scholarly journals Associations of Cardiovascular and All-Cause Mortality with Metabolic Syndrome in Hemodialysis Patients: A Prospective Single-Center Study

Medicina ◽  
2019 ◽  
Vol 55 (10) ◽  
pp. 694
Author(s):  
Zorica Dimitrijevic ◽  
Andriana Jovanovic ◽  
Mina Cvetkovic ◽  
Tamara Vrecic ◽  
Emina Kostic ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Metabolic Syndrome ◽  
Metabolic Disorders ◽  
Cardiometabolic Risk ◽  
Hemodialysis Patients ◽  
Chronic Hemodialysis ◽  
Single Center Study ◽  
All Cause Mortality

Background and objectives: Metabolic syndrome (MetS) is a cluster of risk factors, such as abdominal obesity, insulin resistance, dyslipidemia and hypertension, that together increase the risk of cardiovascular disease. Chronic hemodialysis (HD) patients have multiple comorbidities and many metabolic disorders, causing the frequent occurrence of metabolic syndrome. The goal of this study was to assess the prevalence of MetS in HD patients, and its association with all-cause and cardiovascular (CV) mortality. Patients and methods: A total of 138 HD patients were included in this prospective study. We analyzed demographic, anthropometric and biochemical data. Outcome measures were all-cause and CV mortality during the three-year follow-up. Results: MetS was diagnosed in 57.24% of enrolled patients. During the 36 months of follow-up, 33 patients died. MetS patients showed a significantly higher mortality rate than non-MetS (30.4% versus 16.36%, p < 0.001). The association of different MetS components with cardiovascular mortality reached significance when a minimum of three components were present (1.81 (95% confidence interval CI = 1.21–2.33)), with a grouped increase in effect size for subjects with four or five MetS components. Subjects with MetS exhibited nearly twice as high risk for all-cause (hazard ratio HR = 1.99 (95%CI) = 1.42–2.97) and 2.5 times for CV (HR = 2.51 (95%CI) = 1.25–3.83) mortality compared with those without MetS, after adjustment for age, gender, and cardiovascular disease. Conclusions: The study demonstrates that MetS is widespread in HD patients. In future, the focus must be on an active screening approach, and treatment of cardiometabolic risk factors, aiming to reduce mortality.

Predictors of Survival in Chronic Hemodialysis Patients: A 10-Year Longitudinal Follow-Up Analysis

2021 ◽  
Vol 52 (2) ◽  
pp. 108-118
Author(s):  
Takuhiro Moromizato ◽  
Kentaro Kohagura ◽  
Kiyoyuki Tokuyama ◽  
Yoshiki Shiohira ◽  
Shigeki Toma ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cox Regression ◽  
Significant Risk ◽  
Hemodialysis Patients ◽  
Chronic Hemodialysis ◽  
Regression Analyses ◽  
All Cause Mortality ◽  
History Of ◽  
The Impact

<b><i>Background:</i></b> Risk factors of mortality in chronic hemodialysis patients have not yet been sufficiently evaluated. In particular, chronological transits and interactions of the impact of risk factors have rarely been described. <b><i>Methods:</i></b> This study is a post hoc analysis of the participants in the Olme­sartan Clinical Trial in Okinawan Patients under OKIDS (OCTOPUS) study conducted between June 2006 and June 2011. We additionally followed up on the prognosis of the participants until July 31, 2018. Standardized univariable and multivariable Cox regression analyses were used to evaluate the influences of the participants’ baseline characteristics on all-cause mortality. We also evaluated chronological changes in the impacts of risk factors, interactions among predictors, and the influence of missing values using sensitivity analyses. <b><i>Results:</i></b> Of the 469 original trial participants, 461 participants were evaluated. The median time of follow-up was 10.2 years. A total of 211 (45.8%) participants were deceased. The leading causes of death were infection (<i>n</i> = 72, 34.1%) and cardiovascular disease (<i>n</i> = 66, 31.3%). Univariate and multivariate Cox regression analyses revealed that the impact of diabetes mellitus, history of coronary intervention, and hypoalbuminemia were significant risk factors for mortality during the whole follow-up period. During the early follow-up period (≤3 years), standardized univariate Cox regression analyses revealed that history of amputation (hazard ratio [HR] = 4.61, <i>p</i> &#x3c; 0.001), lower dry weight, higher cardiothoracic ratio, and lower potassium levels were statistically significant risks. In those who survived for longer than 3 years, a history of stroke (HR = 1.73, <i>p =</i> 0.006), higher systolic blood pressure, lower serum sodium levels, and higher levels of hemoglobin, and serum phosphate were significant risks. We also observed a stable interaction between the impacts of serum phosphate and albumin on all-cause mortality. <b><i>Conclusion:</i></b> In chronic hemodialysis patients, targets to improve the short-term prognosis and long-term prognosis are not equivalent. Hyperphosphatemia was a significant risk factor for the all-cause mortality among patients with normal serum albumin levels but not among patients with compromised albumin levels.

scholarly journals Cardiac Troponin T Predicts Long-Term Outcomes in Hemodialysis Patients

2001 ◽  
Vol 47 (3) ◽  
pp. 412-417 ◽  
Author(s):  
Daylily S Ooi ◽  
Deborah Zimmerman ◽  
Janet Graham ◽  
George A Wells
Keyword(s):  
Troponin I ◽  
Troponin T ◽  
Hemodialysis Patients ◽  
Chronic Hemodialysis ◽  
Peripheral Vascular ◽  
Long Term Outcomes ◽  
All Cause Mortality ◽  
End Stage

Abstract Background: Increased plasma troponin T (cTnT), but not troponin I (cTnI), is frequently observed in end-stage renal failure patients. Although generally considered spurious, we previously reported an associated increased mortality at 12 months. Methods: We studied long-term outcomes in 244 patients on chronic hemodialysis for up to 34 months, correlating the outcomes to plasma cTnT in routine predialysis samples. In addition, subsequent plasma samples at least 1 year later and within 6 months of data analysis were available in 97 patients and were used to identify patients with increasing plasma cTnT. The endpoints used were death and new or worsening coronary, cerebro-, and peripheral vascular disease and neuropathy. Results: Transplantation occurred more frequently in patients with low initial cTnT: 31%, 13%, and 3% in the groups with cTnT &lt;0.010, 0.010–0.099, and ≥0.100 μg/L, respectively. In the same groups, total deaths occurred in 6%, 43%, and 59% and cardiac deaths in 0%, 14%, and 24% of patients. In patients with follow-up samples, the group with increasing cTnT had a significantly increased death (relative risk, 2.0; P = 0.028). The increase was mainly in cardiac and sudden deaths. Conclusions: Higher plasma cTnT predicts long-term all-cause mortality in hemodialysis patients, even at concentrations &lt;0.100 μg/L, as does an increasing cTnT concentration over time.

scholarly journals Association of Insulin Dose, Cardiometabolic Risk Factors, and Cardiovascular Disease in Type 1 Diabetes During 30 Years of Follow-up in the DCCT/EDIC Study

Diabetes Care ◽  
2019 ◽  
Vol 42 (4) ◽  
pp. 657-664 ◽  
Author(s):  
Barbara H. Braffett ◽  
Samuel Dagogo-Jack ◽  
Ionut Bebu ◽  
William I. Sivitz ◽  
Mary Larkin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Type 1 Diabetes ◽  
Cardiometabolic Risk ◽  
Insulin Dose ◽  
Cardiometabolic Risk Factors

scholarly journals Impact of Metabolic Syndrome on the Development of Cardiovascular Disease among Kazakhs in Remote Rural Areas of Xinjiang, China: A Cohort Study

2020 ◽  
Author(s):  
Wenwen Yang ◽  
Shuxia Guo ◽  
Haixia Wang ◽  
Yu Li ◽  
Xianghui Zhang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Metabolic Syndrome ◽  
Rural Areas ◽  
Cox Regression ◽  
Baseline Survey ◽  
Minority Populations ◽  
Cox Regression Analysis ◽  
Independent Risk Factors

Abstract Background: Metabolic syndrome (MS) could promote the development of cardiovascular disease(CVD). The aim of this study was to examine the association of MS and its components with CVD among Kazakhs in Xinjiang. Methods: According to the geographical distribution of the minority populations in Xinjiang, we selected the representative prefecture (Yili). A total of 2,644 participants completed the baseline survey between April 2010 and December 2012. The follow-up survey was conducted from April 2016 to December 2016. Only 2,286 out of 2,644 participants were followed-up on, with a follow-up rate of 86.46%. Cox regression was used to evaluate the association of each component and the number of combinations of MS components on the development of CVD. Results: Multivariate Cox regression analysis showed that blood pressure (BP), waist circumference (WC), and triglycerides (TG) were independently associated with CVD. Participants with 1–5 MS components had an increased hazard ratio for developing CVD, from 1.82 to 8.59 (trend P<0.001), compared with those without any MS components. This trend persisted after adjusting for other general risk factors. The risk of developing CVD increased when TG and WC coexisted, or when TG/WC and BP coexisted. However, no significant interactions were found between BP , WC , and TG. Conclusions: BP , WC, and TG were independent risk factors for CVD in Kazakhs. In clinical practice, a more informative assessment may be obtained by taking into account the number of MS components.

scholarly journals The Association of Serum Circulating Neuropeptide Q and Chemerin Levels with Cardiometabolic Risk Factors among Patients with Metabolic Syndrome

Biomolecules ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. 1863
Author(s):  
Marta Pelczyńska ◽  
Aniceta Ada Mikulska ◽  
Krystyna Czyżewska ◽  
Paweł Bogdański ◽  
Teresa Grzelak
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Muscle Mass ◽  
Metabolic Disorders ◽  
Cardiometabolic Risk ◽  
Cardiometabolic Risk Factors ◽  
Entire Study ◽  
Study Population ◽  
Total Muscle

The potential involvement of neuropeptide Q (NPQ) and chemerin (CHEM) in metabolic disorders is yet to be fully elucidated. The aim of this study was to evaluate serum concentrations of NPQ and CHEM and to establish their relationship with cardiometabolic risk factors among individuals with metabolic syndrome. A total of 66 patients with metabolic syndrome (MetS) and 83 healthy volunteers (non-MetS) underwent biochemical, blood pressure, and anthropometric measurements. The concentration of NPQ in the MetS group was significantly lower (0.47 (0.34 ; 0.54) vs. 0.52 (0.43 ; 0.60) ng/mL, p = 0.015) than in non-MetS, while there were no differences in CHEM level. In the entire study population, we observed several negative correlations between NPQ concentration and waist-hip ratio (WHR), visceral adipose tissue, diastolic blood pressure (DBP), triglycerides (TG) along with a positive correlation with high-density lipoprotein (HDL), total muscle mass, and CHEM. Moreover, a negative correlation was observed in the MetS group between NPQ and glycemia. CHEM showed no significant correlations with cardiometabolic risk factors in the study population. In a multiple regression model, the total muscle mass proved to be an independent factor determining NPQ concentration in the population (p < 0.00000001, R2adj = 28.6%). NPQ seems to protect against metabolic disorders correlated with obesity. Thus, it is worth considering NPQ level as a candidate protective biomarker of metabolic syndrome complications.

scholarly journals Long-Term All-Cause Mortality and Its Association with Cardiovascular Risk Factors in Thyroid Cancer Survivors: An Israeli Population-Based Study

2020 ◽  
Author(s):  
Elena Izkhakov ◽  
Lital Keinan-Boker ◽  
Micha Barchana ◽  
Yacov Shacham ◽  
Iris Yaish ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Thyroid Cancer ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Cox Regression ◽  
Increased Risk ◽  
All Cause Mortality

Abstract Background: The global incidence of thyroid cancer (TC) has risen considerably during the last three decades, while prognosis is generally favorable. We assessed the long-term all-cause mortality in TC survivors compared to the general population, and its association with cardiovascular risk factors. Methods: Individuals diagnosed with TC during 2001-2014 (TC group) and age- and sex-matched individuals from the same Israeli healthcare system without thyroid disease or a cancer history (non-TC group) were compared. Cox regression hazard ratios (HRs) and 95% confidence intervals (95%CIs) for all-cause mortality were calculated by exposure status. Results: During a 15-year follow-up (median 8 years), 577 TC survivors out of 5,677 (10.2%) TC patients and 1,235 individuals out of 23,962 (5.2%) non-TC patients died. The TC survivors had an increased risk of all-cause mortality (HR=1.89, 95%CI 1.71-2.10), after adjusting for cardiovascular risk factors already present at follow-up initiation. This increased risk was most pronounced in the 55- to 64-year-old age group (HR=1.49, 95%CI 1.33-1.67). The TC survivors who died by study closure had more hypertension (14.6% vs. 10.3%, P = 0.002), more dyslipidemia (11.4% vs. 7.2%, P < 0.001), and more cardiovascular disease (33.6% vs. 22.3%, P = 0.05) compared to those who died in the non-TC group. Conclusions: This large cohort study showed higher all-cause mortality with a higher prevalence of hypertension, dyslipidemia, and cardiovascular disease among TC survivors compared to matched non-TC individuals. Primary and secondary prevention of cardiovascular risk factors in TC survivors is mandatory.

scholarly journals Association between Cardiovascular Risk Factors and Long-Term All-Cause Mortality in Thyroid Cancer Survivors: An Israeli Population-Based Study

2020 ◽  
Author(s):  
Elena Izkhakov ◽  
Lital Keinan-Boker ◽  
Micha Barchana ◽  
Yacov Shacham ◽  
Iris Yaish ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Thyroid Cancer ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Cox Regression ◽  
Increased Risk ◽  
All Cause Mortality

Abstract Background: The global incidence of thyroid cancer (TC) has risen considerably during the last three decades, while prognosis is generally favorable. We assessed the association between long-term all-cause mortality and cardiovascular risk factors in TC survivors compared to the general population. Methods: Individuals diagnosed with TC during 2001-2014 (TC group) and age- and sex-matched individuals from the same Israeli healthcare system without thyroid disease or a cancer history (non-TC group) were compared. Cox regression hazard ratios (HRs) and 95% confidence intervals (95%CIs) for all-cause mortality were calculated by exposure status. Results: During a 15-year follow-up (median 8 years), 577 TC survivors out of 5,677 (10.2%) TC patients and 1,235 individuals out of 23,962 (5.2%) non-TC patients died. The TC survivors had an increased risk of all-cause mortality (HR=1.89, 95%CI 1.71-2.10), after adjusting for cardiovascular risk factors already present at follow-up initiation. This increased risk was most pronounced in the 55- to 64-year-old age group (HR=1.49, 95%CI 1.33-1.67). The TC survivors who died by study closure had more hypertension (14.6% vs. 10.3%, P = 0.002), more dyslipidemia (11.4% vs. 7.2%, P < 0.001), and more cardiovascular disease (33.6% vs. 22.3%, P = 0.05) compared to those who died in the non-TC group. Conclusions: This large cohort study showed higher all-cause mortality with a higher prevalence of hypertension, dyslipidemia, and cardiovascular disease among TC survivors compared to matched non-TC individuals. Primary and secondary prevention of cardiovascular risk factors in TC survivors is mandatory.

Abstract P177: Discordantly Normal ApoB Relative To Elevated LDL-C In Persons With Metabolic Disorders: A Marker Of Atherogenic Heterogeneity

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Alexander C Razavi ◽  
Lydia A Bazzano ◽  
Jiang He ◽  
Marie Krousel-Wood ◽  
Kirsten S Dorans ◽  
...  
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Metabolic Syndrome ◽  
Carotid Plaque ◽  
Metabolic Disorders ◽  
Atherosclerotic Cardiovascular Disease ◽  
Ascvd Risk

Introduction: A significant proportion of persons with metabolic syndrome, prediabetes, or type 2 diabetes do not develop atherosclerotic cardiovascular disease (ASCVD). Discordantly normal apolipoprotein B (ApoB) relative to elevated LDL-cholesterol (LDL-C) may help to explain underlying heterogeneity in ASCVD risk among these individuals. Hypothesis: We hypothesized that discordantly normal ApoB (<90 mg/dL) relative to elevated LDL-C ( > 100 mg/dL) would be associated with a lower atherosclerosis burden among individuals with metabolic disorders. Methods: There were 331 Bogalusa Heart Study participants with metabolic syndrome (n=107), prediabetes (n=291), or type 2 diabetes (n=34) and LDL-C > 100 who were free of carotid plaque at baseline (2001-02) and underwent carotid ultrasound at follow-up (2013-16). Carotid plaque was defined as a focal wall thickening >1.5 mm. Modified Poisson regression with robust error variance estimated the long-term absence of plaque for normal ApoB after adjusting for established risk factors. Results: Participants were on average 36.3 years old at baseline, 202 (61.0%) were women, and 93 (29.9%) were African American. Overall, LDL-C explained 42.3% of the variability in ApoB as the lipoprotein markers were only modestly correlated (r=0.65). Participants with ApoB <90 (51.1%) were more likely to remain free of carotid plaque compared to those with ApoB > 90 (74.6% versus 57.4%, p=0.001, Figure ). In multivariable modeling, persons with ApoB <90 were 21% more likely to have long-term absence of plaque (RR=1.21, 95% CI: 1.03-1.43), independent of traditional ASCVD risk factors, including LDL-C. Conclusions: More than half of persons with metabolic disorders and elevated LDL-C had normal ApoB with a lower burden of carotid atherosclerosis over 13 years follow-up. ApoB better represents the atherogenic lipid burden among persons with metabolic disorders compared to LDL-C and may be especially helpful for persons with the pattern of high triglycerides and low HDL-cholesterol.

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