Objective The relationship between sodium intake and cardiovascular(CV)events remains unconfirmed.Therefore,we carried out a systematic review and dose-response meta-analysis for evaluating the potential impact of 24-...Objective The relationship between sodium intake and cardiovascular(CV)events remains unconfirmed.Therefore,we carried out a systematic review and dose-response meta-analysis for evaluating the potential impact of 24-hour sodium excretion on CV risk.Besides,24-hour sodium excretion was used to replace daily sodium diet intake.Methods We searched ISI Web of Science,Embase,Pub Med,and the Cochrane Library.Our study included cohort studies reporting hazard ratio(HR).The random-effects model was used for summarizing the total relative risks(RRs)between the included studies.In addition,the generalized least-squares regression was employed to fit the study model.Results A total of 9 studies involving 645,006 participants were included in this study.A significant non-linear relationship was observed between sodium excretion and CV events(P^(non-linearity)<0.001).In studies collecting 24-h urine samples,the sodium excretion and CV events risk were associated linearly(RR:1.04;95%CI:1.01,1.07).Conclusion In a linear dose-response manner,every 1 g increase in sodium intake was associated with an increased risk of CV events up to 4%.Further studies are required to validate our conclusions further.展开更多
Objective:To study the correlation of urinary albumin excretion rate with renal function, inflammatory response and oxidative stress response in patients with diabetic nephropathy (DN).Methods: A total of 78 patients ...Objective:To study the correlation of urinary albumin excretion rate with renal function, inflammatory response and oxidative stress response in patients with diabetic nephropathy (DN).Methods: A total of 78 patients with DN treated in our hospital December 2012 and March 2016 were collected and divided into early diabetic nephropathy group (n=51) and middle-advanced diabetic nephropathy group (n=27) according to the DN grading standard;60 subjects with normal renal function who receiving physical examination in our hospital during the same period were selected as normal control group. Immediately after admission, the urinary albumin excretion rate (UAER) of all groups were determined;automatic biochemical analyzer was used to determine renal function index levels, ELISA method was used to determine inflammatory factor levels, and RIA method was used to determine the oxidative stress index levels;Pearson test was used to analyze the correlation of UAER value with renal function, inflammatory response and oxidative stress response in patients with DN.Results:Differences in UAER value as well as renal function index, inflammatory response index and oxidative stress index levels were statistically significant among three groups of subjects. UAER value as well as BUN, Scr, CysC,β2-MG, IL-6, hs-CRP, TNF- , MDA and AOPP levels of early DN group and middle-advanced DN group were higher than those of normal control group while T-AOC and SOD levels were lower than those of normal control group;UAER value as well as BUN, Scr, CysC,β2-MG, IL-6, hs-CRP, TNF- , MDA and AOPP levels of middle-advanced DN group was higher than those of early DN group while T-AOC and SOD levels were lower than those of early DN group;UAER value in patients with DN was correlated with renal function, inflammatory response and oxidative stress.Conclusion:UAER value can directly reflect the renal injury, inflammation and oxidative stress in patients with DN, and be the reliable means for early disease diagnosis and treatment guidance.展开更多
目的以24 h尿钠排泄水平(24 h UNa)作为钠摄入量评估指标,评估不同钠盐的摄入水平与血清炎症因子对2型糖尿病(T2DM)患者尿白蛋白(UA)发生风险的影响。方法纳入T2DM患者130例,依据尿白蛋白/肌酐比值(UACR)水平分为UA阳性组60例和UA阴性...目的以24 h尿钠排泄水平(24 h UNa)作为钠摄入量评估指标,评估不同钠盐的摄入水平与血清炎症因子对2型糖尿病(T2DM)患者尿白蛋白(UA)发生风险的影响。方法纳入T2DM患者130例,依据尿白蛋白/肌酐比值(UACR)水平分为UA阳性组60例和UA阴性组70例。收集患者的临床资料,检测炎性因子及24 h尿液相关指标。采用Spearman相关分析T2DM患者临床指标与UACR的相关性;二元Logistic回归分析T2DM患者临床指标对UA的影响;二分类回归法分析24 h UNa和IL-18关联对UA的影响。结果24 h UNa水平(OR=1.019,95%CI 1.003~1.035,P=0.017)与IL-18(OR=1.204,95%CI 1.060~1.368,P=0.004)是T2DM患者UA阳性的独立危险因素。联合分析提示,与低钠低IL-18组比较,高钠高IL-18组UA阳性风险显著增加(OR=10.774,95%CI 2.105~55.155,P=0.004)。结论24 h UNa、IL-18水平升高是T2DM患者UA发生的危险因素。展开更多
Background Coronary heart disease is the main complication of type 2 diabetes mellitus; its incidence is closely related to microalbuminuria. The aim of this study was to investigate the correlation between the urinar...Background Coronary heart disease is the main complication of type 2 diabetes mellitus; its incidence is closely related to microalbuminuria. The aim of this study was to investigate the correlation between the urinary albumin excretion rate and the incidence and severity of coronary heart disease in elderly type 2 diabetes mellitus patients. Methods A total of 612 hospitalized type 2 diabetes mellitus patients aged 60 years or older, who were given coronary angiography for diagnosis of possible coronary heart disease, participated. Their urinary albumin excretion rate was measured, and the severity of coronary artery stenosis was quantified with the Gensini scoring system to analyze the incidence of coronary heart disease and the severity of coronary artery stenosis. The optimal urinary albumin excretion rate predictive value for coronary heart disease incidence in elderly type 2 diabetes mellitus patients was determined. Results The incidence of coronary heart disease, the number of patients with coronary vascular disease and the Gensini scores were significantly different between the microalbuminuria group and the normal atbuminuria group (P 〈0.05). The urinary albumin excretion rate was independently correlated with the occurrence of coronary heart disease in elderly type 2 diabetes mellitus patients (odds ratio (OR) =1.058, P 〈0.0001,95% confidence interval (CI): 1.036-1.080). Urinary albumin excretion rate and the Gensini score were independently correlated in elderly type 2 diabetes mellitus patients (β=0.476, P 〈0.0001). The best predictive value of urinary albumin excretion rate was 10.45 tJg/min for elderly type 2 diabetes mellitus patients. The area under the curve was 0.764, with a sensitivity and specificity of 70.0% and 72.2%, respectively. Conclusions The occurrence of coronary heart disease in elderly type 2 diabetes mellitus patients with microalbuminuria was higher than that in patients with normal albuminuria, and the severity of the disease also increased in patients with microalbuminuria. In elderly type 2 diabetes mellitus patients, urinary albumin excretion rate was positively correlated with the incidence and severity of coronary heart disease and was also an independent factor contributing to coronary heart disease.展开更多
Background:Time in range(TIR)refers to the time an individual spends within their target glucose range,which now has been popularized as an important metric to classify glycemic management and also recognized as an im...Background:Time in range(TIR)refers to the time an individual spends within their target glucose range,which now has been popularized as an important metric to classify glycemic management and also recognized as an important outcome of current diabetes therapies.This study aimed to investigate the association between TIR and the severity of the urinary albumin excretion rate(UAER)in patients with type 2 diabetes mellitus(T2DM).Methods:We retrospectively analyzed the data of 1014 inpatients with T2DM at the Department of Endocrinology and Metabolism of Peking University International Hospital,China.TIR was defined as the percentage of blood glucose within the target range of 3.90-10.00 mmol/L.Urine samples for assessment of UAER were collected for 3 consecutive days from the start of hospitalization.Results:The TIR values for patients with normal urine levels of albumin,microalbuminuria,and macroalbuminuria were 70%±20%,50%±20%,and 30%±20%,respectively(allP<0.001).The patients were stratified according to quartiles of TIR as follows:quartile(Q)1,<55%;Q2,55%-72%;Q3,73%-83%;and Q4,>83%.The incidences of microalbuminuria in Q1,Q2,Q3,and Q4 were 41.1%,21.6%,7.1%,and 5.5%(allP<0.001),respectively.The respective incidences of macroalbuminuria were 24.2%,1.1%,1.4%,and 0%(allP<0.001).In multinomial logistic regression analyses,TIR was significantly correlated with microalbuminuria(odds ratio[OR]0.58,95%confidence interval[CI]:0.52-0.65,P<0.001)and macroalbuminuria(OR 0.26,95%CI:0.18-0.38,P<0.001)after adjusting for age,sex,body mass index,diabetes duration,systolic blood pressure,and levels of triglycerides,glycosylated hemoglobin A1c,and creatinine.Conclusion:The proportion of blood glucose in TIR is closely related to the severity of UAER in patients with T2DM.展开更多
Background:The low accuracy of equations predicting 24-h urinary sodium excretion using a single spot urine sample contributed to the misclassification of individual sodium intake levels.The application of single spot...Background:The low accuracy of equations predicting 24-h urinary sodium excretion using a single spot urine sample contributed to the misclassification of individual sodium intake levels.The application of single spot urine sample is limited by a lack of representativity of urinary sodium excretion,possibly due to the circadian rhythm in urinary excretion.This study aimed to explore the circadian rhythm,characteristics,and parameters in a healthy young adult Chinese population as a theoretical foundation for developing new approaches.Methods:Eighty-five participants(mean age 32.4 years)completed the 24-h urine ollction by sccessively cllecing each of the single-voided specimens within 24 h.The concentrations of the urinary sodium,potassium,and creatinine for cach voided specimen were measured.Cosinor analysis was applied to explore the circadian rhythm of the urinary sodium,potassium,and creatinine excretion.The excretion per hour was computed for analyzing the change over time with repeated-measures analysis of variance and a cubic spline model.Results:The metabolism of urinary sodium,potassium,and creatinine showed different patterns of circadian rhythm,although the urinary sodiurm excretion showed non-significant parameters in the cosinor model.A significant circadian rhythm of urinary creatinine excretion was observed,while the circadian rhythm of sodium was less significant than that of potassium.The circadian rhythm of urinary sodium and creatinine excretion showed synchronization to some extent,which had a nocturnal peak and fell to the lowest around noon to afternoon.In contrast,the peak of potassium was observed in the morning and dropped to the lowest point in the evening.The hourly urinary excretion followed a similar circadian rhythm.Conclusion:It is necessary to consider the circadian rhythm of urinary sodium,potassium,and creatinine excretion in adults while exploring the estimation model for 24-h urinary sodium excretion using spot urine.展开更多
文摘Objective The relationship between sodium intake and cardiovascular(CV)events remains unconfirmed.Therefore,we carried out a systematic review and dose-response meta-analysis for evaluating the potential impact of 24-hour sodium excretion on CV risk.Besides,24-hour sodium excretion was used to replace daily sodium diet intake.Methods We searched ISI Web of Science,Embase,Pub Med,and the Cochrane Library.Our study included cohort studies reporting hazard ratio(HR).The random-effects model was used for summarizing the total relative risks(RRs)between the included studies.In addition,the generalized least-squares regression was employed to fit the study model.Results A total of 9 studies involving 645,006 participants were included in this study.A significant non-linear relationship was observed between sodium excretion and CV events(P^(non-linearity)<0.001).In studies collecting 24-h urine samples,the sodium excretion and CV events risk were associated linearly(RR:1.04;95%CI:1.01,1.07).Conclusion In a linear dose-response manner,every 1 g increase in sodium intake was associated with an increased risk of CV events up to 4%.Further studies are required to validate our conclusions further.
文摘Objective:To study the correlation of urinary albumin excretion rate with renal function, inflammatory response and oxidative stress response in patients with diabetic nephropathy (DN).Methods: A total of 78 patients with DN treated in our hospital December 2012 and March 2016 were collected and divided into early diabetic nephropathy group (n=51) and middle-advanced diabetic nephropathy group (n=27) according to the DN grading standard;60 subjects with normal renal function who receiving physical examination in our hospital during the same period were selected as normal control group. Immediately after admission, the urinary albumin excretion rate (UAER) of all groups were determined;automatic biochemical analyzer was used to determine renal function index levels, ELISA method was used to determine inflammatory factor levels, and RIA method was used to determine the oxidative stress index levels;Pearson test was used to analyze the correlation of UAER value with renal function, inflammatory response and oxidative stress response in patients with DN.Results:Differences in UAER value as well as renal function index, inflammatory response index and oxidative stress index levels were statistically significant among three groups of subjects. UAER value as well as BUN, Scr, CysC,β2-MG, IL-6, hs-CRP, TNF- , MDA and AOPP levels of early DN group and middle-advanced DN group were higher than those of normal control group while T-AOC and SOD levels were lower than those of normal control group;UAER value as well as BUN, Scr, CysC,β2-MG, IL-6, hs-CRP, TNF- , MDA and AOPP levels of middle-advanced DN group was higher than those of early DN group while T-AOC and SOD levels were lower than those of early DN group;UAER value in patients with DN was correlated with renal function, inflammatory response and oxidative stress.Conclusion:UAER value can directly reflect the renal injury, inflammation and oxidative stress in patients with DN, and be the reliable means for early disease diagnosis and treatment guidance.
文摘目的以24 h尿钠排泄水平(24 h UNa)作为钠摄入量评估指标,评估不同钠盐的摄入水平与血清炎症因子对2型糖尿病(T2DM)患者尿白蛋白(UA)发生风险的影响。方法纳入T2DM患者130例,依据尿白蛋白/肌酐比值(UACR)水平分为UA阳性组60例和UA阴性组70例。收集患者的临床资料,检测炎性因子及24 h尿液相关指标。采用Spearman相关分析T2DM患者临床指标与UACR的相关性;二元Logistic回归分析T2DM患者临床指标对UA的影响;二分类回归法分析24 h UNa和IL-18关联对UA的影响。结果24 h UNa水平(OR=1.019,95%CI 1.003~1.035,P=0.017)与IL-18(OR=1.204,95%CI 1.060~1.368,P=0.004)是T2DM患者UA阳性的独立危险因素。联合分析提示,与低钠低IL-18组比较,高钠高IL-18组UA阳性风险显著增加(OR=10.774,95%CI 2.105~55.155,P=0.004)。结论24 h UNa、IL-18水平升高是T2DM患者UA发生的危险因素。
基金The study was supported by a grant from the Beijing Municipal Natural Science Foundation of China (No. 7062059).
文摘Background Coronary heart disease is the main complication of type 2 diabetes mellitus; its incidence is closely related to microalbuminuria. The aim of this study was to investigate the correlation between the urinary albumin excretion rate and the incidence and severity of coronary heart disease in elderly type 2 diabetes mellitus patients. Methods A total of 612 hospitalized type 2 diabetes mellitus patients aged 60 years or older, who were given coronary angiography for diagnosis of possible coronary heart disease, participated. Their urinary albumin excretion rate was measured, and the severity of coronary artery stenosis was quantified with the Gensini scoring system to analyze the incidence of coronary heart disease and the severity of coronary artery stenosis. The optimal urinary albumin excretion rate predictive value for coronary heart disease incidence in elderly type 2 diabetes mellitus patients was determined. Results The incidence of coronary heart disease, the number of patients with coronary vascular disease and the Gensini scores were significantly different between the microalbuminuria group and the normal atbuminuria group (P 〈0.05). The urinary albumin excretion rate was independently correlated with the occurrence of coronary heart disease in elderly type 2 diabetes mellitus patients (odds ratio (OR) =1.058, P 〈0.0001,95% confidence interval (CI): 1.036-1.080). Urinary albumin excretion rate and the Gensini score were independently correlated in elderly type 2 diabetes mellitus patients (β=0.476, P 〈0.0001). The best predictive value of urinary albumin excretion rate was 10.45 tJg/min for elderly type 2 diabetes mellitus patients. The area under the curve was 0.764, with a sensitivity and specificity of 70.0% and 72.2%, respectively. Conclusions The occurrence of coronary heart disease in elderly type 2 diabetes mellitus patients with microalbuminuria was higher than that in patients with normal albuminuria, and the severity of the disease also increased in patients with microalbuminuria. In elderly type 2 diabetes mellitus patients, urinary albumin excretion rate was positively correlated with the incidence and severity of coronary heart disease and was also an independent factor contributing to coronary heart disease.
文摘Background:Time in range(TIR)refers to the time an individual spends within their target glucose range,which now has been popularized as an important metric to classify glycemic management and also recognized as an important outcome of current diabetes therapies.This study aimed to investigate the association between TIR and the severity of the urinary albumin excretion rate(UAER)in patients with type 2 diabetes mellitus(T2DM).Methods:We retrospectively analyzed the data of 1014 inpatients with T2DM at the Department of Endocrinology and Metabolism of Peking University International Hospital,China.TIR was defined as the percentage of blood glucose within the target range of 3.90-10.00 mmol/L.Urine samples for assessment of UAER were collected for 3 consecutive days from the start of hospitalization.Results:The TIR values for patients with normal urine levels of albumin,microalbuminuria,and macroalbuminuria were 70%±20%,50%±20%,and 30%±20%,respectively(allP<0.001).The patients were stratified according to quartiles of TIR as follows:quartile(Q)1,<55%;Q2,55%-72%;Q3,73%-83%;and Q4,>83%.The incidences of microalbuminuria in Q1,Q2,Q3,and Q4 were 41.1%,21.6%,7.1%,and 5.5%(allP<0.001),respectively.The respective incidences of macroalbuminuria were 24.2%,1.1%,1.4%,and 0%(allP<0.001).In multinomial logistic regression analyses,TIR was significantly correlated with microalbuminuria(odds ratio[OR]0.58,95%confidence interval[CI]:0.52-0.65,P<0.001)and macroalbuminuria(OR 0.26,95%CI:0.18-0.38,P<0.001)after adjusting for age,sex,body mass index,diabetes duration,systolic blood pressure,and levels of triglycerides,glycosylated hemoglobin A1c,and creatinine.Conclusion:The proportion of blood glucose in TIR is closely related to the severity of UAER in patients with T2DM.
基金This study was supported by the Laboratory Examination Technology Special Fund from International Scientific Exchange Foundation of China(No.Z2019L BJ001)the Beiing Municipal Administration of Hospital Clinical Medicine Development Special Project(No.ZYLX201840).
文摘Background:The low accuracy of equations predicting 24-h urinary sodium excretion using a single spot urine sample contributed to the misclassification of individual sodium intake levels.The application of single spot urine sample is limited by a lack of representativity of urinary sodium excretion,possibly due to the circadian rhythm in urinary excretion.This study aimed to explore the circadian rhythm,characteristics,and parameters in a healthy young adult Chinese population as a theoretical foundation for developing new approaches.Methods:Eighty-five participants(mean age 32.4 years)completed the 24-h urine ollction by sccessively cllecing each of the single-voided specimens within 24 h.The concentrations of the urinary sodium,potassium,and creatinine for cach voided specimen were measured.Cosinor analysis was applied to explore the circadian rhythm of the urinary sodium,potassium,and creatinine excretion.The excretion per hour was computed for analyzing the change over time with repeated-measures analysis of variance and a cubic spline model.Results:The metabolism of urinary sodium,potassium,and creatinine showed different patterns of circadian rhythm,although the urinary sodiurm excretion showed non-significant parameters in the cosinor model.A significant circadian rhythm of urinary creatinine excretion was observed,while the circadian rhythm of sodium was less significant than that of potassium.The circadian rhythm of urinary sodium and creatinine excretion showed synchronization to some extent,which had a nocturnal peak and fell to the lowest around noon to afternoon.In contrast,the peak of potassium was observed in the morning and dropped to the lowest point in the evening.The hourly urinary excretion followed a similar circadian rhythm.Conclusion:It is necessary to consider the circadian rhythm of urinary sodium,potassium,and creatinine excretion in adults while exploring the estimation model for 24-h urinary sodium excretion using spot urine.