scholarly journals Changes in Proteinuria on the Risk of All-Cause Mortality in People with Diabetes or Prediabetes: A Prospective Cohort Study

2017 ◽  
Vol 2017 ◽  
pp. 1-7
Author(s):  
Yang Sun ◽  
Anxin Wang ◽  
Xiaoxue Liu ◽  
Zhaoping Su ◽  
Junjuan Li ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Mortality Risk ◽  
Prospective Cohort ◽  
Cox Proportional Hazard ◽  
Baseline Mortality ◽  
All Cause Mortality ◽  
Cox Proportional Hazard Models ◽  
Study Participants

Background. Proteinuria has been related to all-cause mortality, showing regression or progression. However, few studies have focused on the relationship between proteinuria changes and all-cause mortality. The main purpose of this paper is to examine the associations between proteinuria changes and all-cause mortality in people with diabetes or prediabetes. Methods. Dipstick proteinuria at baseline and a 2-year follow-up were determined in the participants attending the Kailuan prospective cohort study. Participants were then divided into three categories: elevated proteinuria, stable proteinuria, and reduced proteinuria. Four Cox proportional hazard models were built to access the relations of proteinuria changes to all-cause mortality, adjusting for other confounding covariates. Results. A total of 17,878 participants were finally included in this study. There were 1193 deaths after a median follow-up of 6.69 years. After adjusting for major covariates and proteinuria at baseline, mortality risk was significantly associated with elevated proteinuria (hazard ratio (HR): 1.54, 95% confidence interval (CI): 1.33–1.79) and reduced proteinuria (HR: 0.70, 95% CI: 0.55–0.89), compared to those with stable proteinuria. Conclusion. Proteinuria changes were independently associated with mortality risk in either diabetic or prediabetic population.

Circulating angiopoietin-like protein 2 levels and mortality risk in patients receiving maintenance hemodialysis: a prospective cohort study

2019 ◽  
Vol 35 (5) ◽  
pp. 854-860 ◽  
Author(s):  
Jun Morinaga ◽  
Tatsuyuki Kakuma ◽  
Hirotaka Fukami ◽  
Manabu Hayata ◽  
Kohei Uchimura ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Mortality Risk ◽  
Prospective Cohort ◽  
Premature Aging ◽  
Skewed Distribution ◽  
Maintenance Hemodialysis ◽  
All Cause Mortality ◽  
Uremic Patients ◽  
The Relationship

Abstract Background Patients undergoing hemodialysis treatment have a poor prognosis, as many develop premature aging. Systemic inflammatory conditions often underlie premature aging phenotypes in uremic patients. We investigated whether angiopoietin-like protein 2 (ANGPTL 2), a factor that accelerates the progression of aging-related and noninfectious inflammatory diseases, was associated with increased mortality risk in hemodialysis patients. Methods We conducted a multicenter prospective cohort study of 412 patients receiving maintenance hemodialysis and evaluated the relationship between circulating ANGPTL2 levels and the risk for all-cause mortality. Circulating ANGPTL2 levels were log-transformed to correct for skewed distribution and analyzed as a continuous variable. Results Of 412 patients, 395 were included for statistical analysis. Time-to-event data analysis showed high circulating ANGPTL2 levels were associated with an increased risk for all-cause mortality after adjustment for age, sex, hemodialysis vintage, nutritional status, metabolic parameters and circulating high-sensitivity C-reactive protein levels {hazard ratio [HR] 2.04 [95% confidence interval (CI) 1.10–3.77]}. High circulating ANGPTL2 levels were also strongly associated with an increased mortality risk, particularly in patients with a relatively benign prognostic profile [HR 3.06 (95% CI 1.86–5.03)]. Furthermore, the relationship between circulating ANGPTL2 levels and mortality risk was particularly strong in patients showing few aging-related phenotypes, such as younger patients [HR 7.99 (95% CI 3.55–18.01)], patients with a short hemodialysis vintage [HR 3.99 (95% CI 2.85–5.58)] and nondiabetic patients [HR 5.15 (95% CI 3.19–8.32)]. Conclusion We conclude that circulating ANGPTL2 levels are positively associated with mortality risk in patients receiving maintenance hemodialysis and that ANGPTL2 could be a unique marker for the progression of premature aging and subsequent mortality risk in uremic patients, except those with significant aging-related phenotypes.

scholarly journals Vitamin D intake and risk of CVD and all-cause mortality: evidence from the Caerphilly Prospective Cohort Study

2017 ◽  
Vol 20 (15) ◽  
pp. 2744-2753 ◽  
Author(s):  
Jing Guo ◽  
John R Cockcroft ◽  
Peter C Elwood ◽  
Janet E Pickering ◽  
Julie A Lovegrove ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Vitamin D ◽  
Cohort Study ◽  
Diastolic Blood Pressure ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Cvd Risk ◽  
Vitamin D Intake ◽  
All Cause Mortality

AbstractObjectiveProspective data on the associations between vitamin D intake and risk of CVD and all-cause mortality are limited and inconclusive. The aim of the present study was to investigate the associations between vitamin D intake and CVD risk and all-cause mortality in the Caerphilly Prospective Cohort Study.DesignThe associations of vitamin D intake with CVD risk markers were examined cross-sectionally at baseline and longitudinally at 5-year, 10-year and >20-year follow-ups. In addition, the predictive value of vitamin D intake for CVD events and all-cause mortality after >20 years of follow-up was examined. Logistic regression and general linear regression were used for data analysis.SettingParticipants in the UK.SubjectsMen (n452) who were free from CVD and type 2 diabetes at recruitment.ResultsHigher vitamin D intake was associated with increased HDL cholesterol (P=0·003) and pulse pressure (P=0·04) and decreased total cholesterol:HDL cholesterol (P=0·008) cross-sectionally at baseline, but the associations were lost during follow-up. Furthermore, higher vitamin D intake was associated with decreased concentration of plasma TAG at baseline (P=0·01) and at the 5-year (P=0·01), but not the 10-year examination. After >20 years of follow-up, vitamin D was not associated with stroke (n72), myocardial infarctions (n142), heart failure (n43) or all-cause mortality (n281), but was positively associated with increased diastolic blood pressure (P=0·03).ConclusionsThe study supports associations of higher vitamin D intake with lower fasting plasma TAG and higher diastolic blood pressure.

scholarly journals Effects of cardiac rehabilitation on the two-year prognosis of patients with heart failure: a multicentre prospective cohort study

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
T Adachi ◽  
N Iritani ◽  
K Kamiya ◽  
K Iwatsu ◽  
K Kamisaka ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cohort Study ◽  
Propensity Score ◽  
Ejection Fraction ◽  
Cardiac Rehabilitation ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Landmark Analysis ◽  
All Cause Mortality

Abstract Background Cardiac rehabilitation (CR) is a comprehensive disease management program highly recommended by heart failure (HF) guidelines. However, the prognostic effects of outpatient CR are inconsistent among recent meta-analyses which enrolled mainly younger HF with reduced ejection fraction (HFrEF). With an aging population, an increased importance of CR has been put on patients with HF with preserved ejection fraction (HFpEF). Purpose This study aimed to examine the prognostic effects of regularly undergoing CR for 6 months after discharge analysing nationwide cohort data including older population with HFrEF and HFpEF. Methods We analysed 2876 patients who hospitalised for acute HF or worsening chronic HF and capable of walking at discharge in the multicentre prospective cohort study. Frequency of outpatient CR participation of each patient was collected using medical records. We assessed CR frequency within 6 months of discharge since most collaborating hospitals conducted final follow-up examinations at 6 months. The CR group was defined as patients who underwent outpatient CR once or more per week for 6 months after discharge. The main study endpoint was a composite of all-cause mortality and HF rehospitalisation during a 2-year follow-up. We performed a propensity score-matched analysis to compare survival rates between the CR and non-CR groups. Propensity scores for each patient were produced by a logistic regression analysis with the CR group as the dependent variable and 33 potential confounders as independent variables. To evaluate events beyond 6 months, we also conducted landmark analyses at 6 months. Results Of the 2876 enrolled patients, 313 underwent CR for 6 months. After propensity score matching using confounding factors, 626 patients (313 pairs) were included in the survival analysis (median age: 74 years, men: 59.6%, median left ventricular ejection fraction [LVEF]: 42%). During 1006.1 person-years of follow-up, 137 patients were rehospitalised due to HF exacerbation, and 50 patients died in the matched cohort. In Cox proportional hazards model (Figure 1), CR was associated with a reduced risk of composite outcomes (hazard ratio [HR] 0.66; 95% confidence interval [CI] 0.48–0.91), all-cause mortality (HR 0.53; 95% CI 0.30–0.95), and HF rehospitalisation (HR 0.66; 95% CI 0.47–0.92). A subgroup analysis showed similar CR effects in patients with HFpEF (LVEF ≥50%) and HFrEF (LVEF <40%). However, in a landmark analysis, CR did not reduce the adverse outcomes beyond 6 months after discharge (Figure 2). Conclusions The findings of this study demonstrate the needs that CR should become a standard treatment for HF regardless of HF type and the necessity of periodical follow-up after completing CR program to maintain its prognostic effects. FUNDunding Acknowledgement Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Grant-in-Aid for Scientific Research (A) from the Japan Society for the Promotion of Science Figure 1. Prognostic effects of CR Figure 2. Landmark analysis

scholarly journals Long term impact on lung function of patients with moderate and severe COVID-19. A prospective cohort study

2021 ◽  
Author(s):  
Sonia Qureshi ◽  
Nosheen Nasir ◽  
Naveed Haroon Rashid ◽  
Naveed Ahmed ◽  
Zoya Haq ◽  
...  
Keyword(s):  
Cohort Study ◽  
Lung Function ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
List Type ◽  
Long Term Impact ◽  
Study Participants ◽  
The Impact

AbstractIntroductionA significant number of patients continue to recover from COVID-19; however, little is known about the lung function capacity among survivors. We aim to determine the long-term impact on lung function capacity in patients who have survived moderate or severe COVID-19 disease in a resource-poor setting.Methods and analysisThis prospective cohort study will include patients aged 15 years and above and have reverse transcriptase-polymerase chain reaction (RT-PCR) positive for COVID 19 (nasopharyngeal or oropharyngeal). Patients with a pre-existing diagnosis of obstructive or interstitial lung disease, lung fibrosis and cancers, connective tissue disorders, autoimmune conditions affecting the lungs, underlying heart disease, history of syncope and refuse to participate will be excluded. Pulmonary function will be assessed using spirometry and diffusion lung capacity for carbon monoxide (DLCO) at three- and six-months interval. A chest X-ray at three and six-month follow-up and CT-chest will be performed if clinically indicated after consultation with the study pulmonologist or Infectious Disease (ID) physician. Echocardiogram (ECHO) to look for pulmonary hypertension at the three months visit and repeated at six months if any abnormality is identified initially. Data analysis will be performed using standard statistical software.Ethics and disseminationThe proposal was reviewed and approved by ethics review committee (ERC) of the institution (ERC reference number 2020-4735-11311). Informed consent will be obtained from each study participant. The results will be disseminated among study participants, institutional, provincial and national level through seminars and presentations. Moreover, the scientific findings will be published in high-impact peer-reviewed medical journals.Strengths and Limitations of this study-The study has the potential to develop context-specific evidence on the long-term impact on lung function among COVID-19 survivors-Findings will play key role in understanding the impact of the disease on vital functions and help devise rehabilitative strategies to best overcome the effects of disease-This is a single-center, study recruiting only a limited number of COVID-19 survivors-The study participants may loss-to-follow up due to uncertain conditions and disease reemergence

scholarly journals Individual testosterone decline and future mortality risk in men

2018 ◽  
Vol 178 (1) ◽  
pp. 121-128 ◽  
Author(s):  
Stine A Holmboe ◽  
Niels E Skakkebæk ◽  
Anders Juul ◽  
Thomas Scheike ◽  
Tina K Jensen ◽  
...  
Keyword(s):  
Mortality Risk ◽  
Serum Levels ◽  
Proportional Hazard ◽  
Cox Proportional Hazard ◽  
Age Related ◽  
National Mortality ◽  
All Cause Mortality ◽  
Specific Mortality ◽  
Cox Proportional Hazard Models

Objective Male aging is characterized by a decline in testosterone (TS) levels with a substantial variability between subjects. However, it is unclear whether differences in age-related changes in TS are associated with general health. We investigated associations between mortality and intra-individual changes in serum levels of total TS, SHBG, free TS and LH during a ten-year period with up to 18 years of registry follow-up. Design 1167 men aged 30–60 years participating in the Danish Monitoring Trends and Determinants of Cardiovascular Disease (MONICA1) study and who had a follow-up examination ten years later (MONICA10) were included. From MONICA10, the men were followed up to 18 years (mean: 15.2 years) based on the information from national mortality registries via their unique personal ID numbers. Methods Cox proportional hazard models were used to investigate the association between intra-individual hormone changes and all-cause, CVD and cancer mortalities. Results A total of 421 men (36.1%) died during the follow-up period. Men with most pronounced decline in total TS (<10th percentile) had a higher all-cause mortality risk compared to men within the 10th to 90th percentile (hazard ratio (HR): 1.60; 95% confidence interval (CI): 1.08–2.36). No consistent associations were seen in cause-specific mortality analyses. Conclusion Our study showed that higher mortality rates were seen among the men who had the most pronounced age-related decline in TS, independent of their baseline TS levels.

scholarly journals Prospective cohort study showing persistent HSV-2 shedding in women with genital herpes 2 years after acquisition

2017 ◽  
Vol 94 (8) ◽  
pp. 568-570 ◽  
Author(s):  
Meena Ramchandani ◽  
Stacy Selke ◽  
Amalia Magaret ◽  
Gail Barnum ◽  
Meei-Li Wu Huang ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Initial Study ◽  
Viral Shedding ◽  
History Of ◽  
Simplex Virus ◽  
Study Participants ◽  
Over Time

ObjectivesHerpes simplex virus type 2 (HSV-2) is a prevalent infection with great variability in clinical and virological manifestations among individuals. This prospective cohort study aims to evaluate the natural history of HSV-2 reactivation in the genital area in the same group of women over time.MethodsEighteen immunocompetent HSV-2 seropositive women were evaluated for viral shedding for 70 consecutive days within a median of 8 months (range 1–24 months) of HSV-2 acquisition and again approximately 2.5 years later from the original study. Participants obtained daily swabs of genital secretions for HSV PCR and recorded genital symptoms.ResultsThe viral shedding rate was 29% during the initial study and 19% in the follow-up study (32% reduction, P=0.019). Subclinical shedding rate also decreased from 24% to 13% (37% reduction, P=0.032), as did the rate of days with genital lesions from 22% to 15% (33% reduction, P=0.24). The mean copy number during viral shedding remained unchanged over time at 4.8 log10 c/mL (SD=2.0 and 1.6 during each study, respectively, P=0.33). Women with high viral shedding rates in the past were likely to continue to have high shedding rates (r=0.63, P=0.005).ConclusionsDespite some reduction, high viral shedding rates persist in women with genital HSV-2 greater than 2 years after acquisition.

scholarly journals Low testosterone levels predict all-cause mortality and cardiovascular events in women: a prospective cohort study in German primary care patients

2010 ◽  
Vol 163 (4) ◽  
pp. 699-708 ◽  
Author(s):  
Caroline Sievers ◽  
Jens Klotsche ◽  
Lars Pieper ◽  
Harald J Schneider ◽  
Winfried März ◽  
...  
Keyword(s):  
Risk Factors ◽  
Primary Care ◽  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Total Testosterone ◽  
Similar Data ◽  
Testosterone Levels ◽  
All Cause Mortality

ObjectiveAlthough associations between testosterone and cardiovascular (CV) morbidity in women have been proposed, no large prospective study has evaluated potential associations between testosterone and mortality in women. The objective was to determine whether baseline testosterone levels in women are associated with future overall or CV morbidity and mortality.DesignProspective cohort study with a 4.5-year follow-up period.MethodsFrom a representative sample of German primary care practices, 2914 female patients between 18 and 75 years were analyzed for the main outcome measures: CV risk factors, CV diseases, and all-cause mortality.ResultsAt baseline, the study population was aged 57.96±14.37 years with a mean body mass index of 26.71±5.17 kg/m2. No predictive value of total testosterone for incident CV risk factors or CV diseases was observed in logistic regressions. Patients with total testosterone levels in the lowest quintile Q1, however, had a higher risk to die of any cause or to develop a CV event within the follow-up period compared to patients in the collapsed quintiles Q2–Q5 in crude and adjusted Cox regression models (all-cause mortality: Q2–Q5 versus Q1: crude hazard ratios (HR) 0.49, 95% confidence interval (CI) 0.33–0.74; adjusted HR 0.62, 95% CI 0.42–0.939; CV events: Q2–Q5 versus Q1: crude HR 0.54, 95% CI 0.38–0.77; adjusted HR 0.68, 95% CI 0.48–0.97). Kaplan–Meier curves revealed similar data.ConclusionsLow baseline testosterone in women is associated with increased all-cause mortality and incident CV events independent of traditional risk factors.

Relationship between Serum Uric Acid and Mortality Risk in Hemodialysis Patients: A Multicenter Prospective Cohort Study

2020 ◽  
Vol 51 (10) ◽  
pp. 823-832
Author(s):  
Yaya Yang ◽  
Xianhui Qin ◽  
Yumin Li ◽  
Shenglin Yang ◽  
Junzhi Chen ◽  
...  
Keyword(s):  
Uric Acid ◽  
Cohort Study ◽  
Serum Uric Acid ◽  
Prospective Cohort Study ◽  
Mortality Risk ◽  
Prospective Cohort ◽  
All Cause Mortality ◽  
Multicenter Prospective Cohort Study ◽  
Multicenter Prospective Cohort ◽  
Cvd Mortality

<b><i>Background:</i></b> Several studies have reported that low serum uric acid (SUA) levels are related to increased risk of mortality in maintenance hemodialysis (MHD) patients. However, the possible detrimental effects of high SUA on the mortality risk have not been well examined. Moreover, the possible effect modifiers for the SUA-mortality association have not been fully investigated. To address the aforementioned gap, we aimed to explore the nonlinear relationship between SUA levels and all-cause and cardiovascular disease (CVD) mortality risk, and to examine any possible effect modifiers in MHD patients. <b><i>Methods:</i></b> We conducted a multicenter, prospective cohort study among 1,018 MHD patients from 8 hemodialysis centers. The primary outcome was all-cause mortality, and the secondary outcomes were CVD mortality and non-CVD mortality. <b><i>Results:</i></b> The mean value for SUA in the total population was 8.5 ± 1.9 mg/dL. The lowest and highest quintiles of SUA were &#x3c;7.0 and &#x3e;10.1 mg/dL, respectively. Over a median follow-up of 45.6 months, 343 deaths were recorded, of which 202 (58.9%) were due to CVD. When SUA was assessed as quintiles, a significantly higher risk of all-cause mortality was found in patients in quintile 1 (&#x3c;7.0 mg/dL; hazard ratio [HR], 1.33; 95% confidence interval [CI]: 1.02–1.73) or quintile 5 (≥10.1 mg/dL; HR, 1.47; 95% CI: 1.09–2.00), compared to those in quintiles 2–4 (7–10.1 mg/dL). Moreover, the U-shaped SUA-mortality association was mainly found in those with lower C-reactive protein levels (&#x3c;3 compared with ≥3 mg/L; <i>p</i> for interaction = 0.018). Similar trends were found for CVD mortality and non-CVD mortality. <b><i>Conclusion:</i></b> There was a U-shaped relationship between SUA levels and the risk of all-cause mortality, CVD mortality, and non-CVD mortality in MHD patients.

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