Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2023-01-30 Cooperative journals: 《中国全科医学》
Abstract：
Background Hyperuricemia (HUA) caused by elevated serum uric acid (SUA) has been proven to be an independent risk factor for the development and progression of chronic kidney disease (CKD). However, there are few cohort studies on the correlation between SUA level and the development and progression of CKD in the Chinese elderly. Objective To investigate the association between baseline SUA level, changes in SUA levels, the risk of chronic kidney disease (CKD), and estimated glomerular filtration rate (eGFR) in the elderly in longevity areas in China. Methods Based on Healthy Aging and Biomarkers Cohort Study (HABCS), a sub cohort of the Chinese Longitudinal Healthy Longevity Survey (CLHLS), the elderly who underwent physical examination and provided biomedical indicators from 2012 to 2014 were selected as the study subjects. The age, gender, height, weight, waist circumference, calf circumference, blood pressure, blood lipid, blood glucose, blood routine examination, urine routine examination, and other medical indicators were collected at baseline and follow-up period. Cox proportional hazards regression model was used to analyze the association between different SUA levels and the risk of CKD. Pearson linear correlation and linear regression were used to analyze the association between changes in SUA level and changes in eGFR in the elderly. Results A total of 981 subjects were included in the study, with an average age of 80.1±11.9 years. The prevalence of HUA was 6.83%. The cumulative follow-up of 2029 person-years (median 2.05 years) showed 179 new cases of CKD, the cumulative incidence rate of CKD during the follow-up was 18.25% (95%CI: 15.88-20.81%), and the incidence density was 88.22/1000 person-years (95%CI: 76.24-101.41 person-years). After multivariate adjustment, compared with the lowest quartile group of baseline SUA level (Q1: < 223 μmol/L), the HR values of CKD risk in other three high quartile groups (Q2: 223-270 μmol/L, Q3: 271-326 μmol/L, and Q4 ≥ 326 μmol/L) were 1.19 (95%CI: 0.74, 1.94; P=0.474)，1.27 (95%CI: 0.76, 2.10; P=0.362), and 2.08 (95%CI: 1.27, 3.41; P=0.004; Ptrend=0.003), respectively. And a per 10 μmol/L increase in baseline SUA level, the risk of CKD increased by 4% (95%CI: 2%, 7%; P<0.001). The risk of CKD in the elderly with HUA at baseline was 2.00 times (95%CI: 1.20, 3.24; P=0.007) higher than that in the elderly without HUA. The results of Pearson linear correlation analysis showed that changes in eGFR in the elderly (r = -0.355, P<0.001) decreased with the increase of change in SUA level. Multivariate adjusted linear regression analysis result showed that for per 10 μmol/L increase change in SUA level, change in eGFR decreased by 1.03 (95%CI: -1.23, -0.83; P<0.001) ml/min/1.73m2. Conclusion Elevated SUA level are associated with an increased risk of CKD and a decline in eGFR in an elderly Chinese population.
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2023-01-03 Cooperative journals: 《中国全科医学》
Abstract：
Background The chronic kidney disease (CKD) seriously harms the health and the life span of the elderly. Hypertension is closely related to CKD. However, there are few cohort studies focusing on the blood pressure levels and CKD in the older adults. Objective To investigate the relationship between blood pressure and the risk of chronic kidney disease in the elderly aged 65 years and older. Methods Based on the "Chinese Longitudinal Healthy Longevity Survey (CLHLS)", 989 elderly people who underwent physical examination and biomedical indicator tests in 2012 were selected as subjects. Biomedical indicators including age, sex, height, weight, blood pressure, blood lipid, blood glucose and urine test were collected at baseline. The follow-up monitoring was conducted in 2014. Cox proportional hazard model was used to analyze the association between different blood pressure levels and the risk of CKD. Results 989 subjects, with an average age of 80.2±12.0 years, were included in the study. A total of 183 cases of CKD were diagnosed during an average follow-up time of 2.07 years. The cumulative incidence of CKD during the follow-up period was 18.5% (95%CI: 16.1%-21.1%), and the incidence density was 89.4/1000 person-years. Compared with normal blood pressure, older adults with hypertension, after adjusting for multiple factors, had a higher risk of CKD [HR (95%CI) 2.28 (1.13-4.60)]. The risk of CKD in older adults with baseline SBP ≥ 140mmHg was 1.83 times higher than that in older adults with SBP<120mmHg (95%CI: 1.02-3.29). The risk of CKD with baseline DBP ≥ 90mmHg was 1.55 times higher than those with DBP<80mmHg (95%CI: 1.02-2.35). Conclusion Elevated blood pressure is an independent risk factor for chronic kidney disease in the elderly. To increase screening and prevention of CKD is particularly important, especially for those with elevated systolic blood pressure.
Subjects: Physics >> General Physics: Statistical and Quantum Mechanics, Quantum Information, etc. submitted time 2022-11-16 Cooperative journals: 《中国全科医学》
Abstract：
Background Hyperuricemia (HUA) caused by elevated serum uric acid (SUA) has become the fourth most common disease after hyperglycemia, hyperlipidemia, and hypertension, and the second most common metabolic disease after diabetes. It has been shown that elevated SUA levels were significantly associated with the risk of type 2 diabetes mellitus (T2DM). Objective To investigate the association between baseline SUA levels and the risk of T2DM in health examination population. Methods A total of 17626 subjects without diabetes history at baseline who had underwent at least two physical examination from January 2017 to December 2020 were selected to collect demographic information, lifestyle information, physical examination information, and laboratory indicators. Cox proportional risk model was used to analyze the association between baseline SUA levels and the risk of T2DM. Results The median age of subjects were 38.15 (31.89, 49.59) years. The median SUA levels at baseline were 304.50 (248.00, 374.00) umol/L and the prevalence of HUA was 13.12%. The cumulative follow-up was 54634 person-years, with a median follow-up of 3.10 years. There were 479 new cases of T2DM. The incidence density was 8.76/1000 person-years (95%CI: 8.00/1000 - 9.59/1000 person-years) and the cumulative incidence rate was 2.72% (95%CI: 2.48 - 2.97%). There were high cumulative incidence rate of T2DM in high age group (≥ 60 years old), female, current smoking, current alcohol consumption, BMI ≥ 28.0 Kg/m2, hypertension, and dyslipidemia subgroups, and higher risk of T2DM when those subgroup population accompany with HUA. The result of multivariate adjusted Cox proportional risk regression model showed that HUA patients had an increased risk of T2DM, with an HR of 1.32 (95%CI：1.04, 1.67; P=0.001). The risk of T2DM was higher in high SUA groups with the increase of SUA level (Ptrend <0.001). For every 10 umol/L increase in baseline SUA level, the risk of T2DM increased by 3% (95%CI：1%-4%, P<0.001). Conclusion Elevated baseline SUA levels in health examination population are associated with a higher risk of T2DM.
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2022-11-16 Cooperative journals: 《中国全科医学》
Abstract：
Background: Cancer and chronic diseases are multidimensional, and many chronic diseases shared common risk factors with cancers. Objective: To investigate the association between chronic disease risk score and cancer risk. Method: A total of 18009 individuals who received physical examination from January 2015 to December 2019 in the Tianjin Chronic Disease Risk and Health Management Cohort Study were selected as the subjects. With categorical variables of chronic disease related indicators (including BMI, waist circumference, blood pressure, blood glucose, total cholesterol, triglycerides, uric acid, total bilirubin, heart rate, and estimated glomerular filtration rate) as the independent variables and occurrence of cancer as the dependent variable, multivariate adjusted Cox proportional hazards regression model was used to evaluate the relationships between each chronic disease related indicators and cancer risk, and then calculated the comprehensive score of chronic disease risk. According to the tertiles of chronic disease risk score, the subjects were divided into low score group (<6 points), medium score group (6-9 points), and high score group (≥9 points). Cancer risks (HR value) in different chronic disease risk score groups were calculated by Cox proportional hazards regression model. Results: A total of 71835 person-years (median 4.00 years) were followed up, and 91 cases were diagnosed with cancer. Compared with low score group, the HR values of cancer risk were 2.16 (95%CI: 1.20-3.90) and 3.08 (95%CI: 1.72-5.50) (Ptrend<0.001) in medium score group and high score group, respectively. For per point increase in the chronic disease risk score, the risk of cancer increased by 17% (95%CI: 1.09-1.25, P<0.001). In addition, women in high score group (≥9 points) had an increased risk of cancer, with HR value (95%CI) of 3.00 (1.32-6.82, P=0.009). Conclusion: The higher chronic disease risk score, the higher cancer risk.
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