scholarly journals Plant-based diets, insulin sensitivity and inflammation in elderly men with chronic kidney disease

2020 ◽  
Vol 33 (5) ◽  
pp. 1091-1101 ◽  
Author(s):  
Ailema González-Ortiz ◽  
Hong Xu ◽  
Carla M. Avesani ◽  
Bengt Lindholm ◽  
Tommy Cederholm ◽  
...  
Keyword(s):  
Insulin Sensitivity ◽  
Cross Sectional Study ◽  
Glucose Disposal ◽  
Elderly Men ◽  
Cross Sectional ◽  
Metabolic Complications ◽  
Glucose Clamp Technique ◽  
Ckd Stage ◽  
Underlying Mechanisms ◽  
Glucose Disposal Rate

Abstract Background In persons with CKD, adherence to plant-based diets is associated with lower risk of CKD progression and death, but underlying mechanisms are poorly characterized. We here explore associations between adherence to plant-based diets and measures of insulin sensitivity and inflammation in men with CKD stages 3–5. Methods Cross-sectional study including 418 men free from diabetes, aged 70–71 years and with cystatin-C estimated glomerular filtration rate (eGFR) <60 mL/min/1.73m2 and not receiving kidney-specific dietetic advice. Information from 7-day food records was used to evaluate the adherence to a plant-based diet index (PBDi), which scores positively the intake of plant-foods and negatively animal-foods. Insulin sensitivity and glucose disposal rate were assessed with the gold-standard hyperinsulinemic euglycemic glucose clamp technique. Inflammation was evaluated by serum concentrations of C-reactive protein (CRP) and interleukin (IL)-6. Associations were explored through linear regression and restricted cubic splines. Results The majority of men had CKD stage 3a. Hypertension and cardiovascular disease were the most common comorbidities. The median PBDi was 38 (range 14–55). Across higher quintiles of PBDi (i.e. higher adherence), participants were less often smokers, consumed less alcohol, had lower BMI and higher eGFR (P for trend <0.05 for all). Across higher PBDi quintiles, patients exhibited higher insulin sensitivity and lower inflammation (P for trend <0.05). After adjustment for eGFR, lifestyle factors, BMI, comorbidities and energy intake, a higher PBDi score remained associated with higher glucose disposal rate and insulin sensitivity as well as with lower levels of IL-6 and CRP. Conclusion In elderly men with non-dialysis CKD stages 3–5, adherence to a plant-based diet was associated with higher insulin sensitivity and lower inflammation, supporting a possible role of plant-based diets in the prevention of metabolic complications of CKD. Graphic abstract

scholarly journals Myocardial Fat Accumulation Is Independent of Measures of Insulin Sensitivity

2015 ◽  
Vol 100 (8) ◽  
pp. 3060-3068 ◽  
Author(s):  
Ranganath Muniyappa ◽  
Radwa Noureldin ◽  
Ronald Ouwerkerk ◽  
Elizabeth Y. Liu ◽  
Ritu Madan ◽  
...  
Keyword(s):  
Insulin Sensitivity ◽  
Serum Triglyceride ◽  
Tolerance Test ◽  
Cross Sectional Study ◽  
Glucose Disposal ◽  
Sensitivity Index ◽  
Cross Sectional ◽  
Peripheral Insulin Sensitivity ◽  
Cardiac Steatosis ◽  
Myocardial Steatosis

Background: Myocardial steatosis, an independent predictor of diastolic dysfunction, is frequently present in type 2 diabetes mellitus. High free fatty acid flux, hyperglycemia, and hyperinsulinemia may play a role in myocardial steatosis. There are no prior studies examining the relationship between insulin sensitivity (antilipolytic and glucose disposal actions of insulin) and cardiac steatosis. Objective: Using a cross-sectional study design of individuals with and without metabolic syndrome (MetSyn), we examined the relationships between cardiac steatosis and the sensitivity of the antilipolytic and glucose disposal actions of insulin. Methods: Pericardial fat (PF) volume, intramyocardial and hepatic fat (MF and HF) content, visceral fat (VF) and sc fat content were assessed by magnetic resonance imaging in 77 subjects (49 without MetSyn and 28 with MetSyn). In a subset of the larger cohort (n = 52), peripheral insulin sensitivity index (SI) and adipocyte insulin sensitivity (Adipo-SI) were determined from an insulin-modified frequently sampled iv glucose tolerance test. The Quantitative Insulin Sensitivity Check Index was used as a surrogate for hepatic insulin sensitivity. Results: Individuals with the MetSyn had significantly higher body mass index, total body fat, and MF, PF, HF, and VF content. HF and VF, but not MF, were negatively correlated with the Quantitative Insulin Sensitivity Check Index, Adipo-SI, and SI. Stepwise regression revealed that waist circumference and serum triglyceride levels independently predicted MF and PF, respectively. Adipo-SI and serum triglyceride levels independently predict HF. Conclusion: Myocardial steatosis is unrelated to hepatic, adipocyte, or peripheral insulin sensitivity. Although it is frequently observed in insulin-resistant subjects, further studies are necessary to identify and delineate pathogenic mechanisms that differentially affect cardiac and hepatic steatosis.

scholarly journals Physical activity and hippocampal volume in middle-aged patients with type 1 diabetes

Neurology ◽  
2017 ◽  
Vol 88 (16) ◽  
pp. 1564-1570 ◽  
Author(s):  
Karen A. Nunley ◽  
Regina L. Leckie ◽  
Trevor J. Orchard ◽  
Tina Costacou ◽  
Howard J. Aizenstein ◽  
...  
Keyword(s):  
Physical Activity ◽  
Insulin Sensitivity ◽  
Regression Models ◽  
Hippocampal Volume ◽  
Glucose Disposal ◽  
Intracranial Volume ◽  
Cross Sectional ◽  
Total Brain ◽  
Glucose Disposal Rate

Objective:To examine the cross-sectional association between physical activity (PA) and hippocampal volume in middle-aged adults with childhood-onset type 1 diabetes (T1D), and whether hyperglycemia and insulin sensitivity contribute to this relationship.Methods:We analyzed neuroimaging and self-reported PA data from 79 adults with T1D from the Pittsburgh Epidemiology of Diabetes Complications Study (mean age 50 years, mean duration 41 years) and 122 similarly aged adults without T1D (mean age 48 years). Linear regression models, controlling for intracranial volume, sex, education, and age, tested associations between PA and gray matter volumes of hippocampi and total brain in the 2 groups. For the T1D group, models further controlled for hyperglycemia and glucose disposal rate, a measure of insulin sensitivity.Results:PA was significantly lower in the T1D than in the non-T1D group (median [interquartile range] 952 kcal [420–2,044] vs 1,614 kcal [588–3,091], respectively). Higher PA was significantly associated with larger hippocampi for T1D, but not for non-T1D (standardized β [p values] from regression models adjusted for intracranial volume, sex, age, and education: 0.270 [p < 0.001] and 0.098 [p = 0.12], respectively). Neither hyperglycemia nor glucose disposal rate substantially modified this association. Relationships between PA and total brain gray matter volume were similar.Conclusions:A cross-sectional association between higher PA and larger hippocampi is already detectable by middle age for these patients with T1D, and it appears robust to chronic hyperglycemia and insulin sensitivity. Proof-of-concept studies should investigate whether increasing PA preserves hippocampal volume and the mechanisms underlying the effects of PA on hippocampal volume.

scholarly journals The Association between Decreased Kidney Function and FIB-4 Index Value, as Indirect Liver Fibrosis Indicator, in Middle-Aged and Older Subjects

2021 ◽  
Vol 18 (13) ◽  
pp. 6980
Author(s):  
Kazuko Kotoku ◽  
Ryoma Michishita ◽  
Takuro Matsuda ◽  
Shotaro Kawakami ◽  
Natsumi Morito ◽  
...  
Keyword(s):  
Liver Fibrosis ◽  
Kidney Function ◽  
Survival Curve ◽  
Cross Sectional Study ◽  
Trend Test ◽  
Healthy Population ◽  
Middle Aged ◽  
Cross Sectional ◽  
Ckd Stage ◽  
Older Subjects

Liver fibrosis might be linked to the prevalence of chronic kidney disease (CKD). However, there is little information about the association between liver fibrosis and decreased kidney function in middle-aged and older subjects. We aimed to evaluate the influence of liver fibrosis on the incidence or prevalence of CKD stage 3–5 in a retrospective cross-sectional study (Study 1, n = 806) and a 6-year longitudinal study (Study 2, n = 380) of middle-aged and older subjects. We evaluated liver fibrosis using the Fibrosis-4 (FIB-4) index and kidney function using the estimated glomerular filtration rate (eGFR) of all subjects. All subjects were divided into four groups on the basis of their FIB-4 score quartiles (low to high). In the Jonckheere–Terpstra trend test of Study 1, the eGFR decreased significantly from the lowest group to the highest group (p < 0.001). The Kaplan–Meier survival curve in Study 2 showed that the cumulative prevalence of CKD stage 3–5 was higher in the third quartile than the other quartiles. Our results suggest that liver fibrosis could be a useful indicator for the prevalence of CKD, even within a relatively healthy population, although liver fibrosis was not an independent risk factor.

scholarly journals FGF-23 and Phosphate in Children with Chronic Kidney Disease: A Cross-Sectional Study in Kazakhstan

Medicina ◽  
2020 ◽  
Vol 57 (1) ◽  
pp. 15
Author(s):  
Altynay Balmukhanova ◽  
Kairat Kabulbayev ◽  
Harika Alpay ◽  
Assiya Kanatbayeva ◽  
Aigul Balmukhanova
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Fibroblast Growth Factor 23 ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Ckd Stage ◽  
Advanced Stages ◽  
Fgf 23 ◽  
Stage 1

Background and objectives: Chronic kidney disease (CKD) in children is a complex medical and social issue around the world. One of the serious complications is mineral-bone disorder (CKD-MBD) which might determine the prognosis of patients and their quality of life. Fibroblast growth factor 23 (FGF-23) is a phosphaturic hormone which is involved in the pathogenesis of CKD-MBD. The purpose of the study was to determine what comes first in children with CKD: FGF-23 or phosphate. Materials and Methods: This cross-sectional study included 73 children aged 2–18 years with CKD stages 1–5. We measured FGF-23 and other bone markers in blood samples and studied their associations. Results: Early elevations of FGF-23 were identified in children with CKD stage 2 compared with stage 1 (1.6 (1.5–1.8) pmol/L versus 0.65 (0.22–1.08), p = 0.029). There were significant differences between the advanced stages of the disease. FGF-23 correlated with PTH (r = 0.807, p = 0.000) and phosphate (r = 0.473, p = 0.000). Our study revealed that the elevated level of FGF-23 went ahead hyperphosphatemia and elevated PTH. Thus, more than 50% of children with CKD stage 2 had the elevating level of serum FGF-23, and that index became increasing with the disease progression and it achieved 100% at the dialysis stage. The serum phosphate increased more slowly and only 70.6% of children with CKD stage 5 had the increased values. The PTH increase was more dynamic. Conclusions: FGF-23 is an essential biomarker, elevates long before other markers of bone metabolism (phosphate), and might represent a clinical course of disease.

scholarly journals Reduced Oxygenation in Human Obese Adipose Tissue Is Associated with Impaired Insulin Suppression of Lipolysis

2010 ◽  
Vol 95 (8) ◽  
pp. 4052-4055 ◽  
Author(s):  
Magdalena Pasarica ◽  
Jennifer Rood ◽  
Eric Ravussin ◽  
Jean-Marc Schwarz ◽  
Steven R. Smith ◽  
...  
Keyword(s):  
Adipose Tissue ◽  
Insulin Sensitivity ◽  
Capillary Density ◽  
Cross Sectional Study ◽  
Fat Cell ◽  
Euglycemic Hyperinsulinemic Clamp ◽  
Cross Sectional ◽  
Clinical Research Center ◽  
Endothelial Growth Factor

Context: Adipose tissue in obese individuals is characterized by reduced capillary density and reduced oxygenation. Objective: Our objective was to test whether hypoxia is associated with reduced antilipolytic effect of insulin. Participants, Design, and Setting: Twenty-one lean and obese individuals participated in this cross-sectional study at a university-based clinical research center. Intervention: In all subjects, in situ adipose tissue (AT) oxygenation [AT oxygen partial pressure (ATpO2)] was measured with a Clark electrode, insulin sensitivity as well as basal and insulin-suppressed lipolysis (continuous infusion of (2H5)glycerol) were measured during a euglycemic-hyperinsulinemic clamp, and abdominal sc AT biopsies were collected to assess fat cell size (Coulter counting of osmium-fixed cells), capillary density (by staining of histological sections), and gene expression (by quantitative RT-PCR). Main Outcome Measure: In situ ATpO2 was evaluated. Results: The ability of insulin to suppress lipolysis (percent) was positively correlated with insulin sensitivity (r = 0.43; P &lt; 0.05), ATpO2 (r = 0.44; P &lt; 0.05), vascular endothelial growth factor mRNA (r = 0.73; P &lt; 0.01), and capillary density (r = 0.75; P &lt; 0.01). Conclusion: These results indicate that low capillary density and ATpO2 in AT are potentially upstream causes of AT dysfunction.

scholarly journals Measures of Bioavailable Serum Testosterone and Estradiol and Their Relationships with Muscle Strength, Bone Density, and Body Composition in Elderly Men*

2000 ◽  
Vol 85 (9) ◽  
pp. 3276-3282 ◽  
Author(s):  
Annewieke W. van den Beld ◽  
Frank H. de Jong ◽  
Diederick E. Grobbee ◽  
Huibert A. P. Pols ◽  
Steven W. J. Lamberts
Keyword(s):  
Body Composition ◽  
Muscle Strength ◽  
Fat Mass ◽  
Cross Sectional Study ◽  
Positive Relation ◽  
Elderly Men ◽  
Cross Sectional ◽  
Healthy Elderly ◽  
Hip Bmd ◽  
Best Parameter

Abstract In the present cross-sectional study of 403 independently living elderly men, we tested the hypothesis that the decreases in bone mass, body composition, and muscle strength with age are related to the fall in circulating endogenous testosterone (T) and estrogen concentrations. We compared various measures of the level of bioactive androgen and estrogen to which tissues are exposed. After exclusion of subjects with severe mobility problems and signs of dementia, 403 healthy men (age, 73–94 yr) were randomly selected from a population-based sample. Total T (TT), free T (FT), estrone (E1), estradiol (E2), and sex hormone-binding globulin (SHBG) were determined by RIA. Levels of non-SHBG-bound T (non-SHBG-T), FT (calc-FT), the TT/SHBG ratio, non-SHBG-bound E2, and free E2 were calculated. Physical characteristics of aging included muscle strength measured using dynamometry, total body bone mineral density (BMD), hip BMD, and body composition, including lean mass and fat mass, measured by dual-energy x-ray absorptiometry. In this population of healthy elderly men, calc-FT, non-SHBG-T, E1, and E2 (total, free, and non-SHBG bound) decreased significantly with age. T (total and non-SHBG-T) was positively related with muscle strength and total body BMD (for non-SHBG-T, respectively, β = 1.93 ± 0.52, P &lt; 0.001 and β = 0.011 ± 0.002, P &lt; 0.001). An inverse association existed between T and fat mass (β = −0.53 ± 0.15, P &lt; 0.001). Non-SHBG-T and calc-FT were more strongly related to muscle strength, BMD, and fat mass than TT and were also significantly related to hip BMD. E1 and E2 were both positively, independently associated with BMD (for E2, β = 0.21 ± 0.08, P &lt; 0.01). Non-SHBG-bound E2 was slightly strongly related to BMD than total E2. The positive relation between T and BMD was independent of E2. E1 and E2 were not related with muscle strength or body composition. In summary, bioavailable T, E1, total E2, and bioavailable E2 all decrease with age in healthy old men. In this cross-sectional study in healthy elderly men, non-SHBG-bound T seems to be the best parameter for serum levels of bioactive T, which seems to play a direct role in the various physiological changes that occur during aging. A positive relation with muscle strength and BMD and a negative relation with fat mass was found. In addition, both serum E1 and E2 seem to play a role in the age-related bone loss in elderly men, although the cross-sectional nature of the study precludes a definitive conclusion. Non-SHBG-bound E2 seems to be the best parameter of serum bioactive E2 in describing its positive relation with BMD.

scholarly journals Sex Differences in the Association Between Obesity and Cognitive Impairment in a Low-Income Elderly Population in Rural China: A Population-Based Cross-Sectional Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Dandan Guo ◽  
Xin Zhang ◽  
Changqing Zhan ◽  
Qiuxing Lin ◽  
Jie Liu ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Low Income ◽  
Elderly Population ◽  
Elderly Women ◽  
Rural China ◽  
Population Based ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Elderly Men ◽  
Cross Sectional

Background: Obesity is a potentially modifiable risk factor for cognitive impairment. However, sex-specific relationships between obesity and cognitive impairment in late life remain unclear.Objective: We aimed to assess sex differences in the association between various obesity parameters and cognitive impairment in a low-income elderly population in rural China.Methods: A population-based cross-sectional study was conducted to collect basic information from elderly residents aged 60 years and older from April 2014 to August 2014 in rural areas of Tianjin, China. Obesity parameters, including body mass index (BMI) and waist circumference (WC), and Mini Mental State Examination scores were measured, and the relationships between these variables were assessed.Results: A total of 1,081 residents with a mean age of 67.70 years were enrolled in this study. After adjusting for age, educational attainment, smoking status, drinking status, physical exercise participation, and the presence of diabetes and hyperlipidemia, blood pressure group; a high BMI was found to be associated with an increased prevalence of cognitive impairment in elderly women. Each 1-unit increase in BMI was associated with a 5.9% increase in the prevalence of cognitive impairment. WC was related to the prevalence of cognitive impairment in elderly men, and each 1-cm increase in WC was associated with a 4.0% decrease in the prevalence of cognitive impairment. However, there were no significant associations between WC and cognitive function in women or between BMI and cognitive impairment in men.Conclusion: A greater WC was positively associated with better cognitive function in low-income elderly men in rural China, whereas a higher BMI was associated with an increased risk of cognitive impairment in elderly women, independent of sociodemographic, lifestyle, and health-related comorbid factors. Our results suggest weight management of elderly women in rural China may have cognitive benefits. However, randomized controlled trials would be needed to confirm causality.

scholarly journals P0292CONSTIPATION IN CHINESE ELDERLY: A HIDDEN CAUSE OF CHRONIC KIDNEY DISEASE AND THE RISK OF RAPID RENAL FUNCTION DECLINE

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Guihua Jian ◽  
Dongsheng Cheng ◽  
Zhi Wang ◽  
Junhui Li ◽  
Qi Yang ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Function ◽  
Risk Factor ◽  
Retrospective Cohort ◽  
Independent Risk Factor ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Renal Function Decline ◽  
Ckd Stage

Abstract Background and Aims Both constipation and chronic kidney disease (CKD) are common among seniors. However, the association between constipation and CKD remain unclear. This study investigates the correlation between the two to provide a new basis for clinical treatment. Method Data from Shanghai community elderly physical examination database (2010-2018) were used to conduct a cross-sectional study and a retrospective cohort to evaluate the relationship between constipation and the prevalence of CKD and rapid renal function decline in the elderly community. Results The cross-sectional study covered 16,177 participants, with an average age of 71.3. Comparing to no constipation group, seniors with constipation have a higher proportion of suffering from CKD stage 3. Constipation is an independent risk factor contributing to the high prevalence of CKD stage 3 (OR:1.238,95% CI,1.045-1.466). This finding was further tested through a retrospective cohort study that included 4,203 participants with a medium following time of 6.1 years. As a result, 9.5% (n=401) reported to have rapid progression of renal function. After adjustment of confounding factors, the logistic regression analysis indicates that, constipation is an independent predictive variable of rapid renal function decline among aged population. Conclusion Constipation is an independent risk factor for the prevalence of CKD and an independent predictor of rapid renal function decline among seniors in the community. Prevention and treatment for constipation should be taken at an early stage, which may reduce the incidence of CKD and delay the progression of CKD.

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