scholarly journals Dietary Patterns and Renal Health Outcomes in the General Population: A Review Focusing on Prospective Studies

Nutrients ◽  
2019 ◽  
Vol 11 (8) ◽  
pp. 1877 ◽  
Author(s):  
Aparna S. Ajjarapu ◽  
Stefanie N. Hinkle ◽  
Mengying Li ◽  
Ellen C. Francis ◽  
Cuilin Zhang
Keyword(s):  
General Population ◽  
Dietary Patterns ◽  
Renal Outcome ◽  
Inclusion Criteria ◽  
Renal Outcomes ◽  
Current Review ◽  
Increased Risk ◽  
Modifiable Factor ◽  
Kidney Health

Healthy dietary patterns may promote kidney health and prevent adverse renal outcomes. Although reviews have summarized the findings from studies on dietary patterns for chronic kidney disease (CKD) management, less is known about dietary patterns for maintaining kidney health prior to CKD development. The current review summarized the results from observational studies from March 2009 to March 2019 investigating associations between dietary patterns and renal outcomes in the general population. The main renal outcome assessed was CKD (estimated glomerular filtration rate < 60 mL/min/1.73 m2). A total of twenty-six research articles met the inclusion criteria. Adherence to the Dietary Approaches to Stop Hypertension (DASH) and Mediterranean diets were significantly associated with a decreased risk of CKD in the majority of the studies. Furthermore, a posteriori “unhealthy” dietary patterns were associated with an increased risk of CKD. In conclusion, the findings from this review suggest that adherence to DASH and Mediterranean dietary patterns may be useful in promoting kidney health and preventing CKD in the general population. More studies, in particular among minorities, are warranted to investigate the role of diet, a potentially modifiable factor, in promoting kidney health.

scholarly journals Psychopathy: cognitive and neural dysfunction

2013 ◽  
Vol 15 (2) ◽  
pp. 181-190 ◽  
Keyword(s):  
Antisocial Behavior ◽  
Antisocial Personality Disorder ◽  
Developmental Disorder ◽  
Posterior Cingulate Cortex ◽  
Current Review ◽  
Increased Risk ◽  
Emotional Deficits ◽  
Reinforcement Value ◽  
Neural Dysfunction

Psychopathy is a developmental disorder marked by emotional deficits and an increased risk for antisocial behavior. It is not equivalent to the diagnosis Antisocial Personality Disorder, which concentrates only on the increased risk for antisocial behavior and not a specific cause-ie, the reduced empathy and guilt that constitutes the emotional deficit. The current review considers data from adults with psychopathy with respect to the main cognitive accounts of the disorder that stress either a primary attention deficit or a primary emotion deficit. In addition, the current review considers data regarding the neurobiology of this disorder. Dysfunction within the amygdala's role in reinforcement learning and the role of ventromedial frontal cortex in the representation of reinforcement value is stressed. Data is also presented indicating potential difficulties within parts of temporal and posterior cingulate cortex. Suggestions are made with respect to why these deficits lead to the development of the disorder.

scholarly journals Dietary Patterns, Skeletal Muscle Health, and Sarcopenia in Older Adults

Nutrients ◽  
2019 ◽  
Vol 11 (4) ◽  
pp. 745 ◽  
Author(s):  
Antoneta Granic ◽  
Avan Sayer ◽  
Sian Robinson
Keyword(s):  
Older Adults ◽  
Skeletal Muscle ◽  
Dietary Patterns ◽  
Healthy Eating Index ◽  
Muscle Disease ◽  
Nutritional Epidemiology ◽  
Societal Implications ◽  
Increased Risk ◽  
Muscle Health

In recent decades, the significance of diet and dietary patterns (DPs) for skeletal muscle health has been gaining attention in ageing and nutritional research. Sarcopenia, a muscle disease characterised by low muscle strength, mass, and function is associated with an increased risk of functional decline, frailty, hospitalization, and death. The prevalence of sarcopenia increases with age and leads to high personal, social, and economic costs. Finding adequate nutritional measures to maintain muscle health, preserve function, and independence for the growing population of older adults would have important scientific and societal implications. Two main approaches have been employed to study the role of diet/DPs as a modifiable lifestyle factor in sarcopenia. An a priori or hypothesis-driven approach examines the adherence to pre-defined dietary indices such as the Mediterranean diet (MED) and Healthy Eating Index (HEI)—measures of diet quality—in relation to muscle health outcomes. A posteriori or data-driven approaches have used statistical tools—dimension reduction methods or clustering—to study DP-muscle health relationships. Both approaches recognise the importance of the whole diet and potential cumulative, synergistic, and antagonistic effects of foods and nutrients on ageing muscle. In this review, we have aimed to (i) summarise nutritional epidemiology evidence from four recent systematic reviews with updates from new primary studies about the role of DPs in muscle health, sarcopenia, and its components; (ii) hypothesise about the potential mechanisms of ‘myoprotective’ diets, with the MED as an example, and (iii) discuss the challenges facing nutritional epidemiology to produce the higher level evidence needed to understand the relationships between whole diets and healthy muscle ageing.

scholarly journals Metabolite-related dietary patterns and the development of islet autoimmunity

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Randi K. Johnson ◽  
◽  
Lauren Vanderlinden ◽  
Brian C. DeFelice ◽  
Katerina Kechris ◽  
...  
Keyword(s):  
Dietary Patterns ◽  
Dicarboxylic Acids ◽  
Case Control ◽  
Islet Autoimmunity ◽  
Plasma Metabolites ◽  
High Risk Infant ◽  
Increased Risk ◽  
Diabetes Development ◽  
Nested Case Control

Abstract The role of diet in type 1 diabetes development is poorly understood. Metabolites, which reflect dietary response, may help elucidate this role. We explored metabolomics and lipidomics differences between 352 cases of islet autoimmunity (IA) and controls in the TEDDY (The Environmental Determinants of Diabetes in the Young) study. We created dietary patterns reflecting pre-IA metabolite differences between groups and examined their association with IA. Secondary outcomes included IA cases positive for multiple autoantibodies (mAb+). The association of 853 plasma metabolites with outcomes was tested at seroconversion to IA, just prior to seroconversion, and during infancy. Key compounds in enriched metabolite sets were used to create dietary patterns reflecting metabolite composition, which were then tested for association with outcomes in the nested case-control subset and the full TEDDY cohort. Unsaturated phosphatidylcholines, sphingomyelins, phosphatidylethanolamines, glucosylceramides, and phospholipid ethers in infancy were inversely associated with mAb+ risk, while dicarboxylic acids were associated with an increased risk. An infancy dietary pattern representing higher levels of unsaturated phosphatidylcholines and phospholipid ethers, and lower sphingomyelins was protective for mAb+ in the nested case-control study only. Characterization of this high-risk infant metabolomics profile may help shape the future of early diagnosis or prevention efforts.

Suicide among Swedish Dentists

1987 ◽  
Vol 15 (4) ◽  
pp. 243-246 ◽  
Author(s):  
Bengt B. Arnetz ◽  
Lars-Gunnar Hörte ◽  
Anders Hedberg ◽  
Hans Malker
Keyword(s):  
High School ◽  
General Population ◽  
Socioeconomic Factors ◽  
High School Education ◽  
Standardized Mortality Ratio ◽  
Etiologic Role ◽  
Increased Risk ◽  
National Cohort ◽  
Mortality Ratio

In the present study, we have followed a national cohort of dentists, academics, i.e. people with three or more years of post-high school education, and the general population for a period of ten years, and identified all cases of recognized suicide during the period 1961 to 1970. The aim of the study was to assess whether suicide rates are higher among dentists even after adjustment for socioeconomic factors. Results show an elevated standardized mortality ratio (SMR) for male dentists compared to other male academics. Female dentists did not exhibit any increased risk. It is suggested that enhanced interest should be given to the possible etiologic role of not only psychosocial factors but also to psychoorganic consequences of mercury exposure among dentists.

scholarly journals Serum NT-pro-BNP Levels Predict Cardiovascular Events in Acromegaly Patients

2021 ◽  
Author(s):  
Marta Ragonese ◽  
Gianluca Di Bella ◽  
Federica Spagnolo ◽  
Loredana Grasso ◽  
Angela Alibrandi ◽  
...  
Keyword(s):  
Heart Failure ◽  
General Population ◽  
Brain Natriuretic Peptide ◽  
Roc Curve ◽  
Cardiovascular Events ◽  
Roc Analysis ◽  
Middle Term ◽  
Increased Risk

Abstract Background Acromegaly is associated with an increased risk of fatal and non-fatal cardiovascular (CV) events. Controlling acromegaly decreases, but does not normalize this risk. Brain natriuretic peptide (BNP) assessment is used in the general population for the diagnosis of heart failure and to predict ischemic recurrences and mortality. This is a retrospective, longitudinal, monocenter study that evaluates the role of serum N-terminal fragment of BNP (NT-pro-BNP) for predicting CV events in acromegaly patients. Methods Serum NT-pro-BNP levels were measured in 76 patients with acromegaly (23 males, 57.7±1.5 years), and compared with other predictors of CV events. NT-pro-BNP cut-off value discriminating the occurrence of CV events was determined by ROC analysis. CV events were recorded during a follow-up of 78.6±6.4 months. Results CV events occurred in 9.2% of patients. Mean log(NT-pro-BNP) concentration was higher in patients who experienced CV events than in those who did not (p<0.01) and in patients who died due to CV events than in those who died due to other causes (p<0.01). Based on the ROC curve, a cut-off value of 91.55 pg/mL could predict CV events (OR 19.06). Log(NT-pro-BNP) was lower in surgically treated patients by surgery (p<0.05), and in those cured by neurosurgery (p<0.02). Conclusions High NT-pro-BNP value is an independent middle-term predictor of fatal or non-fatal CV events in patients with acromegaly. According to this parameter, surgically treated patients show lower CV risk than those managed with medical therapy, especially if the disease is cured.

scholarly journals Elevated D-Dimer Levels are Associated with Increased Risk of Mortality in COVID-19: A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Siddharth Shah ◽  
Kuldeep Shah ◽  
Siddharth B Patel ◽  
Forum S Patel ◽  
Mohammed Osman ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Severe Disease ◽  
Case Fatality ◽  
Inclusion Criteria ◽  
Risk Of Mortality ◽  
Increased Risk ◽  
Novel Coronavirus ◽  
D Dimer

AbstractIntroductionThe 2019 novel Coronavirus (2019-nCoV), now declared a pandemic has an overall case fatality of 2–3% but it is as high as 50% in critically ill patients. D-dimer is an important prognostic tool, often elevated in patients with severe COVID-19 infection and in those who suffered death. In this systematic review, we aimed to investigate the prognostic role of D-dimer in COVID-19 infected patients.MethodsWe searched PubMed, Medline, Embase, Ovid, and Cochrane for studies reporting admission D-dimer levels in COVID-19 patients and its effect on mortality.Results18 studies (16 retrospective and 2 prospective) with a total of 3,682 patients met the inclusion criteria. The pooled mean difference (MD) suggested significantly elevated D-dimer levels in patients who died versus those survived (MD 6.13 mg/L, 95% CI 4.16 − 8.11, p <0.001). Similarly, the pooled mean D-dimer levels were significantly elevated in patients with severe COVID-19 infection (MD 0.54 mg/L, 95% CI 0.28 − 0.8, p< 0.001). In addition, the risk of mortality was four-fold higher in patients with positive D-dimer vs negative D-dimer (RR 4.11, 95% CI 2.48 − 6.84, p< 0.001) and the risk of developing the severe disease was two-fold higher in patients with positive D-dimer levels vs negative D-dimer (RR 2.04, 95% CI 1.34 − 3.11, p < 0.001).ConclusionOur meta-analysis demonstrates that patients with COVID-19 presenting with elevated D-dimer levels have an increased risk of severe disease and mortality.

Ethnic minority position and migrant status as risk factors for psychotic symptoms in the general population: a meta-analysis

2018 ◽  
Vol 49 (4) ◽  
pp. 545-558 ◽  
Author(s):  
Edouard Leaune ◽  
Marie-Jose Dealberto ◽  
David Luck ◽  
Stéphanie Grot ◽  
Halima Zeroug-Vial ◽  
...  
Keyword(s):  
General Population ◽  
Ethnic Minority ◽  
Ethnic Groups ◽  
Psychotic Disorders ◽  
Meta Analysis ◽  
Psychotic Symptoms ◽  
Migrant Status ◽  
Increased Risk ◽  
Black Populations

AbstractPsychotic symptoms (PS) are experienced by a substantial proportion of the general population. When not reaching a threshold of clinical relevance, these symptoms are defined as psychotic experiences (PEs) and may exist on a continuum with psychotic disorders. Unfavorable socio-environmental conditions, such as ethnic minority position (EMP) and migrant status (MS), may increase the risk of developing PS and PEs. We conducted an electronic systematic review and a meta-analysis assessing the role of EMP and MS for the development and persistence of PS in the general population. Sub-group analyses were performed investigating the influence of ethnic groups, host countries, age, types of PS, and scales. Twenty-four studies met our inclusion criteria. EMP was a relevant risk factor for reporting PS [odds ratio (OR) 1.44, 95% confidence interval (CI) 1.22–1.70) and PEs (OR 1.36, 95% CI 1.16–1.60). The greatest risk was observed in people from the Maghreb and the Middle East ethnic groups in Europe (OR 3.30, 95% CI 2.09–5.21), in Hispanic in the USA (OR 1.98, 95% CI 1.43–2.73), and in the Black populations (OR 1.85, 95% CI 1.39–2.47). We found a significant association between MS and delusional symptoms (OR 1.47, 95% CI 1.33–1.62). We found no association between EMP and persistence of PEs.EMP was associated with increased risk of reporting PS and PEs, and the risk was higher in ethnic groups facing deprivation and discrimination. We found an association between MS and delusional symptoms. These results raise questions about the precise role of socio-environmental factors along the psychosis continuum.

P1839GLOMERULAR HYPERFILTRATION: THEORY AND APPLICATIONS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Ali Moustafa Shendi Mohamed
Keyword(s):  
Type 2 Diabetes ◽  
Clinical Trials ◽  
Glomerular Hyperfiltration ◽  
Renal Outcome ◽  
Glomerular Sclerosis ◽  
Diabetic Nephropathies ◽  
Increased Risk ◽  
Cardiovascular Assessment

Abstract Background and Aims The role of glomerular hyperfiltration in the development and progression of diabetic and non-diabetic chronic kidney disease (CKD) was established during the 80’s of the last century and represented a paradigm shift in current nephrology practice. Method A web-based review of relevant bibliography: articles and textbooks, reporting the development of hyperfiltration theory and its clinical applications was conducted. Results In 1982, after a series of animal studies, Brenner and colleagues proposed that glomerular hyperfiltration, in diabetic and other glomerulopathies, contributes to intrarenal hypertension and predispose to progressive glomerular sclerosis and deterioration of renal function. Clinical trials during late 80’s and early 90’s then focused on inhibition of Renin Angiotensin Aldosteron system (RAAS) to reverse glomerular hyperfiltration, and suggested that ACE inhibitors can be anti-proteinuric independent of their blood pressure-lowering effect in non-diabetic and diabetic nephropathies. In 1993, a randomized controlled trial (RCT) by Lewis and colleagues proved a beneficial effect of captopril in patients with nephropathy caused by type 1 diabetes. Few years later, the results of Ramipril Efficacy in Nephropathy (REIN) study proved the renoprotective role of ACE inhibition in patients with non-diabetic nephropathies with nephrotic and non-nephrotic proteinuria in 2 Lancet articles in 1997 and 1999 respectively. The renoprotective role of RAAS inhibition with ARBs in patients with type 2 diabetes was proven in 3 RCTs published in the New England Journal of Medicine in 2001: Irbesartan in Patients with Type 2 Diabetes and Microalbuminuria (IRMA) Study, Irbesartan Diabetic Nephropathy Trial (IDNT), and Reduction of Endpoints in NIDDM with the Angiotensin II Antagonist Losartan (RENAAL) study. Dual blockade with an ACE inhibitor and an ARB was then attempted to further ameliorate glomerular hyperfiltration. Yet this approach was faced by an increased risk of hyperkalemia and acute kidney injury in 2 RCTs: the Ongoing Telmisartan Alone and in Combination with Ramipril Global Endpoint Trial (ONTARGET) in 2008 and The Veterans Affairs Nephropathy in Diabetes (VA NEPHRON-D) study in 2013. It was until 2014 when evidence appeared for a potential role of SGLT2 inhibition in attenuating glomerular hyperfiltration. The 1st clinical evidence of renoprotective effect of SGLT2i appeared in 2016 when the results of the EMPA-REG OUTCOME study found that empagliflozin was associated with lower rates of renal events. Subsequently, the Canagliflozin Cardiovascular Assessment Study (CANVAS) Program trials and the Dapagliflozin Effect on Cardiovascular Events–Thrombolysis in Myocardial Infarction 58 (DECLARE-TIMI 58) trial found similar reductions in composite renal endpoints. The Canagliflozin and Renal Events in Diabetes with Established Nephropathy Clinical Evaluation (CREDENCE) trial published in 2019 was the first study designed to assess the effects of a SGLT2i, canagliflozin, on renal outcomes in patients with type 2 diabetes and albuminuric CKD, and proved significant reduction in the composite renal outcome with canagliflozin. The potentiality for renoprotective role of SGLT2i in patients with non-diabetic CKD has stimulated a number of ongoing clinical trials: DIAMOND and Dapa-CKD using Dapagliflozin and EMPATHY and EMPA-KIDNEY using Empagliflozin. Conclusion The hyperfiltration theory represents the basis for current therapeutic interventions in diabetic and non-diabetic CKD. Current guidelines recommend using RAAS blockers in diabetic and non-diabetic proteinuric CKD and SGLT2i in patients with type 2 diabetes and CKD. Whether SGLT2i could be considered in patients with CKD independent of the diabetic state awaits the results of ongoing studies which might change the management practice of CKD.

scholarly journals Role of C-reactive protein and gamma-glutamyl transferase in the diagnosis of metabolic syndrome

2021 ◽  
Vol 9 (4) ◽  
pp. 118-124
Author(s):  
Rubina Ghani ◽  
◽  
Mozaffer Rahim Hingorjo ◽  
Samia Perwaiz Khan ◽  
Uzma Naseeb ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Metabolic Syndrome ◽  
General Population ◽  
Gamma Glutamyl Transferase ◽  
C Reactive Protein ◽  
Gamma Glutamyl ◽  
Reactive Protein ◽  
Increased Risk ◽  
Glutamyl Transferase

Previous studies have reported that metabolic syndrome (MetS) is associated with an increased risk of major cardiovascular events and levels of C-Reactive protein (CRP) can be considered as markers of MetS and its constituent components. Oxidative stress plays a major role in the development of MetS, and levels of gamma-glutamyl transferase (GGT) change with response to oxidative stress are also associated with MetS, which may be modulated by CRP. This study was conducted to identify the role of GGT and CRP as biomarkers in the diagnosis of MetS, a high-risk factor for cardiovascular diseases. One hundred and fifty patients meeting the diagnostic criteria of MetS and an equal number of controls were included in the study. The cases were selected from pathology and molecular biology laboratories, Karachi, while the controls came from the general population. Anthropometric indices of adiposity and blood pressure were recorded for both cases and controls. Blood samples were taken from all subjects to determine the levels of CRP and GGT. All those cases and control height, weight, hip waist circumference were noted and the comparison of CRP and GGT by applying students' t-test as markers for detection of metabolic syndrome. p-value 0.001 was considered as significant. This study suggests that in patients with metabolic syndrome were found to have raised the basal metabolic rate, C-reactive protein and GGT were synergistically associated with MetS independently of another confounding factor in the general population. Keywords: C-reactive protein (CRP), gama glutamyl transferase (GGT), metabolic syndrome, (Met-S), inflammation, body mass index.

Hypertensive Disorders of Pregnancy and Preterm Birth Rates among Black Women

2018 ◽  
Vol 36 (02) ◽  
pp. 148-154 ◽  
Author(s):  
Rebecca Baer ◽  
Laura Jelliffe-Pawlowski ◽  
Mary Norton ◽  
Ashish Premkumar
Keyword(s):  
Preterm Birth ◽  
Black Women ◽  
Gestational Hypertension ◽  
Chronic Hypertension ◽  
Inclusion Criteria ◽  
Maternal Factors ◽  
Factors Associated ◽  
Relative Risks ◽  
Increased Risk

Objective The objective of this study was to investigate the role of gestational hypertension (gHTN) and chronic hypertension (cHTN) on rates of preterm birth (PTB) among black women. Study Design Singleton live births between 20 and 44 weeks' gestation among black women in California from 2007 to 2012 were used for analysis. Risk of PTB by subtype and gestational age among women with cHTN or gHTN, including preeclampsia, was calculated via Poisson's logistic regression modeling. Risks were adjusted for maternal factors associated with increased risk of PTB. Results A total of 154,950 women met the inclusion criteria. Of the 5,948 women in the sample with cHTN, 26.2% delivered preterm; for the 11,728 women with gHTN, 21.6% delivered preterm. Women with gHTN or cHTN had a higher risk of medically indicated and spontaneous PTB, both at less than 32 and 32 to 36 weeks, when compared with nonhypertensive women (adjusted relative risks [aRRs]: 3.4–11.6). Women with superimposed preeclampsia had higher risks of spontaneous (aRR: 2.8, 95% confidence interval [CI]: 2.3–3.4) and medically indicated PTB (aRR: 2.8, 95% CI: 2.0–3.8), especially PTB < 32 weeks, when compared with women with preeclampsia. Conclusion Among black women, superimposed preeclampsia increased the risk for spontaneous and medically indicated PTB, especially PTB < 32 weeks.

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