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  • 1
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    Online Resource
    Aortic Root Dilatation Is Attenuated with Diabetes but Is Not Associated with Renal Progression in Chronic Kidney Disease
    MDPI AG ; 2021
    In:  Journal of Personalized Medicine Vol. 11, No. 10 ( 2021-09-28), p. 972-
    Details
    In: Journal of Personalized Medicine, MDPI AG, Vol. 11, No. 10 ( 2021-09-28), p. 972-
    Abstract: Patients with chronic kidney disease (CKD) often have cardiac functional and structural abnormalities which can lead to adverse cardiovascular outcomes. In this study, we investigated associations between diabetes mellitus (DM) and cardiac functional and structural parameters in patients with CKD focusing on aortic root diameter (ARD). We also investigated associations of renal outcomes with DM and cardiac functional and structural characteristics. We enrolled 419 patients with CKD stage 3–5 were enrolled. ARD was normalized to body surface area (BSA) (ARD/BSA), and the rate of decline in renal function was assessed by the estimated glomerular filtration rate (eGFR) slope (mL/min/1.73 m2/year). ARD/BSA ≥2.1 cm/m2 in men or ≥2.2 cm/m2 in women was defined as indicating aortic root dilatation. The patients with DM had lower ARD/BSA, higher left atrial dimension (LAD), lower left ventricular ejection fraction, lower ratio of peak early transmitral filling wave velocity to peak late transmitral filling wave velocity, and higher left ventricular relative wall thickness, than those without DM. After multivariable analysis, DM (vs. non-DM; coefficient β, −0.060; p = 0.018) was significantly associated with low ARD/BSA. Significantly fewer patients with DM had aortic root dilatation compared to those without DM (14.3% vs. 23.1%, p = 0.022). In the patients with DM, there were significant associations between a high left ventricular mass index (LVMI) (per 1 g/m2, β, −0.016; p = 0.040) and high LAD (per 1 cm; β, −1.965; p 〈 0.001) with a low eGFR slope. However, other parameters, including ARD/BSA, were not associated with eGFR slope. Furthermore, there were no associations between eGFR slope and any of the echocardiographic parameters in the patients without DM. Aortic root dilatation was attenuated in the patients with DM, but it was not associated with a decline in renal function. However, high LAD and LVMI were associated with rapid renal function decline in the CKD patients with DM.
    Type of Medium: Online Resource
    ISSN: 2075-4426
    URL: Article
    DOI: 10.3390/jpm11100972
    Language: English
    Publisher: MDPI AG
    Publication Date: 2021
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  • 2
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    Synergetic Association between Anemia and Hyperuricemia on New-Onset Chronic Kidney Disease in a Large Taiwanese Population Follow-Up Study
    MDPI AG ; 2023
    In:  International Journal of Environmental Research and Public Health Vol. 20, No. 2 ( 2023-01-12), p. 1421-
    Details
    In: International Journal of Environmental Research and Public Health, MDPI AG, Vol. 20, No. 2 ( 2023-01-12), p. 1421-
    Abstract: The incidence of chronic kidney disease (CKD) is increasing worldwide; however, the association between CKD and anemia and hyperuricemia has yet to be clarified. In addition, whether anemia and hyperuricemia only influence renal damage in combination with other comorbidities or whether they are direct causative factors is also controversial. Therefore, the aim of this longitudinal study was to investigate these issues in a large Taiwanese cohort. We enrolled 26,631 participants from the Taiwan Biobank (TWB) after excluding those with CKD at the baseline, all of whom had follow-up data for a median of 4 years. In this study, CKD was defined as an estimated glomerular filtration rate 〈 60 mL/min/1.73 m2, incident new-onset CKD was defined as the development of CKD during follow-up, anemia was defined as a hemoglobin level 〈 13 mg/dL in males and 〈 12 mg/dL in females, and hyperuricemia was defined as a serum uric acid (UA) level 〉 7 mg/dL in males and 〉 6 mg/dL in females. The participants were divided into four groups according to whether or not they had anemia and hyperuricemia. Multivariable analysis showed that low hemoglobin (per 1 g/dL; odds ratio [OR], 0.760; p 〈 0.001) and high serum UA (per 1 mg/dL; OR, 1.444; p 〈 0.001) in model 1 and anemia (OR, 2.367; p 〈 0.001) and hyperuricemia (OR, 2.516; p 〈 0.001) in model 2 were significantly associated with new-onset CKD. Furthermore, compared to the group without anemia or hyperuricemia, the groups with anemia without hyperuricemia (OR, 2.502; p 〈 0.001), without anemia with hyperuricemia (OR, 2.559; p 〈 0.001), and with anemia and hyperuricemia (OR, 5.505; p 〈 0.001) were significantly associated with new-onset CKD. There was a significant interaction between hemoglobin and serum UA and new-onset CKD (p 〈 0.001). In conclusion, we found that anemia and hyperuricemia were associated with new-onset CKD, respectively, and also had a synergetic effect on new-onset CKD.
    Type of Medium: Online Resource
    ISSN: 1660-4601
    URL: Article
    DOI: 10.3390/ijerph20021421
    Language: English
    Publisher: MDPI AG
    Publication Date: 2023
    detail.hit.zdb_id: 2175195-X
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  • 3
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    Sex Difference in the Associations among Hyperuricemia with New-Onset Chronic Kidney Disease in a Large Taiwanese Population Follow-Up Study
    MDPI AG ; 2022
    In:  Nutrients Vol. 14, No. 18 ( 2022-09-16), p. 3832-
    Details
    In: Nutrients, MDPI AG, Vol. 14, No. 18 ( 2022-09-16), p. 3832-
    Abstract: The global prevalence and incidence of chronic kidney disease (CKD) continue to increase. Whether hyperuricemia is an independent risk factor for renal progression and whether there are sex differences in the relationships between serum uric acid (UA) and a decline in renal function are unclear. Therefore, in this longitudinal study, we aimed to explore these relationships in a large cohort of around 27,000 Taiwanese participants in the Taiwan Biobank (TWB), and also to identify serum UA cutoff levels in men and women to predict new-onset CKD. A total of 26,942 participants with a median 4 years of complete follow-up data were enrolled from the TWB. We excluded those with CKD (estimated glomerular filtration rate 〈 60 mL/min/1.73 m2) at baseline (n = 297), and the remaining 26,645 participants (males: 9356; females: 17,289) were analyzed. The participants who developed CKD during follow-up were defined as having incident new-onset CKD, and those with a serum UA level 〉 7 mg/dL in males and 〉 6 mg/dL in females were classified as having hyperuricemia. After multivariable analysis, hyperuricemia (odds ratio [OR], 2.541; 95% confidence interval [CI] , 1.970–3.276; p 〈 0.001) was significantly associated with new-onset CKD. Furthermore, in the male participants (n = 9356), hyperuricemia (OR, 1.989; 95% CI, 1.440–2.747; p 〈 0.001), and quartile 4 of UA (vs. quartile 1; OR, 2.279; 95% CI, 1.464–3.547; p 〈 0.001) were significantly associated with new-onset CKD, while in the female participants (n = 17,289), hyperuricemia (OR, 3.813; 95% CI, 2.500–5.815; p 〈 0.001), quartile 3 of UA (vs. quartile 1; OR, 3.741; 95% CI, 1.250–11.915; p = 0.018), and quartile 4 of UA (vs. quartile 1; OR, 12.114; 95% CI, 14.278–34.305; p 〈 0.001) were significantly associated with new-onset CKD. There were significant interactions between hyperuricemia and sex (p = 0.024), and quartiles of serum UA and sex (p = 0.010) on new-onset CKD. Hyperuricemia was associated with new-onset CKD in the enrolled participants, and the interactions between hyperuricemia and sex were statistically significant. Hyperuricemia was more strongly associated with new-onset CKD in the women than in the men.
    Type of Medium: Online Resource
    ISSN: 2072-6643
    URL: Article
    DOI: 10.3390/nu14183832
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2518386-2
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  • 4
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    Determinants of Longitudinal Change of Glycated Hemoglobin in a Large Non-Diabetic Population
    MDPI AG ; 2021
    In:  Journal of Personalized Medicine Vol. 11, No. 7 ( 2021-07-08), p. 648-
    Details
    In: Journal of Personalized Medicine, MDPI AG, Vol. 11, No. 7 ( 2021-07-08), p. 648-
    Abstract: Although many cross-section studies have assessed the determinants of glycated hemoglobin (HbA1c), there have been limited studies designed to evaluate the temporal correlates of HbA1c in non-diabetic patients. This study aimed to identify the major determinants of longitudinal change of HbA1c in non-diabetic patients. This study included subjects from the 104,451 participants enrolled between 2012 and 2018 in the Taiwan Biobank. We only included participants with complete data at baseline and follow-up (n = 27,209). Patients with diabetes at baseline or follow-up (n = 3983) were excluded. Finally, 23,226 participants without diabetes at baseline and follow-up were selected in this study. △Parameters was defined as the difference between the measurement baseline and follow-up. Multivariable linear regression analysis was used to identify the major determinants of HbA1c longitudinal change (△HbA1c). During a mean 3.8 year follow-up, after multivariable analysis, new-onset hypertension (coefficient β: 0.014, p 〈 0.001), high △heart rate (coefficient β: 0.020, p = 0.002), high △BMI (coefficient β: 0.171, p = 0.028), high △fasting glucose (coefficient β: 0.107, p 〈 0.001), low △creatinine (coefficient β: −0.042, p 〈 0.001), high △total cholesterol (coefficient β: 0.040, p 〈 0.001), high △hemoglobin (coefficient β: 0.062, p 〈 0.001), high △GPT (coefficient β: 0.041, p = 0.001), and low △albumin (coefficient β: −0.070, p 〈 0.001) were significantly associated with high △HbA1c. In non-diabetic population, strategies to decrease the development of new-onset hypertension, resting heart rate, body mass index, fasting glucose, total cholesterol, and GPT and increase serum albumin level might be helpful in slowing the longitudinal change of HbA1c. In addition, increased hemoglobin and decreased serum creatinine over time also had an impact on the HbA1c elevation over time in non-diabetic population.
    Type of Medium: Online Resource
    ISSN: 2075-4426
    URL: Article
    DOI: 10.3390/jpm11070648
    Language: English
    Publisher: MDPI AG
    Publication Date: 2021
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  • 5
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    Changes in acoustic cardiographic parameters before and after hemodialysis are associated with overall and cardiovascular mortality in hemodialysis patients
    Springer Science and Business Media LLC ; 2021
    In:  Scientific Reports Vol. 11, No. 1 ( 2021-01-15)
    Details
    In: Scientific Reports, Springer Science and Business Media LLC, Vol. 11, No. 1 ( 2021-01-15)
    Abstract: Acoustic cardiography can provide simultaneous electrocardiography and acoustic cardiac data to assess the electronic and mechanical heart functions. The aim of this study was to assess whether changes in acoustic cardiographic parameters (ACPs) before and after hemodialysis (HD) are associated with overall and cardiovascular (CV) mortality in HD patients. A total of 162 HD patients was enrolled and ACPs were measured before and after HD, including left ventricular systolic time (LVST), systolic dysfunction index (SDI), third (S3) and fourth (S4) heart sounds, and electromechanical activation time (EMAT). During a follow-up of 2.9 years, 25 deaths occurred with 16 from CV causes. Multivariate analysis showed that high △SDI (per 1; hazard ratio [HR], 2.178; 95% confidence interval [CI] , 1.189–3.990), high △EMAT (per 1%; HR, 2.218; 95% CI 1.382–3.559), and low △LVST (per 1 ms; HR, 0.947; 95% CI 0.912–0.984) were independently associated with increased overall mortality. In addition, high △EMAT (per 1%; HR, 2.141; 95% CI 1.117–4.102), and low △LVST (per 1 ms; HR, 0.777; 95% CI 0.637–0.949) were associated with increased CV mortality. In conclusion, the changes in ACPs before and after HD may be a useful clinical marker and stronger prognostic marker of overall and CV mortality than ACPs before HD.
    Type of Medium: Online Resource
    ISSN: 2045-2322
    URL: Article
    DOI: 10.1038/s41598-021-81286-5
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 2615211-3
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  • 6
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    Sex Difference in the Associations among Obesity-Related Indices with Hyperuricemia in a Large Taiwanese Population Study
    MDPI AG ; 2023
    In:  Nutrients Vol. 15, No. 15 ( 2023-08-01), p. 3419-
    Details
    In: Nutrients, MDPI AG, Vol. 15, No. 15 ( 2023-08-01), p. 3419-
    Abstract: Hyperuricemia has been linked with the development of diabetes, gout, kidney, and cardiovascular diseases. Although obesity is associated with hyperuricemia, data on sex differences in this association are scarce. Therefore, this study was conducted to explore sex differences in the correlations among various indices of obesity with hyperuricemia in Taiwan. Data were obtained from the Taiwan Biobank and included 122,067 participants. After excluding 179 participants with missing data, the remaining 121,888 participants (men: 43,790; women: 78,098) were enrolled. The prevalence rates of hyperuricemia (defined as serum uric acid 〉 7.0/6.0 mg/dL in men/women) were 29.8% and 13.6%, respectively (p 〈 0.001). Multivariable analysis revealed high values of body shape index (ABSI), waist-to-height ratio (WHtR), waist–hip ratio (WHR), lipid accumulation product (LAP), conicity index (CI), visceral adiposity index (VAI), body adiposity index (BAI), abdominal volume index (AVI), body mass index (BMI), and body roundness index (BRI) were significantly associated with hyperuricemia in both the male and female participants (all p 〈 0.001). The interactions between sex and all 10 of these indices were significant (all p 〈 0.001) for hyperuricemia. In men, LAP had the highest area under the curve (0.669), followed by BMI (0.655), VAI (0.645), AVI (0.642), BRI (0.640), WHtR (0.633), BAI (0.605), WHR (0.599), CI (0.574), and ABSI (0.510). In women, LAP also had the highest area under the curve (0.754), followed by BMI (0.728), VAI (0.724), WHtR (0.721), BRI (0.720), AVI (0.713), WHR (0.676), BAI (0.673), CI (0.626), and ABSI (0.544). In conclusion, obesity-related indices were associated with hyperuricemia in this large Taiwanese study, and sex differences were found in these associations, with stronger associations in women than in men.
    Type of Medium: Online Resource
    ISSN: 2072-6643
    URL: Article
    DOI: 10.3390/nu15153419
    Language: English
    Publisher: MDPI AG
    Publication Date: 2023
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  • 7
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    Components of the Complete Blood Count as a Risk Predictor for Incident Hypertension in a Large Taiwanese Population Follow-up Study
    Japanese Circulation Society ; 2023
    In:  Circulation Journal Vol. 87, No. 3 ( 2023-2-24), p. 456-462
    Details
    In: Circulation Journal, Japanese Circulation Society, Vol. 87, No. 3 ( 2023-2-24), p. 456-462
    Type of Medium: Online Resource
    ISSN: 1346-9843 , 1347-4820
    URL: Article
    DOI: 10.1253/circj.CJ-22-0512
    Language: English
    Publisher: Japanese Circulation Society
    Publication Date: 2023
    detail.hit.zdb_id: 2084830-4
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  • 8
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    Liver-function parameters are associated with incident hypertension in a large Taiwanese population follow-up study
    Springer Science and Business Media LLC ; 2022
    In:  Journal of Human Hypertension Vol. 37, No. 6 ( 2022-05-26), p. 496-501
    Details
    In: Journal of Human Hypertension, Springer Science and Business Media LLC, Vol. 37, No. 6 ( 2022-05-26), p. 496-501
    Type of Medium: Online Resource
    ISSN: 1476-5527
    URL: Article
    DOI: 10.1038/s41371-022-00694-w
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 2006792-6
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  • 9
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    Aortic Arch Calcification and Cardiomegaly Are Associated with Overall and Cardiovascular Mortality in Hemodialysis Patients
    MDPI AG ; 2021
    In:  Journal of Personalized Medicine Vol. 11, No. 7 ( 2021-07-13), p. 657-
    Details
    In: Journal of Personalized Medicine, MDPI AG, Vol. 11, No. 7 ( 2021-07-13), p. 657-
    Abstract: Patients with end-stage renal disease have a higher risk of cardiovascular morbidity and mortality. In this study, we investigated the predictive ability of a combination of cardiothoracic ratio (CTR) and aortic arch calcification (AoAC) for overall and cardiovascular mortality in patients receiving hemodialysis. We also evaluated the predictive power of AoAC and CTR for clinical outcomes. A total of 365 maintenance hemodialysis patients were included, and AoAC and CTR were measured using chest radiography at enrollment. We stratified the patients into four groups according to a median AoAC score of three and CTR of 50%. Multivariable Cox proportional hazards analysis was used to identify the risk factors of mortality. The predictive performance of the model for clinical outcomes was assessed using the χ2 test. Multivariable analysis showed that, compared to the AoAC 〈 3 and CTR 〈 50% group, the AoAC ≥ 3 and CTR 〈 50% group (hazard ratio [HR], 4.576; p 〈 0.001), and AoAC ≥ 3 and CTR ≥ 50% group (HR, 5.912; p 〈 0.001) were significantly associated with increased overall mortality. In addition, the AoAC 〈 3 and CTR ≥ 50% (HR, 3.806; p = 0.017), AoAC ≥ 3 and CTR 〈 50% (HR, 4.993; p = 0.002), and AoAC ≥ 3 and CTR ≥ 50% (HR, 8.614; p 〈 0.001) groups were significantly associated with increased cardiovascular mortality. Furthermore, adding AoAC and CTR to the basic model improved the predictive ability for overall and cardiovascular mortality. The patients who had a high AoAC score and cardiomegaly had the highest overall and cardiovascular mortality among the four groups. Furthermore, adding AoAC and CTR improved the predictive ability for overall and cardiovascular mortality in the hemodialysis patients.
    Type of Medium: Online Resource
    ISSN: 2075-4426
    URL: Article
    DOI: 10.3390/jpm11070657
    Language: English
    Publisher: MDPI AG
    Publication Date: 2021
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  • 10
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    Low Albumin, Low Bilirubin, and High Alfa-Fetoprotein Are Associated with a Rapid Renal Function Decline in a Large Population Follow-Up Study
    MDPI AG ; 2021
    In:  Journal of Personalized Medicine Vol. 11, No. 8 ( 2021-08-11), p. 781-
    Details
    In: Journal of Personalized Medicine, MDPI AG, Vol. 11, No. 8 ( 2021-08-11), p. 781-
    Abstract: A rapid decline in renal function is associated with high cardiovascular morbidity and mortality, and therefore it is important to identify those at high-risk of rapid renal function decline. The relationship between liver function and renal function is unclear. Therefore, in this longitudinal study, we aimed to investigate associations between liver function and rapid renal function decline. A total of 27,116 participants were enrolled from the Taiwan Biobank and followed for 3.8 years. A rapid decline in renal function was defined as a decline in estimated glomerular filtration rate (eGFR) of ≥25%. Binary logistic regression analysis was used to identify associations between liver function parameters (glutamic-oxalacetic transaminase, glutamic-pyruvic transaminase, albumin, α-fetoprotein [AFP], total bilirubin, and gamma-glutamyl transpeptidase) and eGFR decline ≥ 25%. The rate of eGFR decline of ≥25% was 4.7%. Multivariable analysis showed that low albumin (odds ratio [OR] , 0.173; p 〈 0.001), high AFP (OR, 1.006; p = 0.010), and low total bilirubin (OR, 0.588; p 〈 0.001) were significantly associated with eGFR decline ≥ 25% in all study participants. After excluding abnormal liver function, low albumin (OR, 0.189; p 〈 0.001), high AFP (OR, 1.007; p = 0.011), and low total bilirubin (OR, 0.569; p = 0.001) were still significantly associated with an eGFR decline of ≥25%. The results of this large population-based cohort study showed associations between low albumin, low bilirubin, and high AFP with a rapid renal function decline. A greater understanding of potential risk factors for a rapid decline in renal function may help to reduce the burden of renal failure in this high-risk population.
    Type of Medium: Online Resource
    ISSN: 2075-4426
    URL: Article
    DOI: 10.3390/jpm11080781
    Language: English
    Publisher: MDPI AG
    Publication Date: 2021
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