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Yang M, Yang Y, Xu Y, Wu Y, Lin J, Mai J, Fang K, Ma X, Zou C, Lin Q. Development and Validation of Prediction Models for All-Cause Mortality and Cardiovascular Mortality in Patients on Hemodialysis: A Retrospective Cohort Study in China. Clin Interv Aging 2023; 18:1175-1190. [PMID: 37534232 PMCID: PMC10392814 DOI: 10.2147/cia.s416421] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 07/22/2023] [Indexed: 08/04/2023] Open
Abstract
Purpose This study aimed to develop two predictive nomograms for the assessment of long-term survival status in hemodialysis (HD) patients by examining the prognostic factors for all-cause mortality and cardiovascular (CVD) event mortality. Patients and methods A total of 551 HD patients with an average age of over 60 were included in this study. The patients' medical records were collected from our hospital and randomly allocated to two cohorts: the training cohort (n=385) and the validation cohort (n=166). We employed multivariate Cox assessments and fine-gray proportional hazards models to explore the predictive factors for both all-cause mortality and cardiovascular event mortality risk in HD patients. Two nomograms were established based on predictive factors to forecast patients' likelihood of survival for 3, 5, and 8 years. The performance of both models was evaluated using the area under the curve (AUC), calibration plots, and decision curve analysis. Results The nomogram for all-cause mortality prediction included seven factors: age ≥ 60, sex (male), history of diabetes and coronary artery disease, diastolic blood pressure, total triglycerides (TG), and total cholesterol (TC). The nomogram for cardiovascular event mortality prediction included three factors: history of diabetes and coronary artery disease, and total cholesterol (TC). Both models demonstrated good discrimination, with AUC values of 0.716, 0.722 and 0.725 for all-cause mortality at 3, 5, and 8 years, respectively, and 0.702, 0.695, and 0.677 for cardiovascular event mortality, respectively. The calibration plots indicated a good agreement between the predictions and the decision curve analysis demonstrated a favorable clinical utility of the nomograms. Conclusion Our nomograms were well-calibrated and exhibited significant estimation efficiency, providing a valuable predictive tool to forecast prognosis in HD patients.
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Affiliation(s)
- Min Yang
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, People’s Republic of China
- Department of Nephrology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, People’s Republic of China
| | - Yaqin Yang
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, People’s Republic of China
- Department of Nephrology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, People’s Republic of China
| | - Yuntong Xu
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, People’s Republic of China
- Department of Nephrology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, People’s Republic of China
| | - Yuchi Wu
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, People’s Republic of China
- Department of Nephrology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, People’s Republic of China
| | - Jiarong Lin
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, People’s Republic of China
- Department of Nephrology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, People’s Republic of China
| | - Jianling Mai
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, People’s Republic of China
- Department of Nephrology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, People’s Republic of China
| | - Kunyang Fang
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, People’s Republic of China
- Department of Nephrology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, People’s Republic of China
| | - Xiangxia Ma
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, People’s Republic of China
- Department of Nephrology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, People’s Republic of China
| | - Chuan Zou
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, People’s Republic of China
- Department of Nephrology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, People’s Republic of China
| | - Qizhan Lin
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, People’s Republic of China
- Department of Nephrology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, People’s Republic of China
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Wu J, Ning Y, Tan L, Chen Y, Huang X, Zhuo Y. Characteristics of the vaginal microbiome in women with premature ovarian insufficiency. J Ovarian Res 2021; 14:172. [PMID: 34879874 PMCID: PMC8655991 DOI: 10.1186/s13048-021-00923-9] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 11/18/2021] [Indexed: 11/30/2022] Open
Abstract
PURPOSE To investigate the relationship between vaginal microbial community structure and premature ovarian insufficiency (POI). METHODS Twenty-eight women with POI and 12 healthy women were recruited at Shenzhen Maternity and Child Healthcare Hospital between August and September 2020. Blood samples were collected for glucose tests and detection of sex hormone levels and vaginal secretions were collected for microbial group determination. Vaginal microbial community profiles were analysed by 16S rRNA gene sequencing using the Illumina MiSeq system (Illumina Inc., San Diego, CA, USA). RESULTS Compared to the controls, the serum levels of follicle-stimulating hormone, luteinizing hormone, testosterone, and the follicle-stimulating hormone/luteinizing hormone ratio, significantly increased, and oestradiol and anti-Müllerian hormone levels significantly decreased in women with POI. Higher weighted UniFrac values were observed in women with POI than in healthy women. Bacteria in the genera Lactobacillus, Brevundimonas, and Odoribacter were more abundant in the microbiomes of healthy women, while the quantity of bacteria in the genus Streptococcus was significantly increased in the microbiomes of women with POI. Moreover, these differences in microbes in women with POI were closely related to follicle-stimulating hormone, luteinizing hormone, oestradiol, and anti-Müllerian hormone levels and to the follicle-stimulating hormone/luteinizing hormone ratio. CONCLUSIONS Women with POI had altered vaginal microbial profiles compared to healthy controls. The alterations in their microbiomes were associated with serum hormone levels. These results will improve our understanding of the vaginal microbial community structure in women with POI. TRIAL REGISTRATION CHICTR, ChiCTR2000029576 . Registered 3 August 2020 - Retrospectively registered, https://www.chictr.org.cn/showproj.aspx?proj=48844 .
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Affiliation(s)
- Jiaman Wu
- Department of Chinese Medicine, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, 518028, China
| | - Yan Ning
- Department of Chinese Medicine, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, 518028, China
| | - Liya Tan
- Department of Chinese Medicine, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, 518028, China
- Guangzhou University of Chinese Medicine, Guangzhou, 510006, China
| | - Yan Chen
- Department of Chinese Medicine, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, 518028, China
| | - Xingxian Huang
- Department of Acupuncture and Moxibustion, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, 518033, China
| | - Yuanyuan Zhuo
- Department of Acupuncture and Moxibustion, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, 518033, China.
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