P0157GENETICALLY DETERMINED HYPOALBUMINEMIA AND THE RISK OF HYPERTENSION: GWAS-BASED INSTRUMENTAL VARIABLE ANALYSIS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Sang-Woong Han ◽  
Mi-yeon Yu ◽  
Jong Wook Choi ◽  
Joo-Hark Yi ◽  
Chang Hwa Lee ◽  
...  
Keyword(s):  
Genetic Variation ◽  
Serum Albumin ◽  
Instrumental Variable ◽  
Serum Albumin Level ◽  
Albumin Level ◽  
Albumin Concentration ◽  
Two Stage ◽  
Instrumental Variable Analysis ◽  
Increased Risk ◽  
Variable Analysis

Abstract Background and Aims Hypoalbuminemia is a clinical indicator of vascular endothelial dysfunction. However, the genetic association of hypoalbuminemia with hypertension has not yet been clarified. We investigated whether genetic variation(s) associated with decreased serum albumin level is deeply related with increased risk of hypertension. Method Mild hypoalbuminemia was defined as a serum albumin concentration of less than 4.0 g/dL. We performed GWAS-based instrumental variable analysis using the population-based cohort data collected from KoGES. Eligible as cases were all native Koreans without significant medical illness and a total 4326 participants were divided in into control (n = 3157) and hypoalbuminemic (n = 1168) according to their serum albumin level. Results Our GWAS revealed that 71 susceptibility loci were associated with mild hypoalbuminemia and subsequent two-stage least squares estimation analysis showed that both genetic variations at rs2894536 in LOC107986598 gene and rs10972486 in the ATP8B5P gene were related with systolic blood pressure. In subsequent Cox-proportional hazards model, we found that not only low serum albumin (HR = 0.654, 95% CI = 0.521-0.820), but also polymorphisms of rs2894536 (HR = 1.176, 95% CI = 1.015-1.361) and rs10972486 (HR = 1.152, 95% CI = 1.009-1.316) were significant predictor of hypertension. Our two-stage residual inclusion analysis indicated that candidate genetic variation attenuated the association between serum albumin and hypertension, showing hazard ratios of hypoalbuminemia on development of hypertension were 0.762 (0.659-0.882) for rs2894536 and 0.759 (0.656-0.878) for rs10972486. Conclusion These findings support a causal relationship between hypoalbuminemia-associated genetic variation, hypoalbuminemia and development of hypertension.

scholarly journals Association of admission vs. nadir serum albumin concentration with short-term treatment outcomes in patients with acute heart failure

2018 ◽  
Vol 46 (9) ◽  
pp. 3665-3674 ◽  
Author(s):  
Evan J. Peterson ◽  
Tien M. H. Ng ◽  
Komal A. Patel ◽  
Mimi Lou ◽  
Uri Elkayam
Keyword(s):  
Heart Failure ◽  
Renal Function ◽  
Serum Albumin ◽  
Treatment Outcomes ◽  
Acute Heart Failure ◽  
Albumin Level ◽  
Albumin Concentration ◽  
Short Term ◽  
Short Term Treatment ◽  
Increased Risk

Objectives Hypoalbuminemia occurs in 25% to 76% of patients hospitalized for acute heart failure (HF) and is associated with increased mortality. Hypoalbuminemia may predispose patients to intravascular volume depletion, hypotension, and acute worsening of renal function; however, its association with treatment outcomes during hospitalization is unknown. Methods This retrospective cohort study involved 414 adult patients hospitalized for HF requiring intravenous diuretics. Temporal changes in serum albumin and the association of hypoalbuminemia with urine output, renal function changes, blood pressure, use of intravenous vasoactive drugs, and short-term outcomes were assessed. Results Serum albumin decreased in most patients (72%) during hospitalization. Hypoalbuminemia was present in 29% and 50% of patients based on the mean admission and nadir serum albumin level, respectively. Hypoalbuminemia as assessed by the nadir albumin level was associated with an increased risk of acute worsening of renal function. A nadir albumin level of <3.0 g/dL remained significantly associated in the multivariate analyses. Conclusions Serum albumin commonly decreases during hospitalization for acute HF. Hypoalbuminemia assessed using the nadir level during hospitalization, not the admission level, was associated with an increased risk of acute worsening of renal function. The timing of serum albumin measurement may influence its utility as a biomarker.

scholarly journals Association Between Hypoalbuminemia, Degree of Proteinuria, and Lupus Nephritis Class: A Single-Center Cross-Sectional Biopsy Study

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Ngoc Nguyen Thi ◽  
Dien Tran Minh ◽  
Huong Nguyen Thu ◽  
Phuong Luong Thi ◽  
Nam Thai Thien ◽  
...  
Keyword(s):  
Lupus Nephritis ◽  
Serum Albumin ◽  
Renal Biopsy ◽  
Serum Albumin Level ◽  
Albumin Level ◽  
Viet Nam ◽  
Albumin Concentration ◽  
Single Center ◽  
Cross Sectional ◽  
The Mean

Background: The current study intended to determine whether serum albumin level and urine protein/creatinine rate (uPCR) are appropriate predictors of severe lupus nephritis in childhood-onset SLE. Objectives: Following a cross-sectional single-center design, 85 LN children referred to the National Children Hospital, Ha Noi, Viet Nam, from 6/2019 to 6/2020 were recruited. Renal biopsy was performed for all participants. Methods: Following a cross-sectional single-center design, 85 LN children referred to the National Children Hospital, Ha Noi, Viet Nam, from 6/2019 to 6/2020 were recruited. Renal biopsy was performed for all participants. Results: The mean SLEDAI score of all patients was 14.69. The proportion of patients with high and very high SLEDAI was 61.2 and 17.6%, respectively. The mean concentration of serum albumin was 28.55 g/L, and the proportion of decreased albumin concentration was 55.3%. The median uPCR was 446.6 mg/mmol in which 76.5% of values were ≥ 200 mg/mmol. Pathological morphology of LN class from I to VI was observed in 0%, 17.6%, 37.6 %, 37.6%, 7.1%, and 0%, respectively. Serum albumin level and uPCR presented the predictive value for severe and active LN (class IV and V); (AUC: 0.725 P < 0.001 for both). Conclusions: Serum albumin and uPCR were appropriate predictors for severe and active LN in Vietnamese children.

scholarly journals Two-step Randomisation: Applying the Results of Small Feasibility Studies of Interventions to Large-scale Mendelian Randomisation Studies to Robustly Infer Causal Effects on Clinical Endpoints

2019 ◽  
Author(s):  
Meda R Sandu ◽  
Rhona Beynon ◽  
Rebecca Richmond ◽  
Diana L. Santos Ferreira ◽  
Lucy Hackshaw-McGeagh ◽  
...  
Keyword(s):  
Standard Deviation ◽  
Green Tea ◽  
Instrumental Variable ◽  
Mendelian Randomization ◽  
Causal Effect ◽  
Two Stage ◽  
Instrumental Variable Analysis ◽  
Metabolic Traits ◽  
Randomization Analysis ◽  
Variable Analysis

Background: Feasibility trials are preliminary trials that assess the viability and acceptability of intervention studies and the effects of the intervention on intermediate endpoints. Due to their short duration, they are unable to establish the effects of the intervention on long-term clinical outcomes. We propose a novel method that could transform the interpretation of feasibility trials using modified two-stage randomisation analyses. Methods In this two-stage process, we explored the effects of a 6-month feasibility factorial randomised controlled trial (RCT) of lycopene and green tea dietary interventions (ProDiet) on 159 serum metabolic traits in 133 men with raised PSA levels but prostate cancer (PCA) free. In the first stage, we conducted an intention-to-treat analysis, using linear regression to examine the effects of the interventions on metabolic traits, compared to the placebo group and instrumental variable analysis to assess the causal effect of the intervention on the outcomes. In the second stage, we used a two-sample Mendelian Randomization (MR) approach to assess the causal effect of metabolic traits altered by the interventions, on PCA risk, using summary statistics data from an international PCA consortium of 44,825 cancer cases and 27,904 controls. ResultsThe systemic effects of lycopene and green tea supplementation on serum metabolic profile were comparable to the effects of the respective dietary advice interventions (R2= 0.65 and 0.76 for lycopene and green tea respectively). Metabolites which were altered in response to lycopene supplementation were acetate (standard deviation difference versus placebo (&beta;)): 0.69; 95% CI= 0.24, 1.15; p=0.003), valine (&beta;: -0.62; -1.03, -0.02; p=0.004), pyruvate (&beta;: -0.56; -0.95, -0.16; p=0.006), and docosahexaenoic acid (&beta;: -0.50; -085, -0.14; p=0.006). The instrumental variable analysis showed there was no evidence that green tea altered the metabolome, but lycopene was associated with an increase in acetate (&beta;=2.13; p=0.006) and decreases in pyruvate (&beta;=-1.90; p=0.009), valine (&beta;=-1.79; p=0.023), diacylglycerol (&beta;=-1.81; p=0.026), alanine (&beta;=-1.55; p=0.015) and DHA (p=0.097), where the regression coefficient represents the standard deviation (SD) difference in metabolite measures per unit change in lycopene (&micro;mol/L) or EGCG (nM).Using MR, a genetically instrumented SD increase in pyruvate increased the odds of PCA by 1.29 (1.03, 1.62; p=0.027). Conclusion Using a two-stage randomization analysis in a feasibility RCT, we found that lycopene lowered levels of pyruvate, which our Mendelian randomization analysis suggests may be causally related to reduced PCA risk.

Conditioning factors influencing evolution of experimental glomerulonephritis in rabbits

1959 ◽  
Vol 196 (2) ◽  
pp. 457-460 ◽  
Author(s):  
Constantin V. Teodoru ◽  
Abraham Saifer ◽  
Harry Frankel
Keyword(s):  
Serum Albumin ◽  
Serum Albumin Level ◽  
Clinical Manifestations ◽  
Albumin Level ◽  
Immune Serum ◽  
The Other ◽  
Chronic Glomerulonephritis ◽  
Acute Glomerulonephritis ◽  
Albumin Concentration ◽  
Conditioning Factors

Unilateral nephrectomy (UN) and/or oral saline administration in rabbits did not induce alterations in the concentration of various blood serum constituents for observation periods ranging from 1 to 6 months. Duck antirabbit-kidney immune serum (NTX) given i.v. to UN animals produced an acute glomerulonephritis significantly more severe than in parallel controls. All UN animals died from dry uremia within 3–4 weeks following serum administration. As compared to the other groups, the UN showed the highest retention of urea nitrogen, creatinine and uric acid. When injected into saline-drinking animals, NTX produced either subacute glomerulonephritis, anasarca, convulsions and death from wet uremia, or chronic glomerulonephritis with polyuria and hyposthenuria as the main clinical manifestations. As compared to the other groups, the saline-drinking animals showed lowest serum albumin and highest cholesterol levels. The serum albumin level appeared to be related to the urinary loss of albumin and not to the severity of the disease. The albumin concentration per unit volume was similar in the urine of various groups; hence the albumin loss depended upon the 24-hour urine output, i.e. highest in saline drinking, lowest in UN groups. Hypercholesterolemia and edema inversely paralleled the serum albumin level, being pronounced in saline-drinking and mild in UN animals.

Lower Serum Albumin Level Is Associated With an Increased Risk for Loss of Residual Kidney Function in Patients Receiving Peritoneal Dialysis

2019 ◽  
Vol 24 (1) ◽  
pp. 72-80 ◽  
Author(s):  
Shunsuke Yamada ◽  
Yasuhiro Kawai ◽  
Shoji Tsuneyoshi ◽  
Hiroaki Tsujikawa ◽  
Hokuto Arase ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Serum Albumin ◽  
Kidney Function ◽  
Serum Albumin Level ◽  
Albumin Level ◽  
Lower Serum ◽  
Residual Kidney Function ◽  
Increased Risk

Using instrumental variables to estimate the attributable fraction

2019 ◽  
Vol 29 (8) ◽  
pp. 2063-2073
Author(s):  
Elisabeth Dahlqwist ◽  
Zoltán Kutalik ◽  
Arvid Sjölander
Keyword(s):  
Coronary Heart Disease ◽  
Risk Factor ◽  
Heart Disease ◽  
Instrumental Variables ◽  
Instrumental Variable ◽  
Mendelian Randomization ◽  
Attributable Fraction ◽  
Two Stage ◽  
Instrumental Variable Analysis ◽  
Variable Analysis

In order to design efficient interventions aimed to improve public health, policy makers need to be provided with reliable information of the health burden of different risk factors. For this purpose, we are interested in the proportion of cases that could be prevented had some harmful exposure been eliminated from the population, i.e. the attributable fraction. The attributable fraction is a causal measure; thus, to estimate the attributable fraction from observational data, we have to make appropriate adjustment for confounding. However, some confounders may be unobserved, or even unknown to the investigator. A possible solution to this problem is to use instrumental variable analysis. In this work, we present how the attributable fraction can be estimated with instrumental variable methods based on the two-stage estimator or the G-estimator. One situation when the problem of unmeasuredconfounding may be particularly severe is when assessing the effect of low educational qualifications on coronary heart disease. By using Mendelian randomization, a special case of instrumental variable analysis, it has been claimed that low educational qualifications is a causal risk factor for coronary heart disease. We use Mendelian randomization to estimate the causal risk ratio and causal odds ratio of low educational qualifications as a risk factor for coronary heart disease with data from the UK Biobank. We compare the two-stage and G-estimator as well as the attributable fraction based on the two estimators. The plausibility of drawing causal conclusion in this analysis is thoroughly discussed and alternative genetic instrumental variables are tested.

scholarly journals SERUM ALBUMIN LEVEL IN PERSISTENT ORGAN FAILURE IN ACUTE PANCREATITIS

2019 ◽  
Vol 3 (5) ◽  
Author(s):  
Dr. Shefali Mehta ◽  
Dr. Shuchi Goyal ◽  
Dr. Rajendra Triloki ◽  
Dr. A. K. Verma
Keyword(s):  
Acute Pancreatitis ◽  
Serum Albumin ◽  
Organ Failure ◽  
Serum Albumin Level ◽  
Rapid Assessment ◽  
Elevated Serum ◽  
Albumin Level ◽  
Persistent Organ Failure ◽  
Increased Risk ◽  
Patient Department

Introduction: The research emphasises on the association bond of Serum Albumin Level used as a marker for diagnosis of Persistent Organ Failure in Acute Pancreatitis. Material and Methods: The samples for the study were collected from the central lab, out-patient department and in-patient department of Department of Biochemistry, adult patients suffering from Acute Pancreatitis correlated to tropical medicinal stream and Gastroenterology Rabindranath Tagore Medical College, Udaipur, Rajasthan  The research was carried out on a total of 100 patients for  1 year  which  were satisfying   Atlanta criteria  for Acute Pancreatitis will be diagnosed based on the following symptoms; elevated serum amylase, and lipase levels, that is greater than the normal limit, findings associated with the characteristics of the radiological findings. Also, with the abdominal computerized ultrasonography and tomography Results: In the present research, albumin always descends obviously in AP patients with POF (p < 0.05). The AUC under ROC line is 0.869. Albumin has been proved as an excellent marker of POF in AP. However, no previous study has researched into the association between albumin and incidence of POF in AP. Therefore, this study is the first time to show that the reduction of serum albumin is significantly associated with increased risk of POF in AP. Conclusion: Thus it can be concluded that serum albumin on admission is independently associated with POF in AP. The study suggests that albumin is a valuable tool for a rapid assessment of POF in patients with AP. Keywords: Serum Albumin, Persistent Organ Failure, Acute Pancreatitis

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