scholarly journals Homocysteine Plasmatic Concentration in Brain-Injured Neurocritical Care Patients: Systematic Review of Clinical Evidence

2022 ◽  
Vol 11 (2) ◽  
pp. 394
Author(s):  
Maria Paola Lauretta ◽  
Rita Maria Melotti ◽  
Corinne Sangermano ◽  
Anneliya Maria George ◽  
Rafael Badenes ◽  
...  

Background: Hyperhomocysteinemia (HHcy) is considered as an independent risk factor for several diseases, such as cardiovascular, neurological and autoimmune conditions. Atherothrombotic events, as a result of endothelial dysfunction and increased inflammation, are the main mechanisms involved in vascular damage. This review article reports clinical evidence on the relationship between the concentration of plasmatic homocysteine (Hcy) and acute brain injury (ABI) in neurocritical care patients. Materials and methods: a systematic search of articles in the PubMed and EMBASE databases was conducted, of which only complete studies, published in English in peer-reviewed journals, were included. Results: A total of 33 articles, which can be divided into the following 3 subchapters, are present: homocysteine and acute ischemic stroke (AIS); homocysteine and traumatic brain injury (TBI); homocysteine and intracranial hemorrhage (ICH)/subarachnoid hemorrhage (SAH). This confirms that HHcy is an independent risk factor for ABI and a marker of poor prognosis in the case of stroke, ICH, SAH and TBI. Conclusions: Several studies elucidate that Hcy levels influence the patient’s prognosis in ABI and, in some cases, the risk of recurrence. Hcy appears as biochemical marker that can be used by neuro-intensivists as an indicator for risk stratification. Moreover, a nutraceutical approach, including folic acid, the vitamins B6 and B12, reduces the risk of thrombosis, cardiovascular and neurological dysfunction in patients with severe HHcy that were admitted for neurocritical care.

2017 ◽  
Vol 54 (6) ◽  
pp. 705-711 ◽  
Author(s):  
N. V. Toroptsova ◽  
A. Yu. Feklistov

The paper discusses the materials of investigations dealing with falls as an independent risk factor for fractures in patients with rheumatoid arthritis (RA). It gives data on the incidence and possible risk factors of falls in this category of patients. According to the data obtained, the prevalence of falls in different countries varies from 10 to 50%, which may be related to differences in the methods of collecting information, and the relationship of the investigated factors with the risk of falls in patients with RA is uniquely unproven and calls for further investigations.


Neurology ◽  
2013 ◽  
Vol 81 (1) ◽  
pp. 33-39 ◽  
Author(s):  
J. F. Burke ◽  
J. L. Stulc ◽  
L. E. Skolarus ◽  
E. D. Sears ◽  
D. B. Zahuranec ◽  
...  

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Ping Zhang ◽  
Ying Wang ◽  
Xi Yao ◽  
Shaohua Chen ◽  
Chunping Xu ◽  
...  

Abstract Background and Aims The volume factor of maintenance hemodialysis patients is closely related to the prognosis. We hypothesized that the excess weight after dialysis (end-dialysis over-weight, edOW) is an important factor of volume impact survival in hemodialysis (HD) patients. The purpose of this study was to analyze the relationship between edOW and long-term prognosis of patients with maintenance hemodialysis. Method This retrospective study observed incident hemodialysis patients who treated in Kidney Disease Center, the First Affiliated Hospital, College of Medicine, Zhejiang University from January 1, 2008 to April 30, 2017, three times a week for at least one year. The end point of follow-up was death, abdominal dialysis, kidney transplantation, transfer or until April 30, 2018. The general data of the patients included age, gender, BMI, primary renal disease, CVD, first hemodialysis access, albumin(Alb), Haemoglobin(Hb), blood pressure, heart rate, ultrafiltration rate(UFR), interdialytic weight gain IDWG, end -dialysis overweight (edOW). Cox multivariate regression was used to analyze the relationship between edow and all-cause mortality and cardiovascular mortality. Results Totally 469 patients male, 64% were enrolled, with an average age of 56.9 ± 17.1 years. During the follow-up period, 102 patients died. The main cause of death was cardiovascular and cerebrovascular events, accounting for 44.7%. The mean value of edow was 0.28 ± 0.02 kg. Kaplan-Meier(Log-rank test) survival analysis showed that the long-term survival rate of the group with edow ≤ 0.28kg was better than that of the group with edow > 0.28kg (P = 0.042), and the cardiovascular mortality of the group with edow > 0.28kg was significantly higher than that of the group with edow ≤ 0.28kg (P = 0.001). Cox multivariate regression analysis showed that edow was an independent risk factor for all-cause death in hemodialysis patients (P = 0.025, AhR = 1.541, 95% CI 1.057-2.249), and also an independent risk factor for CVD death in hemodialysis patients (P = 0.007, AhR = 1.929, 95% CI 1.198-3.107). Conclusion EdOW is an independent risk factor of long-term all-cause and cardiovascular death in hemodialysis patients.


2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Siwen Zhang ◽  
Yujia Liu ◽  
Gang Wang ◽  
Xianchao Xiao ◽  
Xiaokun Gang ◽  
...  

Aim. The relationship between alcohol consumption and glycometabolic abnormality is controversial, especially in different ethnic population. In this study, a cross-sectional survey was carried out to examine the relationship between alcohol consumption and glycometabolic abnormality in middle-aged and elderly Chinese men. Methods. Using cluster random sampling, Chinese men aged more than 40 years from Changchun, China, were given standardized questionnaires. In total, 1996 individuals, for whom complete data was available, were recruited into the study. We calculated the incidence of prediabetes and newly diagnosed diabetes by three levels of alcohol consumption: light, moderate, and heavy. Multivariate logistic regression models adjusted for socioeconomic variables and diabetes-related risk factors were used to analyze the association between alcohol consumption and the onset of prediabetes and diabetes. Results. The univariate analysis revealed higher incidence of prediabetes among drinkers (32.8%) compared with nondrinkers (28.6%), particularly in heavy alcohol consumers. The logistic regression analysis showed that alcohol consumption, especially heavy consumption, was an independent risk factor for prediabetes. Conclusions. Alcohol consumption, heavy consumption in particular, is an independent risk factor for the development of prediabetes, but not for diabetes.


2018 ◽  
Vol 1 (3) ◽  
Author(s):  
Xinzheng Wang ◽  
Hongbin Luo

Objective This study aims to explore the relationship between sedentary behavior and the diabetes mellitus prevalence of middle-aged and elderly people. Methods  we conduct a questionnaire survey and physical examination for a total of 3,000 middle-aged and elderly people (≥45 years old) ,analysing by he software of  SPSS21.0 and Stata12.0. Results The logistic regression analysis shows that the risk of diabetes is 1.617 (95% CI, 0.762-1.789, P <0.05) at 2-4h, 4-6h, 6-8h, ≥8h, = 0.003), 1.235 (95% CI, 0.818-1.865, P = 0.034), 3.420 (95% CI, 2.241-5.218, P = 0.000), 5.014 (95% CI, 3.049-8.247, P = 0.000). With each additional one-hour sedentariness the risk of diabetes increases by 23% (OR1.23, 95% CI 1.18-1.29, p <0.0001). Conclusions The sedentary behavior is an independent risk factor for diabetes. The prevalence of diabetes is gradually increasing with the increase of sedentary time, which indicates the longer sedentary time, the higher prevalence of diabetes.


2021 ◽  
Author(s):  
Quan Zhang ◽  
Luyao Dong ◽  
Hongling Han

Abstract Background IgA Nephropathy (IgAN) is one of the most common glomerular diseases. However, the effect of uric acid on the prognosis of IgAN is still unclear, especially between males and females. Therefore, the present study aimed to explore the role of hyperuricemia in IgAN patients and the differences in gender. Consequently, the study conducted a retrospective analysis of the prognosis of IgAN in patients from the General Hospital of Tianjin Medical University. Methods: A total of 1,022 patients with primary IgAN, diagnosed through renal biopsy were enrolled from the Department of Nephrology, General Hospital of Tianjin Medical University. However, after applying the exclusion criteria, only 463 patients remained and were regularly followed up in the hospital. In addition, the relationship between Time Average Uric Acid (TA-UA) and prognosis of IgAN was analyzed. Results: The findings showed that TA-UA was an independent risk factor for the prognosis of IgAN in the 463 patients studied (OR=1.752,95%CI=1.348-2.277,p<0.001). Additionally, higher TA-UA values were associated with a faster progression of disease and worse prognosis (p < 0.05). Elevated TA-UA was also shown to be an independent risk factor for the progression of disease in female patients but not in their male counterparts (women: HR=1.998,95%CI=1.398-2.854,p<0.001,men: HR=1.405,95%CI=0.869-2.274, p=0.166). Conclusion: Increased TA-UA is an independent risk factor for the progression of IgAN, especially in women.


2018 ◽  
Vol 3 (2) ◽  
pp. 81
Author(s):  
Muhammad Haris ◽  
Hariadi Hariawan ◽  
Muhamad Taufik Ismail ◽  
Abdus Samik Wahab

Background: Atherosclerosis is a fundamental process in the natural course of coronary heart disease (CHD), carotid artery disease and peripheral artery disease. Atherosclerosis is caused by an imbalance of homeostasis in the level of the endothelial layer and the presence of risk factors. The manifestations of coronary atherosclerosis have a wide spectrum of diseases, ranging from subclinical to clinical phases. In patients without CHD symptoms, changes incarotid artery morphology include carotid intimal-media thickness (CIMT) and carotid plaques which correlated with CHD. This study aims to see the relationship between CIMT with the severity of coronary lesions in stable coronary artery disease.Methods: The study was an analytical observational research using cross sectional design. Data was taken by consecutive sampling from outpatient hospital clinic. The CIMT score was obtained from the examination of a communis carotid artery using a B-mode ultrasound device. The value ofCIMT is divided into 2 groups based on the value of the sensitivity curve and the specifcity curve. The value of Syntax was obtained from the catheterization laboratory and the factors that influenced it were recorded. Pearson correlation test is used to analyze the relationship of CIMT and Syntax value. The logistic regression test used for multivariate test.Results: Of the 58 patients, there were 33 subjects who had a CIMT score of > 0.71 mm and 25 subjects who had a CIMT score of ≤0.71 mm. There is a positive correlation (r = 0.403; p <0.05) between CIMT value and Syntax value. Subjects who have high Syntax value in the group with a CIMT value >0.71 mm compared to CIMT values ≤0.71 mm were 29 versus 4 (RR: 1.831; CI 95%:1.194-2.807; p = 0.01). A multivariate test showed CIMT consistently as a independent risk factor of Syntax value in stable coronary artery disease with RP 5.27 (CI 95%: 1.306-25.047; p = 0.021).Conclusion: The increase in CIMT value has a signifcant positive correlation with the Syntax value. A CIMT > 0.71 mm is a independent risk factor of high Syntax value in stable coronary artery disease with prevalence ratio 5.27


2020 ◽  
Vol 2020 ◽  
pp. 1-11 ◽  
Author(s):  
Jiajia Wang ◽  
Wenjuan Li ◽  
Chuan Wang ◽  
Lingshu Wang ◽  
Tianyi He ◽  
...  

Background. More and more studies focus on the relationship between the gastrointestinal microbiome and type 2 diabetes, but few of them have actually explored the relationship between enterotypes and type 2 diabetes. Materials and Methods. We enrolled 134 patients with type 2 diabetes and 37 nondiabetic controls. The anthropometric and clinical indices of each subject were measured. Fecal samples of each subject were also collected and were processed for 16S rDNA sequencing. Multiple logistic regression analysis was used to determine the associations of enterotypes with type 2 diabetes. Multiple linear regression analysis was used to explore the relationship between lipopolysaccharide levels and insulin sensitivity after adjusting for age, BMI, TG, HDL-C, DAO, and TNF-α. The correlation analysis between factors and microbiota was identified using Spearman correlation analysis. The correlation analysis between factors was identified using partial correlation analysis. Results. Gut microbiota in type 2 diabetes group exhibited lower bacterial diversity compared with nondiabetic controls. The fecal communities from all subjects clustered into two enterotypes distinguished by the levels of Bacteroides and Prevotella. Logistic regression analysis showed that the Bacteroides enterotype was an independent risk factor for type 2 diabetes by decreasing insulin sensitivity. The levels of lipopolysaccharide and tumor necrosis factor-alpha were higher in the Bacteroides enterotype compared to the Prevotella enterotype. Partial correlation analysis showed that lipopolysaccharide was closely associated with diamine oxidase, tumor necrosis factor-alpha, and Gutt insulin sensitivity index after adjusting for multiple covariates. Furthermore, the level of lipopolysaccharide was found to be an independent risk factor for insulin sensitivity. Conclusions. We identified two enterotypes, Bacteroides and Prevotella, among all subjects. Our results showed that the Bacteroides enterotype was an independent risk factor for type 2 diabetes, which was due to increased levels of lipopolysaccharide causing decreased insulin sensitivity.


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