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Ogi M, Seto T, Wakabayashi Y. A comparison of the utility of the urine dipstick and urine protein-to-creatinine ratio for predicting microalbuminuria in patients with non-diabetic lifestyle-related diseases -a comparison with diabetes. BMC Nephrol 2022; 23:377. [PMID: 36434544 PMCID: PMC9700904 DOI: 10.1186/s12882-022-02974-6] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 10/16/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND The utility of dipstick proteinuria for predicting microalbuminuria in non-diabetic lifestyle-related diseases compared with the urine protein-to-creatinine ratio (uPCR) and the effect of dipstick proteinuria on the cut-off value (CO) and accuracy of uPCR are unclear. METHODS The subjects included Japanese patients ≥ 18 years old with lifestyle-related diseases who had an estimated glomerular filtration rate of ≥ 15 ml/min/1.73 m2 and uPCR of < 0.5 g/gCr at initiation. Urine dipstick, uPCR and urine albumin-to-creatinine ratio (uACR) were measured three times per case. Microalbuminuria was defined as uACR of 30-299 mg/gCr for at least 2 of 3 measurements. Youden's Index was used as the optimal CO. Factors associated with microalbuminuria were analyzed using a logistic regression model. RESULTS In 313 non-diabetic cases (median 70.8 years old), 3 dipstick proteinuria measurements were independently useful for detecting microalbuminuria, and the CO was set when a trace finding was obtained at least 1 of 3 times (sensitivity 0.56, specificity 0.80, positive predictive value [PPV] 0.73, negative predictive value [NPV] 0.65). A single uPCR measurement was more useful than 3 dipstick measurements, and was useful for detecting microalbuminuria even in cases with three consecutive negative proteinuria findings, indicating that the CO of the second uPCR with G1-3a (n = 136) was 0.06 g/gCr (sensitivity 0.76, specificity 0.84. PPV 0.68, NPV 0.89), while that with G3-b4 (n = 59) was 0.10 g/gCr (sensitivity 0.56, specificity 0.91. PPV 0.83, NPV 0.71). The sum of 3 uPCRs was useful for detecting microalbuminuria in cases with G1-3a (sensitivity 0.67, specificity 0.94, PPV 0.82, NPV 0.86) and G3b-4 (sensitivity 0.78, specificity 0.94, PPV 0.91 NPV 0.83), with both COs being 0.23 g/gCr. These COs of microalbuminuria did not change when trace or more proteinuria was included, although the sensitivity increased. A high uPCR and low urine specific gravity or creatinine level were independent factors for uACR ≥ 30 mg/gCr in cases with negative proteinuria, although the uPCR was a major predictive factor of a uACR ≥ 30 mg/gCr. CONCLUSIONS The uPCR (preferably determined using early-morning urine), including in dipstick-negative proteinuria cases with non-diabetic lifestyle-related diseases, can aid in the early detection of microalbuminuria. TRIAL REGISTRATION Retrospectively registered.
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Affiliation(s)
- Makoto Ogi
- Department of Internal Medicine, Yuurinkouseikai Fuji Hospital, 1784 Niihashi, Gotemba, Shizuoka 412-0043 Japan
| | - Takuya Seto
- Department of Internal Medicine, Yuurinkouseikai Fuji Hospital, 1784 Niihashi, Gotemba, Shizuoka 412-0043 Japan
| | - Yoshinori Wakabayashi
- Department of Internal Medicine, Yuurinkouseikai Fuji Hospital, 1784 Niihashi, Gotemba, Shizuoka 412-0043 Japan
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Yoshida Y, Ishizaki T, Masui Y, Arai Y, Inagaki H, Ogawa M, Yasumoto S, Iwasa H, Kamide K, Rakugi H, Ikebe K, Gondo Y. Association of personality traits with polypharmacy among community-dwelling older adults in Japan: a cross-sectional analysis of data from the SONIC study. BMC Geriatr 2022; 22:372. [PMID: 35484487 PMCID: PMC9047377 DOI: 10.1186/s12877-022-03069-5] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 04/13/2022] [Indexed: 11/30/2022] Open
Abstract
Background Polypharmacy is a serious concern among older adults and is frequently related to adverse outcomes, including health problems, reduced quality of life, and increased medical expenses. Although personality traits are associated with health behaviors and diseases, the effect of polypharmacy on personality traits is unclear. Therefore, we examined the association of personality traits with polypharmacy among community-dwelling older adults. Methods This cross-sectional study analysed data on 836 community-dwelling older adults aged 69–71 years who participated in the Japanese longitudinal cohort study of Septuagenarians, Octogenarians, and Nonagenarians Investigation with Centenarians. Polypharmacy was defined as the intake of ≥ 5 medications concurrently. Personality traits were assessed using the Japanese version of the NEO-Five-Factor Inventory (NEO-FFI). A five-factor model of personality traits, including “neuroticism,” “extraversion,” “openness,” “agreeableness,” and “conscientiousness,” was measured by the NEO-FFI. Results The average number of medications was about 3 in both men and women. Among the participants, polypharmacy was observed in 23.9% of men and 28.0% of women. Multivariable logistic regression analysis showed that neuroticism (adjusted odds ratio [aOR] per 1 point increase = 1.078, 95% confidence interval [CI] = 1.015–1.144) in men and extraversion (aOR = 0.932, 95% CI = 0.884–0.983) in women were associated with polypharmacy. Conclusions Higher neuroticism in men and lower extraversion in women were associated with polypharmacy. This study suggests that personality traits may be involved in the process leading to the development of polypharmacy. Information on individual personality traits may help medical professionals in decision-making regarding medication management for lifestyle-related diseases.
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Affiliation(s)
- Yuko Yoshida
- Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo, Japan.
| | - Tatsuro Ishizaki
- Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo, Japan
| | - Yukie Masui
- Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo, Japan
| | - Yasumichi Arai
- Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan
| | - Hiroki Inagaki
- Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo, Japan
| | - Madoka Ogawa
- Osaka University, 2-2 Yamadaoka, Suita, Osaka, Japan
| | | | - Hajime Iwasa
- Fukushima Medical University, 1 Hikariga-oka, Fukushima, Japan
| | - Kei Kamide
- Osaka University, 2-2 Yamadaoka, Suita, Osaka, Japan
| | - Hiromi Rakugi
- Osaka University, 2-2 Yamadaoka, Suita, Osaka, Japan
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Ogi M, Seto T, Wakabayashi Y. Prediction of microalbuminuria from proteinuria in chronic kidney disease due to non-diabetic lifestyle-related diseases: comparison with diabetes. Clin Exp Nephrol 2021; 25:727-750. [PMID: 33656638 PMCID: PMC8154776 DOI: 10.1007/s10157-021-02027-6] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 01/28/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND To suppress increases in kidney failure and cardiovascular disease due to lifestyle-related diseases other than diabetes, early intervention is desirable. We examined whether microalbuminuria could be predicted from proteinuria. METHODS The participants consisted of adults who exhibited a urinary protein-to-creatinine ratio (uPCR) of < 0.5 g/gCr and an eGFR of ≥ 15 ml/min/1.73 m2 in their spot urine at their first examination for lifestyle-related disease. Urine was tested three times for each case, with microalbuminuria defined as a urinary albumin-to-creatinine ratio (uACR) of 30-299 mg/gCr, at least twice on three measurements. Youden's Index was used as an index of the cut-off value (CO) according to the ROC curve. RESULTS A single uPCR was useful for differentiating normoalbuminuria and micro- and macroalbuminuria in patients with non-diabetic lifestyle-related diseases. Regarding the GFR categories, the CO of the second uPCR was 0.09 g/gCr (AUC 0.89, sensitivity 0.76, specificity 0.89) in G1-4 (n = 197) and 0.07 g/gCr (AUC 0.92, sensitivity 0.85, specificity 0.88) in G1-3a (n = 125). Using the sum of two or three uPCR measurements was more useful than a single uPCR for differentiating microalbuminuria in non-diabetic lifestyle disease [CO, 0.16 g/gCr (AUC 0.91, sensitivity 0.85, specificity 0.87) and 0.23 g/gCr (AUC 0.92, sensitivity 0.88, specificity 0.84), respectively]. CONCLUSION Microalbuminuria in Japanese individuals with non-diabetic lifestyle-related diseases can be predicted from the uPCR, wherein the CO of the uPCR that differentiates normoalbuminuria and micro- and macroalbuminuria was 0.07 g/gCr for G1-3a, while that in G3b-4 was 0.09 g/gCr.
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Affiliation(s)
- Makoto Ogi
- Department of Internal Medicine, Yuurinkouseikai Fuji Hospital, 1784 Niihashi, Gotemba, Shizuoka, 412-0043, Japan.
| | - Takuya Seto
- Department of Internal Medicine, Yuurinkouseikai Fuji Hospital, 1784 Niihashi, Gotemba, Shizuoka, 412-0043, Japan
| | - Yoshinori Wakabayashi
- Department of Internal Medicine, Yuurinkouseikai Fuji Hospital, 1784 Niihashi, Gotemba, Shizuoka, 412-0043, Japan
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Sonderlund AL, Thilsing T, Korevaar J, Hollander M, Lionis C, Schellevis F, Wändell P, Carlsson AC, de Waard AK, de Wit N, Seifert B, Angelaki A, Kral N, Sondergaard J. An evidence-based toolbox for the design and implementation of selective-prevention primary-care initiatives targeting cardio-metabolic disease. Prev Med Rep 2019; 16:100979. [PMID: 31508298 DOI: 10.1016/j.pmedr.2019.100979] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 07/01/2019] [Accepted: 08/20/2019] [Indexed: 11/29/2022] Open
Abstract
Cardio-metabolic diseases (CMD; cardiovascular disease, type 2 diabetes, chronic kidney disease) represent a global public health problem. Worldwide, nearly half a billion people are currently diagnosed with diabetes, and cardiovascular disease is the leading cause of death. Most of these diseases can be assuaged/prevented through behavior change. However, the best way to implement preventive interventions is unclear. We aim to fill this knowledge gap by creating an evidence-based and adaptable “toolbox” for the design and implementation of selective prevention initiatives (SPI) targeting CMD. We built our toolbox based on evidence from a pan-European research project on primary-care SPIs targeting CMD. The evidence includes (1) two systematic reviews and two surveys of patient and general practitioner barriers and facilitators of engaging with SPIs, (2) a consensus meeting with leading experts to establish optimal SPI design, and (3) a feasibility study of a generic, evidence-based primary-care SPI protocol in five European countries. Our results related primarily to the five different national health-care contexts from which we derived our data. On this basis, we generated 12 general recommendations for how best to design and implement CMD-SPIs in primary care. We supplement our recommendations with practical, evidence-based suggestions for how each recommendation might best be heeded. The toolbox is generic and adaptable to various national and systemic settings by clinicians and policy makers alike. However, our product needs to be kept up-to-date to be effective and we implore future research to add relevant tools as they are developed.
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Kiyoshige E, Kabayama M, Gondo Y, Masui Y, Ryuno H, Sawayama Y, Inoue T, Akagi Y, Sekiguchi T, Tanaka K, Nakagawa T, Yasumoto S, Ogawa M, Inagaki H, Oguro R, Sugimoto K, Akasaka H, Yamamoto K, Takeya Y, Takami Y, Itoh N, Takeda M, Nagasawa M, Yokoyama S, Maeda S, Ikebe K, Arai Y, Ishizaki T, Rakugi H, Kamide K. Association between long-term care and chronic and lifestyle-related disease modified by social profiles in community-dwelling people aged 80 and 90; SONIC study. Arch Gerontol Geriatr 2018; 81:176-181. [PMID: 30597340 DOI: 10.1016/j.archger.2018.12.010] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 12/13/2018] [Accepted: 12/21/2018] [Indexed: 11/18/2022]
Abstract
BACKGROUND Chronic and lifestyle-related diseases and social status were reported to be associated with long-term care (LTC). The social factors should be treated as social sub-groups of which characteristics show social profiles. However, few previous studies considered that. The present study aimed to investigate the associations between LTC and chronic and lifestyle-related diseases, and whether the associations were modified by the social sub-groups in the community-dwelling elderly. METHOD A cross-sectional study was conducted among 1004 community-dwelling participants aged 80 and 90. LTC was used as the outcome. Chronic and lifestyle-related diseases (i.e., stroke, heart disease, joint pain, osteoporosis, lung disease, cancer, hypertension, dyslipidemia, and diabetes) were used as the predictors. Education, household income, residential area, and support environment were analyzed by latent class analysis (LCA) to derive social profiles. We obtained odds ratios (ORs) of LTC from those diseases and tested interactions between those diseases and the social profiles by logistic regression analyses. RESULT The participants were categorized into two sub-groups of social factors (n = 675 and 329) by LCA. Logistic regression analyses showed ORs (95% CI) of LTC were 4.69 (2.49, 8.71) from stroke, 2.22 (1.46, 3.38) from joint pain, 1.99 (1.22, 3.25) from osteoporosis, and 2.05 (1.22, 3.40) from cancer adjusting for the social sub-groups. There were no significant interactions between the social subgroups and those diseases in relation to LTC except for osteoporosis. CONCLUSION The associations between LTC and chronic and lifestyle-related diseases were significant with adjusting for the social sub-groups, and not modified by that except osteoporosis.
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Affiliation(s)
- Eri Kiyoshige
- Division of Health Science, Osaka University, Graduate School of Medicine, Osaka, Japan
| | - Mai Kabayama
- Division of Health Science, Osaka University, Graduate School of Medicine, Osaka, Japan
| | - Yasuyuki Gondo
- Clinical Thanatology and Geriatric Behavioral Science, Graduate School of Human Sciences, Osaka University, Osaka, Japan
| | - Yukie Masui
- Tokyo Metropolitan Institute of Gerontology, Research Team for Human Care, Tokyo, Japan
| | - Hirochika Ryuno
- Division of Health Science, Kobe University, Graduate School of Medicine, Hyogo, Japan
| | - Yasuka Sawayama
- Division of Health Science, Osaka University, Graduate School of Medicine, Osaka, Japan
| | - Takako Inoue
- Division of Health Science, Osaka University, Graduate School of Medicine, Osaka, Japan
| | - Yuya Akagi
- Division of Health Science, Osaka University, Graduate School of Medicine, Osaka, Japan
| | - Toshiaki Sekiguchi
- Division of Health Science, Osaka University, Graduate School of Medicine, Osaka, Japan
| | - Kentaro Tanaka
- Division of Health Science, Osaka University, Graduate School of Medicine, Osaka, Japan
| | - Takeshi Nakagawa
- Section of NILS-LSA, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Saori Yasumoto
- Clinical Thanatology and Geriatric Behavioral Science, Graduate School of Human Sciences, Osaka University, Osaka, Japan
| | - Madoka Ogawa
- Tokyo Metropolitan Institute of Gerontology, Research Team for Human Care, Tokyo, Japan
| | - Hiroki Inagaki
- Tokyo Metropolitan Institute of Gerontology, Research Team for Human Care, Tokyo, Japan
| | - Ryousuke Oguro
- Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Ken Sugimoto
- Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Hiroshi Akasaka
- Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Koichi Yamamoto
- Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yasushi Takeya
- Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yoichi Takami
- Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Norihisa Itoh
- Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Masao Takeda
- Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Motonori Nagasawa
- Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Serina Yokoyama
- Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Satomi Maeda
- Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Kazunori Ikebe
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Yasumichi Arai
- Center for Supercentenarian Medical Research, Keio University School of Medicine, Tokyo, Japan
| | - Tatsuro Ishizaki
- Tokyo Metropolitan Institute of Gerontology, Research Team for Human Care, Tokyo, Japan
| | - Hiromi Rakugi
- Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Kei Kamide
- Division of Health Science, Osaka University, Graduate School of Medicine, Osaka, Japan; Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Osaka, Japan.
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Abstract
This narrative review examines the changes required in dietary behaviours to address the current global burden of disease resulting from diet-associated cardiometabolic dysfunction. Beginning with known relationships between nutritional factors and health outcomes, the review identifies a number of problems with current dietary behaviours, using examples from the Australian context. Implications for practice are then discussed drawing on insights from research in dietary trials. From a concerted research effort across the globe, the effects of foods, food components and dietary patterns on cardiometabolic parameters have been reasonably well exposed. The evidence base for these effects underpins dietary guidelines, which aim to meet nutritional requirements and protect against cardiometabolic disease. Thus foods recommended in dietary guidelines tend to be consistent with research that identifies foods that appear protective and those that appear detrimental to health. The need for dietary behaviour change is apparent through analyses that have exposed increasing consumption of detrimental foods, despite the availability of healthy foods. However, behaviour change is a complex area, and where weight loss is also required, there is high level evidence that interdisciplinary efforts combining diet, physical activity and psychological support are warranted. Insights from dietary trials and research indicate that focussing on foods and dietary patterns is integral to the specific dietary change required for health outcomes, but social and behavioural factors will influence the achievement of these changes.
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Affiliation(s)
- Linda C Tapsell
- School of Medicine, Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW 2522, Australia
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Sakai A, Nakano H, Ohira T, Hosoya M, Yasumura S, Ohtsuru A, Satoh H, Kawasaki Y, Suzuki H, Takahashi A, Sugiura Y, Shishido H, Hayashi Y, Takahashi H, Kobashi G, Ozasa K, Hashimoto S, Ohto H, Abe M. Persistent prevalence of polycythemia among evacuees 4 years after the Great East Japan Earthquake: A follow-up study. Prev Med Rep 2017; 5:251-256. [PMID: 28127528 PMCID: PMC5257186 DOI: 10.1016/j.pmedr.2017.01.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [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: 06/22/2016] [Revised: 01/05/2017] [Accepted: 01/08/2017] [Indexed: 11/25/2022] Open
Abstract
We previously reported that the lifestyle of evacuees significantly increased the prevalence of polycythemia compared with non-evacuees at an average of 1.6 years (2011–2012) from the previous annual health checkup before the Great East Japan Earthquake (GEJE). Here we analyzed how the prolonged evacuation affected the prevalence of polycythemia an average of 2.5 years (2013–2014) after the previous data. Subjects were individuals aged 40–90 years living in the vicinity of the Fukushima Daiichi Nuclear Power Plant in Fukushima Prefecture who had attended the annual health checkups since 2008. The prevalence of polycythemia and changes in its defining factors of red blood cell count (RBC), hemoglobin (Hb) level, hematocrit (Ht) level were compared between before and after the GEJE in 7713 individuals (3349 men and 4364 women) receiving follow-up examinations both 2011–2012 and 2013–2014. RBC, Hb levels and Ht levels in 2011–2012 were higher among evacuees than non-evacuees in both men and women. However, all levels in 2013–2014 were on the decline from those in 2011–2012. On the other hand, among evacuees, Hb and Ht levels continued to be higher than before the GEJE in both men and women evacuees. The prevalence of polycythemia, which was diagnosed if one of the defining factors was beyond the standard value, was significantly higher among evacuees than non-evacuees regardless of the presence or the absence of overweight/obesity, smoking, and hypertension. Therefore, prolonged evacuation is a cause of polycythemia even 3 to 4 years after the GEJE and regular health management of evacuees is important. Evacuation after the Great East Japan Earthquake (GEJE) causes polycythemia. Evacuation is an independent factor of polycythemia. Prevalence of polycythemia among evacuees persists even after 4 years of the GEJE.
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Affiliation(s)
- Akira Sakai
- Dept. of Radiation Life Sciences, Fukushima Medical University School of Medicine, Fukushima, Japan; Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Hironori Nakano
- Dept. of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan; Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Tetsuya Ohira
- Dept. of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan; Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Mitsuaki Hosoya
- Dept. of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Japan; Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Seiji Yasumura
- Dept. of Public Health, Fukushima Medical University School of Medicine, Fukushima, Japan; Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Akira Ohtsuru
- Dept. of Radiation Health Management, Fukushima Medical University School of Medicine, Fukushima, Japan; Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Hiroaki Satoh
- Dept. of Nephrology, Hypertension, Diabetology, and Endocrinology, Fukushima Medical University School of Medicine, Fukushima, Japan; Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Yukihiko Kawasaki
- Dept. of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Japan; Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Hitoshi Suzuki
- Dept. of Cardiology and Hematology, Fukushima Medical University School of Medicine, Fukushima, Japan; Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Atsushi Takahashi
- Dept. of Gastroenterology, Fukushima Medical University School of Medicine, Fukushima, Japan; Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Yoshihiro Sugiura
- Dept. of Neurology, Fukushima Medical University School of Medicine, Fukushima, Japan; Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Hiroaki Shishido
- Dept. of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Fukushima, Japan; Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Yoshimitsu Hayashi
- Dept. of Nephrology, Hypertension, Diabetology, and Endocrinology, Fukushima Medical University School of Medicine, Fukushima, Japan; Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Hideto Takahashi
- Information Management and Statistics Office, Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University School of Medicine, Fukushima, Japan; Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Gen Kobashi
- Dept. of Public Health, Dokkyo Medical University School of Medicine, Shimotsuga, Japan
| | - Kotaro Ozasa
- Dept. of Epidemiology, Radiation Effects Research Foundation, Hiroshima, Japan
| | - Shigeatsu Hashimoto
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Hitoshi Ohto
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Masafumi Abe
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University School of Medicine, Fukushima, Japan
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Kashima A, Higashiyama Y, Kubota M, Kawaguchi C, Takahashi Y, Nishikubo T. Children with Down's syndrome display high rates of hyperuricaemia. Acta Paediatr 2014; 103:e359-64. [PMID: 24766390 DOI: 10.1111/apa.12664] [Citation(s) in RCA: 5] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2014] [Revised: 03/13/2014] [Accepted: 04/22/2014] [Indexed: 11/29/2022]
Abstract
AIM Several studies show that hyperuricaemia, abnormally high levels of uric acid in the blood, frequently occurs in adult Down's syndrome patients, but paediatric research is scarce. We aimed to clarify its prevalence in paediatric Down's syndrome patients and its association with lifestyle-related laboratory variables and nutritional intake, to consider possible effects in later life. METHODS We compared 52 Down's syndrome patients, from one to 15 years of age, with age-matched controls. Hyperuricaemia was defined using reference values established for children, as uric acid z-scores of more than 2.0. Nutritional intake was estimated using 3-day dietary records. RESULTS Hyperuricaemia occurred in 17 Down's patients (32.7%) and was significantly higher in Down's patients than the controls. The prevalence was also significantly higher in males. There were no significant differences between hyperuricaemia-positive and hyperuricaemia-negative patients in terms of age, body mass index standard deviation scores, fasting blood glucose, insulin, homeostasis model assessment-insulin resistance and triglyceride, and purine body intake was similar. There were differences in high-density lipoprotein cholesterol. CONCLUSION We found high rates of hyperuricaemia from early childhood in Down's syndrome patients. This suggests careful management of Down's syndrome patients, as hyperuricaemia is an independent risk factor for lifestyle-related diseases in adulthood.
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Affiliation(s)
- Ayako Kashima
- Faculty of Human Life and Environment; Nara Women's University; Nara Japan
| | - Yukie Higashiyama
- Faculty of Human Life and Environment; Nara Women's University; Nara Japan
| | - Masaru Kubota
- Faculty of Human Life and Environment; Nara Women's University; Nara Japan
| | - Chiharu Kawaguchi
- Department of Pediatrics; Todaiji Medical and Education Center; Nara Japan
| | - Yukihiro Takahashi
- Department of Neonatal Intensive Care Unit; Nara Medical University Hospital; Nara Japan
| | - Toshiya Nishikubo
- Department of Neonatal Intensive Care Unit; Nara Medical University Hospital; Nara Japan
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