The Association between Baseline Serum Lipids and Mortality in Peritoneal Dialysis Patients

<b><i>Introduction:</i></b> Lipid disturbances are common in ESRD patients. In peritoneal dialysis (PD) patients, dyslipidemia is even more common. This study aimed to examine whether serum lipids were associated with prognosis of PD patients. <b><i>Methods:</i></b> Patients from a multicenter retrospective cohort were used for the present study. The primary endpoint was all-cause mortality. Cox regression was used to analyze the association between serum lipids including total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein, and triglycerides and the prognosis. <b><i>Results:</i></b> The results showed that lower total cholesterol and LDL levels at the initiation of PD predicted higher all-cause mortality in PD patients. Multivariate analysis reveal that the association disappeared after adjusting for age, gender, albumin, prealbumin, protein catabolic rate normalized to body weight, C-reactive protein, and residual renal function. Further analysis showed that patients with lower total cholesterol/LDL had a higher mortality only during the first 24 months of follow-up. In the patients who survived &#x3e;2 years after PD, lower total cholesterol/LDL was not associated with higher long-term all-cause mortality any more. <b><i>Conclusion:</i></b> Lower total cholesterol/LDL levels at the initiation of PD were associated with overall mortality in PD patients. The association could be potentially modified by malnutrition, inflammation, and residual renal function or disappeared after 24 months.

Ideal cardiovascular health at age 5–6 years and cardiometabolic outcomes in preadolescence

Background The American Heart Association (AHA) developed a definition of ideal cardiovascular health (ICH) based on the presence of both ideal health behaviours (diet, physical activity, weight status and smoking) and ideal health factors (glucose, total cholesterol and blood pressure levels). However, research of ICH in the paediatric population is scarce. We aimed to study ICH at age 5–6 years by extending the original ICH score with the health behaviours: sleep duration, screen time and prenatal smoke exposure, and to evaluate its association with cardiometabolic outcomes at age 11–12. Methods A total of 1666 children aged 5–6 years were selected from the database of the ABCD-study, a prospective cohort study on the health and development of children born in Amsterdam, the Netherlands. Of these, 846 (50.8%) were boys and 1460 (87.6%) had a healthy weight. Data on self-reported health behaviours and health factors were used to calculate the ICH scores (original and extended) by adding the frequency of scoring ‘healthy’ on each indicator, based on international cut-offs. The children were followed up for 6 years and cardiometabolic outcomes (carotid intima-media thickness (CIMT), blood pressure, glucose and lipids) were measured. Associations between ICH (both original and extended) and cardiometabolic outcomes were examined using multivariable regression models. Results At age 5–6 years, 11% scored poor (score 1–5), 56% intermediate (score 6–7) and 33% good (score 8–9) on extended ICH. Healthy diet and normal total cholesterol concentrations were the least prevalent. Neither the original nor the extended ICH scores were associated with CIMT at age 11–12. A higher score on the extended ICH was associated with lower total cholesterol (p for trend < 0.001), lower systolic (p for trend = 0.012) and diastolic blood pressure (p for trend = 0.011), and lower body mass index (BMI) (p < 0.001) at age 11–12. The original ICH score was associated with lower total cholesterol (p < 0.001) and BMI (p < 0.001) only. Conclusion Our findings suggest that extending the ICH score in young children with additional health behaviours improves prediction of some cardiometabolic outcomes, but not CIMT in preadolescence, compared to the original ICH score. We would recommend other researchers to incorporate objective measures of health behaviours and longer follow-up to find out whether associations persist into adulthood.

Ideal cardiovascular health at age 5-6 years and cardiometabolic outcomes in preadolescence

Background- The American Heart Association (AHA) developed a definition of ideal cardiovascular health (ICH) based on the presence of both ideal health behaviours (diet, physical activity, weight status and smoking) and ideal health factors (glucose, total cholesterol and blood pressure levels). However, research of ICH in the paediatric population is scarce. We aimed to study ICH at age 5-6 years by extending the original ICH score with the health behaviours: sleep duration, screen time and prenatal smoke exposure, and to evaluate its association with cardiometabolic outcomes at age 11-12.Methods- A total of 1,666 children aged 5-6 years were selected from the database of the ABCD-study, a prospective cohort study on the health and development of children born in Amsterdam, the Netherlands. Of these, 846 (50.8%) were boys and 1460 (87.6%) had a healthy weight. Data on self-reported health behaviours and health factors were used to calculate the ICH scores (original and extended) by adding the frequency of scoring ‘healthy’ on each indicator, based on international cut-offs. The children were followed up for 6 years and cardiometabolic outcomes (carotid intima-media thickness (CIMT), blood pressure, glucose and lipids) were measured. Associations between ICH (both original and extended) and cardiometabolic outcomes were examined using multivariable regression models.Results- At age 5-6 years, 11% scored poor (score 1-5), 56% intermediate (score 6-7) and 33% good (score 8-9) on extended ICH. Healthy diet and normal total cholesterol concentrations were the least prevalent. Neither the original nor the extended ICH scores were associated with CIMT at age 11-12. A higher score on the extended ICH was associated with lower total cholesterol (p for trend <0.001), lower systolic (p for trend=0.012) and diastolic blood pressure (p for trend=0.011), and lower body mass index (BMI) (p<0.001) at age 11-12. The original ICH score was associated with lower total cholesterol (p<0.001) and BMI (p<0.001) only.Conclusion- Our findings suggest that extending the ICH score in young children with additional health behaviours improves prediction of some cardiometabolic outcomes, but not CIMT in preadolescence, compared to the original ICH score. We would recommend other researchers to incorporate objective measures of health behaviours and longer follow-up to find out whether associations persist into adulthood.

Ideal Cardiovascular Health at Age 5-6 years and Cardiometabolic Outcomes in Preadolescence

Background- The American Heart Association (AHA) developed a definition of ideal cardiovascular health (ICH) based on the presence of both ideal health behaviours (diet, physical activity, weight status and smoking) and ideal health factors (glucose, total cholesterol and blood pressure levels). However, research of ICH in the paediatric population is scarce. We aimed to study ICH at age 5-6 years by extending the original ICH score with the health behaviours: sleep duration, screen time and prenatal smoke exposure, and to evaluate its association with cardiometabolic outcomes at age 11-12.Methods- A total of 1,666 children aged 5-6 years were selected from the prospective ABCD-cohort study. Data on health behaviours and factors were used to calculate the ICH scores (original and extended) by adding the frequency of scoring ‘healthy’ on each indicator, based on international cut-offs. The children were followed up for 6 years and cardiometabolic outcomes (carotid intima-media thickness (CIMT), blood pressure, glucose and lipids) were measured. Associations between ICH (both original and extended) and cardiometabolic outcomes were examined using multivariable regression models. Results- At age 5-6 years, 11% scored poor (score 1-5), 56% intermediate (score 6-7) and 33% good (score 8-9) on extended ICH. Healthy diet and normal total cholesterol concentrations were the least prevalent. Neither the original nor the extended ICH scores were associated with CIMT at age 11-12. A higher score on the extended ICH was associated with lower total cholesterol (p for trend <0.001), lower systolic (p for trend=0.012) and diastolic blood pressure (p for trend=0.011), and lower body mass index (BMI) (p<0.001) at age 11-12. The original ICH score was associated with lower total cholesterol (p<0.001) and BMI (p<0.001) only. Conclusion- Our findings suggest that extending the ICH score in young children with additional health behaviours improves prediction of some cardiometabolic outcomes, but not CIMT in preadolescence, compared to the original ICH score. Further research with longer follow-up is needed to find out whether associations persist into adulthood.

Haemodialysis with Tinzaparin Versus Dialysate Citrate as Anticoagulation

Anticoagulation with citrate-containing haemodialysate (cHD) is an alternative to tinzaparin haemodialysate (tHD). The study investigated whether cHD would differ when changed from tHD. The same 18 patients were their own controls followed up with cHD for 5 months. LDL-cholesterol decreased at the end of a cHD session (p = 0.01). Neutrophils (p = 0.013) and monocytes (p = 0.007) dropped more during a cHD session. During the follow-up period of cHD, approximately 50% needed additional tinzaparin. Before the cHD session could start, there was a lower total cholesterol at 2 weeks (p = 0.014) and LDL-cholesterol at 1 month (p = 0.011) versus an increase of LDL at 5 months (p = 0.02). Only patients without additional tinzaparin had a reduction of ­C-reactive protein (CRP) at 2 months of cHD (p < 0.05) but not later. Solely cHD seems possible only in half of the patients. A greater reduction in granulocytes and monocytes during cHD indicates a more extensive blood membrane interaction, while CRP may be lower.

PENGARUH EKSTRAK JAHE MERAH (Zingiber officinale) DAN MADU TERHADAP KADAR KOLESTEROL TOTAL TIKUS MODEL DIABETES MELITUS

Diabetes mellitus (DM) is a disease characterized by elevated blood glucose levels (hyperglycemia) caused by deficiency of insulin, and insulin resistance or both. This chronic disease prevalence is increasing nationally and globally. This study aimed to determine the effect of ginger extract and honey various doses on levels of total cholesterol in the Wistar diabetic rat model induced by alloxan. This research is true experimental post-test only with control group design. Subject of the study 30 male Wistar rats weight 150-200 grams, divided into 6 groups: A) healthy controls (K1), B) DM control (K2), C) Treatment with red ginger extract 1000 mg / kg and honey 1 ml / kg (K3), D) Treatment with ginger extract red 1000 mg / kg and honey 2 ml / kg (K4), E) Treatment with red ginger extract 500 mg / kg and honey 1 ml / kg (K5), F) Treatment with red ginger extract 500 mg / kg and honey 2 ml / kg (K6). DM induction by alloxan 160 mg / kg intraperitoneally for 5 days, and the provision of treatment for 14 days. Total cholesterol levels were measured by CHOD-PAP method. Results: The mean total cholesterol levels of healthy control group vs the diabetic control 58.20 ± 8.76 vs. 87.80 ± 5.81 mg / dL. Based on one way ANOVA test, red ginger extract and honey various doses significantly lower total cholesterol level (p <0.05). The mean total cholesterol levels between the group K3 to K4 was not statistically different, as well as K5 with K6. However, mean total cholesterol levels at K3 and K4 differ significantly from the K5 and K6. Conclusion: Combination of red ginger extract and honey can lower total cholesterol levels in diabetic rat model induced by alloxan.