Sex specific trajectories of central adiposity, lipid indices, and glucose level with incident hypertension: 12 years Follow-up in Tehran lipid and glucose study

Abstract Aims To identify sex specific trajectories of waist circumference (WC),triglyceride (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C) and fasting plasma glucose (FPG) during adulthood and examine their associations with incident hypertension. Methods The cohort consisted of 5030 participants (2051 males) with at least 2 repeated measurement during a median of 12 years follow up. We identified trajectory groups using latent class growth mixture model, their association with hypertension was examined using multivariate Cox-regression analysis. Results We found 997 cases of hypertension (483 male). For both exposures, three distinct trajectory groups were identified in both genders. For WC, in women: low-increasing, 82.4%; high-stable, 13.4%; high-increasing, 4.2% and in men: stable, 94.6%; low-increasing, 3.6% and for high- increasing, 1.7%. For TG, in women: stable, 91.3%; decreasing, 5.9%; inverse U-shape, 2.8%; in men: stable, 89.7%; inverse U- shape, 6.2% and for decreasing, 4.1%. Regarding WC, high stable and high-increasing trajectories were associated with hypertension in the multivariate model [(hazard ratio (HR) = 1.66 (95% CI 1.26–2.20) and 2.78(1.79–3.60), respectively]. Among men, this association was shown only for the low-increasing trajectory [2.76: 1.49–5.10]. For TG, among women decreasing and inverse U-shape trajectories were significantly associated with hypertension in the multivariate model [1.32:1.01–1.76] and [2.23:1.58–3.23, respectively]. We did not find any impact of increasing trajectories of FPG and HDL-C on incident hypertension. Considering TC, all individuals followed a stable trajectory. Conclusion WC dynamic changes in both gender and TG trajectory among women were significantly associated with incident hypertension.

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Incidence of Hypertension among Persons Living with HIV in China A Multicenter Study

10.21203/rs.2.20649/v1 ◽

2020 ◽

Author(s):

Hongwei Fan ◽

fuping guo ◽

Evelyn Hsieh ◽

Wei-Ti Chen ◽

Wei Lv ◽

...

Keyword(s):

Cox Regression ◽

Cox Proportional Hazards ◽

Hiv Care ◽

Multicenter Studies ◽

Cox Regression Analysis ◽

Incident Hypertension ◽

Persons Living With Hiv ◽

Living With Hiv ◽

Prospective Longitudinal

Abstract Objectives Life expectancy among persons living with HIV (PLWH) has improved with increasing access to antiretroviral therapy (ART), however incidence of chronic comorbidities has simultaneously increased. No data are available regarding the incidence of hypertension among Chinese PLWH.Methods We analyzed data collected from patients enrolled in two prospective longitudinal multicenter studies of PLWH initiating ART in China. Incidence rate of hypertension per 100 person-years (PYs) among PLWH was calculated, and Cox proportional hazards models was used to evaluate the association between incident hypertension and traditional and HIV-associated risk factors.Results Of 1078 patients included in this analysis, 984 ART-naïve patients were hypertension-free at baseline, and contributed 2337.7 PYs of follow up, with a median follow-up period of 1.8 years (range: 1.2-3.2) after initiation of ART. Incidence of hypertension was 7.6 [95% confidence interval (CI): 6.5-8.7] per 100 PYs. In the Cox regression analysis, incidence of hypertension was positively associated with BMI [adjusted hazard ratio (aHR) 1.07 (1.01,1.13), p=0.02] and recent viral load (aHR 1.28, 95% CI:1.08-1.51, p=0), and negatively associated with recent CD4+/CD8+ ratio (aHR 0.14, 95% CI:0.06-0.31, p<0.001), zidovudine exposure (aHR 0.15, 95% CI: 0.10-0.24, p<0.001) and tenofovir exposure (aHR 0.13, 95% CI: 0.08-0.21, p<0.001).Conclusions The incidence of hypertension was relatively high among Chinese PLWH initiating ART. Independent risk factors for incident hypertension included recent low CD4+/CD8+ ratio and detectable HIV viremia, whereas receipt of ART was associated with reduced risk. Hypertension may be mitigated, in part, by excellent HIV care, including viral suppression with ART.

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Incidence of Hypertension among Persons Living with HIV in China: A Multicenter Cohort Study

10.21203/rs.2.20649/v2 ◽

2020 ◽

Author(s):

Hongwei Fan ◽

fuping guo ◽

Evelyn Hsieh ◽

Wei-Ti Chen ◽

Wei Lv ◽

...

Keyword(s):

Cox Regression ◽

Cox Proportional Hazards ◽

Hiv Care ◽

Multicenter Cohort Study ◽

Cox Regression Analysis ◽

Incident Hypertension ◽

Persons Living With Hiv ◽

Living With Hiv ◽

Prospective Longitudinal

Abstract Background Life expectancy among persons living with HIV (PLWH) has improved with increasing access to antiretroviral therapy (ART), however incidence of chronic comorbidities has simultaneously increased. No data are available regarding the incidence of hypertension among Chinese PLWH. Methods We analyzed data collected from patients enrolled in two prospective longitudinal multicenter studies of PLWH initiating ART in China. Incidence rate of hypertension per 100 person-years (PYs) among PLWH was calculated, and Cox proportional hazards models was used to evaluate the association between incident hypertension and traditional and HIV-associated risk factors. Results Of 1078 patients included in this analysis, 984 ART-naïve patients were hypertension-free at baseline, and contributed 2337.7 PYs of follow up, with a median follow-up period of 1.8 years (range: 1.2-3.2) after initiation of ART. Incidence of hypertension was 7.6 [95% confidence interval (CI): 6.5-8.7] per 100 PYs. In the Cox regression analysis, incidence of hypertension was positively associated with body mass index [adjusted hazard ratio (aHR) 1.07 (1.01,1.13), p=0.02] and recent viral load (aHR 1.28, 95% CI:1.08-1.51, p=0), and negatively associated with recent CD4+/CD8+ ratio (aHR 0.14, 95% CI:0.06-0.31, p<0.001), zidovudine exposure (aHR 0.15, 95% CI: 0.10-0.24, p<0.001) and tenofovir disoproxil fumarate exposure (aHR 0.13, 95% CI: 0.08-0.21, p<0.001). Conclusions The incidence of hypertension was relatively high among Chinese PLWH initiating ART. Recent low CD4+/CD8+ ratio and detectable HIV viremia were associated with incident hypertension, whereas receipt of ART was associated with reduced risk . Hypertension may be mitigated, in part, by excellent HIV care, including viral suppression with ART.

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Abstract MP015: Resistance Exercise and Incident Metabolic Syndrome in Men

Circulation ◽

10.1161/circ.125.suppl_10.amp015 ◽

2012 ◽

Vol 125 (suppl_10) ◽

Author(s):

Duck-chul Lee ◽

Xuemei Sui ◽

Enrique G. Artero ◽

Steven N. Blair

Keyword(s):

Metabolic Syndrome ◽

Resistance Exercise ◽

Aerobic Exercise ◽

Cox Regression ◽

Density Lipoprotein ◽

Physical Activity Guidelines ◽

Cox Regression Analysis ◽

Muscle Strengthening ◽

Diagnosed Diabetes

Introduction: There is little evidence on the association between resistance exercise and incident metabolic syndrome. Hypothesis: We examined the hypothesis that resistance exercise reduces the risk of developing metabolic syndrome in men. Methods: Participants were 6,098 men aged 18 to 83 years (mean age, 46) who received an extensive preventive medical examination during 1987–2006, and were free of cardiovascular disease, cancer, and metabolic syndrome at baseline. Resistance exercise was assessed by self-reported muscle strengthening activities using either free weights or weight training machines. We used the frequency of resistance exercise (0, 1, 2, 3, 4, and ≥5 days/week) as our main exposure categories. Metabolic syndrome was defined as the presence of ≥3 of the following criteria: waist circumference >102 cm, triglycerides ≥150 mg/dL, high-density lipoprotein cholesterol <40 mg/dL, systolic/diastolic blood pressure ≥130/85 mm Hg or physician-diagnosed hypertension, and fasting glucose ≥100 mg/dL or physician-diagnosed diabetes according to the National Cholesterol Education Program Adult Treatment Panel III. Follow-up was calculated from the baseline examination to the first event of metabolic syndrome or the last examination through 2006. Cox regression analysis was used to estimate the hazard ratio (HR) and 95% confidence interval (CI) of incident metabolic syndrome across resistance exercise. Age, examination year, body mass index, current smoking, heavy alcohol drinking (>14 drinks/week), abnormal electrocardiography, and aerobic exercise (inactive, low, medium, and high) were included in the multivariate regression model. Results: During the 5-year mean follow-up, 1,088 men developed metabolic syndrome. About 62% of men did not participate in resistance exercise, 3% of men participated in 1 day/week of resistance exercise, and 35% of men met the Physical Activity Guidelines for resistance exercise (≥2 days/week). Resistance exercise was inversely associated with incident metabolic syndrome after adjusting for possible confounders including aerobic exercise (trend P <0.01). Compared with no resistance exercise, the HRs (95% CIs) of developing metabolic syndrome were 0.83 (0.55–1.26), 0.88 (0.70–1.11), 0.85 (0.72–1.02), 0.62 (0.43–0.88), and 0.74 (0.51–1.07) for 1, 2, 3, 4, and ≥5 days/week of resistance exercise, respectively. Men meeting the recommended resistance exercise (≥2 days/week) had 18% lower risk of developing metabolic syndrome (HR=0.82, 95% CI=0.71–0.94) compared with men not meeting the recommendation (0 or 1 day/week of resistance exercise). Conclusions: Participating in resistance exercise may reduce the risk of developing metabolic syndrome in adult men.

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The risk and added values of the atherosclerotic cardiovascular risk enhancers on prediction of cardiovascular events: Tehran lipid and glucose study

Journal of Translational Medicine ◽

10.1186/s12967-020-02686-1 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Farzad Hadaegh ◽

Samaneh Asgari ◽

Fatemeh Moosaie ◽

Meysam Orangi ◽

Farzaneh Sarvghadi ◽

...

Keyword(s):

Cox Regression ◽

Multivariable Analysis ◽

Density Lipoprotein ◽

Predictive Ability ◽

Heart Association ◽

Premature Menopause ◽

Atherosclerotic Cardiovascular Disease ◽

Cox Regression Analysis ◽

History Of

Abstract Background In 2013 American College of Cardiology and the American Heart Association released a guideline on the management of atherosclerotic cardiovascular disease (ASCVD) including a composite of death from CVD, non-fatal myocardial infarction, or non-fatal stroke (hard CVD). This guideline recommended a risk score that was calculated using pooled cohort equations (ASCVD-PCE). The guideline was updated in 2018/2019 and further risk discussion was suggested for deciding whether to continue or initiate statin therapy among non-diabetic individuals with ASCVD-PCE score ranged 5–20%. They recommended a risk discussion with considering risk enhancing factors (ASCVD-REFs) including family history of premature CVD, chronic kidney disease, triglycerides ≥ 175 mg/dl, low-density lipoprotein cholesterol (LDL-C) ≥ 160 mg/dl, metabolic syndrome (Mets), and for women premature menopause, and hypertensive disorders of pregnancy (HDP). In the current study, we aimed to examine the predictability of recommended ASCVD-REFs on incident hard CVD in non-diabetic individuals with LDL-C 70-189 mg/dl, with ASCVD-PCE risk 5–20% during 10 and 15-year follow-up. Methods Among a total of 3546 non-diabetic individuals aged 40-75 years, after excluding those with ASCVD-PCE score < 5% and ≥ 20% (n = 2342), 1204 individuals (women = 332) were included. The univariable and multivariable (further adjusted for ASCVD-PCE) Cox regression analysis were used to evaluate the association of each potential ASCVD-REFs with hard CVD. Additionnaly, the role of different components of Mets and a history of gestational diabetes (GDM)/macrosomia was also examined. The predictive ability of each significant ASCVD-REFs, then was evaluated by the discrimination accuracy and risk reclassification index. Results During the 10-year follow-up, 73 hard CVD events occurred. Although in univariable analysis, high blood pressure (BP) component of Mets, GDM/macrosomia, and HDP remained as significant ASCVD-REFs, in the multivariable analysis, only the history of HDP (5.35 (1.22–23.38)) and GDM/macrosomia (3.18 (1.05–9.65)) showed independent risks. During the 15-year follow-up, Mets (1.47 (1.05–2.06)) and its components of high waist circumference (1.40 (1.0–1.95)) and high BP (1.52 (1.07–2.15)) significantly increased the risk. These ASCVD-REFs did not improve discrimination or predictive ability. Conclusions In a decade follow-up, only conditions specific for women and in longer follow-up, the presence of Mets perse, and its components of high WC and high BP were shown as significant ASCVD-REFs.

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Low density Lipoprotein Cholesterol and all-Cause Mortality rate Findings from a Study on Japanese Community-Dwelling Persons

10.21203/rs.3.rs-597720/v1 ◽

2021 ◽

Author(s):

Ryuichi Kawamoto ◽

Asuka Kikuchi ◽

Taichi Akase ◽

Daisuke Ninomiya ◽

Teru Kumagi

Keyword(s):

Regression Analysis ◽

Cox Regression ◽

Low Density Lipoprotein ◽

Density Lipoprotein ◽

Low Density ◽

Low Density Lipoprotein Cholesterol ◽

Cox Regression Analysis ◽

All Cause Mortality ◽

History Of

Abstract Background: Low-density lipoprotein cholesterol (LDL-C) independently impacts aging-related health outcomes and plays a critical role in cardiovascular diseases (CVDs). However, there are limited predictive data on all-cause mortality, especially for the Japanese community population. In this study, it was examined whether LDL-C is related to survival prognosis based on 7 or 10 years of follow-up.Methods: Participants included 1,610 men (63 ± 14 years old) and 2,074 women (65 ± 12 years old) who participated in the Nomura cohort study conducted in 2002 (first cohort) and 2014 (second cohort) and who continued throughout the follow-up periods (follow-up rates: 94.8% and 98.0%). Adjusted relative risk estimates were obtained for all-cause mortality using a basic resident register. The data were analyzed by a Cox regression with age as the time variable and risk factors including gender; age; body mass index (BMI); presence of diabetes; lipid levels; renal function; serum uric acid levels; blood pressure; and history of smoking, drinking, and CVD.Results: Of the 3,684 participants, 326 (8.8%) were confirmed to be deceased. Of these, 180 were men (11.2% of all men) and 146 were women (7.0% of all women). The univariate Cox regression analysis revealed that the hazard ratios (HRs) for all-cause mortality significantly increased with a decrease in LDL-C level (P < 0.001). The multivariate Cox regression analysis with adjustment variables showed that LDL-C grouping (HR: 0.71; 95% confidence interval [CI]: 0.62–0.82), gender (HR: 0.69, 95% CI: 0.51–0.93), age (HR: 1.09; 95% CI: 1.08–1.11), BMI (HR: 0.68; 95% CI: 0.54–0.86), history of CVD (HR: 1.38; 95% CI: 1.03–1.82), and presence of diabetes (HR: 1.65; 95% CI: 1.23–2.22) were significantly associated with all-cause mortality. Compared with individuals with LDL-C levels of 144 mg/dL or higher, the multivariate-adjusted HRs (95% CI) for all-cause mortality were 2.68 (1.67–4.28) for those with LDL-C levels under 70 mg/dL and 1.74 (1.17–2.59) for those with LDL-C levels between 70 and 92 mg/dL. Conclusions: There is an inverse relationship between the risk of all-cause mortality and LDL-C level, and this association is statistically significant.

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AST/ALT ratio as a predictor of mortality and exacerbations of PM/DM-ILD in 1 year—a retrospective cohort study with 522 cases

Arthritis Research & Therapy ◽

10.1186/s13075-020-02286-w ◽

2020 ◽

Vol 22 (1) ◽

Author(s):

Renjiao Li ◽

Wen-Jun Zhu ◽

Faping Wang ◽

Xiaoju Tang ◽

Fengming Luo

Keyword(s):

Mechanical Ventilation ◽

Cohort Study ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Cox Regression ◽

Low Cost ◽

Density Lipoprotein ◽

Cox Regression Analysis ◽

Neutrophil Lymphocyte Ratio

Abstract Objective To assess the associations between aspartate transaminase/alanine transaminase ratio (DRR) and mortality in patients with polymyositis/dermatomyositis-associated interstitial lung disease (PM/DM-ILD). Patients and methods This was a retrospective cohort study, which included 522 patients with PM/DM-ILD whose DRR on admission were tested at West China Hospital of Sichuan University during the period from January 1, 2008, to December 31, 2018. Cox regression models were used to estimate hazard ratios for mortality in four predefined DRR strata (≤ 0.91, 0.91–1.26, 1.26–1.73, and > 1.73), after adjusting for age, sex, DRR stratum, diagnosis, overlap syndrome, hemoglobin, platelet count, white blood cell count, the percentage of neutrophils, neutrophil/lymphocyte ratio, albumin, creatine kinase, uric acid/creatinine ratio, triglycerides, or low-density lipoprotein. Results Higher DRR (> 1.73) was an independent predictor of 1-year mortality in multivariate Cox regression analysis (hazard ratio 3.423, 95% CI 1.481–7.911, p = .004). Patients with higher DRR more often required the use of mechanical ventilation and readmission for acute exacerbation of PM/DM-ILD at 1-year follow-up. Conclusion Higher DRR on admission for PM/DM-ILD patients are associated with increased mortality, risk of mechanical ventilation, and hospitalization in 1-year follow-up. This low-cost, easy-to-obtain, rapidly measured biomarker may be useful in the identification of high-risk PM/DM-ILD patients that could benefit from intensive management.

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The Role of Atherosclerotic Cardiovascular Risk Enhancers in the Prediction of Cardiovascular Events: Tehran Lipid and Glucose Study

10.21203/rs.3.rs-80674/v1 ◽

2020 ◽

Author(s):

Farzad Hadaegh ◽

Samaneh Asgari ◽

Fatemeh Moosaie ◽

Meysam Orangi ◽

Farzaneh Sarvghadi ◽

...

Keyword(s):

Cardiovascular Disease ◽

Predictive Power ◽

Cox Regression ◽

Disease Risk ◽

Cardiovascular Disease Risk ◽

Density Lipoprotein ◽

Added Value ◽

Atherosclerotic Cardiovascular Disease ◽

Cox Regression Analysis

Abstract Background: To assess the effect of the atherosclerotic cardiovascular disease risk enhancing factors (ASCVD-REFs) on incident cardiovascular disease (CVD) events among non-diabetic individuals with borderline and intermediate ACC/AHA score during 10 and 15-year follow-up. Moreover, the added value of these ASCVD-REFs on the predictive power of the pooled cohort equations (PCE) was examined. Methods: A total of 1204 adults aged 40-75 years, free from CVD at baseline with low-density lipoprotein cholesterol (LDL-C) between 70-189 mg/dl, were included. Unadjusted Cox regression analysis was used. The predictive ability of each significant ASCVD-REFs was estimated using the cut-point-free integrated discrimination improvement (IDI).Results: During 10-year follow up, 181 CVD events (including 73 hard CVD) occurred. For hard CVD events, the high blood pressure (BP) component (i.e. ≥130/85 mmHg) of metabolic syndrome (Mets) (Hazard ratio: HR (95% CI; 1.67(1.03-2.70)) and positive history of preeclampsia (5.06(1.17-22.0)) were significant ASCVD-REFs. During the longer follow-up, Mets and its components of high waist circumference (WC) and high BP significantly increased the risk. As for CVD events, the Mets and its high BP and high WC components significantly increased the risk. However, in the ACC/AHA adjusted score, these covariates did not significantly improve the predictive power of the CVD or hard CVD. Conclusions: The high BP was the most consistent and independent ASCVD-REFs in the prediction of all CVD and hard CVD, among the population with borderline/intermediate risk. Hence, considering pharmacologic therapies for patients with high BP and high LDL-C might be beneficial for preventive initiatives.

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Does Hospitalization Predict the Disease Course in Ulcerative Colitis? Prevalence and Predictors of Hospitalization and Re- Hospitalization in Ulcerative Colitis in a Population-based Inception Cohort (2000-2012)

Journal of Gastrointestinal and Liver Diseases ◽

10.15403/jgld.2014.1121.243.pag ◽

2015 ◽

Vol 24 (3) ◽

pp. 287-292 ◽

Cited By ~ 5

Author(s):

Petra A. Golovics ◽

Laszlo Lakatos ◽

Michael D. Mandel ◽

Barbara D. Lovasz ◽

Zsuzsanna Vegh ◽

...

Keyword(s):

Ulcerative Colitis ◽

Cox Regression ◽

Diagnostic Procedures ◽

Population Based ◽

Disease Course ◽

Inception Cohort ◽

Disease Extent ◽

Cox Regression Analysis ◽

Hospitalization Rates

Background & Aims: Limited data are available on the hospitalization rates in population-based studies. Since this is a very important outcome measure, the aim of this study was to analyze prospectively if early hospitalization is associated with the later disease course as well as to determine the prevalence and predictors of hospitalization and re-hospitalization in the population-based ulcerative colitis (UC) inception cohort in the Veszprem province database between 2000 and 2012. Methods: Data of 347 incident UC patients diagnosed between January 1, 2000 and December 31, 2010 were analyzed (M/F: 200/147, median age at diagnosis: 36, IQR: 26-50 years, follow-up duration: 7, IQR 4-10 years). Both in- and outpatient records were collected and comprehensively reviewed. Results: Probabilities of first UC-related hospitalization were 28.6%, 53.7% and 66.2% and of first re-hospitalization were 23.7%, 55.8% and 74.6% after 1-, 5- and 10- years of follow-up, respectively. Main UC-related causes for first hospitalization were diagnostic procedures (26.7%), disease activity (22.4%) or UC-related surgery (4.8%), but a significant percentage was unrelated to IBD (44.8%). In Kaplan-Meier and Cox-regression analysis disease extent at diagnosis (HR extensive: 1.79, p=0.02) or at last follow-up (HR: 1.56, p=0.001), need for steroids (HR: 1.98, p<0.001), azathioprine (HR: 1.55, p=0.038) and anti-TNF (HR: 2.28, p<0.001) were associated with the risk of UC-related hospitalization. Early hospitalization was not associated with a specific disease phenotype or outcome; however, 46.2% of all colectomies were performed in the year of diagnosis. Conclusion: Hospitalization and re-hospitalization rates were relatively high in this population-based UC cohort. Early hospitalization was not predictive for the later disease course.

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Red Blood Cell Indices in Relation to Post-stroke Psychiatric Disorders: A Longitudinal Study in a Follow-up Stroke Clinic

Current Neurovascular Research ◽

10.2174/1567202617666200423090958 ◽

2020 ◽

Vol 17 (3) ◽

pp. 218-223

Author(s):

Haichao Wang ◽

Li Gong ◽

Xiaomei Xia ◽

Qiong Dong ◽

Aiping Jin ◽

...

Keyword(s):

Regression Analysis ◽

Ischemic Stroke ◽

Blood Cell ◽

Cox Regression ◽

Depression And Anxiety ◽

Cox Regression Analysis ◽

Post Stroke ◽

Rbc Indices ◽

Post Stroke Depression

Background: Depression and anxiety after stroke are common conditions that are likely to be neglected. Abnormal red blood cell (RBC) indices may be associated with neuropsychiatric disorders. However, the association of RBC indices with post-stroke depression (PSD) and poststroke anxiety (PSA) has not been sufficiently investigated. Methods: We aimed to investigate the trajectory of post-stroke depression and anxiety in our follow- up stroke clinic at 1, 3, and 6 months, and the association of RBC indices with these. One hundred and sixty-two patients with a new diagnosis of ischemic stroke were followed up at 1, 3, and 6 months, and underwent Patient Health Questionnaire-9 (PHQ-9) and the general anxiety disorder 7-item (GAD-7) questionnaire for evaluation of depression and anxiety, respectively. First, we used Kaplan-Meier analysis to investigate the accumulated incidences of post-stroke depression and post-stroke anxiety. Next, to explore the association of RBC indices with psychiatric disorders after an ischemic stroke attack, we adjusted for demographic and vascular risk factors using multivariate Cox regression analysis. Results: Of the 162 patients with new-onset of ischemic stroke, we found the accumulated incidence rates of PSD (1.2%, 17.9%, and 35.8%) and PSA (1.2%, 13.6%, and 15.4%) at 1, 3, and 6 months, respectively. The incident PSD and PSA increased 3 months after a stroke attack. Multivariate Cox regression analysis indicated independent positive associations between PSD risk and higher mean corpuscular volume (MCV) (OR=1.42, 95% CI=1.16-1.76), older age (OR=2.63, 95% CI=1.16-5.93), and a negative relationship between male sex (OR=0.95, 95% CI=0.91-0.99) and PSA. Conclusion: The risks of PSD and PSA increased substantially 3 months beyond stroke onset. Of the RBC indices, higher MCV, showed an independent positive association with PSD.

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P-Cresyl Sulfate Is a Valuable Predictor of Clinical Outcomes in Pre-ESRD Patients

BioMed Research International ◽

10.1155/2014/526932 ◽

2014 ◽

Vol 2014 ◽

pp. 1-7 ◽

Cited By ~ 7

Author(s):

Cheng-Jui Lin ◽

Chi-Feng Pan ◽

Chih-Kuang Chuang ◽

Fang-Ju Sun ◽

Duen-Jen Wang ◽

...

Keyword(s):

Clinical Outcomes ◽

Cardiovascular Event ◽

Cox Regression ◽

Medical Center ◽

Serum Biochemistry ◽

Cox Regression Analysis ◽

Kaplan Meier ◽

Valuable Marker ◽

Valuable Predictor

Background/Aims. Previous studies have reported p-cresyl sulfate (PCS) was related to endothelial dysfunction and adverse clinical effect. We investigate the adverse effects of PCS on clinical outcomes in a chronic kidney disease (CKD) cohort study.Methods. 72 predialysis patients were enrolled from a single medical center. Serum biochemistry data and PCS were measured. The clinical outcomes including cardiovascular event, all-cause mortality, and dialysis event were recorded during a 3-year follow-up.Results. After adjusting other independent variables, multivariate Cox regression analysis showed age (HR: 1.12,P=0.01), cardiovascular disease history (HR: 6.28,P=0.02), and PCS (HR: 1.12,P=0.02) were independently associated with cardiovascular event; age (HR: 0.91,P<0.01), serum albumin (HR: 0.03,P<0.01), and PCS level (HR: 1.17,P<0.01) reached significant correlation with dialysis event. Kaplan-Meier analysis revealed that patients with higher serum p-cresyl sulfate (>6 mg/L) were significantly associated with cardiovascular and dialysis event (log rankP=0.03, log rankP<0.01, resp.).Conclusion. Our study shows serum PCS could be a valuable marker in predicting cardiovascular event and renal function progression in CKD patients without dialysis.

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