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Shi Y, Hu H, Wu Z, Chen Z, Li P. Blood selenium level can alleviate the nephrotoxicity of lead and cadmium in the general population of the United States: a retrospective cross section analysis of population-based nationally representative data. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023:10.1007/s11356-023-27663-1. [PMID: 37191747 DOI: 10.1007/s11356-023-27663-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 05/11/2023] [Indexed: 05/17/2023]
Abstract
The current understanding of the interplay between blood selenium, cadmium and lead levels, and chronic kidney disease (CKD) is limited. Our objective was to investigate whether elevated blood selenium levels can mitigate the nephrotoxic effects of lead and cadmium. The exposure variables examined in this study include blood selenium, cadmium, and lead levels measured by ICP-MS. The outcome of interest was CKD, defined as an estimated glomerular filtration rate (eGFR) below 60 mL/min/1.73 m2. In total, 10630 participants (mean (SD) age:48.9 ± 18.4; 48.3% male) were included in this analysis. The median (IQR) of blood selenium, cadmium, and lead levels was 191 (177-207) μg/L, 0.300 (0.180-0.540) μg/L, and 0.940 (0.570-1.510) μg/dL, respectively. We observed a significant positive association between cadmium and lead levels and CKD (OR; 1.86; 95%CI: 1.31- 2.64; OR:2.23; 95%CI:1.54-3.24). However, selenium had a negative association with CKD (OR:0.096; 95%CI:0.020-0.457). Based on a reference group with a selenium concentration of ≤ 191 μg/L and cadmium level of > 0.300 μg/L, a significant protective factor in the CKD was seen in subjects with high plasma selenium and lower cadmium concentrations (OR:0.685; 95%CI:0.515-0.912). Then selenium concentration of ≤ 191 μg/L and lead level of > 0.940 μg/dL were set as a reference group, and the OR for CKD decreased among the other group (OR:0.564; 95%CI;0.417- 0.762). The subgroup analysis indicated that there were no effect modifiers. Blood selenium has the potential to mitigate the nephrotoxic effects of lead and cadmium in the general population of the United States.
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Affiliation(s)
- Yumeng Shi
- Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University, No. 1 Minde Road, Nanchang, 330006, Jiangxi, China.
| | - Huan Hu
- Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University, No. 1 Minde Road, Nanchang, 330006, Jiangxi, China
| | - Zuxiang Wu
- Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University, No. 1 Minde Road, Nanchang, 330006, Jiangxi, China
| | - Zhiqiang Chen
- Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University, No. 1 Minde Road, Nanchang, 330006, Jiangxi, China
| | - Ping Li
- Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University, No. 1 Minde Road, Nanchang, 330006, Jiangxi, China
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Tada K, Maeda T, Takahashi K, Ito K, Yasuno T, Funakoshi S, Satoh A, Kawazoe M, Yoshimura C, Mukoubara S, Masutani K, Arima H, Nakashima H. Association between serum uric acid and new onset and progression of chronic kidney disease in a Japanese general population: Iki epidemiological study of atherosclerosis and chronic kidney disease. Clin Exp Nephrol 2021; 25:751-759. [PMID: 33689045 DOI: 10.1007/s10157-021-02042-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 02/26/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Although several risk factors for chronic kidney disease (CKD) have been proposed, it remains unclear whether elevated serum uric acid (SUA) is negatively association with kidney function. The aim of this study was to elucidate the association between SUA and new onset and progression of CKD in a Japanese general population. METHODS This was a population-based retrospective cohort study using annual health checkup data of residents of Iki Island. A total of 5,507 adults (979 with CKD and 4,528 without) were included. The outcomes were new onset of CKD among participants without CKD at baseline, and progression of CKD among those with CKD. A Cox proportional hazards model was used to evaluate the association between SUA and new onset and progression of CKD. RESULTS During mean follow-up of 4.6 years, 757 cases of new onset of CKD and 193 with progression of CKD were observed. SUA was significantly associated with new onset of CKD (adjusted hazard ratio 1.13, [95% confidence interval 1.03-1.24] per standard deviation [SD] increase in SUA). In contrast, SUA was not significantly associated with progression of CKD (hazard ratio 1.08, [0.92-1.27] per SD increase). Similar results were obtained when classifying uric acid as categorical. CONCLUSION SUA was significantly associated with increased risk for new onset of CKD, but not with progression of CKD among a Japanese general population.
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Affiliation(s)
- Kazuhiro Tada
- Division of Nephrology and Rheumatology, Department of Internal Medicine, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma Jonan-ku, Fukuoka, 814-0180, Japan
| | - Toshiki Maeda
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma Jonan-ku, Fukuoka, 814-0180, Japan.
| | - Koji Takahashi
- Division of Nephrology and Rheumatology, Department of Internal Medicine, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Kenji Ito
- Division of Nephrology and Rheumatology, Department of Internal Medicine, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Tetsuhiko Yasuno
- Division of Nephrology and Rheumatology, Department of Internal Medicine, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Shunsuke Funakoshi
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma Jonan-ku, Fukuoka, 814-0180, Japan
| | - Atsushi Satoh
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma Jonan-ku, Fukuoka, 814-0180, Japan
| | - Miki Kawazoe
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma Jonan-ku, Fukuoka, 814-0180, Japan
| | - Chikara Yoshimura
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma Jonan-ku, Fukuoka, 814-0180, Japan
| | | | - Kosuke Masutani
- Division of Nephrology and Rheumatology, Department of Internal Medicine, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Hisatomi Arima
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma Jonan-ku, Fukuoka, 814-0180, Japan
| | - Hitoshi Nakashima
- Division of Nephrology and Rheumatology, Department of Internal Medicine, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
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Hu G, Bai Y, Chen T, Tang S, Hu L. Threshold Effects of Serum Uric Acid on Chronic Kidney Disease in US Women without Hypertension and Diabetes: A Cross-Sectional Study. Kidney Blood Press Res 2019; 44:1036-1049. [DOI: 10.1159/000502183] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 07/17/2019] [Indexed: 12/21/2022] Open
Abstract
Background: Serum uric acid (SUA) has been associated with increased risk of chronic kidney disease (CKD) in observational studies; however, data in women without hypertension and diabetes are sparse. Purpose: To examine the association between SUA and CKD among women without hypertension and diabetes. Methods: In this cross-sectional study of 6,776 US women without hypertension and diabetes from the National Health and Nutrition Examination Survey (1999–2006), we investigated the relationship between SUA and CKD using multivariable logistic regression models. Moreover, a generalized additive model and smooth curve fitting (penalized spline method) and a 2 piecewise logistic regression models were conducted to address for nonlinearity. Results: The prevalence of CKD was 8.3%. Multiple logistic analyses showed that per 1 mg/dL increase in SUA was associated with 39% increased prevalence of CKD. Analyses using restricted cubic spline confirmed that the association between SUA and CKD was nonlinear. Further, threshold and saturation effect analysis showed that the inflection point of SUA was 4.5 mg/dL. The ORs (95% CIs) were 0.84 (0.66–1.08) on the left side of inflection point and 1.87 (1.56–2.24) on the right side of inflection point, respectively. Subgroup analysis showed that the stronger association between SUA and CKD was observed in elder women with never/former smoking and higher fasting blood glucose levels (all p values for interaction <0.05). Conclusion: Our study suggested threshold effects of SUA on the prevalence of CKD among US women without hypertension and diabetes. SUA levels >4.5 mg/dL were positively and independently associated with CKD.
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Abdel-Motal UM, G A, Abdelalim EM, Ponnuraja C, Iken K, Jahromi M, Doss GP, El Bekay R, Zayed H. Prevalence of nephropathy in type 1 diabetes in the Arab world: A systematic review and meta-analysis. Diabetes Metab Res Rev 2018; 34:e3026. [PMID: 29774648 DOI: 10.1002/dmrr.3026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 04/13/2018] [Accepted: 05/07/2018] [Indexed: 11/08/2022]
Abstract
The aim of this study was to conduct a systematic review and meta-analysis and determine the prevalence of diabetic nephropathy (DN) among Arab patients with T1D. A systematic literature search was conducted using 4 different literature databases (PubMed, ScienceDirect, Web of Science, and Embase) to capture all relevant data about Arab patients with T1D that had DN. Meta-analysis and systematic review were performed using the random effect model, and the heterogeneity of the studies was assessed using the Q-test, I2, and Tau-squared statistics. Publication bias was assessed using the funnel-plot test. Our search strategy captured 372 studies in only 10 out of the 22 Arab countries in a period of 48 years (1969-2017); of which, 41 met our inclusion criteria for full article analysis, of those, 15 were eligible for meta-analysis. We estimated the prevalence of DN among Arab people with T1D to be 18.2% (95% confidence interval 13.1%-24.8%). In conclusion, DN prevalence is underexplored among Arab patients with T1D and represents a significant risk for the well-being of Arab patients with T1D. Therefore, there is an urgent need for comprehensive epidemiological studies for DN among Arab patients with T1D.
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Affiliation(s)
- Ussama M Abdel-Motal
- Division of Translational Medicine, Research Branch, Sidra Medicine, Doha, Qatar
| | - Akila G
- Department of Biomedical Sciences, College of Health Sciences, Qatar University, Doha, Qatar
| | - Essam M Abdelalim
- Diabetes Research Center, Qatar Biomedical Research Institute, Hamad Bin Khalifa University, Qatar Foundation, Doha, Qatar
| | - Chinnaiyan Ponnuraja
- Department of Statistics, National Institute for Research in Tuberculosis, Chennai, India
| | - Khadija Iken
- Department of Medicine/Paediatrics', Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | | | - George Priya Doss
- Department of Integrative Biology, School of Biosciences and Technology, VIT University, Vellore, India
| | - Rajaa El Bekay
- CIBER Pathophysiology of obesity and nutrition CB06/03, Carlos III Health Institute. Unidad de Gestion Clínica Intercentros de Endocrinología y Nutrición, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga/Universidad de Málaga, Málaga, Spain
| | - Hatem Zayed
- Department of Biomedical Sciences, College of Health Sciences, Qatar University, Doha, Qatar
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Liu X, Zhai T, Ma R, Luo C, Wang H, Liu L. Effects of uric acid-lowering therapy on the progression of chronic kidney disease: a systematic review and meta-analysis. Ren Fail 2018; 40:289-297. [PMID: 29619870 PMCID: PMC6014338 DOI: 10.1080/0886022x.2018.1456463] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVES Whether uric acid levels were associated with the progression of chronic kidney disease (CKD) remained controversial. This meta-analysis was aimed to assess the effect of lowering serum uric acid therapy on the progression of CKD to clarify the role of uric acid in the progression of CKD indirectly. METHODS Pubmed, Embase, the Cochrane library, CBM were searched for randomized controlled trials (RCTs) that assessed the efficiency of lowering serum uric acid therapy on the progression of CKD without language restriction. Summary estimates of weighted mean differences (WMDs) and relative risk (RR) were obtained by using random-effect or fixed-effect models. Sensitivity analyses were performed to identify the source of heterogeneity. RESULTS A total of 12 randomized controlled trials with 832 CKD participants were included in the analysis. Pooled estimate for eGFR was in favor of lowering serum uric acid therapy with a mean difference (MD) of 3.88 ml/min/1.73 m2, 95% CI 1.26-6.49 ml/min/1.73 m2, p = .004 and this was consistent with results for serum creatinine. The risk of worsening of kidney function or ESRD or death was significantly decreased in the treatment group compared to the control group (RR 0.39, 95% CI 0.28-0.52, p< .01). CONCLUSIONS Uric acid-lowering therapy may be effective in retarding the progression of CKD. Further randomized controlled trials should be performed to confirm the effect of lowering serum uric acid therapy on the progression of CKD.
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Affiliation(s)
- Xuemei Liu
- a Department of Nephrology , The Affiliated Hospital of Qingdao University , Qingdao , China
| | - Tingting Zhai
- a Department of Nephrology , The Affiliated Hospital of Qingdao University , Qingdao , China
| | - Ruixia Ma
- a Department of Nephrology , The Affiliated Hospital of Qingdao University , Qingdao , China
| | - Congjuan Luo
- a Department of Nephrology , The Affiliated Hospital of Qingdao University , Qingdao , China
| | - Huifang Wang
- a Department of Nephrology , The Affiliated Hospital of Qingdao University , Qingdao , China
| | - Liqiu Liu
- a Department of Nephrology , The Affiliated Hospital of Qingdao University , Qingdao , China
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El-Samahy MH, Adly AA, Elhenawy YI, Ismail EA, Pessar SA, Mowafy MES, Saad MS, Mohammed HH. Urinary miRNA-377 and miRNA-216a as biomarkers of nephropathy and subclinical atherosclerotic risk in pediatric patients with type 1 diabetes. J Diabetes Complications 2018; 32:185-192. [PMID: 29175120 DOI: 10.1016/j.jdiacomp.2017.10.014] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2017] [Revised: 10/23/2017] [Accepted: 10/28/2017] [Indexed: 12/28/2022]
Abstract
BACKGROUND Urinary microRNAs (miRNAs) play a role in the pathogenesis of chronic kidney disease (CKD). AIM To identify the expression of urinary miR-377 and miR-216a in 50 children and adolescents with type 1 diabetes (T1DM) compared with 50 healthy controls and assess their relation to the degree of albuminuria, glycemic control and carotid intimal thickness (CIMT) as an index of atherosclerosis. METHODS Diabetic subjects were divided into normoalbuminuric and microalbuminuric groups according to urinary albumin creatinine ration (UACR). Urinary miRNAs were assessed using real time polymerase chain reaction. CIMT was measured using high resolution carotid ultrasound. RESULTS The expression of urinary miR-377 was significantly higher in patients with microalbumiuria (median, 3.8) compared with 2.65 and 0.98 in normoalbuminic patients and healthy controls, respectively (p<0.05). Urinary miR-216a was significantly lower in all patients with type 1 diabetes and the lowest levels were among the microalbumiuric group. Significant positive correlations were found between urinary miR-377 and HbA1C, UACR and CIMT while urinary miR-216a was negatively correlated to these variables. CONCLUSIONS Urinary miR-377 and miR-216a can be considered early biomarkers of nephropathy in pediatric type 1 diabetes. Their correlation with CIMT provides insights on the subclinical atherosclerotic process that occurs in diabetic nephropathy.
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Affiliation(s)
| | - A A Adly
- Pediatrics Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
| | | | - E A Ismail
- Clinical Pathology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | | | | | - Mohammed Salah Saad
- Pediatrics Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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