Accepted: 09/23/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Sexually transmitted infections (STIs) can cause leukocyturia. We aimed to estimate the prevalence of leukocyturia in asymptomatic aircrews and the proportion of STIs in those presenting leukocyturia. METHODS The LEUCO survey was a prospective cohort study conducted among aircrews between 14th October 2019 and 13th March 2020 at the Toulon aeromedical centre in France. All participants performed a dipstick urinalysis. Those positive for leukocyturia were offered STI screening by nucleic acid amplification test (NAAT) for Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium and Trichomonas vaginalis. RESULTS Among the 2236 included asymptomatic participants (1912 men and 324 women), 127 (36 men and 91 women) were positive for leukocyturia. The prevalence of leukocyturia was 1.9% (1.3-2.6) in men and 28.1% (23.3-33.3) in women (p < 0.001). In men positive for leukocyturia, the NAAT positivity rate for C. trachomatis, N. gonorrhoeae, M. genitalium and T. vaginalis was 28.6% (3.7-71.0) in the age group 18-24, 20.0% (0.5-71.6) in the age group 25-34, and zero in the older age group (p 0.65). In women positive for leukocyturia it was 16.7% (4.7-37.4) in the age group 18-24, 18.2% (2.3-51.8) in the age group 25-34, and zero in the older age group (p 0.16). CONCLUSIONS In asymptomatic individuals, leukocyturia is rare in men and more common in women. In asymptomatic adults under 35 years of age with leukocyturia, multiplex NAAT shows a high proportion of STIs and might be useful in improving STI detection.
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Adetunji AE, Ayenale M, Akhigbe I, Akerele LO, Isibor E, Idialu J, Aideloje FO, Emuebonam E, Aire C, Adomeh DI, Odia I, Atafo RO, Okonofua MO, Owobu A, Ogbaini-Emovon E, Tobin EA, Asogun DA, Okogbenin SA, Sabeti P, Happi CT, Günther S, Azubuike CO, Rafiu M, Odike A, Olomu SC, Ibadin MO, Okokhere PO, Akpede GO. Acute kidney injury and mortality in pediatric Lassa fever versus question of access to dialysis. Int J Infect Dis 2020; 103:124-131. [PMID: 33176203 DOI: 10.1016/j.ijid.2020.11.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 10/31/2020] [Accepted: 11/03/2020] [Indexed: 01/16/2023] Open
Abstract
OBJECTIVES To assess the prevalence of acute kidney injury (AKI), and its impact on outcome in hospitalized pediatric patients with Lassa fever (LF). METHODS We reviewed the presenting clinical and laboratory features and outcomes of 40 successive hospitalized children with PCR-confirmed LF. The diagnosis and staging of AKI was based on KDIGO criteria. We compared groups of patients using t- or χ2 tests as necessary, and took p-values <0.05 as indicative of the presence of significant differences. RESULTS Sixteen (40%) children had AKI. Case fatality rate (CFR) was 9/16 (56%) in children with and 1/24 (4%) in those without AKI (OR [95% CI] of CFR associated with AKI = 29.57 [3.17, 275.7]). Presentation with abnormal bleeding (p = 0.008), encephalopathy (p = 0.004), hematuria plus proteinuria (p = 0.013), and elevated serum transaminase levels (p <0.02) were significantly associated with an increased prevalence of AKI. CONCLUSION AKI prevalence in hospitalized pediatric patients with Lassa fever is high, and correlated with illness severity/CFR. The high prevalence underscores the need for access to hemodialysis, and clinical presentation and/or presence of hematuria plus proteinuria could serve as a ready prompt for referral for such specialized care.
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Affiliation(s)
- Adewale E Adetunji
- Department of Paediatrics, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria
| | - Magdalene Ayenale
- Department of Paediatrics, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria
| | - Irene Akhigbe
- Department of Paediatrics, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria
| | - Lilian O Akerele
- Department of Paediatrics, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria
| | - Efosa Isibor
- Department of Paediatrics, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria
| | - Juliet Idialu
- Department of Paediatrics, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria
| | - Florence O Aideloje
- Department of Nursing Services, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria
| | - Ekene Emuebonam
- Institute of Lassa Fever Research and Control, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria
| | - Chris Aire
- Institute of Lassa Fever Research and Control, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria
| | - Donatus I Adomeh
- Institute of Lassa Fever Research and Control, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria
| | - Ikponmwosa Odia
- Institute of Lassa Fever Research and Control, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria
| | - Rebecca O Atafo
- Nursing Services Unit, Institute of Lassa Fever Research and Control, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria
| | - Martha O Okonofua
- Nursing Services Unit, Institute of Lassa Fever Research and Control, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria
| | - Adaugo Owobu
- Department of Paediatrics, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria
| | - Ephraim Ogbaini-Emovon
- Institute of Lassa Fever Research and Control, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria
| | - Ekaete A Tobin
- Institute of Lassa Fever Research and Control, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria
| | - Danny A Asogun
- Institute of Lassa Fever Research and Control, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria
| | - Sylvanus A Okogbenin
- Department of Obstetrics and Gynaecology, Irrua Specialist Teaching Hospital, Irrua, Nigeria
| | - Pardis Sabeti
- Department of Organismic and Evolutionary Biology, Harvard University, Cambridge, MA, United States
| | - Christian T Happi
- Department of Biological Sciences and African Center of Excellence for Genomics of Infectious Diseases, Redeemer's University, Ede, Nigeria
| | - Stephan Günther
- Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany, and German Center for Infection Research (DZIF), Partner site Hamburg - Lübeck - Borstel - Riems, Germany
| | | | - Mojeed Rafiu
- Department of Medicine, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria
| | - Angela Odike
- Department of Paediatrics, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria
| | - Sylvia C Olomu
- Department of Paediatrics, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria
| | - Michael O Ibadin
- Department of Paediatrics, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria
| | - Peter O Okokhere
- Department of Medicine, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria
| | - George O Akpede
- Department of Paediatrics, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria.
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Nakajima K, Higuchi R, Mizusawa K. Trace Proteinuria and the Incidence of Overt Proteinuria After Five Years: Results of the Kanagawa Investigation of the Total Checkup Data From the National Database-5 (KITCHEN-5). J Clin Med Res 2020; 12:618-623. [PMID: 32849951 PMCID: PMC7430916 DOI: 10.14740/jocmr4274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Accepted: 07/23/2020] [Indexed: 11/11/2022] Open
Abstract
Background Trace proteinuria (TrP), which is usually defined as ± by dipstick urinalysis, is considered as normal and of limited clinical significance. However, the relationship between TrP and overt proteinuria (OP) (≥ +1) in the future is unknown. Therefore, we investigated the association between TrP and future incidence of OP in a community-based cohort study. Methods TrP detected during the initial 2 years, which was classified into transient TrP (once/2 years) (T-TrP) and recurrent TrP (twice/2 years) (R-TrP); and the incidence of OP after 5 years were investigated in 292,257 general Japanese people aged 40 - 68 years who attended checkups. To determine TrP and OP, dipstick urinalysis was conducted with visual reading (VR) by medical staff or automated reading (AR) using a machine reader. Results Overall, T-TrP and R-TrP were observed in 24,782 (8.5%) and 3,767 (1.3%) subjects, respectively. Both types of TrP were prevalent in the detection with AR than VR. The prevalences of T-TrP and R-TrP showed J-shaped relationships against baseline body mass index (BMI), regardless of sex and BMI categories. The incident of OP after 5 years was larger (around 10%) in R-TrP than T-TrP (around 5%): approximately two times. Logistic regression analysis showed that T-TrP and R-TrP were significantly associated with OP, even after adjustment for relevant confounding factors including age, sex, and BMI (odds ratios (95% confidence intervals (CIs)): 2.77 (2.60 - 2.95) and 4.85 (4.34 - 5.43)), which were not largely altered when sub-analysis was conducted according to men and women, non-obesity and obesity, or AR and VR. In all analysis above, the odds ratios (95% CIs) of R-TrP for OP were higher than T-TrP. Conclusions Our findings suggest that TrP, particularly R-TrP, is substantially associated with the future incidence of OP, which may be independent of confounding factors and the methods detecting TrP.
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Affiliation(s)
- Kei Nakajima
- School of Nutrition and Dietetics, Faculty of Health and Social Services, Kanagawa University of Human Services, 1-10-1 Heisei-cho, Yokosuka, Kanagawa 238-8522, Japan.,Graduate School of Health Innovation, Kanagawa University of Human Services, Research Gate Building Tonomachi 2-A, 3-25-10 Tonomachi, Kawasaki, Kanagawa 210-0821, Japan.,Department of Endocrinology and Diabetes, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama 350-8550, Japan
| | - Ryoko Higuchi
- School of Nutrition and Dietetics, Faculty of Health and Social Services, Kanagawa University of Human Services, 1-10-1 Heisei-cho, Yokosuka, Kanagawa 238-8522, Japan
| | - Kaori Mizusawa
- School of Nutrition and Dietetics, Faculty of Health and Social Services, Kanagawa University of Human Services, 1-10-1 Heisei-cho, Yokosuka, Kanagawa 238-8522, Japan
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5
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Poloni JAT, de Moraes Sassi MG, de Oliveira TF, Rotta LN, Perazella MA. Blue-green discoloration of urine and false nephrotic range proteinuria at dipstick urinalysis. Clin Chim Acta 2018; 482:74-77. [PMID: 29608875 DOI: 10.1016/j.cca.2018.03.036] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Revised: 03/24/2018] [Accepted: 03/28/2018] [Indexed: 11/16/2022]
Abstract
A 32 year-old woman presented to the emergency department with symptoms of urinary tract infection. Over the past 2 days, she reported the use of a medication whose active compounds were methenamine (120 mg) + methylthioninium chloride (20 mg). A collected urine sample had a strong blue-green discoloration. Uroculture was negative and dipstick urinalysis revealed the following results: SG 1.015, pH 7, Albumin 3+, Bilirubin 2+ and Haemoglobin 2+. Urine microscopic analysis revealed 5-6 squamous epithelial cells/high power field (HPF), 5-6 leukocytes/HPF and 7-8 erythrocytes/HPF. No bacteria, cellular casts, or renal tubular epithelial cells were present in the urine sample. The most remarkable feature of the urine sediment was that some cells (squamous epithelial cells, macrophages, leukocytes and erythrocytes) were strongly stained in blue. The albuminuria measured by dipstick shows 3+ (300 mg/dL), but in turbidimetric method the urine protein concentration was 18 mg/dL, showing an important interference of methylene blue on the dipstick albumin area.
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Affiliation(s)
- José Antonio Tesser Poloni
- Carlos Franco Voegeli Clinical Analysis Laboratory, Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, Brazil; Universidade do Vale do Rio dos Sinos, São Leopoldo, Brazil; Controllab, Rio de Janeiro, Brazil; Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil.
| | - Marina Gomes de Moraes Sassi
- Carlos Franco Voegeli Clinical Analysis Laboratory, Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, Brazil
| | | | - Liane Nanci Rotta
- Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil
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Chang-Chien C, Chuang GT, Tsai IJ, Chiang BL, Yang YH. A large retrospective review of persistent proteinuria in children. J Formos Med Assoc 2017; 117:711-719. [PMID: 28943081 DOI: 10.1016/j.jfma.2017.09.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 08/13/2017] [Accepted: 09/05/2017] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Proteinuria is a common finding in children. It may be due to a benign cause, but it can also represent early renal injury. Of children with persistent proteinuria noted in mass urine screening programs, 35% have a urine protein level greater than 100 mg/dl and many of them are associated with many underlying renal diseases. The aim of this study was to identify the etiology and prognosis of persistent proteinuria in children. METHODS We collected data on urine protein from January 2011 to December 2016 in a tertiary medical center. During this 6-year period, 37,645 children received urinalysis, and 2.3% were found to have persistent proteinuria. We reviewed their medical charts for clinical diagnoses and renal function. According to the level of persistent proteinuria, we divided the children into three groups (mild, moderate, and severe). RESULTS Most clinical diagnoses in the mild persistent proteinuria group were not readily identifiable. In the moderate and severe groups, acute kidney injury was the leading cause of significant proteinuria, followed by systemic lupus erythematosus, steroid-sensitive nephrotic syndrome, and congenital urogenital tract anomalies. There were significant differences in the rate of chronic renal insufficiency among the three groups. Prematurity with extremely low birth weight was also a major factor associated with pediatric chronic renal insufficiency. CONCLUSION Assessing persistent proteinuria in children is important due to the diverse range of associated diseases or mortality.
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Affiliation(s)
- Chingying Chang-Chien
- Department of Pediatrics, National Taiwan University Children's Hospital, College of Medicine, National Taiwan University, No. 8 Chung-Shan South Rd., Taipei, 10061, Taiwan
| | - Gwo-Tsann Chuang
- Department of Pediatrics, National Taiwan University Children's Hospital, College of Medicine, National Taiwan University, No. 8 Chung-Shan South Rd., Taipei, 10061, Taiwan
| | - I-Jung Tsai
- Department of Pediatrics, National Taiwan University Children's Hospital, College of Medicine, National Taiwan University, No. 8 Chung-Shan South Rd., Taipei, 10061, Taiwan
| | - Bor-Luen Chiang
- Department of Medical Research, National Taiwan University Hospital, Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, No. 7 Chung-Shan South Rd., Taipei, 10061, Taiwan
| | - Yao-Hsu Yang
- Department of Pediatrics, National Taiwan University Children's Hospital, College of Medicine, National Taiwan University, No. 8 Chung-Shan South Rd., Taipei, 10061, Taiwan.
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Abstract
Urinalysis is a frequently performed test that provides valuable information as to the health of individuals. The presence of nitrites in the urine may indicate infection. Antibiotic therapy is commonly started following the results of dipstick urine taken from non-sterile urine samples. This is especially prevalent in men who are immobile, because sterile containers large enough to hold a full bladder of urine are not available (at the author's trust). Urine samples were taken from 25 male A&E patients in a sterile container. Half of each sample was decanted into an ordinary cardboard urine bottle and both samples were then tested using dipstick urinalysis after 1 minute and after 10 minutes to see if there was a difference in the presence of nitrites between the two container types. After 10 minutes, 21 of the 25 samples showed a positive nitrite dipstick in the cardboard container while it remained negative when the urine remained in the sterile container. These results demonstrate that care needs to be taken when collecting urine samples, and the results of dipstick urinalysis should be used with caution depending on the collection method.
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Affiliation(s)
- Rhiannon Eley
- Clinical Teacher, Florence Nightingale Faculty of Nursing and Midwifery, King's College London
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8
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Ting H, Liou CM, Shih TS, Wang CH, Chang SY, Chung AH, Lee JF, Wang L, Huang RJ, Lee SD. Obstructive sleep apnea rather than diabetes or obesity associated with proteinuria in late mid-aged male workers: a decision tree analysis. Sleep Breath 2015; 19:1167-74. [PMID: 25876173 DOI: 10.1007/s11325-015-1132-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2014] [Revised: 12/28/2014] [Accepted: 01/22/2015] [Indexed: 12/22/2022]
Abstract
BACKGROUND Both proteinuria and obstructive sleep apnea (OSA) are associated with cardiovascular events and consequent mortality. To examine whether age, OSA, diabetes, and obesity are potential predictors of proteinuria, a data-driven analysis was performed to delineate a potential categorical classification algorithm. METHODS In this cross-sectional community-based cohort study, demographic data, blood pressure, serum biochemical analyses, proteinuria via single dipstick urinalysis, and overnight polysomnographies were measured in 300 males with sedentary work styles. RESULTS Sixty-one (20.3 %) of all these participants had proteinuria. Logistic regression analysis showed that glycated hemoglobin (HbA1c), duration of arterial oxygen saturation <90 %, age, and log high-sensitivity C-reactive protein, but not apnea-hypopnea index (AHI), were responsible for 16.7 % of the variance of proteinuria's presence. A decision tree analysis showed that subjects over 49 years old had a higher risk for proteinuria than those subjects of 49 years old, or less. In the over 49-year-old group, subjects with an AHI >21 events/h had a higher risk for proteinuria; whereas in the 49-year-old and less group, subjects with HbA1c >7 %, or with HbA1c ≤7, and body mass index (BMI) >27.4 kg/m(2) had a higher risk for proteinuria than their counterparts. CONCLUSIONS AHI was the major determinant responsible for the presence of proteinuria in late mid-aged male workers, while HbA1c and BMI were found in the junior subgroup. By algorithmic analysis, this study provides a comprehensive hierarchical model for better understanding of the correlates of proteinuria and sleep apnea.
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Affiliation(s)
- Hua Ting
- Department of Physical Medicine and Rehabilitation, Chung-Shan Medical University Hospital, Chung-Shan Medical University, Taichung, Taiwan.,Center of Sleep Medicine, Chung-Shan Medical University Hospital, Chung-Shan Medical University, Taichung, Taiwan.,Institute of Medicine, Chung-Shan Medical University, Taichung, Taiwan
| | - Cher-Ming Liou
- Institute of Medicine, Chung-Shan Medical University, Taichung, Taiwan.,Department of Anesthesiology, Chung-Shan Medical University Hospital, Taichung, Taiwan
| | - Tung-Sheng Shih
- Institute of Occupational Safety and Health Council of Labor Affairs, Executive Yuan, Taipei, Taiwan.,Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan
| | - Chih-Huan Wang
- Center of Sleep Medicine, Chung-Shan Medical University Hospital, Chung-Shan Medical University, Taichung, Taiwan.,Department of Psychology, National Chengchi University, Taipei, Taiwan
| | - Shu-Yun Chang
- Center of Sleep Medicine, Chung-Shan Medical University Hospital, Chung-Shan Medical University, Taichung, Taiwan.,Institute of Medicine, Chung-Shan Medical University, Taichung, Taiwan
| | - Ai-Hui Chung
- Center of Sleep Medicine, Chung-Shan Medical University Hospital, Chung-Shan Medical University, Taichung, Taiwan
| | - Jia-Fei Lee
- Center of Sleep Medicine, Chung-Shan Medical University Hospital, Chung-Shan Medical University, Taichung, Taiwan
| | - Lee Wang
- Department of Public Health, Chung-Shan Medical University, Taichung, Taiwan
| | - Ren-Jing Huang
- Center of Sleep Medicine, Chung-Shan Medical University Hospital, Chung-Shan Medical University, Taichung, Taiwan.,Department of Medical Image and Radiological Sciences, Chung-Shan Medical University, Taichung, Taiwan
| | - Shin-Da Lee
- Department of Physical Therapy and Graduate Institute of Rehabilitation Science, China Medical University, 91 Hsueh-Shih Road, Taichung, 40202, Taiwan. .,Department of Healthcare Administration, Asia University, Taichung, Taiwan. .,School of Rehabilitation Medicine, Shanghai University of TCM, Shanghai, China.
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