scholarly journals Association of Urinary Sodium Excretion and Left Ventricular Hypertrophy in People With Type 2 Diabetes Mellitus: A Cross-Sectional Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Jianfang Liu ◽  
Xiaoyu Yang ◽  
Peizhen Zhang ◽  
Dan Guo ◽  
Bingyan Xu ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Sodium Excretion ◽  
Ventricular Hypertrophy ◽  
Sodium Intake ◽  
Urinary Sodium Excretion ◽  
Left Ventricular ◽  
Urinary Sodium ◽  
Cross Sectional

BackgroundIt has been well documented that left ventricular hypertrophy (LVH) is highly associated with the incidence of cardiovascular disease (CVD). Evidence indicated that high sodium intake was closely related with LVH in general population. However, information is not available regarding the association between urinary sodium excretion and LVH in patients with type 2 diabetes mellitus (T2DM). This study aimed to explore the association between urinary sodium excretion and LVH in patients with T2DM.MethodsThis cross-sectional analysis included baseline data from 1,556 individuals with T2DM enrolled in the NanFang Prospective Diabetes Study (NFPDS). Urinary sodium excretion levels were measured from 24-hour urine samples of inpatients and morning fasting urine samples of outpatients. Left ventricular dimensions were assessed by echocardiography. The associations between urinary sodium excretion and the risks of cardiovascular events, LVH and left ventricular mass index (LVMI) were examined using linear regression analysis, logistic regression and restricted cubic splines (RCS).ResultsUrinary sodium excretion levels were positively associated with cardiometabolic risk factors, including systolic blood pressure, body mass index, waist circumference and LVMI (All P<0.001). Odds ratios of the highest quartile of urinary sodium excretion compared with the lowest quartile were 1.80 (95% CI, 1.28-2.54; P=0.001) for LVH and 1.77 (95% CI, 1.06-2.94; P=0.028) for CVD, after adjusted for demographics, lifestyle risk factors and cardiovascular risk factors. Multivariable-adjusted RCS analysis of the association between urinary sodium excretion and LVMI showed a significant association (P=0.001) and lacked evidence of a nonlinear association (P=0.406).ConclusionThis study indicated that high urinary sodium excretion was independently associated with increased risk of LVH and CVD in patients with T2DM, suggesting that control of sodium intake may be valuable for the prevention of diabetic cardiovascular complications.

scholarly journals Association of Urinary Sodium Excretion and Left Ventricular Hypertrophy in Patients With Type 2 Diabetes: A Cross-Section Study

2021 ◽  
Author(s):  
Jianfang Liu ◽  
Dan Guo ◽  
Peizhen Zhang ◽  
Xiaoyu Yang ◽  
Jiayang Lin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Logistic Regression ◽  
Sodium Excretion ◽  
Ventricular Hypertrophy ◽  
Sodium Intake ◽  
Urinary Sodium Excretion ◽  
Left Ventricular ◽  
Urinary Sodium

Abstract Background: It has been well documented that left ventricular hypertrophy (LVH) is highly associated with incidence of cardiovascular disease (CVD). Evidence indicated that high sodium intake has been observed related with LVH in general population. However, information is not available regarding the association between urinary sodium excretion and LVH in patients with type 2 diabetes (T2DM). This study aimed to explore the association between urinary sodium excretion and LVH in patients with T2DM.Methods: A total of 1356 patients with T2DM were recruited. Urinary sodium was measured from 24-hour urine samples of inpatients and morning fasting urine samples of outpatients. LVH was assessed by echocardiography. The associations between urinary sodium excretion and the risk factors for cardiovascular events, LVH and left ventricular mass index (LVMI) were examined using linear regression analysis, logistic regression and restricted cubic splines.Results: Urinary sodium excretion levels was positively associated with cardiometabolic risk factors, including systolic blood pressure (P<0.001), body mass index (P<0.001), waist circumference (P<0.001) and LVMI (P<0.001). In multivariable logistic regression analyses, increased urinary sodium excretion were significantly associated with increased risks of LVH [OR (95% CI), 1.47 (1.02-2.10); P=0.037] and CVD [OR (95% CI), 2.08 (1.20-3.61); P=0.009], after adjusted for demographics, lifestyle risk factors and cardiovascular risk factors. Multivariable-adjusted restricted cubic spline analyses of the association between urinary sodium excretion and LVMI showed a significant association (P=0.002) and provided no evidence of a nonlinear association (P=0.135).Conclusions: This study indicated that high urinary sodium excretion was independently associated with increased risk of LVH and CVD in patients with T2DM, suggesting that control of sodium intake is valuable in the prevention of diabetic cardiovascular complications.

scholarly journals Urine Spot Samples Can Be Used to Estimate 24-Hour Urinary Sodium Excretion in Children

2018 ◽  
Vol 148 (12) ◽  
pp. 1946-1953 ◽  
Author(s):  
Magali Rios-Leyvraz ◽  
Pascal Bovet ◽  
René Tabin ◽  
Bernard Genin ◽  
Michel Russo ◽  
...  
Keyword(s):  
Sodium Excretion ◽  
Salt Intake ◽  
Sodium Intake ◽  
Population Level ◽  
Urinary Sodium Excretion ◽  
Cross Sectional Study ◽  
Urinary Sodium ◽  
Cross Sectional ◽  
High Sodium ◽  
Individual Level

ABSTRACT Background The gold standard to assess salt intake is 24-h urine collections. Use of a urine spot sample can be a simpler alternative, especially when the goal is to assess sodium intake at the population level. Several equations to estimate 24-h urinary sodium excretion from urine spot samples have been tested in adults, but not in children. Objective The objective of this study was to assess the ability of several equations and urine spot samples to estimate 24-h urinary sodium excretion in children. Methods A cross-sectional study of children between 6 and 16 y of age was conducted. Each child collected one 24-h urine sample and 3 timed urine spot samples, i.e., evening (last void before going to bed), overnight (first void in the morning), and morning (second void in the morning). Eight equations (i.e., Kawasaki, Tanaka, Remer, Mage, Brown with and without potassium, Toft, and Meng) were used to estimate 24-h urinary sodium excretion. The estimates from the different spot samples and equations were compared with the measured excretion through the use of several statistics. Results Among the 101 children recruited, 86 had a complete 24-h urine collection and were included in the analysis (mean age: 10.5 y). The mean measured 24-h urinary sodium excretion was 2.5 g (range: 0.8–6.4 g). The different spot samples and equations provided highly heterogeneous estimates of the 24-h urinary sodium excretion. The overnight spot samples with the Tanaka and Brown equations provided the most accurate estimates (mean bias: −0.20 to −0.12 g; correlation: 0.48–0.53; precision: 69.7–76.5%; sensitivity: 76.9–81.6%; specificity: 66.7%; and misclassification: 23.0–27.7%). The other equations, irrespective of the timing of the spot, provided less accurate estimates. Conclusions Urine spot samples, with selected equations, might provide accurate estimates of the 24-h sodium excretion in children at a population level. At an individual level, they could be used to identify children with high sodium excretion. This study was registered at clinicaltrials.gov as NCT02900261.

scholarly journals High Dietary Salt Intake in Pediatric Patients with Type 1 Diabetes Mellitus Not Related to Overweight and Obesity

2020 ◽  
pp. 1-5
Author(s):  
Angela Zanfardino ◽  
Angela Zanfardino ◽  
Pierluigi Marzuillo ◽  
Linda Sessa ◽  
Assunta S Rollato ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Children And Adolescents ◽  
Sodium Excretion ◽  
Salt Intake ◽  
Sodium Intake ◽  
Urinary Sodium Excretion ◽  
Urinary Sodium

Aim: People around the world are consuming much more sodium than is physiologically necessary. A number of studies suggest that dietary sodium intake is related to weight gain. The aim of our study was to evaluate in a population of children and adolescents with type 1 diabetes mellitus, possible correlations between the urinary sodium excretion (UNa24h), indirect marker of sodium intake, and both duration of diabetes and BMI z-score. Moreover, we also evaluated the correlation between UNa24h and duration of diabetes according with the presence/absence of overweight/obesity. Research Design and Methods: Children and adolescents aged between 4 and 18 years with type 1 diabetes were consecutively enrolled from Regional Center for Pediatric Diabetes in Naples. Urinary sodium concentrations were tested in three 24 h urine samples of 68 individuals (204 tests). Results: Mean UNa24h was 141.3±68.2 mmol/24h corresponding to 8.1±3.9 gr of NaCl intake. Seventyfive percent of subjects aged between 4 and 6 years, 95% of subjects aged between 7 and 10 years and 79.5% of subjects aged between 11 and 18 years consume more salt of the LARN’s advice. Urinary sodium excretion increased in relation to the increase of duration, in years, of diabetes (p=0.0027). No statistically significant relationship is between UNa24h (mmol/24h) and zBMI (p=0.705). Conclusions: This study shows that young patients with type 1 diabetes have high levels of UNa24h. Given the close correlation between the UNa24h and salt intake we can conclude that they take more salt with their diet. High salt intake is not related to overweight but to diabetes duration.

scholarly journals Association of Urinary Sodium Excretion and Diabetic Kidney Disease in Patients With Type 2 Diabetes Mellitus: A Cross-Sectional Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Yan Huang ◽  
Wenhui Liu ◽  
Jianfang Liu ◽  
Dan Guo ◽  
Peizhen Zhang ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Kidney Disease ◽  
Sodium Excretion ◽  
Diabetic Kidney Disease ◽  
Urinary Sodium Excretion ◽  
Cross Sectional Study ◽  
Urinary Sodium ◽  
Sectional Study ◽  
Cross Sectional

BackgroundDiabetic kidney disease (DKD) is the leading cause of end-stage kidney disease worldwide. Epidemiological evidence of the association between urinary sodium excretion and the presence of DKD in patients with type 2 diabetes mellitus (T2DM) has not yet been well established.MethodsWe performed a cross-sectional study of 1545 patients with T2DM over aged 20 years old from January 2018 to December 2020. Urinary sodium excretion was measured by 24-hour urine samples in inpatients and morning fasting urine samples in outpatients. The associations between urinary sodium excretion and the risks of DKD were examined using stepwise regression analysis, logistic regression analysis and multivariable-adjusted restricted cubic splines (RCS).ResultsRegression analysis showed that urinary sodium was independently associated with urinary albumin to creatinine ratio (UACR) level (P = 0.006) and the risks of DKD (P = 0.042). In multivariable-adjusted RCS analysis, urinary sodium excretion was significantly associated with UACR in all patients (P = 0.008), and exhibited a J-shaped relationship. Logistic regression analysis showed that increased urinary sodium excretion was significantly associated with increased risks of DKD [OR (95% CI); 1.56 (1.07-2.27); P = 0.020]. However, the relationships between urinary sodium excretion and the risks of DKD and albuminuria showed no significance, after further adjustment for HOMA-IR and ba-PWV (brachial-ankle pulse wave velocity) (Both P &gt; 0.05).ConclusionsHigher urinary sodium excretion level was associated with increased risks of DKD among patients with T2DM, dependent of vascular sclerosis and insulin resistance.

ASSESSMENT OF DEMENTIA IN THE TYPE 2 DIABETES BY MOCA

2017 ◽  
pp. 35-44
Author(s):  
Dinh Toan Nguyen
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
High Sensitivity ◽  
Cross Sectional ◽  
Average Value ◽  
Lifestyle Risk ◽  
Diabetes Mellitus Risk

Background: Studies show that diabetes mellitus is the greatest lifestyle risk factor for dementia. Appropriate management and treatment of type 2 diabetes mellitus could prevent the onset and progression of mild cognitive impairment to dementia. MoCA test is high sensitivity with mild dementia but it have not been used and studied widespread in Vietnam. Aim: 1. Using MoCA and MMSE to diagnose dementia in patients with type 2 diabetes mellitus. 2. Assessment of the relationship between dementia and the risk factors. Methods: cross-sectional description in 102 patients with type 2 diabetes mellitus. The Mini-Mental State Examination(MMSE) and the Montreal Cognitive Assessment (MoCA) were used to assess cognitive function. The diagnosis of dementia was made according to Diagnostic and Statistical Manual of Mental Disorders. Results: The average value for MoCA in the group of patients with dementia (15.35 ± 2.69) compared with non-dementia group (20.72 ± 4.53). The sensitivity and specificity of MoCA were 84.8% and 78.3% in identifying individuals with dementia, and MMSE were 78.5% and 82.6%, respectively. Using DSMIV criteria as gold standard we found MoCA and MMSE were more similar for dementia cases (AUC 0.871 and 0.890). The concordance between MoCA and MMSE was moderate (kappa = 0.485). When considering the risk factors, the education,the age, HbA1c, dyslipidemia, Cholesterol total related with dementia in the type 2 diabetes. Conclusion: MoCA scale is a good screening test of dementia in patients with type 2 diabetes mellitus.When compared with the MMSE scale, MoCA scale is more sensitive in detecting dementia. Key words: MoCA, dementia, type 2 diabetes mellitus, risk factors

Bladder dysfunction in women with diabetes mellitus

2019 ◽  
pp. 34-40
Author(s):  
Thi Bich Ngoc Hoang ◽  
Hai Thuy Nguyen
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Bladder Dysfunction ◽  
Clinical Symptoms ◽  
Residual Volume ◽  
Cross Sectional ◽  
Diabetic Cystopathy ◽  
Postvoid Residual ◽  
Postvoid Residual Volume

Introduction: Lower urinary tract dysfunctions secondary to type 2 DM are common, chronic and costly disorders. The incidence of diabetic bladder dysfunction was estimated range between 43% and 87% for type 1 and 25% for type 2 diabetes. Ultrasonography is an easy-to-use, fast, safe, non-invasive, painless, pleasant and valuable method of assessing Bladder Post-Void Residual Volume (PVR). Aim: To investigate prevalence of bladder dysfunction and its relation with risk factors, clinical features of diabetic cystopathy in women with diabetes, to identify the values predicting to have postvoid residual volume of the risk factors. Methods: A cross sectional descriptive study, a cohort of 84 female inpatients and outpatients with diabetes mellitus who were treated at Hue University of Medicine and Pharmacy Hospital from 08/2017 to 08/2019 and 84 healthy control subjects were enrolled, the patients were carried out clinical finding, taken blood tests, and estimated postvoid residual volume using 2D ultrasound. Results: the postvoid residual volume was presented in 67 cases (79.80%), the clinical symptoms of diabetic cystopathy were reported in 75% of women with diabetes. Blood glucose, HbA1c, clinical symptoms of diabetic cystopathy, postural hypotension and diabetic peripheral neuropathy were associated with postvoid residual volume. The HbA1c level had a great capability to predict who had postvoid residual volume, at HbA1c cutoff value of 9.1%, Se 65.67%, Sp 94.12%, AUC 0.811, p < 0.001. Conclusion: Bladder dysfunction made up a highly prevalent in women with poor glycemic control. Key words: bladder dysfunction, diabetic cystopathy, bladder postvoid residual volume (PVR)

scholarly journals Association between 24-h urinary sodium and potassium excretion and blood pressure among Chinese adults aged 18–69 years

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Xiaofu Du ◽  
Le Fang ◽  
Jianwei Xu ◽  
Xiangyu Chen ◽  
Yamin Bai ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Sodium Excretion ◽  
Sodium Intake ◽  
Urinary Sodium Excretion ◽  
Urinary Sodium ◽  
Inverse Association ◽  
Potassium Excretion ◽  
Chinese Adults ◽  
Potassium Intake ◽  
Sodium And Potassium

AbstractThe direction and magnitude of the association between sodium and potassium excretion and blood pressure (BP) may differ depending on the characteristics of the study participant or the intake assessment method. Our objective was to assess the relationship between BP, hypertension and 24-h urinary sodium and potassium excretion among Chinese adults. A total of 1424 provincially representative Chinese residents aged 18 to 69 years participated in a cross-sectional survey in 2017 that included demographic data, physical measurements and 24-h urine collection. In this study, the average 24-h urinary sodium and potassium excretion and sodium-to-potassium ratio were 3811.4 mg/day, 1449.3 mg/day, and 4.9, respectively. After multivariable adjustment, each 1000 mg difference in 24-h urinary sodium excretion was significantly associated with systolic BP (0.64 mm Hg; 95% confidence interval [CI] 0.05–1.24) and diastolic BP (0.45 mm Hg; 95% CI 0.08–0.81), and each 1000 mg difference in 24-h urinary potassium excretion was inversely associated with systolic BP (− 3.07 mm Hg; 95% CI − 4.57 to − 1.57) and diastolic BP (− 0.94 mm Hg; 95% CI − 1.87 to − 0.02). The sodium-to-potassium ratio was significantly associated with systolic BP (0.78 mm Hg; 95% CI 0.42–1.13) and diastolic BP (0.31 mm Hg; 95% CI 0.10–0.53) per 1-unit increase. These associations were mainly driven by the hypertensive group. Those with a sodium intake above about 4900 mg/24 h or with a potassium intake below about 1000 mg/24 h had a higher risk of hypertension. At higher but not lower levels of 24-h urinary sodium excretion, potassium can better blunt the sodium-BP relationship. The adjusted odds ratios (ORs) of hypertension in the highest quartile compared with the lowest quartile of excretion were 0.54 (95% CI 0.35–0.84) for potassium and 1.71 (95% CI 1.16–2.51) for the sodium-to-potassium ratio, while the corresponding OR for sodium was not significant (OR, 1.28; 95% CI 0.83–1.98). Our results showed that the sodium intake was significantly associated with BP among hypertensive patients and the inverse association between potassium intake and BP was stronger and involved a larger fraction of the population, especially those with a potassium intake below 1000 mg/24 h should probably increase their potassium intake.

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