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Tang L, Yang Q, Ma R, Zhou P, Peng C, Xie C, Liang Q, Wu T, Gao W, Yu H, Deng G, Dai Z, Mao N, Xiao X. Association between lactate dehydrogenase and the risk of diabetic kidney disease in patients with type 2 diabetes. Front Endocrinol (Lausanne) 2024; 15:1369968. [PMID: 38567310 PMCID: PMC10985160 DOI: 10.3389/fendo.2024.1369968] [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] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Accepted: 02/28/2024] [Indexed: 04/04/2024] Open
Abstract
Objective This study aims to investigate the association between lactate dehydrogenase (LDH) and the risk of diabetic kidney disease (DKD) in patients with type 2 diabetes (T2D). Methods The study enrolled patients with diagnosis of T2D between 2009 and 2018 from the National Nutrition and Health Examination Survey (NHANES) database. Demographic information, laboratory test, and diagnostic data were collected. Restricted cubic spline (RCS) plots were used to assess the dose-effect relationship between LDH levels and the risk of DKD in patients with T2D. Based on LDH levels, individuals were divided into higher and lower groups using dichotomy, and multivariate logistic regression analysis was conducted to explore the relationship between different LDH levels and the risk of DKD in T2D patients. Stratified analysis was performed to assess the consistency of the result. Results A total of 4888 patients were included in the study, with 2976 (60.9%) patients without DKD and 1912 (39.1%) patients with DKD. RCS plots showed that the risk of DKD increased with increasing LDH levels. Multifactorial logistic regression analysis revealed that T2D patients with higher LDH levels had a 45% increased risk of DKD compared to those with lower LDH levels (OR=1.45; 95% CI: 1.11-1.89). Furthermore, each standard deviation increase in LDH level was associated with a 24% increase in DKD incidence among T2D patients (OR=1.24; 95% CI: 1.07-1.44). Stratified analysis consistently supported these findings. Conclusions LDH can serve as a valuable biomarker for screening DKD in patients with T2D.
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Affiliation(s)
- Linqiao Tang
- Research Core Facility of West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Qianyu Yang
- Department of Nephrology, The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
- Department of Clinical Medicine, Chengdu Medical College, Chengdu, China
| | - Rong Ma
- Department of Nephrology, People’s Hospital of Xindu District, Chengdu, China
| | - Ping Zhou
- Department of Nephrology, The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
- Department of Clinical Medicine, Chengdu Medical College, Chengdu, China
| | - Cong Peng
- Department of Nephrology, The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
- Department of Clinical Medicine, Chengdu Medical College, Chengdu, China
| | - Chunpeng Xie
- Department of Nephrology, The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
- Department of Clinical Medicine, Chengdu Medical College, Chengdu, China
| | - Qiyuan Liang
- Department of Nephrology, The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
- Department of Clinical Medicine, Chengdu Medical College, Chengdu, China
| | - Tingyu Wu
- Department of Nephrology, The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
- Department of Clinical Medicine, Chengdu Medical College, Chengdu, China
| | - Wuyu Gao
- Department of Nephrology, The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
- Department of Clinical Medicine, Chengdu Medical College, Chengdu, China
| | - Haiyan Yu
- Department of Nephrology, The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
- Department of Clinical Medicine, Chengdu Medical College, Chengdu, China
| | - Guifei Deng
- Department of Nephrology, The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
- Department of Clinical Medicine, Chengdu Medical College, Chengdu, China
| | - Zhen Dai
- Department of Nephrology, The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
- Department of Clinical Medicine, Chengdu Medical College, Chengdu, China
| | - Nan Mao
- Department of Nephrology, The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
- Department of Clinical Medicine, Chengdu Medical College, Chengdu, China
| | - Xiang Xiao
- Research Core Facility of West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Department of Nephrology, The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
- Department of Clinical Medicine, Chengdu Medical College, Chengdu, China
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Sun K, Shi Z, Abudureheman Y, Liu Q, Zhao Y, Zhang X, Lv Q, Zhang Y, Shou S, Jin H. Clinical and Epidemiological Characteristics of Rhabdomyolysis: A Retrospective Study. Int J Clin Pract 2023; 2023:6396576. [PMID: 37808625 PMCID: PMC10558265 DOI: 10.1155/2023/6396576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 09/11/2023] [Accepted: 09/23/2023] [Indexed: 10/10/2023] Open
Abstract
Background Rhabdomyolysis (RM) refers to a clinical syndrome in which muscle cells are damaged by various causes and the clinical manifestations are mainly muscle pain, weakness, and dark urine. Acute kidney injury (AKI) is a serious complication of RM with complex mechanisms and high mortality. Therefore, understanding the pathogenesis and clinical manifestations, early diagnosis and treatment of RM are crucial to improve its prognosis. Method Analysis of medical records of RM patients admitted to Tianjin Medical University General Hospital from October 2019 to October 2022. Statistical software SPSS 25.0 was used to analyze the data. The risk factors of RM-complicated AKI were analyzed by logistic regression. The receiver operating characteristic (ROC) curve was plotted, the area under the curve (AUC) was calculated, and the optimal cutoff value was determined by the Youden index. P < 0.05 indicates a statistically significant difference between the groups. Result Among the 71 patients, the median age of the patients was 53.0 (30.0, 71.0) years and was 2.5 times higher in men than in women. Infection was the most common etiology. History of alcohol consumption, CK, and creatinine were independent influencing factors for AKI due to RM. Logistic regression analysis showed that CK combined with creatinine had a better predictive value than the single index. Conclusion Our study revealed the clinical and laboratory characteristics of RM in the population attending the Tianjin Medical University General Hospital in the last three years, which is a reference for future multicenter, prospective studies.
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Affiliation(s)
- Keke Sun
- Department of Emergency Medicine, Tianjin Medical University General Hospital, Tianjin, China
| | - Zhenhua Shi
- Department of Emergency Medicine, Tianjin Medical University General Hospital, Tianjin, China
- Department of Intensive Care Unit, PLA 983rd Hospital, Tianjin, China
| | - Yushanjiang Abudureheman
- Department of Emergency Medicine, Tianjin Medical University General Hospital, Tianjin, China
- Department of Critical Care Medicine, Hotan District People's Hospital, Xinjiang, China
| | - Qihui Liu
- Department of Emergency Medicine, Tianjin Medical University General Hospital, Tianjin, China
| | - Yibo Zhao
- Department of Emergency Medicine, Tianjin Medical University General Hospital, Tianjin, China
| | - Xiangqun Zhang
- Department of Emergency Medicine, Tianjin Medical University General Hospital, Tianjin, China
| | - Qi Lv
- Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin, China
| | - Yan Zhang
- Department of Emergency Medicine, Tianjin Medical University General Hospital, Tianjin, China
| | - Songtao Shou
- Department of Emergency Medicine, Tianjin Medical University General Hospital, Tianjin, China
| | - Heng Jin
- Department of Emergency Medicine, Tianjin Medical University General Hospital, Tianjin, China
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Młynarska E, Krzemińska J, Wronka M, Franczyk B, Rysz J. Rhabdomyolysis-Induced AKI (RIAKI) Including the Role of COVID-19. Int J Mol Sci 2022; 23:8215. [PMID: 35897810 DOI: 10.3390/ijms23158215] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [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: 06/09/2022] [Revised: 07/14/2022] [Accepted: 07/22/2022] [Indexed: 01/08/2023] Open
Abstract
Rhabdomyolysis is a compound disease that may be induced by many factors, both congenital and acquired. Statin therapy is considered one of the most common acquired factors. However, recent scientific reports suggest that serious complications such as rhabdomyolysis are rarely observed. Researchers suggest that, in many cases, side effects that occur with statin therapy, including muscle pain, can be avoided with lower-dose statin therapy or in combination therapy with other drugs. One of the most recent agents discovered to contribute to rhabdomyolysis is COVID-19 disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Rhabdomyolysis is defined as a damage to striated muscle cells with escape of intracellular substances into the bloodstream. These substances, including myoglobin, creatine kinase (CK), potassium, and uridine acid, are markers of muscle damage and early complications of rhabdomyolysis. Symptoms may be helpful in establishing the diagnosis. However, in almost 50% of patients, they do not occur. Therefore, the diagnosis is confirmed by serum CK levels five times higher than the upper limit of normal. One of the late complications of this condition is acute kidney injury (AKI), which is immediately life-threatening and has a high mortality rate among patients. Therefore, the prompt detection and treatment of rhabdomyolysis is important. Markers of muscle damage, such as CK, lactate dehydrogenase (LDH), myoglobin, troponins, and aspartate aminotransferase (AST), are important in diagnosis. Treatment of rhabdomyolysis is mainly based on early, aggressive fluid resuscitation. However, therapeutic interventions, such as urinary alkalinization with sodium bicarbonate or the administration of mannitol or furosemide, have not proven to be beneficial. In some patients who develop AKI in the course of rhabdomyolysis, renal replacement therapy (RRT) is required.
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Yazdanbakhsh M, Saghaei Dehkordi S. An Overview of Published Articles in Archives of Academic Emergency Medicine in 2021. Arch Acad Emerg Med 2022; 10:e18. [PMID: 35402996 PMCID: PMC8986493 DOI: 10.22037/aaem.v10i1.1555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Mehrnoosh Yazdanbakhsh
- Journal Office, Emergency Ward, Shohadaye Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Somayeh Saghaei Dehkordi
- Journal Office, Emergency Ward, Shohadaye Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Corresponding author: Somayeh Saghaei Dehkordi; Emergency Ward, Shohadaye Tajrish Hospital, Shahrdari Avenue, Tajrish Square, Tehran, Iran. Tel: 00989388136564
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Huang DN, Zhong HJ, Cai YL, Xie WR, He XX. Serum Lactate Dehydrogenase Is a Sensitive Predictor of Systemic Complications of Acute Pancreatitis. Gastroenterol Res Pract 2022; 2022:1131235. [PMID: 36329782 PMCID: PMC9626216 DOI: 10.1155/2022/1131235] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 09/06/2022] [Indexed: 12/08/2022] Open
Abstract
BACKGROUND Acute pancreatitis (AP) is a common and potentially life-threatening inflammatory disease that can cause various complications, including systemic inflammatory response syndrome (SIRS), pleural effusion, ascitic fluid, myocardial infarction, and acute kidney injury (AKI). However, there is still a lack of rapid and effective indicators to assess the disease. The aim of this study was to investigate the associations of high serum lactate dehydrogenase (LDH) levels with AP severity and systemic complications. METHODS AP patients treated from July 2014 to December 2020 were retrospectively enrolled. They were divided into elevated (n = 93) and normal (n = 143) LDH groups. Their demographic data, clinical data, hospital duration, and hospital expenses were analyzed. Linear and binary logistic regression analyses were used to determine whether elevated LDH is a risk factor for AP severity and complications after adjusting for confounders. RESULTS There were significant differences in AP severity scores (Ranson, MODS, BISAP, APACHE II, and CTSI), hospital duration, hospital expenses, and the incidences of complications (SIRS, pleural effusion, ascitic fluid, myocardial infarction, and AKI) between the elevated and normal LDH groups. After adjusting for confounders, elevated LDH was associated with AP severity scores and hospital duration and expenses (based on linear regression analyses) and was a risk factor for the occurrence of AP complications and interventions, that is, diuretic and vasoactive agent use (based on binary logistic regression analyses). CONCLUSIONS Elevated LDH is associated with high AP severity scores and high incidences of complications (SIRS, pleural effusion, ascitic fluid, myocardial infarction, and AKI).
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Affiliation(s)
- Dong-Ni Huang
- Department of Gastroenterology, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, China
- Department of Gastroenterology, Research Center for Engineering Techniques of Microbiota-Targeted Therapies of Guangdong Province, Guangzhou, China
| | - Hao-Jie Zhong
- Department of Gastroenterology, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, China
- Department of Gastroenterology, Research Center for Engineering Techniques of Microbiota-Targeted Therapies of Guangdong Province, Guangzhou, China
- School of Biology and Biological Engineering, South China University of Technology, Guangzhou, China
| | - Ying-Li Cai
- Department of Gastroenterology, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, China
- Department of Gastroenterology, Research Center for Engineering Techniques of Microbiota-Targeted Therapies of Guangdong Province, Guangzhou, China
| | - Wen-Rui Xie
- Department of Gastroenterology, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, China
- Department of Gastroenterology, Research Center for Engineering Techniques of Microbiota-Targeted Therapies of Guangdong Province, Guangzhou, China
| | - Xing-Xiang He
- Department of Gastroenterology, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, China
- Department of Gastroenterology, Research Center for Engineering Techniques of Microbiota-Targeted Therapies of Guangdong Province, Guangzhou, China
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