Abstract P153: Racial Disparities in Diabetic Complications in a Middle and Low Income Population of Louisiana

Background: Although coronary heart disease (CHD), heart failure (HF), stroke, and end-stage renal disease (ESRD) are major microvascular and macrovascular complications of diabetes, they are less clear for diabetic subgroups especially on those with middle and low income. Aim: To investigate racial disparities in the incidence of diabetic complications in middle and low income adults. Methods: We performed a prospective cohort study (1985-2010) on diabetic patients enrolled in the LSU Hospital-Based Longitudinal Study. Study cohorts included 89,353 diabetic patients (16,326 White men, 21,496 White women, 19,422 African American men and 32,109 African American women) who were 30 to 96 years of age. We calculated the gender specific age-standardized incident rates using the direct method to the year 2010 Census population. Cox proportional hazard models were used to compare racial or gender specific hazard ratios for CHD, HF, stroke and ESRD after adjustment for age, race, type of health insurance, family income, body mass index, smoking, systolic blood pressure, LDL cholesterol, HDL cholesterol, HbA 1c , estimated GFR, albuminuria, and drug treatments for diabetes, hypertension and hyperlipidemia. Results: During an average 4.0 years of follow-up, 16,935 CHD, 13,421 HF, 6,804 stroke, and 13,281 ESRD incident cases were ascertained. The age-standardized incident rates of the four diabetic complications are presented in table 1 . Compared with White diabetic patients, African Americans experienced higher rates of ESRD and lower rates of CHD, HF, and stroke. Female diabetic patients had lower rates of the four complications than males. Results of the Cox proportional hazard models confirmed the racial disparity and gender difference we found in the age-standardized incident rates. Conclusions: The results support the existence of racial differences in the incidence of diabetic complications in this population. Table 1 Age-adjusted incident rates of type 2 diabetes complications in the LSUHLS study Age-standardized incident rates White African American Male Female Male Female Coronary Heart Disease 101.6 (98.8-104.5) 62.0 (60.4-63.7) 50.7 (49.2-52.2) 44.4 (43.4-45.5) Heart Failure 54.9 (52.9-56.8) 41.9 (40.6-43.1) 43.4 (42.0-44.8) 38.4 (37.4-39.3) Stroke 22.1 (20.9-23.3) 20.7 (19.8-21.6) 19.9 (19.0-20.8) 18.5 (17.8-19.1) End-stage Renal Disease 43.3 (41.6-45.0) 33.4 (32.2-34.5) 51.4 (50.0-52.9) 35.2 (34.3-36.1)

Download Full-text

Cox proportional hazard model analysis of survival in end-stage renal disease patients with small-sized high-density lipoprotein particles

Clinical Biochemistry ◽

10.1016/j.clinbiochem.2011.02.002 ◽

2011 ◽

Vol 44 (8-9) ◽

pp. 635-641 ◽

Cited By ~ 9

Author(s):

Jelena Vekic ◽

Aleksandra Zeljkovic ◽

Natasa Bogavac-Stanojevic ◽

Zorana Jelic-Ivanovic ◽

Vesna Spasojevic-Kalimanovska ◽

...

Keyword(s):

Renal Disease ◽

High Density Lipoprotein ◽

End Stage Renal Disease ◽

Density Lipoprotein ◽

Cox Proportional Hazard Model ◽

Proportional Hazard ◽

Proportional Hazard Model ◽

Cox Proportional Hazard ◽

Stage Renal Disease ◽

End Stage

Download Full-text

Depression among end-stage renal disease patients undergoing hemodialysis: a cross-sectional study from Palestine

Renal Replacement Therapy ◽

10.1186/s41100-021-00331-1 ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Samah W. Al-Jabi ◽

Ansam Sous ◽

Fatimah Jorf ◽

Mahmoud Taqatqa ◽

Mahdi Allan ◽

...

Keyword(s):

Renal Disease ◽

Low Income ◽

End Stage Renal Disease ◽

West Bank ◽

Psychological Status ◽

The West ◽

Depression Prevalence ◽

Stage Renal Disease ◽

End Stage ◽

The Impact

Abstract Background The impact of end-stage renal disease on the patient’s psychological status necessitates the value of increasing depression awareness. The current study aimed to assess the depression prevalence among Palestinian hemodialyzed patients and its association with patients’ characteristics. Methods A convenience clustered sampling technique was followed. Sample was collected from ten hemodialysis centers in the West Bank, Palestine, during 3 months in 2015. We used the Beck Depression Inventory-II scale (BDI-II) to evaluate depression among participants. All data were analyzed using Statistical Package for the Social Sciences version 16.0. Results Two hundred and eighty-six hemodialyzed patients were interviewed. The mean age (± standard deviation) of the patients was 52.0 ± 14.3 years, and most participants were males 172 (60.1%). Regarding the dialysis characteristics, the median of years of dialysis was 2 years (1–4). The prevalence of depression was 73.1%. Elderly patients (p = 0.001), female (p = 0.036), living in rural areas or camp (p = 0.032), low income (p = 0.041), unemployment (p = 0.001), not doing regular exercise (p = 0.001), and having multi comorbidities (p = 0.001) were significantly associated with more depression scores. The results of binary logistic regression showed that only patients who were living in camps, patients who were previously employed, and patients who were not practicing exercise remained significantly associated with a higher depression score. Conclusions This study is the first one confirmed about depression and its prevalence among hemodialyzed patients in the West Bank, Palestine. Compared to other communities, the study found a higher depression prevalence rate. There is a need to offer psychological interviews and non-pharmacological and pharmacological interventions.

Download Full-text

LAMB1 Is Related to the T Stage and Indicates Poor Prognosis in Gastric Cancer

Technology in Cancer Research & Treatment ◽

10.1177/15330338211004944 ◽

2021 ◽

Vol 20 ◽

pp. 153303382110049

Author(s):

Tao Ran ◽

ZhiJi Chen ◽

LiWen Zhao ◽

Wei Ran ◽

JinYu Fan ◽

...

Keyword(s):

Gastric Cancer ◽

Poor Prognosis ◽

Hazard Models ◽

Proportional Hazard ◽

Kegg Analysis ◽

Proportional Hazard Models ◽

Cox Proportional Hazard ◽

Kaplan Meier ◽

Cox Proportional Hazard Models ◽

Gastric Cancer Patients

Background and Objective: Gastric cancer (GC) is a common tumor malignancy with high incidence and poor prognosis. Laminin is an indispensable component of basement membrane and extracellular matrix, which is responsible for bridging the internal and external environment of cells and transmitting signals. This study mainly explored the association of the LAMB1 expression with clinicopathological characteristics and prognosis in gastric cancer. Methods: The expression data and clinical information of gastric cancer patients were downloaded from The Cancer Genome Atlas (TCGA) and Asian Cancer Research Group (ACRG). And we analyzed the relationship between LAMB1 expression and clinical characteristics through R. CIBERSORTx was used to calculate the absolute score of immune cells in gastric tumor tissues. Then COX proportional hazard models and Kaplan-Meier curves were performed to evaluate the role of LAMB1 and its influence on prognosis in gastric cancer patients. Finally, GO and KEGG analysis were applied for LAMB1-related genes in gastric cancer, and PPI network was constructed in Cytoscape software. Results: In the TCGA cohort, patients with gastric cancer frequently generated LAMB1 gene copy number variation, but had little effect on mRNA expression. Both in the TCGA and ACRG cohorts, the mRNA expression of LAMB1 in gastric cancer tissues was higher than it in normal tissues. All patients were divided into high expression group and low expression group according to the median expression level of LAMB1. The elevated expression group obviously had more advanced cases and higher infiltration levels of M2 macrophages. COX proportional hazard models and Kaplan-Meier curves revealed that patients with enhanced expression of LAMB1 have a worse prognosis. GO/KEGG analysis showed that LAMB1-related genes were enriched in PI3K-Akt signaling pathway, focal adhesion, ECM-receptor interaction, etc. Conclusions: The high expression of LAMB1 in gastric cancer is related to the poor prognosis of patients, and it may be related to microenvironmental changes in tumors.

Download Full-text

Inflammatory and Hypercoagulable Biomarkers and Clinical Outcomes in COVID-19 Patients

Journal of Clinical Medicine ◽

10.3390/jcm10143086 ◽

2021 ◽

Vol 10 (14) ◽

pp. 3086

Author(s):

Hiroki Kitakata ◽

Shun Kohsaka ◽

Shunsuke Kuroda ◽

Akihiro Nomura ◽

Takeshi Kitai ◽

...

Keyword(s):

Hospital Mortality ◽

Risk Estimation ◽

Interquartile Range ◽

Proportional Hazard ◽

Multicenter Observational Study ◽

Cox Proportional Hazard ◽

Cox Proportional Hazard Models ◽

Time Of Admission ◽

Mortality Hazard Ratio ◽

D Dimer

Systemic inflammation and hypercoagulopathy are known pathophysiological processes of coronavirus disease 2019 (COVID-19), particularly in patients with known cardiovascular disease or its risk factors (CVD). However, whether a cumulative assessment of these biomarkers at admission could contribute to the prediction of in-hospital outcomes remains unknown. The CLAVIS-COVID registry was a Japanese nationwide retrospective multicenter observational study, supported by the Japanese Circulation Society. Consecutive hospitalized patients with pre-existing CVD and COVID-19 were enrolled. Patients were stratified by the tertiles of CRP and D-dimer values at the time of admission. Multivariable Cox proportional hazard models were constructed. In 461 patients (65.5% male; median age, 70.0), the median baseline CRP and D-dimer was 58.3 (interquartile range, 18.2–116.0) mg/L and 1.5 (interquartile range, 0.8–3.0) mg/L, respectively. Overall, the in-hospital mortality rate was 16.5%, and the rates steadily increased in concordance with both CRP (5.0%, 15.0%, and 28.2%, respectively p < 0.001) and D-dimer values (6.8%, 19.6%, and 22.5%, respectively p = 0.001). Patients with the lowest tertiles of both biomarkers (CRP, 29.0 mg/L; D-dimer, 1.00 mg/L) were at extremely low risk of in-hospital mortality (0% until day 50, and 1.4% overall). Conversely, the elevation of both CRP and D-dimer levels was a significant predictor of in-hospital mortality (Hazard ratio, 2.97; 95% confidence interval, 1.57–5.60). A similar trend was observed when the biomarker threshold was set at a clinically relevant threshold. In conclusion, the combination of these abnormalities may provide a framework for rapid risk estimation for in-hospital COVID-19 patients with CVD.

Download Full-text

Review: Preventing End-Stage Renal Disease in Diabetic Patients — Dual Blockade of the Renin-Angiotensin System (Part II)

Journal of the Renin-Angiotensin-Aldosterone System ◽

10.3317/jraas.2005.011 ◽

2005 ◽

Vol 6 (2) ◽

pp. 55-68 ◽

Cited By ~ 6

Author(s):

Peter Karl Jacobsen

Keyword(s):

Renal Disease ◽

End Stage Renal Disease ◽

Renin Angiotensin System ◽

Diabetic Patients ◽

Angiotensin System ◽

Renin Angiotensin ◽

System Part ◽

Dual Blockade ◽

Stage Renal Disease ◽

End Stage

Download Full-text

Identification of Novel Biomarker for Early Detection of Diabetic Nephropathy

Biomedicines ◽

10.3390/biomedicines9050457 ◽

2021 ◽

Vol 9 (5) ◽

pp. 457

Author(s):

Kyeong-Seok Kim ◽

Jin-Sol Lee ◽

Jae-Hyeon Park ◽

Eun-Young Lee ◽

Jong-Seok Moon ◽

...

Keyword(s):

Diabetic Nephropathy ◽

Early Stage ◽

Kidney Injury ◽

Diabetic Patients ◽

High Morbidity ◽

Neutrophil Gelatinase Associated Lipocalin ◽

Zucker Diabetic Fatty Rats ◽

Kidney Injury Molecule 1 ◽

Stage Renal Disease ◽

End Stage

Diabetic nephropathy (DN) is one of the most common complications of diabetes mellitus. After development of DN, patients will progress to end-stage renal disease, which is associated with high morbidity and mortality. Here, we developed early-stage diagnostic biomarkers to detect DN as a strategy for DN intervention. For the DN model, Zucker diabetic fatty rats were used for DN phenotyping. The results revealed that DN rats showed significantly increased blood glucose, blood urea nitrogen (BUN), and serum creatinine levels, accompanied by severe kidney injury, fibrosis and microstructural changes. In addition, DN rats showed significantly increased urinary excretion of kidney injury molecule-1 (KIM-1) and neutrophil gelatinase-associated lipocalin (NGAL). Transcriptome analysis revealed that new DN biomarkers, such as complementary component 4b (C4b), complementary factor D (CFD), C-X-C motif chemokine receptor 6 (CXCR6), and leukemia inhibitory factor (LIF) were identified. Furthermore, they were found in the urine of patients with DN. Since these biomarkers were detected in the urine and kidney of DN rats and urine of diabetic patients, the selected markers could be used as early diagnosis biomarkers for chronic diabetic nephropathy.

Download Full-text

Renoprotective Effects of the Dipeptidyl Peptidase-4 Inhibitor Sitagliptin: A Review in Type 2 Diabetes

Journal of Diabetes Research ◽

10.1155/2017/5164292 ◽

2017 ◽

Vol 2017 ◽

pp. 1-14 ◽

Cited By ~ 14

Author(s):

Cristina Mega ◽

Edite Teixeira-de-Lemos ◽

Rosa Fernandes ◽

Flávio Reis

Keyword(s):

Type 2 Diabetes ◽

Current Knowledge ◽

Diabetic Patients ◽

Dipeptidyl Peptidase 4 ◽

Dipeptidyl Peptidase 4 Inhibitor ◽

Increased Risk ◽

Long Time ◽

Stage Renal Disease ◽

End Stage

Diabetic nephropathy (DN) is now the single commonest cause of end-stage renal disease (ESRD) worldwide and one of the main causes of death in diabetic patients. It is also acknowledged as an independent risk factor for cardiovascular disease (CVD). Since sitagliptin was approved, many studies have been carried out revealing its ability to not only improve metabolic control but also ameliorate dysfunction in various diabetes-targeted organs, especially the kidney, due to putative underlying cytoprotective properties, namely, its antiapoptotic, antioxidant, anti-inflammatory, and antifibrotic properties. Despite overall recommendations, many patients spend a long time well outside the recommended glycaemic range and, therefore, have an increased risk for developing micro- and macrovascular complications. Currently, it is becoming clearer that type 2 diabetes mellitus (T2DM) management must envision not only the improvement in glycaemic control but also, and particularly, the prevention of pancreatic deterioration and the evolution of complications, such as DN. This review aims to provide an overview of the current knowledge in the field of renoprotective actions of sitagliptin, namely, improvement in diabetic dysmetabolism, hemodynamic factors, renal function, diabetic kidney lesions, and cytoprotective properties.

Download Full-text