1
|
Zhang B, Wang J, Liu N, Liu W, Xi R, Wang P. Association between polypharmacy and chronic kidney disease among community-dwelling older people: a longitudinal study in southern China. BMC Nephrol 2024; 25:169. [PMID: 38760750 PMCID: PMC11100214 DOI: 10.1186/s12882-024-03606-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 05/10/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND Polypharmacy would increase the risk of adverse drug events and the burden of renal drug excretion among older people. Nevertheless, the association between the number of medication and the risk of chronic kidney disease (CKD) remains controversial. Therefore, this study aims to investigate the association between the number of medication and the incidence of CKD in older people. METHODS This study investigates the association between the number of medications and CKD in 2672 elderly people (≥ 65 years older) of the community health service center in southern China between 2019 and 2022. Logistic regression analysis was used to evaluate the relationship between polypharmacy and CKD. RESULTS At baseline, the average age of the study subjects was 71.86 ± 4.60, 61.2% were females, and 53 (2.0%) suffer from polypharmacy. During an average follow-up of 3 years, new-onset CKD developed in 413 (15.5%) participants. Logistic regression analysis revealed that taking a higher number of medications was associated with increase of CKD. Compared with people who didn't take medication, a higher risk of CKD was observed in the older people who taken more than five medications (OR 3.731, 95% CI 1.988, 7.003), followed by those who take four (OR 1.621, 95% CI 1.041, 2.525), three (OR 1.696, 95% CI 1.178, 2.441), two drugs (OR 1.585, 95% CI 1.167, 2.153), or one drug (OR 1.503, 95% CI 1.097, 2.053). Furthermore, age, systolic blood pressure (SBP), white blood cell (WBC), blood urea nitrogen (BUN) and triglyceride (TG) were also independent risk factors CKD (P < 0.05). CONCLUSION The number of medications was associated with CKD in older people. As the number of medications taken increased, the risk of CKD was increased.
Collapse
Affiliation(s)
- Bowen Zhang
- General Practice Center, The seventh Affiliated Hospital of Southern Medical University, Foshan, 528244, China
- School of Nursing and Health, Henan University, Kaifeng, 475004, China
| | - Jingrui Wang
- School of Nursing and Health, Henan University, Kaifeng, 475004, China
| | - Nan Liu
- School of Nursing and Health, Henan University, Kaifeng, 475004, China
- College of Public Health, Zhengzhou University, Zhengzhou, 540001, P. R. China
- Institute of Environment and Health, Health Science Center, South China Hospital, Shenzhen University, Shenzhen, 518116, P. R. China
| | - Weijia Liu
- School of Nursing and Health, Henan University, Kaifeng, 475004, China
| | - Ruihan Xi
- School of Nursing and Health, Henan University, Kaifeng, 475004, China
| | - Peixi Wang
- General Practice Center, The seventh Affiliated Hospital of Southern Medical University, Foshan, 528244, China.
- School of Nursing and Health, Henan University, Kaifeng, 475004, China.
| |
Collapse
|
2
|
Kashyap S, AN I, KN S, R H. A mathematical model for thrombotic risk assessment in type 2 diabetes. Bioinformation 2023; 19:971-975. [PMID: 37928492 PMCID: PMC10625368 DOI: 10.6026/97320630019971] [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: 09/01/2023] [Revised: 09/30/2023] [Accepted: 09/30/2023] [Indexed: 11/07/2023] Open
Abstract
Hyperglycaemia is known to alter the circulating lipids in diabetics. Combinatorial effect of in vivo synthesis of lipids and dietary lipids leads to atherosclerosis. Uncontrolled diabetes is linked with the cardiovascular outcome. This data has correlated the Castelli's Risk Index (CRI-I and CRI-II), Atherogenic Index of Plasma and Atherogenic Coefficient with microvascular complications of T2DM. Etio-pathogenesis of cardiovascular risk factors and lipid biomarkers speaks of the thrombotic events of cerebrovascular accidents and also the reno-vascular mechanisms of renal arterial thrombotic events. Documentary evidence have proved that the micro albuminuria is a "cutting edge" to assess the microvascular complications of renal and retina. Uncontrolled diabetes is known to alter the triglycerides, lower HDL-cholesterol and elevate LDL-cholesterol. Alteration of lipid profile mimics a major link between diabetes and the increased cardiovascular risk in diabetic patients.
Collapse
Affiliation(s)
- Sahana Kashyap
- Department of Biochemistry, Sri Devaraj Urs Medical College, Constituent college of Sri Devaraj Urs Academy of Higher Education and Research, Tamaka, Kolar, Karnataka, India
| | - Indumathi AN
- Department of Biochemistry, Sri Devaraj Urs Medical College, Constituent college of Sri Devaraj Urs Academy of Higher Education and Research, Tamaka, Kolar, Karnataka, India
| | - Shashidhar KN
- Department of Biochemistry, Sri Devaraj Urs Medical College, Constituent college of Sri Devaraj Urs Academy of Higher Education and Research, Tamaka, Kolar, Karnataka, India
| | - Harish R
- Department of Biochemistry, Sri Devaraj Urs Medical College, Constituent college of Sri Devaraj Urs Academy of Higher Education and Research, Tamaka, Kolar, Karnataka, India
| |
Collapse
|
3
|
Liao S, Lin D, Feng Q, Li F, Qi Y, Feng W, Yang C, Yan L, Ren M, Sun K. Lipid Parameters and the Development of Chronic Kidney Disease: A Prospective Cohort Study in Middle-Aged and Elderly Chinese Individuals. Nutrients 2022; 15:nu15010112. [PMID: 36615770 PMCID: PMC9823682 DOI: 10.3390/nu15010112] [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: 11/09/2022] [Revised: 12/16/2022] [Accepted: 12/21/2022] [Indexed: 12/28/2022] Open
Abstract
Epidemiological evidence suggests that lipid parameters are related to the progression of chronic kidney disease (CKD). Nevertheless, prospective studies that comprehensively assess the effect of routinely available lipid measures on the development of CKD are lacking. The aim of this study was to longitudinally assess the influence of lipid metabolism indicators on the presence of CKD in a large community-based population. We conducted a prospective cohort study at Sun Yat-sen Memorial Hospital, China, with 5345 patients of 40 years or older. Cox regression models were conducted, and hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated to assess lipid parameters and their relationship with the incidence of CKD. During the follow-up period, 340 (6.4%) subjects developed CKD. The incidence of CKD increased progressively with quartile values of triglyceride (TG), the ratio of non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol (non-HDL-C/HDL-C) and the ratio of TG to HDL-C, but decreased with HDL-C quartiles (p < 0.0001 for all trends). Pearson’s correlation analysis and multiple regression analyses indicated that these parameters were also associated with various indicators of kidney function. Moreover, we found that among all the lipid parameters, TG/HDL-C emerged as the most effective predictor of CKD. In conclusion, our findings suggest that TG/HDL-C better predicts the incidence of CKD in middle-aged and elderly Chinese individuals than other lipid parameters tested in the study.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | - Meng Ren
- Correspondence: (M.R.); (K.S.); Tel.: +86-20-81332518 (K.S.); Fax: +86-20-81332042 (K.S.)
| | - Kan Sun
- Correspondence: (M.R.); (K.S.); Tel.: +86-20-81332518 (K.S.); Fax: +86-20-81332042 (K.S.)
| |
Collapse
|
4
|
Toprak K. Atherogenic Index of Plasma is an Independent Risk Factor for Contrast Induced Nephropathy in Patients With Non-ST Elevation Myocardial Infarction. Angiology 2022; 74:427-434. [PMID: 35750499 DOI: 10.1177/00033197221110723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study investigated the role of atherogenic index of plasma (AIP) in predicting contrast induced nephropathy (CIN) in patients who underwent percutaneous coronary intervention due to non-ST elevated myocardial infarction. Of these, 1644 patients were included in the study. Retrospective data of patients were obtained from hospital records. For the diagnosis of CIN, peri-procedural patient records were scanned. There was a significant difference between age, diabetes mellitus, hyperlipidemia, albumin, high density lipoprotein cholesterol, triglycerides, number of stenotic vessels, creatinine increase rate, baseline creatinine, hemoglobin, hematocrit, AIP, and two groups (CIN- and CIN+) (P < .05, for all). In multivariate logistic regression analysis, AIP was an independent predictor of CIN (odds ratio: 20.352, 95% CI: 12.696-32.624, P < .001). Receiver operating characteristic analysis showed that AIP values of ≥.62 could predict CIN with a sensitivity of 70% and specificity of 58% for predicting CIN (area under curve = .710, P < .001). Atherogenic index of plasma may be helpful as a biomarker to predict CIN.
Collapse
Affiliation(s)
- Kenan Toprak
- Department of Cardiology, Siverek State Hospital, Sanliurfa 63600, Turkey
| |
Collapse
|
5
|
Study on the Interaction between the Characteristics of Retinal Microangiopathy and Risk Factors for Cerebral Small Vessel Disease. CONTRAST MEDIA & MOLECULAR IMAGING 2022; 2022:9505945. [PMID: 35800241 PMCID: PMC9203197 DOI: 10.1155/2022/9505945] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 04/18/2022] [Accepted: 05/03/2022] [Indexed: 11/24/2022]
Abstract
Objective This study was designed to explore the characteristics of retinal microangiopathy in patients with cerebral small vessel disease (CSVD) and clarify its interaction with the risk factors for CSVD. Methods Sixty patients with CSVD and 15 healthy individuals were enrolled. Demographic data, risk factors, and medical history were recorded, and magnetic resonance imaging was performed to detect and analyze the characteristics of retinal microangiopathy in the two groups. The interaction among retinal microangiopathy, vascular risk factors, and total imaging load of CSVD was compared. Results (1) Hypertension, standard deviation of systolic blood pressure (SBPSD), standard deviation of blood glucose (SDBG), and atherogenic index of plasma (AIP) were independent vascular risk factors for CSVD. (2) Statistically significant differences in hypertension, SBPSD, SDBG, and AIP were observed between the two groups in terms of the total imaging burden of CSVD (p < 0.05). (3) Multivariate logistic linear regression showed that CSVD was associated with a wider central retinal vein equivalent (CRVE) (p = 0.015), a smaller arteriole-to-venule ratio (AVR) (p = 0.001), and a higher incidence of vessel tortuosity (p = 0.027). (4) When the total imaging burden of CSVD ranges from 0 to 4 points, the CRVE is larger, the AVR is smaller, and the incidence of vascular tortuosity is higher, with a statistically significant difference (p < 0.05). (5) The characteristics of retinal microangiopathy were correlated with hypertension, SBPSD, SDBG, and AIP (p < 0.05). (6) An association was observed between the characteristics of retinal microangiopathy and vascular risk factors and the total imaging burden of CSVD (p < 0.05). Conclusions (1) Hypertension, SBP variability, BG fluctuation, and AIP are independent vascular risk factors for CSVD. (2) Retinal microvessels are changed in patients with CSVD, and venous dilatation, decreased arteriovenous ratio, and vascular tortuosity are the main characteristics of the disease. (3) The characteristics of retinal microangiopathy are interactively correlated with the total imaging load and risk factors for CSVD and can be used as indicators of the severity of CSVD.
Collapse
|
6
|
Grinshtein YI, Shabalin VV, Ruf RR, Shalnova SA, Drapkina OM. Atherogenic index of plasma as an additional marker of adverse cardiovascular outcomes. КАРДИОВАСКУЛЯРНАЯ ТЕРАПИЯ И ПРОФИЛАКТИКА 2022. [DOI: 10.15829/1728-8800-2022-3176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Aim. Using a representative sample of the Krasnoyarsk Krai population, to evaluate the distribution of the atherogenic index of plasma (AIP), logarithmically transformed ratio of molar concentrations of triglycerides to high-density lipoprotein-cholesterol, and to identify possible associations between AIP, various cardiovascular diseases, and metabolic parameters.Material and methods. The study included a random representative sample of 1603 residents of the Krasnoyarsk and Berezovsky rural district aged 25-64 years as part of the Epidemiology of Cardiovascular Diseases and their Risk Factors in Regions of Russian Federation (ESSE-RF) study. Statistical processing was performed using IBM SPSS v22 and Microsoft Excel 2021 programs. We assessed the prevalence of hypertension (HTN), coronary artery disease, myocardial infarction (MI), stroke and renal dysfunction in the whole sample and in groups with different risk depending on AIP. Differences between groups were tested by Yates’s chi-squared test and were considered significant at p≤0,05.Results. Depending on AIP value, 73,5% of participants were in the low-risk group (AIP <0,10), 10,4% — in moderate risk group (AIP, 0,100,24) and 16,1% — in high-risk group (AIP>0,24). The prevalence of prior MI or stroke in the moderate and high-risk group for AIP was significantly higher than in the low-risk group (p=0,024). A regular increase in HTN prevalence was registered from 42,6% in the lowrisk group to 71,4% in the high-risk group for AIP (p<0,001 for all). There was a significant increase in the proportion of patients with a combination of HTN + elevated low-density lipoprotein cholesterol levels as AIP risk increased — from 28,4% at low risk to 45,2% at high risk. There were no significant differences between AIP risk groups in the prevalence of coronary artery disease and renal dysfunction.Conclusion. AIP is a simple additional estimated parameter that characterizes the atherogenic properties of plasma. Based on a cohort of Krasnoyarsk Krai subjects, an elevated level of AIP is associated with an increased prevalence of MI and strokes. Determination of AIP may be especially useful in the case of normal baseline low-density lipoprotein cholesterol levels.
Collapse
Affiliation(s)
| | - V. V. Shabalin
- V.F. Voyno-Yasenetsky Krasnoyarsk State Medical University
| | - R. R. Ruf
- V.F. Voyno-Yasenetsky Krasnoyarsk State Medical University
| | - S. A. Shalnova
- National Medical Research Center for Therapy and Preventive Medicine
| | - O. M. Drapkina
- National Medical Research Center for Therapy and Preventive Medicine
| |
Collapse
|
7
|
Mirashrafi S, Kafeshani M, Hassanzadeh A, Entezari MH. Is any association between alternate healthy eating index (AHEI) with lipid profile and liver enzymes? A cross-sectional Study. J Diabetes Metab Disord 2021; 20:1537-1544. [PMID: 34900806 PMCID: PMC8630323 DOI: 10.1007/s40200-021-00898-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 09/06/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE Based on evidence, there is a significant relationship between diet quality and the chronic conditions such as dyslipidemia and liver disorders. In the current study, we investigated the relationship between alternative healthy eating index (AHEI) and some biochemical measurements (lipid profile and liver enzymes). METHODS In this cross-sectional study, 127 hospital employees were randomly selected (of 250 screened volunteers). AHEI was estimated based on a 168 items food frequency questionnaire. The laboratory data [triglyceride (TG), total cholesterol (TC), high density lipoprotein (HDL), low density lipoprotein (LDL), alanine transaminase (ALT), aspartate transaminase (AST)] were extracted from periodic examinations. The physical activity was also estimated with international physical activity questionnaire (IPAQ). RESULTS Among 127 completed data, the mean AHEI score was 47.1. There was a direct relationship between AHEI score and HDL (P = 0.02). Among the AHEI components, the score of nuts and soybeans was directly associated with HDL level (P = 0.007). There was no association between the other AHEI components and selected biomarkers. CONCLUSION Nuts and soybeans consumption-one unit per day-may increase HDL levels. More studies are needed to evaluate the diet quality with the other dietary indices. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s40200-021-00898-w.
Collapse
Affiliation(s)
- Shahrzad Mirashrafi
- Department of Clinical Nutrition, School of Nutrition & Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Marzieh Kafeshani
- Department of Clinical Nutrition, School of Nutrition & Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Hezar-Jerib Ave, P.O. Box 319, 8174673461 Isfahan, Iran
| | - Akbar Hassanzadeh
- Department of Epidemiology and Biostatistics, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Hassan Entezari
- Department of Clinical Nutrition, School of Nutrition & Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Hezar-Jerib Ave, P.O. Box 319, 8174673461 Isfahan, Iran
| |
Collapse
|
8
|
Paz Landim M, Cosenso-Martin LN, Polegati Santos A, Roma Uyemura JR, Barufi Fernandes L, da Silva Lopes V, Yugar-Toledo JC, Vilela-Martin JF. Predictive Factors for Target Organ Injuries in Hypertensive Individuals. Integr Blood Press Control 2021; 14:113-121. [PMID: 34429649 PMCID: PMC8374840 DOI: 10.2147/ibpc.s324151] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 07/27/2021] [Indexed: 01/13/2023] Open
Abstract
Background The causal relationship between systemic arterial hypertension and target organ damage (TOD) is well known, as well as the association with cardiovascular risk factors (CV). Ambulatory blood pressure monitoring (ABPM) is important in monitoring hypertension and assessing the risk of TOD. Objective To evaluate the relationship between blood pressure (BP) and clinical and biochemical parameters in the development of TOD in hypertensive patients. Methods This was a retrospective cohort study with 162 hypertensive patients followed for an average period of 13 years. The TOD investigated were left ventricular hypertrophy (LVH), microalbuminuria, coronary artery disease (CAD) and stroke. Blood pressure was assessed by ABPM and LVH using echocardiogram and electrocardiogram, respectively. Biochemical-metabolic tests and 24-hour microalbuminuria were performed at baseline and follow-up. The P-value <0.05 was considered significant. Results The average age was 69±11.8 years, with a predominance of women (64.8%), white ethnicity (79.6%) and diabetics (78.4%). ABPM showed a significant reduction in BP values during follow-up, although without association with TOD (microalbuminuria, stroke, and CAD), except for LVH that showed a correlation with sleep BP ≥120/70 mmHg (P=0.044). The most frequent TODs were LVH (29.6%), microalbuminuria (26.5%), CAD (19.8%) and stroke (17.3%). In the follow-up, there was an association between LVH and diabetes; microalbuminuria was associated with diabetes and triglycerides; stroke was associated with HDL-cholesterol (HDL-c), microalbuminuria and carotid disease. CAD showed a relationship with age and HDL-c. Conclusion Predictive factors for TOD are age, microalbuminuria, diabetes, HDL-c, triglycerides and carotid disease. Nocturnal BP is correlated with LVH. The absence of a relationship between ABPM and other TODs can be explained by the use of effective drugs, improvement of metabolic and blood pressure parameters.
Collapse
Affiliation(s)
- Manoel Paz Landim
- Internal Medicine Department, State Medical School at Sao Jose do Rio Preto (FAMERP), Sao Jose do Rio Preto, Sao Paulo, Brazil
| | - Luciana Neves Cosenso-Martin
- Internal Medicine Department, State Medical School at Sao Jose do Rio Preto (FAMERP), Sao Jose do Rio Preto, Sao Paulo, Brazil
| | - Aleandra Polegati Santos
- Internal Medicine Department, State Medical School at Sao Jose do Rio Preto (FAMERP), Sao Jose do Rio Preto, Sao Paulo, Brazil
| | - Jessica Rodrigues Roma Uyemura
- Internal Medicine Department, State Medical School at Sao Jose do Rio Preto (FAMERP), Sao Jose do Rio Preto, Sao Paulo, Brazil
| | - Leticia Barufi Fernandes
- Internal Medicine Department, State Medical School at Sao Jose do Rio Preto (FAMERP), Sao Jose do Rio Preto, Sao Paulo, Brazil
| | - Valquiria da Silva Lopes
- Internal Medicine Department, State Medical School at Sao Jose do Rio Preto (FAMERP), Sao Jose do Rio Preto, Sao Paulo, Brazil
| | - Juan Carlos Yugar-Toledo
- Internal Medicine Department, State Medical School at Sao Jose do Rio Preto (FAMERP), Sao Jose do Rio Preto, Sao Paulo, Brazil
| | - Jose Fernando Vilela-Martin
- Internal Medicine Department, State Medical School at Sao Jose do Rio Preto (FAMERP), Sao Jose do Rio Preto, Sao Paulo, Brazil
| |
Collapse
|
9
|
Zhao Z, Song L, Yao J. What is the relationship between higher triglyceride and kidney function decline in adults? Ren Fail 2021; 43:533-534. [PMID: 33726617 PMCID: PMC7971290 DOI: 10.1080/0886022x.2021.1896549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Zhifang Zhao
- Department of Medicine, Northwest Minzu University, Lanzhou, PR China
| | - Lei Song
- Department of Medicine, Northwest Minzu University, Lanzhou, PR China
| | - Jibin Yao
- Department of Surgical Oncology, Gansu Provincial Hospital, Lanzhou, P.R. China
| |
Collapse
|