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Association of hyperglycemic crisis with an increased risk of end-stage renal disease: A nationwide population-based cohort study
انجمن بحران هیپرگلیسمی با افزایش خطر ابتلا به بیماری کلیوی در مرحله پایانی: مطالعات کوهورت مبتنی بر جمعیت در سراسر کشور-2018 Background: A hyperglycemic crisis episode (HCE) is associated with poor management of
diabetes, which is a risk factor for end-stage renal disease (ESRD); however, the association
between an HCE and ESRD has not been clarified. We conducted a nationwide population
based cohort study with the purpose of delineating this issue.
Methods: We identified 9208 diabetic patients with an HCE and an identical number of dia
betic patients with matched age, sex, and index date without an HCE between 2000 and
2002. A comparison of the risk of ESRD between the diabetic patients with and without
an HCE was achieved by a follow-up until 2014.
Results: A Cox proportional hazard regression analysis showed that the diabetic patients
with an HCE were at a higher risk of ESRD than those without an HCE (the adjusted hazard
ratio [AHR]: 1.47; 95% confidence interval [CI]: 1.34–1.62) by adjusting for renal disease,
hypertension, hyperlipidemia, coronary artery disease, hyperuricemia, anemia, chronic
obstructive pulmonary disease, liver disease, malignancy, connective tissue disease, non
steroid anti-inflammatory drug use, and monthly income. The increased risk of ESRD
was more prominent in the age subgroup of 15–25 years (AHR: 4.91; 95% CI: 1.92–12.56);
25–35 years (AHR: 2.42; 95% CI: 1.51–3.86); 35–45 years (AHR: 3.01; 95% CI: 2.21–4.09); and
45–55 years (AHR: 1.75; 95% CI: 1.41–2.19).
Conclusions: An HCE was associated with an increased risk of ESRD, especially in the
younger diabetic patients (15–55 years). A close follow-up for the control of diabetes and
for monitoring renal function is proposed.
Keywords: Diabetes ، End-stage renal disease ، Hyperglycemic crisis |
مقاله انگلیسی |
2 |
Associations between social relationship measures, serum brain-derived neurotrophic factor, and risk of stroke and dementia
ارتباط بین معیارهای ارتباط اجتماعی، عامل سرطان مغز، نوروپاتی و خطر ابتلا به سکته مغزی و زوال عقل-2017 Introduction: Mechanisms underlying social determinants of stroke and dementia are unclear and
brain-derived neurotrophic factor (BDNF) may contribute as a molecular link.
Methods: Using the Framingham Study, we examined social relationship measures as predictors of
higher serum BDNF level and cumulative incidence of stroke and dementia.
Results: Among 3294 participants, controlling for age and sex, isolation trended with lower BDNF
(odds ratio 5 0.69 [0.47–1.00]). Participants with more companionship had reduced risk for stroke
(hazard ratio [HR] 5 0.59 [0.41–0.83]) and dementia (HR 5 0.67 [0.49–0.92]). Greater emotional
support was associated with higher BDNF (odds ratio 5 1.27 [1.04–1.54]), reduced dementia risk
(HR 5 0.69 [0.51–0.94], and among smokers, reduced stroke risk (HR 5 0.23 [0.10–0.57]). Associ
ations persisted after additional adjustments. BDNF partly mediated the total effect between
emotional support and dementia risk.
Conclusions: Availability of social support appears to be associated with increased BDNF levels and, in
certain subsets, reduce risk of subsequent dementia and stroke, thus warranting study of these pathways to
understand their role in neuroprotection.
Keywords: Brain-derived neurotrophic factor | Social relationships | Social support | Social networks | Dementia | Stroke | Epidemiology | Cohort studies |
مقاله انگلیسی |
3 |
Social networks and patterns of health risk behaviours over two decades_ A multi-cohort study
شبکه های اجتماعی و الگوهای رفتاری خطرسلامت بیش از دو دهه _ یک مطالعه چند کوهورت-2017 Objective: To determine the associations between social network size and subsequent long-term health behaviour
patterns, as indicated by alcohol use, smoking, and physical activity.
Methods: Repeat data from up to six surveys over a 15- or 20-year follow-up were drawn from the Finnish Public
Sector study (Raisio-Turku cohort, n = 986; Hospital cohort, n = 7307), and the Health and Social Support
study (n = 20,115). Social network size was determined at baseline, and health risk behaviours were assessed
using repeated data from baseline and follow-up. We pooled cohort-specific results from repeated-measures log
binomial regression with the generalized estimating equations (GEE) method using fixed-effects meta-analysis.
Results: Participants with up to 10 members in their social network at baseline had an unhealthy risk factor
profile throughout the follow-up. The pooled relative risks adjusted for age, gender, survey year, chronic con
ditions and education were 1.15 for heavy alcohol use (95% CI: 1.06–1.24), 1.19 for smoking (95% CI:
1.12–1.27), and 1.25 for low physical activity (95% CI: 1.21–1.29), as compared with those with > 20 members
in their social network. These associations appeared to be similar in subgroups stratified according to gender, age
and education.
Keywords: Cohort studies | Health behaviour | Longitudinal studies | Meta-analysis | Psychosocial factors |
مقاله انگلیسی |