Decreased urine albumin:creatinine ratios in infants of diabetic mothers: does exposure to diabetic pregnancies alter fetal renal development?

2011 ◽  
Vol 2 (5) ◽  
pp. 265-271 ◽  
Author(s):  
R. F. Dyck ◽  
W. T. Bingham ◽  
H. Lim ◽  
Y. Jiang ◽  
N. D. Osgood
Keyword(s):  
Logistic Regression ◽  
Odds Ratio ◽  
Logistic Regression Model ◽  
Independent Predictor ◽  
Developmental Changes ◽  
Intrauterine Environment ◽  
Infants Of Diabetic Mothers ◽  
Increased Risk ◽  
Diabetic Mothers

Offspring of diabetic mothers experience an increased risk for type 2 diabetes but it is not known whether diabetic pregnancies also confer a higher inter-generational risk for diabetic complications. Because microalbuminuria is a sensitive indicator of glomerular damage, we compared the urine albumin:creatinine ratios (ACRs) between 65 infants of diabetic mothers (InfDM+) and 59 infants of non-diabetic mothers (InfDM−), and repeated the comparisons in 21 InfDM+ and 19 InfDM− when children were 5–19 months old. ACRs were higher among neonates compared with normal reference values for adults, but declined with increasing age. The only independent predictor of higher ACRs in a logistic regression model (⩾13 mg/mmol v. <13 mg/mmol) was the presence of delivery complications (odds ratio 2.95; P = 0.015). Neither high nor low birth weight was associated with higher neonatal ACRs. The most unique finding of the study was that InfDM+ had significantly lower ACRs than InfDM− [mean = 12.9 (median = 6.0) v. mean = 16.6 (median = 11.5), respectively at P = 0.05] even after adjusting for other variables using logistic regression (odds ratio 0.25; P = 0.001). In contrast, by 5–19 months, there was a trend toward higher ACRs among InfDM+ compared with InfDM− [mean = 6.3 mg/mmol (median = 1.9) v. mean = 3.0 mg/mmol (median = 2.5), respectively at P = 0.25]. Lower ACRs in InfDM+ may be due to developmental changes in fetal kidneys induced by hyperinsulinemia. Although the implications of this observation are unclear, it is possible that exposure to a diabetic intrauterine environment might influence the later risk for renal disease.

scholarly journals Consumption of Nutrition Supplements Is Associated with Less Hypoglycemia during Admission—Results from the MENU Project

Nutrients ◽  
2019 ◽  
Vol 11 (8) ◽  
pp. 1832 ◽  
Author(s):  
Eyal Leibovitz ◽  
Fariba Moore ◽  
Irina Mintser ◽  
Anat Levi ◽  
Ron Dubinsky ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Model ◽  
Medical Records ◽  
Logistic Regression Model ◽  
Medical Center ◽  
Nutrition Support ◽  
Oral Nutrition ◽  
Nutrition Supplement ◽  
Increased Risk

Aim: We studied the effect of the addition of an oral nutrition supplement (ONS) on the rate of hypoglyemia among hospitalized type 2 diabetes mellitus (DM) patients. Methods: In this retrospective analysis, all DM patients with hypoalbuminemia (albumin < 3.5 g/dL) admitted to internal medicine “E” at Wolfson Medical Center between 1 June 2016 and 30 April 2017 were included. One bottle of ONS (Glucerna, 330 KCAL, 28 g carbohydrates, 17 g protein, 17 g fat) was added to the morning meal. The consumption of the ONS was verified during the morning rounds. All glucose measurements were recorded automatically in the patients’ electronic medical records. A logistic regression model was used to evaluate the effect of the nutrition support on the occurrence of hypoglycemia. Results: 218 patients (mean age 77.4 ± 12.0 years, 63.3% female, mean albumin 3.13 ± 0.32 g/dL), of whom 27.9% had documented hypoglycemia during hospitalization were included. The patients consumed 69.5% ± 37.1 of the ONS provided, and ONS was started 4.3 ± 5.3 days from admission. A logistic regression model indicated that age (Odds ratio [OR] 1.048, 95% CI 1.014–1.083, p = 0.005), insulin treatment (OR 3.059, 95% CI 1.497–6.251, p = 0.002), and the day of ONS started from admission (OR 1.094, 95% CI 1.021–1.173, p = 0.011) were associated with an increased risk of hypoglycemia. Complete consumption of the ONS was associated with a reduced risk of hypoglycemia: OR 0.364, 95% CI 0.149–0.890, p = 0.027. Age, other DM medications and serum albumin did not affect the risk. Conclusion: The intake of a complete serving of ONS may be associated with a reduction of the risk of hypoglycemia among diabetes in-patients with hypoalbuminemia.

scholarly journals Severe stunting and its associated factors among children aged 6–59 months in Ethiopia; multilevel ordinal logistic regression model

2021 ◽  
Vol 47 (1) ◽  
Author(s):  
Amare Muche ◽  
Reta Dewau
Keyword(s):  
Logistic Regression ◽  
Odds Ratio ◽  
Associated Factors ◽  
Logistic Regression Model ◽  
Adjusted Odds Ratio ◽  
Wealth Index ◽  
Maternal Height ◽  
Severe Stunting ◽  
Mothers And Children ◽  
Ordinal Logistic Regression Model

Abstract Background In Ethiopia, stunting is the most common form of undernutriton. Identifying the determinants of severe stunting among children is crucial for public health interventions to improve child health. Therefore, this study aimed to identify the determinants of severe stunting among under-five children in Ethiopia. Methods A community-based cross-sectional study design was employed. A two stage stratified cluster sampling technique was used. A multilevel ordinal logistic regression model was fitted to identify independent determinants. Adjusted odds ratio (AOR) and median odds ratio (MOR) with its 95% confidence interval at p-value< 0.05 were used to declare statistical significance. Results The result of this study showed that about 18% of the children were severely stunted. Being male increased the severity of stunting in children by 26% adjusted odds ratio (AOR): 1.26 (95% CI: 1.09–1.46), compared to female sex; over-weight mothers increased the severity of stunting in their children AOR: 3.43 (95% CI: 2.21–5.33) compared to normal BMI mothers; and children from middle, poorer, and poorest wealth index households were 1.84 (95% CI:1.27–2.67), 2.13 (95% CI, CI:1.45–3.14) and 2.52 (95% CI,1.72–3.68). In contrast, severe stunting was reduced by 62% (AOR: 0.38, 95% CI: 0.20–0.74) and 48% (AOR = 0.52, 95% CI: 0.37–0.72) in children of educated mothers compared to children of uneducated mothers and children of underweight mothers compared with those children of normal BMI mothers respectively. For each one-unit increase in maternal height, there is a 5% significant reduction in the child’s odds of being severely stunted. After controlling for other factors, the effect of predictors on the likelihood of stunting in high risk clusters increased by a median odds ratio (MOR) of 1.83 (95% CI: 1.69–2.00). Conclusions The magnitude of severe childhood stunting was still high with regional variation in Ethiopia. Child age, sex, maternal height, age, education and household wealth index as well as administrative regions were significantly associated factors with severe stunting. Significant interventions shall be implemented at the individual, household and community levels in order to reduce the problem.

scholarly journals Prediction of Hospital Mortality Rates by Admission Laboratory Tests

2006 ◽  
Vol 52 (2) ◽  
pp. 325-328 ◽  
Author(s):  
Paul Froom ◽  
Zvi Shimoni
Keyword(s):  
Internal Medicine ◽  
Logistic Regression ◽  
Confidence Interval ◽  
Regression Model ◽  
Odds Ratio ◽  
Laboratory Tests ◽  
Logistic Regression Model ◽  
Complete Blood Count ◽  
Laboratory Data ◽  
Regional Hospital

Abstract Background: The aim of this study was to explore whether electronically retrieved laboratory data can predict mortality in internal medicine departments in a regional hospital. Methods: All 10 308 patients hospitalized in internal medicine departments over a 1-year period were included in the cohort. Nearly all patients had a complete blood count and basic clinical chemistries on admission. We used logistic regression analysis to predict the 573 deaths (5.6%), including all variables that added significantly to the model. Results: Eight laboratory variables and age significantly and independently contributed to a logistic regression model (area under the ROC curve, 88.7%). The odds ratio for the final model per quartile of risk was 6.44 (95% confidence interval, 5.42–7.64), whereas for age alone, the odds ratio per quartile was 2.01 (95% confidence interval, 1.84–2.19). Conclusions: A logistic regression model including only age and electronically retrieved laboratory data highly predicted mortality in internal medicine departments in a regional hospital, suggesting that age and routine admission laboratory tests might be used to ensure a fair comparison when using mortality monitoring for hospital quality control.

scholarly journals An Observational Cohort Study ofClostridium difficileRibotype 027 and Recurrent Infection

mSphere ◽  
2018 ◽  
Vol 3 (3) ◽  
Author(s):  
Krishna Rao ◽  
Peter D. R. Higgins ◽  
Vincent B. Young
Keyword(s):  
Logistic Regression ◽  
Independent Predictor ◽  
The United States ◽  
Public Health Issue ◽  
Clinical Microbiology Laboratory ◽  
Clinical Predictors ◽  
Content Type ◽  
Ribotype 027 ◽  
Increased Risk ◽  
Wide Range

ABSTRACTRecurrentClostridium difficileinfection (rCDI) frequently complicates recovery from CDI. Accurately predicting rCDI would allow judicious allocation of limited resources, but published models have met with limited success. Thus, biomarkers predictive of recurrence have been sought. This study tested whether PCR ribotype independently predicted rCDI. Stool samples from nonpregnant inpatients ≥18 years of age with diarrhea were included from October 2010 to January 2013 after the patients tested positive forC. difficilein the clinical microbiology laboratory. Per guidelines, the rCDI was defined as a positive test forC. difficileat >2 weeks but ≤8 weeks from the index episode. For each sample, a single colony ofC. difficilewas isolated by anaerobic culture, confirmed to be toxigenic by PCR, and ribotyped. Simple logistic regression and multiple logistic regression were used to model the primary outcome of rCDI, incorporating a wide range of clinical parameters. In total, 927 patients with 968 index episodes of CDI were included, with 110 (11.4%) developing rCDI. Age and use of proton pump inhibitors or concurrent antibiotics did not increase the risk of rCDI. Low serum bilirubin levels and ribotype 027 were associated with increased risk of rCDI on unadjusted analysis, with health care-associated CDI being inversely associated. In the final multivariable model, ribotype 027 was the strongest independent predictor of rCDI (odds ratio, 2.17; 95% confidence interval, 1.33 to 3.56;P= 0.002). Ribotype 027 is an independent predictor of rCDI.IMPORTANCECDI is a major public health issue, with over 400,000 cases per year in the United States alone. Recurrent CDI is common, occurring in approximately one in five individuals after a primary episode. Although interventions exist that could reduce the risk of recurrence, deployment in all patients is limited by cost, invasiveness, and/or an undetermined long-term safety profile. Thus, clinicians need risk stratification tools to properly allocate treatments. Because prior research on clinical predictors has failed to yield a reliable, reproducible, and effective predictive model to assist treatment decisions, accurate biomarkers of recurrence would be of great value. This study tested whether PCR ribotype independently predicted rCDI, and the data build upon prior research in showing that ribotype 027 is associated with rCDI.

scholarly journals Retrospective analysis of risk factors of hypotensive bradycardic events during shoulder arthroscopic surgery under interscalene blockade in the sitting position

2020 ◽  
Vol 73 (6) ◽  
pp. 542-549
Author(s):  
Taeha Ryu ◽  
Baek Jin Kim ◽  
Seong Jun Woo ◽  
So Young Lee ◽  
Jung A Lim ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Odds Ratio ◽  
Arthroscopic Surgery ◽  
Sitting Position ◽  
Past Medical History ◽  
Frequent Adverse Event ◽  
Increased Risk ◽  
Potential Risk Factors ◽  
Independent Risk Factors

Background: Hypotensive bradycardic events (HBEs) are a frequent adverse event in patients who underwent shoulder arthroscopic surgery under interscalene block (ISB) in the sitting position. This retrospective study was conducted to investigate the independent risk factors of HBEs in shoulder arthroscopic surgery under ISB in the sitting position. Methods: A total of 2549 patients who underwent shoulder arthroscopic surgery under ISB and had complete clinical data were included in the study. The 357 patients who developed HBEs were included in the HBEs group, and the remaining 2192 in the non-HBEs group. The potential risk factors for HBEs, such as age, sex, past medical history, anesthetic characteristics, and intraoperative medications were collected and compared between the groups. Statistically significant variables were included in a logistic regression model to further evaluate the independent risk factors for HBEs in shoulder arthroscopic surgery under ISB. Results: The incidence of HBEs was 14.0% (357/2549). Logistic regression analysis revealed that the intraoperative use of hydralazine (odds ratio [OR] 4.2; 95% confidence interval [CI] 2.9–6.3), propofol (OR 2.1; 95% CI 1.3–3.6), and dexmedetomidine (OR 3.9; 95% CI 1.9–7.8) before HBEs were independent risk factors for HBEs in patients who received shoulder arthroscopic surgery under ISB. Conclusions: The intraoperative use of antihypertensives such as hydralazine and sedatives such as propofol or dexmedetomidine leads to increased risk of HBEs during shoulder arthroscopic surgery under ISB in the sitting position.

scholarly journals Developing a Multi-variate Logistic Regression Model to Analyze Accident Scenarios: Case of Electrical Contractors

2020 ◽  
Vol 17 (13) ◽  
pp. 4852
Author(s):  
Pouya Gholizadeh ◽  
Behzad Esmaeili
Keyword(s):  
Logistic Regression ◽  
Regression Model ◽  
Odds Ratio ◽  
Logistic Regression Model ◽  
The Body ◽  
Occupational Accidents ◽  
Multivariate Logistic Regression Model ◽  
Ratio Analysis ◽  
Accident Scenarios ◽  
Significant Factors

The ability to identify factors that influence serious injuries and fatalities would help construction firms triage hazardous situations and direct their resources towards more effective interventions. Therefore, this study used odds ratio analysis and logistic regression modeling on historical accident data to investigate the contributing factors impacting occupational accidents among small electrical contracting enterprises. After conducting a thorough content analysis to ensure the reliability of reports, the authors adopted a purposeful variable selection approach to determine the most significant factors that can explain the fatality rates in different scenarios. Thereafter, this study performed an odds ratio analysis among significant factors to determine which factors increase the likelihood of fatality. For example, it was found that having a fatal accident is 4.4 times more likely when the source is a “vehicle” than when it is a “tool, instrument, or equipment”. After validating the consistency of the model, 105 accident scenarios were developed and assessed using the model. The findings revealed which severe accident scenarios happen commonly to people in this trade, with nine scenarios having fatality rates of 50% or more. The highest fatality rates occurred in “fencing, installing lights, signs, etc.” tasks in “alteration and rehabilitation” projects where the source of injury was “parts and materials”. The proposed analysis/modeling approach can be applied among all specialty contracting companies to identify and prioritize more hazardous situations within specific trades. The proposed model-development process also contributes to the body of knowledge around accident analysis by providing a framework for analyzing accident reports through a multivariate logistic regression model.

scholarly journals Triglyceride-containing lipoprotein sub-fractions and risk of coronary heart disease and stroke: A prospective analysis in 11,560 adults

2020 ◽  
Vol 27 (15) ◽  
pp. 1617-1626 ◽  
Author(s):  
Roshni Joshi ◽  
S Goya Wannamethee ◽  
Jorgen Engmann ◽  
Tom Gaunt ◽  
Deborah A Lawlor ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Odds Ratio ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Increased Risk ◽  
The Individual

Aims Elevated low-density lipoprotein cholesterol (LDL-C) is a risk factor for cardiovascular disease; however, there is uncertainty about the role of total triglycerides and the individual triglyceride-containing lipoprotein sub-fractions. We measured 14 triglyceride-containing lipoprotein sub-fractions using nuclear magnetic resonance and examined associations with coronary heart disease and stroke. Methods Triglyceride-containing sub-fraction measures were available in 11,560 participants from the three UK cohorts free of coronary heart disease and stroke at baseline. Multivariable logistic regression was used to estimate the association of each sub-fraction with coronary heart disease and stroke expressed as the odds ratio per standard deviation increment in the corresponding measure. Results The 14 triglyceride-containing sub-fractions were positively correlated with one another and with total triglycerides, and inversely correlated with high-density lipoprotein cholesterol (HDL-C). Thirteen sub-fractions were positively associated with coronary heart disease (odds ratio in the range 1.12 to 1.22), with the effect estimates for coronary heart disease being comparable in subgroup analysis of participants with and without type 2 diabetes, and were attenuated after adjustment for HDL-C and LDL-C. There was no evidence for a clear association of any triglyceride lipoprotein sub-fraction with stroke. Conclusions Triglyceride sub-fractions are associated with increased risk of coronary heart disease but not stroke, with attenuation of effects on adjustment for HDL-C and LDL-C.

scholarly journals Motor and Postural Patterns Concomitant with General Movements Are Associated with Cerebral Palsy at Term and Fidgety Age in Preterm Infants

2019 ◽  
Vol 8 (8) ◽  
pp. 1189
Author(s):  
Fabrizio Ferrari ◽  
Carlotta Plessi ◽  
Laura Lucaccioni ◽  
Natascia Bertoncelli ◽  
Luca Bedetti ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Logistic Regression ◽  
Cerebral Palsy ◽  
Preterm Infants ◽  
Odds Ratio ◽  
Logistic Regression Model ◽  
Typical Development ◽  
Resonance Imaging ◽  
Video Recordings ◽  
General Movements

General movements (GMs) in combination with neurological examination and magnetic resonance imaging at term age can accurately determine the risk of cerebral palsy. The present study aimed to assess whether 11 motor and postural patterns concomitant with GMs were associated with cerebral palsy. Video recordings performed after birth in 79 preterm infants were reviewed retrospectively. Thirty-seven infants developed cerebral palsy at 2 years corrected age and the remaining 42 showed typical development. GMs were assessed from preterm to fidgety age and GM trajectories were defined. The 11 motor and postural patterns were evaluated at each age and longitudinally, alone and in combination with GM trajectories. A logistic regression model was used to assess the association between GMs, concomitant motor and postural patterns, and cerebral palsy. We confirmed that high-risk GM trajectories were associated with cerebral palsy (odds ratio = 44.40, 95% confidence interval = 11.74–167.85). An association between concomitant motor and postural patterns and cerebral palsy was found for some of the patterns at term age and for all of them at fidgety age. Therefore, at term age, concomitant motor and postural patterns can support GMs for the early diagnosis of cerebral palsy.

scholarly journals Association of Angiotensin Converting Enzyme Insertion-Deletion Polymorphism with Hypertension in Emiratis with Type 2 Diabetes Mellitus and Its Interaction with Obesity Status

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Habiba Alsafar ◽  
Ahmed Hassoun ◽  
Shaikha Almazrouei ◽  
Wala Kamal ◽  
Mustafa Almaini ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Angiotensin Converting Enzyme ◽  
Odds Ratio ◽  
Association Studies ◽  
Converting Enzyme ◽  
Obesity Status ◽  
Increased Risk

The association of Angiotensin Converting Enzyme (ACE) insertion-deletion (I/D) polymorphism with Type 2 Diabetes Mellitus (T2DM) and hypertension has been extensively studied throughout various ethnic populations but largely with inconsistent findings. We investigated these associations in Emirati population and their interaction with obesity status. Saliva samples were collected from a total of 564 Emiratis (277 T2DM and 297 healthy). DNA was extracted and the samples were genotyped forACEI/D polymorphism by a PCR based method followed by gel electrophoresis. Upon evaluation of theACEI/D polymorphism amongst all T2DM, hypertensive patients, and respective controls regardless of obesity status,ACEDD genotype was not found to be associated with either T2DM [odds ratio (OR) = 1.34,p=0.086] or hypertension [odd ratio (OR) = 1.02,p=0.93]. When the genetic variants amongst the nonobese and obese population were analyzed separately, the risk genotypeACEDD conferred significantly increased risk of hypertension in nonobese population [odds ratio (OR) = 1.80,p=0.02] but was found to be protective against the hypertension in the obese group ((OR) = 0.54,p=0.01). However, there was no effect of obesity status on the association ofACEgenotypes with T2DM. The risk of hypertension associated withACEDD is modulated by obesity status and hence future genetic association studies should take obesity into account for the interpretation of data. We also confirmed thatACEI/D polymorphism is not associated with T2DM risk in Emirati population.

scholarly journals Cadmium Is Associated with Type 2 Diabetes in a Superfund Site Lead Smelter Community in Dallas, Texas

2020 ◽  
Vol 17 (12) ◽  
pp. 4558
Author(s):  
Bert B. Little ◽  
Robert Reilly ◽  
Brad Walsh ◽  
Giang T. Vu
Keyword(s):  
Type 2 Diabetes ◽  
Logistic Regression ◽  
Fixed Effects ◽  
Smoking Status ◽  
Meta Analysis ◽  
Two Phase ◽  
Lead Smelter ◽  
Increased Risk ◽  
Cd Exposure

Objective: To test the hypothesis that cadmium (Cd) exposure is associated with type 2 diabetes mellitus (T2DM). Materials and Methods: A two-phase health screening (physical examination and laboratory tests) was conducted in a lead smelter community following a Superfund Cleanup. Participants were African Americans aged >19 years to <89 years. Multiple logistic regression was used to analyze T2DM regressed on blood Cd level and covariates: body mass index (BMI), heavy metals (Ar, Cd, Hg, Pb), duration of residence, age, smoking status, and sex. Results: Of 875 subjects environmentally exposed to Cd, 55 were occupationally exposed to by-products of lead smelting and 820 were community residents. In addition, 109 T2DM individuals lived in the community for an average of 21.0 years, and 766 non-T2DM individuals for 19.0 years. T2DM individuals (70.3%) were >50 years old. Blood Cd levels were higher among T2DM subjects (p < 0.006) compared to non-T2DM individuals. Logistic regression of T2DM status identified significant predictors: Cd level (OR = 1.85; 95% CI: 1.14–2.99, p < 0.01), age >50 years (OR = 3.10; 95% CI: 1.91–5.02, p < 0.0001), and BMI (OR = 1.07; CI: 1.04–1.09, 0.0001). In meta-analysis of 12 prior studies and this one, T2DM risk was OR = 1.09 (95% CI: 1.03–1.15, p < 0.004) fixed effects and 1.22 (95% CI: 1.04–1.44, p < 0.02) random effects. Discussion: Chronic environmental Cd exposure was associated with T2DM in a smelter community, controlling for covariates. T2DM onset <50 years was significantly associated with Cd exposure, but >50 years was not. Meta-analysis suggests that Cd exposure is associated with a small, but significant increased risk for T2DM. Available data suggest Cd exposure is associated with an increased propensity to increased insulin resistance.

Sign in / Sign up

Export Citation Format

Share Document