scholarly journals Is there a relationship between sleep apnoea and microalbuminuria?

Author(s):  
Melek Cihanbeylerden ◽  
Melike Bağnu Yüceege

Abstract Introduction Obstructive sleep apnoea (OSA) is a cause of hypoxia, and the correlation between hypoxia and microvascular complications is well known. Microalbuminuria (MAU) is a marker for endovascular dysfunction and an indicator of cardiovascular events and all-cause mortality in the general population. The aim of this study was to investigate the relationship between microvascular damage and the metabolic complications of OSA based on the presence of MAU. Material and method Urinary albumin/creatinine ratio (ACR) and microalbumin level were examined in patients with an apnoea-hypopnoea index (AHI) greater than 5/h (study group) and in patients with an AHI less than 5/h (control group). The exclusion criteria were other possible causes of MAU (hypertension, nephropathy, coronary artery disease, and severe thyroid dysfunction). Results Of 103 patients enrolled, 80 formed the group with OSA and 23 served as controls. According to the AHI values, the patients were divided into four groups as normal, mild, moderate and severe. There was no significant difference between the four groups in terms of the microalbumin level and urinary albumin/creatinine ratio. Conclusion In this study, no significant relationship was found between MAU and sleep apnoea.

1970 ◽  
Vol 5 (2) ◽  
pp. 59-62
Author(s):  
Asma Ul-Hosna ◽  
Asma Rumanaz Shahid ◽  
AKM Mohiuddin Bhuyan ◽  
Hosna Zari Thamina ◽  
Mohammad Salman ◽  
...  

The purpose of this study was to assess the value of MA in the prediction of PE and also to compare urinary collagen IV with MA in this prediction. A total of 200 subjects (age 25±4 years, M±SC), were selected in their early pregnancy (10 to 14 weeks). Blood glucose, serum lipids, serum and urinary creatinine, urinary albumin and urinary collagen IV were measured in these subjects and they were followed up to the term for the possible development of PE, MA was defined by albumin creatinine ratio (ACR) above 32mg/g and high urinary collagen IV was defined by values above the cut-off point 2.54 ng/ml determined by the median value of the controls. The data were analyzed by grouping the subjects who developed PE in later stages of pregnancy (the PE group) and those who did not develop PE in later stages (the control group). Out of 200 subjects 94 were primigravida and 106 were multigravida. From the total subjects 16 developed PE, which shows a prevalence of about 8.4%. The PE group showed a relatively higher value of ACR as compared to control group. 106 subjects had MA out of which 13 developed PE. The sensitivity of ACR in predicting the development of PE was 80%, specificity 49.54%, PPV 12.69% and NPV 96.42%. Regarding urinary collagen IV the PE group showed no significant difference with the value of the control group. 103 subjects had high urinary collagen IV and out of them 11 developed PE. The sensitivity of high urinary collagen IV in prediction PE was found to have no significant difference with ACR in this respect. The data suggest the following conclusions:Early pregnancy levels of microalbuminuria and urinary collagen IV can be used as predictors of PE with high negative value.Urinary collagen IV has no added advantage over MA in this respect. Keywords : MA-Micro DOI: 10.3329/uhj.v5i2.4555 University Heart Journal Vol.5(2) July 2009 pp.59-62


Author(s):  
Aalaa Desoky Ahmad Abohamar ◽  
Wesam Abd El Salam Ghareeb ◽  
Gihan Farouk Attia ◽  
El Sayed Abd El Hamied Gad

Background and Aim: Drug use disorders are serious health issues with a significant burden for individuals affected and their families. There are also significant costs to society including lost productivity, security challenges and crime. Heroin has the highest dependence, tolerance and withdrawal score. The aim of this study is to assess the effect of heroin on liver and renal functions. Materials and Methods: This comparative case - control study was carried out on 60 males aged from 15 to 45 years old at the Department of Neuropsychiatry and the Center of Psychiatry, Neurology and Neurosurgery, Tanta University, Egypt from March 2019 through April 2020. Patients group: 30 patients with heroin use disorders diagnosed according to DSM-5 criteria with history of smoking. Control group: thirty smoker persons were taken as a control group matching with patients group. All participants were subjected to: History taking, physical examination and investigations including liver and renal function tests, urine drug screening and psychometry by the addiction severity index scale. Results: Heroin addicts had significant elevation in liver enzyme (Aspartate and Alanine transaminase) and alkaline phosphatase (p<0.001). There was no significant difference between heroin group and control regarding Albumin/Globulin ratio, Prothrombin Time, International Normalized Ratio and bilirubin level. Heroin addicts had significant elevation in blood urea, serum creatinine and Albumin/Creatinine ratio (P <0.001). There was significant decrease in Estimated Glomerular Filtration Rate in heroin group in comparison to control group (p<0.001). Positive correlation with statistical significance between (dose of heroin in grams, duration of use of heroin and severity index of addiction) and (liver functions and renal functions) in patient group. Conclusion: In heroin addicts, there was significant elevation in liver enzymes, ALP, Albumin/creatinine ratio, Urea and Creatinine and significant decrease in eGFR. The higher the dose of heroin use, the more the impairment of liver and renal functions. The longer the duration of heroin use,the more the deterioration of liver and renal functions. The more the severity index of addiction, the more the impairment of liver and renal functions.


2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M.H Muhmad Hamidi ◽  
H Sani ◽  
M.A Ibrahim ◽  
K.S Ibrahim ◽  
A.B Md Radzi ◽  
...  

Abstract Background and objective Acute coronary syndrome (ACS) remains the principal cause of death in Malaysia. It is estimated about 20% of ACS occurs at nighttime during sleep between 12am to 6am. Factors associated with nocturnal ACS are unknown. Acute nocturnal pathophysiological response to obstructive sleep apnea (OSA) may increase risk of nocturnal ACS. We hypothesized that OSA risk is associated with timing of ACS onset. Methodology This study included 200 patients with ACS who underwent coronary angiogram for which the time of chest pain onset was clearly identified and divided into 2 groups; nocturnal ACS (12am-5.59am) and non-nocturnal ACS (6am–11.59pm). Two validated questionnaires, STOP-BANG and Epworth Sleepiness Scale (ESS) were self-administered by subjects to determine OSA risk. All subjects timing of ACS onset, OSA risk, demography, anthropometric measurements, comorbidities and echocardiographic characteristics were analyzed. Results Acute coronary syndrome occurs nocturnally in 19% of ACS patients. The prevalence of high risk OSA individuals among ACS patients is 43%. There is significantly higher prevalence of high risk OSA individuals in nocturnal ACS group of 95% compared to 30% of high risk OSA individuals in non-nocturnal ACS group (p=0.001). Nocturnal ACS patients was significantly younger (50.1±8.7yrs, p=0.001), had higher BMI (33.9±4.3kg/m2, p=0.005), waist circumference (106.7±10.3cm, p=0.003) and larger neck circumference (44.6±3.3cm, p=0.001) compared to non-nocturnal ACS group. These groups had similar prevalence of other comorbidities for ACS and showed no significant difference between left and right ventricular systolic function. In multiple logistic regression analysis, the most significant predictors for nocturnal ACS are OSA risk, neck circumference and age. Conclusion There is a strong association between high risk OSA individuals and nocturnal ACS onset. Patient with nocturnal ACS onset should be screened for OSA and prioritized for polysomnography. OSA prevalence according to ACS onset Funding Acknowledgement Type of funding source: None


OTO Open ◽  
2021 ◽  
Vol 5 (1) ◽  
pp. 2473974X2198959
Author(s):  
Ahmed Yassin Bahgat

Objective Plasma is formed by creating a high-density energy field within an electrically conductive fluid such as saline. Sometimes ablated bits of tissue get stuck between the electrodes of the wand, obstructing the suction channel. The purpose of this study is to investigate the effect of cooling the irrigating saline during ablation of the hypertrophied tongue base in patients with obstructive sleep apnea. Study Design Prospective randomized controlled trial. Setting An otorhinolaryngology department in Main University hospitals. Methods Sixty adult patients with obstructive sleep apnea and tongue base hypertrophy underwent tongue base ablation surgery. Patients were randomly divided into 2 groups of 30 patients each: cooled saline and room temperature saline. The Coblation wand used was the EVac 70 Xtra HP (Smith & Nephew). Results In this study, a significant difference in operative time (mean ± SD) was seen between groups: 21.2 ± 5.5 minutes in the cold group and 47 ± 9.5 minutes in the control group ( P = .001). The wands in the cold group did not obstruct, while all the wands in the control group were obstructed by tissue clogs with variable degrees, hence wasting more time to clean the wands’ tips. Conclusion Cooling the irrigating saline overcame the problem of wand clogs, and the wand tip did not occlude at all during the procedures, thus saving time lost in wand cleaning and demonstrating a faster and safer surgical procedure. Further studies are needed to identify the hemostatic effect of the cooled saline over the regular one.


BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e040214
Author(s):  
Shan Qin ◽  
Anping Wang ◽  
Shi Gu ◽  
Weiqing Wang ◽  
Zhengnan Gao ◽  
...  

ObjectiveThe relationship between obesity and albuminuria has not been clarified. This study aimed to investigate the correlation between obesity and the urinary albumin-creatinine ratio (UACR) in Southern and Northern China.DesignA descriptive, cross-sectional study.SettingEight regional centres in REACTION (China’s Risk Evaluation of cAncers in Chinese diabeTic Individuals, a lONgitudinal study), including Dalian, Lanzhou, Zhengzhou, Guangzhou, Guangxi, Luzhou, Shanghai and Wuhan.ParticipantsA total of 41 085 patients who were not diagnosed with chronic kidney disease (CKD) and had good compliance were selected according to the inclusion criteria. Patients who were diagnosed with CKD, who had other kidney diseases that could lead to increased urinary protein excretion, who were using angiotensin-converting-enzyme inhibitors or angiotensin II receptor blockers and whose important data were missing were excluded.ResultsParticipants with both, central and peripheral obesity, had a higher risk of elevated UACR, even after adjusting for multiple factors (OR: 1.14, 95% CI: 1.07 to 1.12, p<0.001), and the risk of high UACR in the South was more prominent than that in the North (OR South: 1.22, 95% CI: 1.11 to 1.34; OR North: 1.13, 95% CI: 1.04 to 1.22, p<0.001). The risk was also elevated in the male population, hypertensive individuals, glycosylated haemoglobin (HbA1c)≥6.5% and age ≥60 years in the South. Besides the above groups, diabetes was also a risk factor for the Northern population.ConclusionsIn China, people with both central and peripheral obesity are prone to a high UACR, and the southern population has a higher risk than northern population. Factors such as male sex, hypertension, HbA1c≥6.5% and an age ≥60 years are also risk factors for CKD.


2010 ◽  
Vol 80 (1) ◽  
pp. 37-42 ◽  
Author(s):  
S. M. Banabilh ◽  
A. R. Samsudin ◽  
A. H. Suzina ◽  
Sidek Dinsuhaimi

Abstract Objective: To test the null hypothesis that there is no difference in facial profile shape, malocclusion class, or palatal morphology in Malay adults with and without obstructive sleep apnea (OSA). Materials and Methods: Subjects were 120 adult Malays aged 18 to 65 years (mean ± standard deviation [SD], 33.2 ± 13.31) divided into two groups of 60. Both groups underwent clinical examination and limited channel polysomnography (PSG). The mean OSA and control values were subjected to t-test and the chi square test. Results: Physical examination showed that 61.7% of the OSA patients were obese, and 41.7% of those obese patients had severe OSA. The mean body mass index (BMI) was significantly greater for the OSA group (33.2 kg/m2 ± 6.5) than for the control group (22.7 kg/m2 ± 3.5; P &lt; .001). The mean neck size and systolic blood pressure were greater for the OSA group (43.6 cm ± 6.02; 129.1 mm Hg ± 17.55) than for the control group (35.6 cm ± 3.52; 114.1 mm Hg ± 13.67; P &lt; .001). Clinical examination showed that the most frequent findings among OSA groups when compared with the control group were convex profiles (71.7%), Class II malocclusion (51.7%), and V palatal shape (53.3%), respectively; the chi square test revealed a significant difference in terms of facial profile and malocclusion class (P &lt; .05), but no significant difference in palatal shape was found. Conclusion: The null hypothesis is rejected. A convex facial profile and Class II malocclusion were significantly more common in the OSA group. The V palatal shape was a frequent finding in the OSA group.


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