scholarly journals Association between obesity and urinary albumin-creatinine ratio in the middle-aged and elderly population of Southern and Northern China: a cross-sectional study

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e040214
Author(s):  
Shan Qin ◽  
Anping Wang ◽  
Shi Gu ◽  
Weiqing Wang ◽  
Zhengnan Gao ◽  
...  

ObjectiveThe relationship between obesity and albuminuria has not been clarified. This study aimed to investigate the correlation between obesity and the urinary albumin-creatinine ratio (UACR) in Southern and Northern China.DesignA descriptive, cross-sectional study.SettingEight regional centres in REACTION (China’s Risk Evaluation of cAncers in Chinese diabeTic Individuals, a lONgitudinal study), including Dalian, Lanzhou, Zhengzhou, Guangzhou, Guangxi, Luzhou, Shanghai and Wuhan.ParticipantsA total of 41 085 patients who were not diagnosed with chronic kidney disease (CKD) and had good compliance were selected according to the inclusion criteria. Patients who were diagnosed with CKD, who had other kidney diseases that could lead to increased urinary protein excretion, who were using angiotensin-converting-enzyme inhibitors or angiotensin II receptor blockers and whose important data were missing were excluded.ResultsParticipants with both, central and peripheral obesity, had a higher risk of elevated UACR, even after adjusting for multiple factors (OR: 1.14, 95% CI: 1.07 to 1.12, p<0.001), and the risk of high UACR in the South was more prominent than that in the North (OR South: 1.22, 95% CI: 1.11 to 1.34; OR North: 1.13, 95% CI: 1.04 to 1.22, p<0.001). The risk was also elevated in the male population, hypertensive individuals, glycosylated haemoglobin (HbA1c)≥6.5% and age ≥60 years in the South. Besides the above groups, diabetes was also a risk factor for the Northern population.ConclusionsIn China, people with both central and peripheral obesity are prone to a high UACR, and the southern population has a higher risk than northern population. Factors such as male sex, hypertension, HbA1c≥6.5% and an age ≥60 years are also risk factors for CKD.

2021 ◽  
Author(s):  
Wanlu Su ◽  
Jie Wang ◽  
Songyan Yu ◽  
Kang Chen ◽  
Wenhua Yan ◽  
...  

Abstract BackgroundThe metabolic score for insulin resistance (METS-IR) is a novel noninsulin-based metabolic index used as a substitution marker of insulin resistance. However, whether METS-IR is associated with the urinary albumin–creatinine ratio (UACR) is not well known. Therefore, we explored the associations between METS-IR and UACR and compared the discriminative ability of METS-IR and its components for elevated UACR. MethodsThis study included 37,290 subjects. METS-IR was calculated as follows: (Ln [2 × fasting blood glucose (FBG) + fasting triglyceride level (TG 0 )] × body mass index (BMI))/[Ln (high-density lipoprotein cholesterol (HDL-C))]. Participants were divided into four groups on the basis of METS-IR: <25%, 25%–49%, 50%–74%, and ≥75%. Logistic regression analyses were conducted to determine the associations between METS-IR vs. its components (FBG, TG 0 , BMI, and HDL-C) with UACR. ResultsParticipants with the highest quartile METS-IR presented a more significant trend towards elevated UACR than towards its components (odds ratio [OR]: 1.260, 95% CI: 1.152–1.378, P < 0.001 in all subjects; OR: 1.321, 95% CI: 1.104–1.579, P = 0.002 in men; OR: 1.201, 95% CI: 1.083–1.330, P < 0.001 in women). There were significant associations between METS-IR and UACR in younger participants (<65 years for women and 55–64 years for men). Increased METS-IR was significantly associated with UACR in men with FBG ≥ 5.6 mmol/L or postprandial blood glucose ≥ 7.8 mmol/L and systolic blood pressure ≥ 120 mmHg or diastolic blood pressure ≥ 80 mmHg. The relationships were significant in women with diabetes and hypertension.ConclusionsIncreased METS-IR was significantly associated with elevated UACR, and its discriminative power for elevated UACR was superior to that of its components. This findings support the clinical significance of METS-IR for evaluating renal function damage.


2019 ◽  
Vol 57 (216) ◽  
Author(s):  
Pankaj Pant ◽  
Santosh Baniya ◽  
Ashish Jha

Introduction: Chronic kidney diseases affect patients with multiple respiratory complications by varied etiopathogenesis adversely affecting the outcome in them. The aim of the study is to find out the respiratory manifestations among patients with chronic kidney disease. Methods: The descriptive cross-sectional study was carried out Tribhuvan University Teaching Hospital from January 2019 to March 2019 after ethical approval. One hundred and two patients with established chronic kidney diseases being treated in a tertiary hospital for a month were included for the study. Clinical evaluation and relevant investigations; chest x ray, pleural fluid analysis, sputum analysis, echocardiography, biochemical investigations and hematological investigations were done to assess the respiratory manifestations of the patients. Results: Pulmonary edema 41 (24.84%) was the most common manifestation followed by pleural effusion 18 (10.9%). Pleural effusions were predominantly bilateral and transudative type. Pneumonia 17 (10.3%) was predominantly lobar pneumonia. Sixteen (9.7%) of the patients were screened positive for obstructive sleep apnea syndrome. Pulmonary tuberculosis was present in 9 (5.45%) patients. Conclusions: Varieties of respiratory complications can present in varied spectrum in patients with chronic kidney diseases and this carries adverse outcome to patient management as well as affects the quality of life of the patient and their family.


Viruses ◽  
2019 ◽  
Vol 11 (8) ◽  
pp. 700 ◽  
Author(s):  
Sarathkumara ◽  
Gamage ◽  
Lokupathirage ◽  
Muthusinghe ◽  
Nanayakkara ◽  
...  

Chronic kidney disease of unknown etiology (CKDu) imposes a substantial burden on public health in Sri Lankan agricultural communities. High seroprevalences of hantavirus have been reported in CKDu patients in several locations of Sri Lanka. We carried out a cross-sectional study followed by an unmatched case-control comparison in two geographically distinct areas of Sri Lanka, Girandurukotte (CKDu endemic) and Kandy (CKDu non-endemic) to determine whether exposure to hantaviruses is a potential risk factor in patients with kidney disease. An indirect immunofluorescent antibody assay using two antigens, Thailand orthohantavirus-infected and recombinant N protein-expressing Vero E6 cells, were used for serodiagnosis. Participants’ demographic and other socio-economic data were collected through a structured questionnaire. Fifty kidney disease patients and 270 controls from Kandy and 104 kidney disease patients and 242 controls from Girandurukotte were examined. Seropositivities were 50% and 17.4% in kidney patients and controls, respectively, in Girandurukotte, and they were 18% and 7% in Kandy. The odds of exposure to hantaviruses were higher for kidney disease patients than for controls in both Girandurukotte (OR:3.66, 95% CI:2.01 to 6.64) and Kandy (OR:2.64, 95% CI:1.07 to 6.54) in binary logistic regression models. According to statistical analysis, individuals exposed to hantaviruses had a higher risk of developing renal impairment. Therefore, hantavirus infection might be an important risk factor for development of kidney disease in Sri Lanka.


2019 ◽  
Vol Volume 14 ◽  
pp. 1649-1656 ◽  
Author(s):  
Christian Buhtz ◽  
Denny Paulicke ◽  
Karsten Schwarz ◽  
Patrick Jahn ◽  
Dietrich Stoevesandt ◽  
...  

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