scholarly journals Health-Risk Factors and 8-Year Incidence of Kidney Disease in Transitional Thailand: Prospective Findings From a Large National Cohort Study

2018 ◽  
Vol 10 (3) ◽  
pp. 132
Author(s):  
Prasutr Thawornchaisit ◽  
Fredinandus De Looze ◽  
Christopher M Reid ◽  
Sam-ang Seubsman ◽  
Adrian Sleigh

OBJECTIVE: Kidney disease (KD) is increasing its burden in Thailand but prospective observational KD studies are few. So we analysed 8-year nationwide Thai Cohort Study (TCS) data on KD incidence, distribution and risk association among Thais.DESIGN & METHOD: TCS is a longitudinal study of the Thai health-risk transition among Open University student residing nationwide. At baseline (2005) the cohort members analysed here were aged 15-88 years and did not have KD. At the follow up in 2013 (n=41638) incident KD was reported based on doctor diagnosis. We analysed the 8-year cumulative incidence of KD and its association with risk factors by using multivariable logistic regression.RESULTS: The incidence of KD (2005 to 2013) was 4.0%; the rate in men (5.9) was significantly higher than in women (2.5). KD increased significantly for both increasing age and body mass index (BMI) (p trend <0.001 for both). Its incidence was strongly associated with concurrent diseases including hypertension, diabetes and high blood lipids and moderately associated with increased frequency of cigarette smoking, instant food, roast or smoked food and soft drink consumption. KD decreased with increases in personal income, household assets, walking and physical activity.CONCLUSION: Physical activity, high income and household assets prevented KD. Lifestyle changes such as smoking and high consumption of instant, roast or smoked food and soft drink increased risk of KD. Government should encourage more physical activity and less smoking, salt and sugar.

2018 ◽  
Vol 10 (2) ◽  
pp. 99
Author(s):  
Prasutr Thawornchaisit ◽  
Fredinandus De Looze ◽  
Christopher M Reid ◽  
Sam-ang Seubsman ◽  
Adrian Sleigh

OBJECTIVE: Rapid economic growth is transforming Thailand into a middle-income country. Also emerging are chronic diseases particularly hypertension, diabetes mellitus and kidney disease. There are few studies of the incidence of hypertension. We analyse the effect on 8-year incidence of hypertension of transitional health-risk factors including demography, socioeconomic status (SES), body mass index (BMI), sedentariness, physical activity, underlying diseases, personal behaviours, food, fruit and vegetable consumption.DESIGN & METHODS: Health-risk factors and their effects on the incidence of hypertension were evaluated prospectively in the national Thai Cohort Study from 2005 to 2013. All data were derived from 40,548 Sukhothai Thammathirat Open University students returning mail-based questionnaire surveys in both 2005 and 2013. Adjusted relative risks of association between each risk factor and incidence of hypertension were calculated after controlling for confounding factors.RESULTS: In Thailand, the 8-year incidence of hypertension was 5.1% (men 7.1%, women 3.6%). Hypertension was associated with ageing, higher BMI, diabetes mellitus, chronic kidney disease, high lipids, SES, lower education level, lower household asset, physical inactivity, smoking, instant food intake and soft drink. Sex, having a partner, urbanization and sedentary habits had no influence on hypertension.CONCLUSION: In Thailand, hypertension is becoming a serious risk factor for chronic disease with a wide array of associations with modern life. As Thailand’s socio-economy develops the health-risk transition will further impact on population health. Thais should be encouraged by government policy to consume less instant food, maintain normal BMI, increased physical activity, stop smoking and consume less soft drink.


2021 ◽  
pp. 026010602199693
Author(s):  
Prince Atorkey ◽  
Mariam Akwei ◽  
Winifred Asare-Doku

Background: Carbonated soft drinks consumption is associated with weight gain and other chronic diseases. Aim: To examine whether socio-demographic factors, health risk factors and psychological distress are associated with carbonated soft drink consumption among adolescents in selected senior high schools in Ghana. Methods: Data were obtained from the 2012 Ghana Global School-based Student Health Survey (GSHS). Participants consisted of 1756 school-going adolescents sampled using a two-stage cluster sampling method. Binomial logistic regression was used to determine whether socio-demographic factors, health risk factors and psychological distress were associated with consumption of soft drinks. Results: The prevalence of carbonated soft drinks consumption was 34.9%. Males (odds ratio (OR) = 0.73 (95% confidence intervals (CI) 0.59–0.92); p = 0.007), and participants with high socio-economic status (OR = 0.76 (95% CI 0.48–0.97); p = 0.033) had smaller odds for consumption of soft drinks. Also, adolescents in Senior High School (SHS) 3 (OR = 0.72 (95% CI 0.53–0.97); p = 0.034) and SHS 4 (OR = 0.63 (95% CI 0.43–0.91); p = 0.014) had smaller odds for soft drinks intake compared to those in SHS 1. Health risk factors associated with greater odds of high soft drink consumption were tobacco use (OR = 1.68, (95% CI 1.07–2.65); p = 0.025), fast food consumption (OR = 1.88, (95% CI 1.47–2.41); p = 0.011) and alcohol consumption (OR = 1.43, (95% CI 1.02–1.99); p = 0.039). Consuming adequate fruit (OR = 0.19 (95% CI 0.15–0.24); p = 0.000) and adequate vegetable (OR = 0.55 (95% CI 0.34–0.87); p = 0.011) were associated with lower odds for soft drink consumption. Adolescents who reported feeling anxious had smaller odds for soft drink intake (OR = 0.65, (95% CI 0.47–0.91); p = 0.011). Conclusions: The findings from this study show that socio-demographic characteristics, health risk factors and psychological distress are associated with the soft drink consumption among adolescents in Ghana. Interventions aimed at reducing soft drink consumption and other health risk factors are needed.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Ali S. Omrani ◽  
Muna A. Almaslamani ◽  
Joanne Daghfal ◽  
Rand A. Alattar ◽  
Mohamed Elgara ◽  
...  

Abstract Background There are limited data on Coronavirus Disease 2019 (COVID-19) outcomes at a national level, and none after 60 days of follow up. The aim of this study was to describe national, 60-day all-cause mortality associated with COVID-19, and to identify risk factors associated with admission to an intensive care unit (ICU). Methods This was a retrospective cohort study including the first consecutive 5000 patients with COVID-19 in Qatar who completed 60 days of follow up by June 17, 2020. The primary outcome was all-cause mortality at 60 days after COVID-19 diagnosis. In addition, we explored risk factors for admission to ICU. Results Included patients were diagnosed with COVID-19 between February 28 and April 17, 2020. The majority (4436, 88.7%) were males and the median age was 35 years [interquartile range (IQR) 28–43]. By 60 days after COVID-19 diagnosis, 14 patients (0.28%) had died, 10 (0.2%) were still in hospital, and two (0.04%) were still in ICU. Fatal COVID-19 cases had a median age of 59.5 years (IQR 55.8–68), and were mostly males (13, 92.9%). All included pregnant women (26, 0.5%), children (131, 2.6%), and healthcare workers (135, 2.7%) were alive and not hospitalized at the end of follow up. A total of 1424 patients (28.5%) required hospitalization, out of which 108 (7.6%) were admitted to ICU. Most frequent co-morbidities in hospitalized adults were diabetes (23.2%), and hypertension (20.7%). Multivariable logistic regression showed that older age [adjusted odds ratio (aOR) 1.041, 95% confidence interval (CI) 1.022–1.061 per year increase; P < 0.001], male sex (aOR 4.375, 95% CI 1.964–9.744; P < 0.001), diabetes (aOR 1.698, 95% CI 1.050–2.746; P 0.031), chronic kidney disease (aOR 3.590, 95% CI 1.596–8.079, P 0.002), and higher BMI (aOR 1.067, 95% CI 1.027–1.108 per unit increase; P 0.001), were all independently associated with increased risk of ICU admission. Conclusions In a relatively younger national cohort with a low co-morbidity burden, COVID-19 was associated with low all-cause mortality. Independent risk factors for ICU admission included older age, male sex, higher BMI, and co-existing diabetes or chronic kidney disease.


Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Taylor Eagle ◽  
Elizabeth A Jackson ◽  
Susan Aaronson ◽  
Catherine Fitzgerald ◽  
Lindsey Mitchell ◽  
...  

Background. Middle school children residing in a community with fewer resources may have less opportunity to be physically active or consume a healthy diet which may lead to an increased risk for obesity, and poorer baseline cardiovascular health. Methods. We compared health status of middle school students (average age 12 years) in two Michigan communities; Ann Arbor (AA) and an adjacent town, Ypsilanti (YPSI) (median household income 77,000 and 28,610, respectively). Blood pressure (BP), cholesterol, blood glucose, body mass index (BMI), and self-reported diet and physical activity habits were collected at baseline in students (n=733) from 5 AA and 2 YPSI middle schools. Results. The percentage of children receiving free lunch was higher among the YPSI children compared to the AA children (60% vs. 26%, p =0.01). More YPSI children were in the 95 th percentile for weight compared to the AA children (22.2% vs. 12.6%) and on average had a greater BMI (21.2 ± 4.8 vs. 19.9 ± 4.1, p =0.004) and LDL-cholesterol (99.9 ± 27.5 vs. 91.7 ± 26.9, p =0.005). Compared to AA children, the YPSI children were less likely to consume one or more servings of vegetables/day (67.7% vs. 80.6%, p =0.004) while no difference was observed in fruit consumption. Non-diet soft drink consumption was higher among the YPSI children compared to those from AA (45.9% vs. 30.8%, p =0.002). YPSI children were less likely to report attending a school-based physical education class in the past week (41.4% vs. 9.9%, p<0.001) or to participate on a school-based sports team (65.4% vs. 38.3%, p<0.001). The majority of children in both communities reported watching one or more hours of TV/day; however YPSI children were more likely to watch six or more hours/day compared to AA children (12.8% vs. 4.0%, p<0.001). A similar pattern was observed for video games, with 11.3% of YPSI children reporting six or more hours/day of playing video games compared to 1.9% AA children (p<0.001). Conclusions. We observed a marked difference in diet, physical activity habits and cardiovascular parameters among children from two neighboring communities with varying resources. The local and national response to childhood obesity must focus on these community resources in order to improve childhood health.


Author(s):  
Ali S. Omrani ◽  
Muna A. Almaslamani ◽  
Joanne Daghfal ◽  
Rand A. Alattar ◽  
Mohamed Elgara ◽  
...  

Background There are limited data on Coronavirus Disease 2019 (COVID-19) outcomes at a national level, and none after 60 days of follow up. The aim of this study was to describe national, 60-day all-cause mortality associated with COVID-19, and to identify risk factors associated with admission to an intensive care unit (ICU). Methods This was a retrospective cohort study including the first consecutive 5000 patients with COVID-19 in Qatar who completed 60 days of follow up by June 17, 2020. Outcomes included all-cause mortality at 60 days after COVID-19 diagnosis, and risk factors for admission to ICU. Results Included patients were diagnosed with COVID-19 between February 28 and April 17, 2020. The majority (4436, 88.7%) were males and the median age was 35 years [interquartile range (IQR) 28-43]. By 60 days after COVID-19 diagnosis, 14 patients (0.28%) had died, 10 (0.2%) were still in hospital, and two (0.04%) were still in ICU. Fatal COVID-19 cases had a median age of 59.5 years (IQR 55.8-68), and were mostly males (13, 92.9%). All included pregnant women (26, 0.5%), children (131, 2.6%), and healthcare workers (135, 2.7%) were alive and not hospitalized at the end of follow up. A total of 1424 patients (28.5%) required hospitalization, out of which 108 (7.6%) were admitted to ICU. Most frequent co-morbidities in hospitalized adults were diabetes (23.2%), and hypertension (20.7%). Multivariable logistic regression showed that older age [adjusted odds ratio (aOR) 1.041, 95% confidence interval (CI) 1.022-1.061 per year increase; P <0.001], male sex (aOR 4.375, 95% CI 1.964-9.744; P <0.001), diabetes (aOR 1.698, 95% CI 1.050-2.746; P 0.031), chronic kidney disease (aOR 3.590, 95% CI 1.596-8.079, P 0.002), and higher BMI (aOR 1.067, 95% CI 1.027-1.108 per unit increase; P 0.001), were all independently associated with increased risk of ICU admission. Conclusions In a relatively younger national cohort with a low co-morbidity burden, COVID-19 was associated with low all-cause mortality. Independent risk factors for ICU admission included older age, male sex, higher BMI, and co-existing diabetes or chronic kidney disease.


BMJ Open ◽  
2017 ◽  
Vol 7 (8) ◽  
pp. e017034
Author(s):  
Grace M Egeland ◽  
Grethe S Tell ◽  
Øyvind Næss ◽  
Jannicke Igland ◽  
Kari Klungsøyr

ObjectivesTo evaluate whether family history of disease and pregravid lifestyle and cardiovascular risk factors are associated with subsequent stillbirth delivery.DesignPrepregnancy cohort study.SettingCohort Norway regional health surveys (1994–2003) linked to Medical Birth Registry of Norway for deliveries through 2012.Participants13 497 singleton births (>22 weeks gestation) in 8478 women.Main outcome measureRisk of stillbirth evaluated by Poisson regression.ResultsMean (SD) length of follow-up was 5.5 (3.5) years. In analyses adjusting for baseline age and length of follow-up, ≥3 hours of baseline past-year vigorous physical activity per week (resulting in shortness of breath/sweating) was associated with increased risk of stillbirth compared with <1 hour/week of vigorous activity (incidence rate ratio, IRR 2.46; 95% CI 1.23 to 4.90). In contrast, baseline past-year light physical activity of ≥3 hours per week associated with reduced risk of stillbirth compared with <3 hours of light physical activity per week (IRR 0.53; 95% CI 0.30 to 0.93). A family history of stroke associated with increased risk of stillbirth delivery (IRR 2.53; 95% CI 1.06 to 6.01). Because overweight/obese women may experience shortness of breath and sweating with less physical exertion than normal weight women, a sensitivity analysis was conducted limited to women with a normal BMI (>18.5 and <25 kg/m2). Vigorous activity of ≥3 hours per week (IRR of 4.50; 95% CI 1.72 to 11.79) and a family history of stroke (IRR of 3.81; 95% CI 1.31 to 11.07) were more strongly related to stillbirth risk among women with a normal BMI than that observed for all women combined. Established risk factors also associated with stillbirth risk.ConclusionsThe study identified physical activity and family history of stroke as potential new risk factors for stillbirth delivery.


2008 ◽  
Vol 22 (10) ◽  
pp. 811-816 ◽  
Author(s):  
Nimer Assy ◽  
Gattas Nasser ◽  
Iad Kamayse ◽  
William Nseir ◽  
Zaza Beniashvili ◽  
...  

BACKGROUND: Little is known about dietary habits and their relationships with liver disease in nonalcoholic fatty liver disease (NAFLD) patients, particularly in the absence of obesity, diabetes or hyperlipidemia.OBJECTIVE: To assess the association between soft drink consumption and the presence of fatty liver in NAFLD patients who do not have classic risk factors.METHODS: Three hundred ten patients with NAFLD diagnosed by ultrasound were assessed for 36 months in a cross-sectional manner. Thirty-one patients (10%) who had NAFLD without classic risk factors were compared with 30 healthy controls. Physical activity was assessed during the preceding week and year, and every six months for 36 months. Data on daily dietary intake of food and soft drink, and the source of added sugar were collected during two seven-day periods, at the beginning of the study, and within two weeks after the metabolic tests by using a validated food questionnaire given by a trained dietician. Insulin resistance and lipid peroxidation were assessed by homeostasis model assessment-insulin resistance index (HOMA-IRI) and malondialdehyde (MDA) levels, respectively.RESULTS: Eighty per cent of patients (25 of 31) consumed an excessive amount of soft drink beverages (more than 50 g/day of added sugar) for 36 months, compared with 20% in healthy controls (P<0.001). Twenty per cent of patients consumed one drink per day, 40% consumed two to three drinks per day, and 40% consumed more than four drinks per day for most days during 36 months. The most common soft drinks consumed were regular Coca-Cola (40% of patients), Diet Coke (40%) and flavoured fruit juices (20%). Ultrasound findings revealed mild fatty liver in 44% of cases (n=14), moderate fatty liver in 38% (n=12), and severe fatty liver in 18% (n=5). HOMA-IRI and MDA levels were significantly higher in patients with NAFLD than in healthy controls (HOMA-IRI, 3.7 versus 1.7, P<0.001; and MDA, 420±300 μmol/mL versus 200±100 μmol/mL; P<0.001). When controlled for other factors, including dietary composition and physical activity, soft drink beverage consumption was the only independent variable that was able to predict the presence of fatty liver in 82.5% of cases with a sensitivity of 100%, a specificity of 76%, a positive predictive value of 57% and a negative predictive value of 100%.CONCLUSION: The present study may add important insight into the role of sugar-sweetened beverage consumption as a cause of fatty liver in patients without risk factors. Patients are encouraged to change their long-standing drinking behaviour.


2008 ◽  
Vol 149 (15) ◽  
pp. 691-696
Author(s):  
Dániel Bereczki

Chronic kidney diseases and cardiovascular diseases have several common risk factors like hypertension and diabetes. In chronic renal disease stroke risk is several times higher than in the average population. The combination of classical risk factors and those characteristic of chronic kidney disease might explain this increased risk. Among acute cerebrovascular diseases intracerebral hemorrhages are more frequent than in those with normal kidney function. The outcome of stroke is worse in chronic kidney disease. The treatment of stroke (thrombolysis, antiplatelet and anticoagulant treatment, statins, etc.) is an area of clinical research in this patient group. There are no reliable data on the application of thrombolysis in acute stroke in patients with chronic renal disease. Aspirin might be administered. Carefulness, individual considerations and lower doses might be appropriate when using other treatments. The condition of the kidney as well as other associated diseases should be considered during administration of antihypertensive and lipid lowering medications.


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