[OP.2B.03] GLOMERULAR HYPERFILTRATION AS A RISK FACTOR FOR RENAL IMPAIRMENT AND HYPERTENSION IN APPARENTLY HEALTHY SUBJECTS

ObjectiveCardiovascular disease (CVD) occurs frequently and may progress more rapidly in overt hypothyroidism (OVH). However, the role of mild thyroid failure as a risk factor for CVD is not clear. This study is aimed at exploring the association between subclinical hypothyroidism (SCH) and coronary artery disease (CAD), as detected by cardiac computed tomography (CT), in apparently healthy subjects.Subjects and methodsWe retrospectively enrolled 2404 asymptomatic subjects who underwent cardiac CT with an intermediate to high risk (Framingham 10-year risk ≥10%) of developing CAD but with no known CAD or thyroid disease. Coronary artery calcium score (CACS) was assessed by calcium scan, and the presence of the plaques (CAD), with ≥50% stenosis being indicative of obstructive CAD, was assessed by coronary CT angiography.ResultsOf the 2404 subjects, 2355 subjects were euthyroid (Eu; 53±9 years, 83 females) and 49 had SCH (58±12 years, seven females). CAD and CACS >100 were more prevalent in SCH subjects than in Eu subjects (Eu vs SCH: CAD, 948 (40.6%) vs 31 (63.3%), P=0.002; CACS >100, 239 (10.3%) vs 10 (20.4%), P=0.031). SCH was also an independent risk factor for CAD after a multivariate analysis (odds ratio: 2.125, 95% confidence interval: 1.049–4.307, P=0.036).ConclusionsSCH subjects who were at an intermediate-to-high risk of developing CAD were significantly more likely to exhibit occult CAD than Eu subjects, especially in men with SCH. These findings suggest that mild thyroid failure also independently contributes to the development of CAD.

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Concentrations of non-glucose polyols in serum and cerebrospinal fluid from apparently healthy adults and children.

Clinical Chemistry ◽

10.1093/clinchem/30.2.188 ◽

1984 ◽

Vol 30 (2) ◽

pp. 188-191 ◽

Cited By ~ 6

Author(s):

S Yoshioka ◽

S Saitoh ◽

S Seki ◽

K Seki

Keyword(s):

Mass Spectrometry ◽

Cerebrospinal Fluid ◽

Liquid Chromatography ◽

Healthy Subjects ◽

Metabolic Diseases ◽

Gas Liquid Chromatography ◽

Liquid Chromatography Mass Spectrometry ◽

Adults And Children ◽

Healthy Persons ◽

Apparently Healthy

Abstract Six non-glucose polyols--mannose, fructose, 1-deoxyglucose, mannitol, glucitol, and inositol--were identified and evaluated in human serum and cerebrospinal fluid by gas-liquid chromatography and by gas-liquid chromatography/mass spectrometry. Concentrations of fructose, mannose, and inositol in the serum of healthy persons or children without metabolic diseases varied with age, as already reported for 1-deoxyglucose. Fructose, inositol, and glucitol concentrations in cerebrospinal fluid significantly exceeded those in serum. The method described here for determining polyols and for evaluating polyol patterns in serum, as well as the resulting data on children and healthy subjects, should be useful in investigations of the clinical and physiological significance of polyols.

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Simultaneous measurement of two major prostacyclin metabolites in urine

Clinical Chemistry ◽

10.1093/clinchem/36.11.1978 ◽

1990 ◽

Vol 36 (11) ◽

pp. 1978-1980 ◽

Cited By ~ 5

Author(s):

S Zureick ◽

J Nadler ◽

J Yamamoto ◽

R Horton

Keyword(s):

Angiotensin Ii ◽

Blood Vessels ◽

Simultaneous Measurement ◽

Healthy Subjects ◽

High Accuracy ◽

High Concentration ◽

Accuracy And Precision ◽

Overall Evaluation ◽

Excretion Rates ◽

Apparently Healthy

Abstract We describe a combined HPLC-RIA technique to measure both major metabolites of prostacyclin (PGI2): 6-keto PGF1 alpha and 2,3-dinor-6 keto PGF1 alpha. The measurement of the former, which originates from renal blood vessels, and the latter, from systemic vessels and the liver, may provide a better overall evaluation of production than measurement of one metabolite. An aliquot of acidified urine with added 3H-labeled metabolites is adsorbed and then eluted from a C18 Bond-Elut column. The sample is then passed through an HPLC system by use of an isocratic solvent combination that separates the two metabolites from known prostaglandins. The purified metabolites are then quantified by RIA. Using a logit-log10 transform, one can measure between 12 and 250 pg of either metabolite, with high accuracy and precision (CVs of 12% for a low concentration and 7% for a high concentration). Reference values for apparently healthy subjects were, respectively, 107 (SD 45) and 171 (SD 69) ng/g creatinine for 6-keto PGF1 alpha and the dinor metabolite in men (n = 18) and 45 (SD 22) and 141 (SD 28) ng/g creatinine, respectively, in women (n = 15). Indomethacin in standard doses reduced both metabolite values by 50%. Intravenous administration of angiotensin II (5 ng/kg of body wt per minute) did not alter excretion rates, but equipressor doses of norepinephrine (0.1 microgram/kg per minute) increased the production of both metabolites (6-keto greater than dinor).

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Exercise-Induced Release of Cardiac Troponins in Adolescent vs. Adult Swimmers

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18031285 ◽

2021 ◽

Vol 18 (3) ◽

pp. 1285

Author(s):

Rafel Cirer-Sastre ◽

Francisco Corbi ◽

Isaac López-Laval ◽

Luis Enrique Carranza-García ◽

Joaquín Reverter-Masià

Keyword(s):

Cardiac Troponin ◽

Healthy Subjects ◽

Troponin T ◽

Training Experience ◽

Post Exercise ◽

Baseline Values ◽

Exercise Induced ◽

Cardiac Troponins ◽

Similar Peak ◽

Apparently Healthy

To examine the exercise-induced release of cardiac troponin T (cTnT) in adolescent and adult swimmers. Thirty-two trained male (18 adolescents, 14 adults) swam at maximal pace in a 45 min distance trial, and blood samples were drawn before, immediately and 3 h after exercise for subsequent cTnT analysis and comparison. Having comparable training experience and baseline values of cTnT (p = 0.78 and p = 0.13), adults exercised at lower absolute and relative intensity (p < 0.001 and p < 0.001, respectively), but presented higher immediate cTnT after exercise than adolescents (p < 0.001). Despite that, peak concentrations were observed at 3 h post exercise and peak elevations were comparable between groups (p = 0.074). Fourteen (44%) apparently healthy subjects exceeded the cutoff value for myocardial infarction (MI). Adolescents presented a delayed elevation of cTnT compared with adults, but achieved similar peak values.

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Anticoagulant dosing in renal impairment

Phlebologie ◽

10.12687/phleb2290-6-2015 ◽

2015 ◽

Vol 44 (06) ◽

pp. 316-319 ◽

Cited By ~ 2

Author(s):

S. Harder

Keyword(s):

Risk Factor ◽

Venous Thromboembolism ◽

Renal Impairment ◽

Anticoagulant Therapy ◽

Severe Renal Impairment ◽

Dabigatran Etexilate ◽

The Elderly ◽

Thrombin Inhibitor ◽

Safety And Efficacy ◽

Direct Acting

SummaryAnticoagulants are widely used for prophylaxis and treatment of venous thromboembolism in the elderly, who commonly have renal impairment and other comorbidities. Renal impairment is a risk factor for bleeding and thrombosis during anticoagulant therapy and can influence the balance between the safety and efficacy of such agents. Some anticoagulants, such as fondaparinux and the direct acting oral thrombin inhibitor dabigatran etexilate are contraindicated for use in patients with severe renal impairment (eGFR <30 ml/min). However, also the direct acting oral FXa-inhibitors rivaroxaban, edoxaban and apixaban need caution regarding dosing advice or contraindications when used in patients with renal impairment.

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Prevalence and Predictors of Undiagnosed Hypertension in an Apparently Healthy Western Indian Population

Advances in Epidemiology ◽

10.1155/2015/649184 ◽

2015 ◽

Vol 2015 ◽

pp. 1-5 ◽

Cited By ~ 5

Author(s):

Anand N. Shukla ◽

Tarun Madan ◽

Bhavesh M. Thakkar ◽

Meena M. Parmar ◽

Komal H. Shah

Keyword(s):

Blood Pressure ◽

Risk Factor ◽

Cardiovascular Diseases ◽

Odds Ratio ◽

Indian Population ◽

Total Population ◽

Undiagnosed Hypertension ◽

History Of ◽

Major Illness ◽

Apparently Healthy

This epidemiological study was designed to evaluate the prevalence of undetected hypertension in an apparently healthy western Indian population having no history of major illness. 3629 individuals of ≥18 years of age were included in the study. Hypertension (HTN) was defined as systolic blood pressure (SBP) ≥ 140 mmHg or diastolic blood pressure (DBP) ≥ 90 mmHg and prehypertension (PHTN) as SBP ≥ 120–139 mmHg or DBP ≥ 80–89 mmHg, but without HTN. The prevalence of undiagnosed HTN in the total population was 26% and was 11% and 40% in the young (≤40-year) and old (>40-year) populations, respectively. The prevalence of PHTN, 40% in the overall population, was nearly the same in the young (39%) and the old population (42%). The risk factor most strongly associated with PHTN and HTN was obesity, showing the highest odds ratio in the overall (PHTN 2.14; 95% CI 1.20–3.81; HTN 2.72; 95% CI 1.53–4.85), the young (PHTN 2.29; 95% CI 1.25–4.21; HTN 2.92; 95% CI 1.59–5.35), and the old (PHTN 1.13; 95% CI 0.65–1.96; HTN 1.38; 95% CI 0.79–2.4) populations. Hypertension is a major risk factor for cardiovascular diseases which must not be ignored, especially in the western Indian population.

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Evaluation of renal and cardiovascular protection mechanisms of SGLT2 inhibitors: model-based analysis of clinical data

AJP Renal Physiology ◽

10.1152/ajprenal.00202.2018 ◽

2018 ◽

Vol 315 (5) ◽

pp. F1295-F1306 ◽

Cited By ~ 15

Author(s):

K. Melissa Hallow ◽

Peter J. Greasley ◽

Gabriel Helmlinger ◽

Lulu Chu ◽

Hiddo J. Heerspink ◽

...

Keyword(s):

Renal Impairment ◽

Clinical Data ◽

Healthy Subjects ◽

Interstitial Fluid ◽

Sglt2 Inhibitors ◽

Fluid Volume ◽

Diabetic Patients ◽

Pressure Reduction ◽

Physiological Variables ◽

Interstitial Fluid Volume

The mechanisms of cardiovascular and renal protection observed in clinical trials of sodium-glucose cotransporter 2 (SGLT2) inhibitors (SGLT2i) are incompletely understood and likely multifactorial, including natriuretic, diuretic, and antihypertensive effects, glomerular pressure reduction, and lowering of plasma and interstitial fluid volume. To quantitatively evaluate the contribution of proposed SGLT2i mechanisms of action on changes in renal hemodynamics and volume status, we coupled a mathematical model of renal function and volume homeostasis with clinical data in healthy subjects administered 10 mg of dapagliflozin once daily. The minimum set of mechanisms necessary to reproduce observed clinical responses (urinary sodium and water excretion, serum creatinine and sodium) was determined, and important unobserved physiological variables (glomerular pressure, blood and interstitial fluid volume) were then simulated. We further simulated the response to SGLT2i in diabetic virtual patients with and without renal impairment. Multiple mechanisms were required to explain the observed response: 1) direct inhibition of sodium and glucose reabsorption through SGLT2, 2) SGLT2-driven inhibition of Na+/H+ exchanger 3 sodium reabsorption, and 3) osmotic diuresis coupled with peripheral sodium storage. The model also showed that the consequences of these mechanisms include lowering of glomerular pressure, reduction of blood and interstitial fluid volume, and mild blood pressure reduction, in agreement with clinical observations. The simulations suggest that these effects are more significant in diabetic patients than healthy subjects and that while glucose excretion may diminish with renal impairment, improvements in glomerular pressure and blood volume are not diminished at lower glomerular filtration rate, suggesting that cardiorenal benefits of SGLT2i may be sustained in renally impaired patients.

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