MO506RELATIONSHIP BETWEEN SODIUM CONSUMPTION, PRO-INFLAMMATORY PARAMETERS AND KIDNEY DISEASE IN THE JACKSON HEART STUDY

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Eliane Wenstedt ◽  
Liffert Vogt
Keyword(s):  
Kidney Disease ◽  
Linear Regression ◽  
Prospective Cohort ◽  
Jackson Heart Study ◽  
Endothelin 1 ◽  
Inflammatory Parameters ◽  
Heart Study ◽  
The Relationship ◽  
Sodium Consumption

Abstract Background and Aims Kidney disease is thought to be linked to inflammation. Pro-inflammatory parameters like C-reactive protein (CRP), endothelin-1, and TNF-a inversely associate with kidney function cross-sectionally and some have predictive value for longer-term kidney outcomes. Given the recently argued pro-inflammatory effect of sodium, we questioned whether sodium consumption has a role in the relationship between pro-inflammatory parameters and renal outcomes. Method Our research question was investigated using the Jackson Heart Study, which is a large prospective cohort study involving n=5301 Afro-Americans residing in Jackson, Mississippi, US. Spot urine sodium was used to estimate 24-hour sodium excretion with the Kawasaki formula, serving as a proxy for sodium consumption, and was available for n=1831 participants (depicting a random sample of the total population) that had a median follow-up of 8 years. Multiple linear regression was used to assess the relationship between sodium consumption and pro-inflammatory parameters. The parameters available for this cohort involved endothelin-1, high-sensitivity CRP, and leukocyte subsets (monocytes, neutrophils, and lymphocytes). Models were adjusted for potential confounders, involving sex, age, body mass index, estimated potassium intake, smoking status, and presence of diabetes. Subsequently, linear regression analyses between pro-inflammatory parameters and baseline estimated glomerular filtration rate (eGFR CKD-EPI) and change during follow-up were carried out with and without adjustment for sodium consumption as a confounder, to explore the possibility of a causal mediating pathway. Results Increased sodium consumption significantly associates with increased serum endothelin-1 levels in both unadjusted and adjusted models (Table 1). There was no association between sodium consumption and leukocyte subsets. There was a negative association between sodium consumption and CRP (Table 2). CRP was not associated with eGFR at baseline (p=0.20) or eGFR change from baseline (p=0.20). Endothelin-1 was inversely associated with eGFR at baseline (beta -0.06, p<0.001) and with eGFR change from baseline (beta 2.3 p=0.03). However, when these models were corrected for sodium consumption, endothelin-1 was no longer a significant predictor (beta -0.01 p=0.4 for eGFR at baseline) or was inversed (beta -0.1; p=0.001 eGFR during follow-up). Conclusion In this prospective cohort of Afro-Americans, increased sodium consumption is associated with increased circulating endothelin-1 levels. If this relationship proves to be causal (as suggested by animal sodium loading studies), this implies that sodium consumption may (at least partly) be underlying the relationship between endothelin-1 and worse renal outcomes.

Sugar in Beverage and the Risk of Incident Dementia, Alzheimer’s Disease and Stroke: A Prospective Cohort Study

2020 ◽  
pp. 1-6
Author(s):  
H. Miao ◽  
K. Chen ◽  
X. Yan ◽  
F. Chen
Keyword(s):  
Cohort Study ◽  
Alzheimer Disease ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Community Based ◽  
Incident Dementia ◽  
Heart Study ◽  
Increased Risk ◽  
The Us

Background: This study aimed to investigate the association between sugar in beverage and dementia, Alzheimer Disease (AD) dementia and stroke. Methods: This prospective cohort study were based on the US community-based Framingham Heart Study (FHS). Sugar in beverage was assessed between 1991 and 1995 (5th exam). Surveillance for incident events including dementia and stroke commenced at examination 9 through 2014 and continued for 15-20 years. Results: At baseline, a total of 1865 (63%) subjects consumed no sugar in beverage, whereas 525 (18%) subjects consumed it in 1-7 servings/week and 593 (29%) in over 7 servings/week. Over an average follow-up of 19 years in 1384 participants, there were 275 dementia events of which 73 were AD dementia. And 103 of 1831 participants occurred stroke during the follow-up nearly 16 years. After multivariate adjustments, individuals with the highest intakes of sugar in beverage had a higher risk of all dementia, AD dementia and stroke relative to individuals with no intakes, with HRs of 2.80(95%CI 2.24-3.50) for all dementia, 2.55(95%CI 1.55-4.18) for AD dementia, and 2.11(95%CI 1.48-3.00) for stroke. And the same results were shown in the subgroup for individuals with median intakes of sugar in beverage. Conclusion: Higher consumption of sugar in beverage was associated with an increased risk of all dementia, AD dementia and stroke.

Abstract P053: Diabetes Risk Prediction and Sickle Cell Trait in African Americans From CARDIA and the Jackson Heart Study

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Mary E Lacy ◽  
Gregory A Wellenius ◽  
Adolfo Correa ◽  
Mercedes R Carnethon ◽  
Robert I Leim ◽  
...  
Keyword(s):  
African Americans ◽  
Risk Prediction ◽  
Sickle Cell ◽  
Prediction Models ◽  
Sickle Cell Trait ◽  
Model Performance ◽  
Jackson Heart Study ◽  
Discriminative Ability ◽  
Heart Study

Introduction: Existing models to predict incident diabetes mellitus (DM) perform better in Whites than African Americans. In models that incorporate hemoglobin A1c (A1C) as a predictor of DM, the difference in model performance by race is more pronounced. In a recent study, we found that A1C was systematically underestimating glycemia in African Americans with sickle cell trait (SCT). Hypothesis: Given the poorer performance of DM prediction models in African Americans than Whites and the impact of SCT on the A1C-glycemia association, we hypothesized that incorporating sickle cell trait into DM prediction models would improve the ability of the model to predict future risk of DM. Methods: We pooled data collected from 2000-2012 on 3,122 African Americans (8.6% with SCT) from the Jackson Heart Study (JHS; n=2,065; mean age=54.71 years) and CARDIA (n=1,057; mean age=44.53). Over 5 years of follow-up in CARDIA and 10 years of follow-up in JHS, 85 CARDIA participants (8.1%) and 342 JHS participants (16.6%) developed DM. Using generalized estimating equations to account for correlation of repeated measures, we compared the discriminative ability and net reclassification improvement (NRI) resulting from the addition of SCT for a series of prediction models. Results: Overall, the addition of SCT to prediction models did not result in significant improvement in the discriminative ability. However, by the NRI index, the addition of SCT to measures of glycemia and to a fuller risk prediction model did improve prediction of DM. In the full model, adding SCT*A1C as a predictor resulted in 2% of events being reclassified as higher risk and 45% of non-events being reclassified as lower risk. Conclusion: Our results suggest that incorporating SCT into DM prediction for African Americans may result in modest improvement in model performance.

Association of Plasma Endothelin-1 with Blood Pressure Progression Among African Americans: The Jackson Heart Study

2022 ◽  
Author(s):  
Arnaud D. Kaze ◽  
Xiang Gao ◽  
Solomon K. Musani ◽  
Aurelian Bidulescu ◽  
Alain G. Bertoni ◽  
...  
Keyword(s):  
Blood Pressure ◽  
African Americans ◽  
Jackson Heart Study ◽  
Endothelin 1 ◽  
Heart Study

Abstract P099: The Relation of Kidney Disease to Measures of Digital Arterial Tonometry in the Jackson Heart Study

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Eric McClendon ◽  
Solomon Musani ◽  
Sushante Khaire ◽  
Herman Taylor ◽  
Ervin Fox
Keyword(s):  
Chronic Kidney Disease ◽  
African Americans ◽  
Endothelial Dysfunction ◽  
Kidney Disease ◽  
Least Square ◽  
Jackson Heart Study ◽  
Pulse Wave Amplitude ◽  
Arterial Tonometry ◽  
Heart Study ◽  
Age And Sex

Background: The presence of chronic kidney disease is greater in African Americans than in non-Hispanic whites. Though there is data to show a relation between endothelial dysfunction and end-stage kidney disease, the relation to mild and moderate chronic kidney disease (particularly in African Americans) is unclear. Methods and Results: Digital arterial tonometry was performed during Exam 2 and 3 of the Jackson Heart Study using the endoPAT2000. Data from digital arterial tonometry included baseline pulse wave amplitude (BPA) as a measure of endothelial tone and reactive hyperemic index (F-RHI) as a measure of endothelial function. For this study, the estimated glomerular filtration rate (eGFR) was calculated using the MDRD equation. Those participants with eGFR < 60 ml/min/1.73m2 were defined as having CKD. Participants with eGFR < 15 ml/min/1.73m2 were excluded from the analysis. Microalbuminuria in this study was defined as a urinary albumin:creatinine ratio ≥ 17mg/g in men and ≥ 25 mg/g in women. We compared the differences in least square means adjusted for age and sex, and adjusted for multiple traditional clinical covariates using a generalized linear model. Results: There were 834 participants in the study population (mean age 58.5 years, 61% women); 87 (10.4%) participants with CKD and 108 (13.0%) with microalbuminuria. In age and sex adjusted samples, we found that both BPA and F-RHI were significantly associated with CKD in the pooled samples. However in multivariable adjusted analysis the relation was no longer significant in either the pooled or sex-specific samples. In the multivariable adusted analysis,BPA was significantly (P=0.036) associated with microalbuminuria in men and F-RHI was weakly significantly (P=0.08) associated with microalbuminuria in women. Conclusion: We found that endothelial dysfunction as measured by digital arterial tonometry is not significantly associated with chronic kidney disease. There is an association of endothelial tone in men and endothelial dysfunction in women with microalbuminuria.

Abstract P488: Discrimination and Hypertension Risk Among African Americans in The Jackson Heart Study

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Allana T Forde ◽  
Mario Sims ◽  
Paul Muntner ◽  
Tené Lewis ◽  
Amanda Onwuka ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
African Americans ◽  
The United States ◽  
Jackson Heart Study ◽  
Incident Hypertension ◽  
Hypertension Risk ◽  
Heart Study ◽  
Low Levels

Background: African Americans have a higher risk for hypertension compared to other racial or ethnic groups in the United States. One possible explanation for this health disparity is perceived discrimination. Few studies have prospectively examined the association between discrimination and the incidence of hypertension. Methods: We examined the associations of everyday, lifetime, and stress from lifetime discrimination with incident hypertension and whether these associations differed by sex, discrimination attribution (i.e. the main reason for the discrimination event), and coping responses to discrimination among African Americans enrolled in the Jackson Heart Study. Discrimination was self-reported by 1845 African Americans aged 21 to 85 years without hypertension at baseline (2000-2004). Participants completed two follow-up study visits from 2005-2008 and 2009-2013. We used interval-censored Cox regression to estimate associations of discrimination with incident hypertension (antihypertensive medication use; and/or systolic blood pressure ≥ 140 mm Hg and diastolic blood pressure ≥ 90 mm Hg at follow-up visits 2 or 3) after adjustment for confounding variables. Results: Overall, 52% (954 of 1845) of participants developed hypertension over the follow-up period. After adjustment for age, sex, education and hypertension risk factors (body mass index, alcohol use, smoking, diet and physical activity), medium versus low levels of lifetime discrimination (hazard ratio-HR: 1.45, 95% confidence interval-CI: 1.15-1.82) and high versus low levels of lifetime discrimination (HR: 1.35, CI: 1.08-1.68) were associated with a higher incidence of hypertension. High versus low stress from lifetime discrimination was associated with hypertension risk after adjustment for demographics (HR: 1.20, CI: 1.02-1.41), but the association was attenuated after adjustment for hypertension risk factors (HR: 1.14, CI: 0.97-1.35). Lifetime discrimination and stress from discrimination were associated with an increased hypertension risk among females, but not males. No interactions with age, attribution or coping were present for any type of discrimination. Conclusions: Findings from this study support an association between lifetime discrimination and incident hypertension in African Americans.

scholarly journals SO081LITHIUM EXPOSURE AND OCCURENCE OF CHRONIC KIDNEY DISEASE IN THE IRISH HEALTH SYSTEM: A COHORT STUDY

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Mark Behan ◽  
Leonard Browne ◽  
Stack Austin
Keyword(s):  
Chronic Kidney Disease ◽  
Cohort Study ◽  
Kidney Disease ◽  
Linear Regression ◽  
Health System ◽  
Multiple Linear Regression ◽  
Kidney Function ◽  
Ckd Progression ◽  
Duration Of Treatment

Abstract Background and Aims Lithium is implicated as a causative factor in the development and progression of chronic kidney disease (CKD). Few studies have assessed the independent impact of plasma levels and duration of lithium therapy on CKD progression. We examined the influence of lithium on CKD progression in the Irish health system. Method We utilised data from the Irish Kidney Disease Surveillance System (IKDSS) to explore associations of lithium levels and duration of exposure with kidney function in a regional cohort. A retrospective cohort study was conducted between 1999 to 2014 from the Midwest Region. All adult patients with lithium levels were identified and followed longitudinally. Kidney function was assessed at baseline and longitudinally using serum creatinine and estimated glomerular filtration rate (eGFR) was calculated using the CKD-EPI. Patients with &lt; 2 lithium values, missing data on creatinine were excluded. The index date was the date of the first lithium blood test. Toxicity from lithium was defined as levels &gt;1.2mmol/L as per NICE guidelines while duration of treatment was calculated based on patient –years of exposure as determined by positive blood lithium levels. Relationships between baseline kidney function, lithium levels, duration of exposure and each patients most recent eGFR value on follow up were assessed using multiple linear regression Results We identified 1,978 patients exposed to lithium from 1999-2014, mean age was 47.4 (15.6), 45.1% were men, eGFR [median (IQR)] at baseline was 84.4 (32.1) ml/min1.73m and the median duration of exposure was 3.0 years (IQR=4 years). Frequency of lithium testing increased from 1.77 in 1999 to 2.66 in 2014. In multiple linear regression, the final eGFR on follow-up was significantly lower in older patients (-0.48 ml/min/1.73m per year increase in age), P&lt;0.001; in patients with elevated baseline lithium levels (-2.18 ml/min1.73m lower per unit increase), P&lt;0.05, with long duration of exposure (-1.42 ml/min/1.73m lower for each year on lithium), P&lt;0.001, and for patients with low GFR at baseline (P&lt;0.001). Together these variables explained 58% of the variation in the final model. Conclusion Both the magnitude of and the duration of lithium exposure are both independently associated with CKD progression among lithium users in the Irish health system. Higher baseline lithium values had a more deleterious impact on kidney function. Continued efforts should be expended in minimising the risks of lithium induced nephrotoxicity through switching to alternatives and dose reduction when over possible. Funding This study is funded by the Health Research Board and the Midwest Research and Education Foundation (MKid).

scholarly journals Optimism is associated with chronic kidney disease and rapid kidney function decline among African Americans in the Jackson Heart Study

2020 ◽  
Vol 139 ◽  
pp. 110267
Author(s):  
LáShauntá M. Glover ◽  
Crystal Butler-Williams ◽  
Loretta Cain-Shields ◽  
Allana T. Forde ◽  
Tanjala S. Purnell ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
African Americans ◽  
Kidney Disease ◽  
Kidney Function ◽  
Jackson Heart Study ◽  
Heart Study ◽  
Kidney Function Decline
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