Chronic kidney disease affects people worldwide. Approximately 1 out of 3 adults with diabetes have kidney disease. Among several etiological factors for CKD, diabetes mellitus (DM) and hypertension are the main facto...Chronic kidney disease affects people worldwide. Approximately 1 out of 3 adults with diabetes have kidney disease. Among several etiological factors for CKD, diabetes mellitus (DM) and hypertension are the main factors. These factors not only cause CKD but are also responsible for several complications related to CKD. In this article, we have reviewed Diabetic Nephropathy (DN) in terms of etiology, pathophysiology, diagnosis, management, current guidelines for diabetic nephropathy management, and some of the research study findings. Diabetic nephropathy (DN) is the chief factor for end-stage renal disease (ESRD) development across the globe. The primary cause of DN is Diabetes Mellitus, which is an autoimmune lifestyle disorder having several etiological factors. Checking for urine albuminuria, estimated GFR (eGFR), and blood glucose are unswerving tests for DN diagnosis and subsequent monitoring. Controlling hyperglycemia, blood pressure, and proteinuria are critical in stopping the progression of DKD. Clinical practice and evidence-based medicine demonstrated that early diagnosis followed by treatment can prevent or halt DKD progression.展开更多
Background:Life’s Simple 7,the former construct of cardiovascular health(CVH)has been used to evaluate adverse non-communicable chronic diseases(NCDs).However,some flaws have been recognized in recent years and Life...Background:Life’s Simple 7,the former construct of cardiovascular health(CVH)has been used to evaluate adverse non-communicable chronic diseases(NCDs).However,some flaws have been recognized in recent years and Life’s Essential 8 has been established.In this study,we aimed to analyze the association between CVH defined by Life’s Essential 8 and risk of 44 common NCDs and further estimate the population attributable fractions(PAFs)of low-moderate CVH scores in the 44 NCDs.Methods:In the UK Biobank,170,726 participants free of 44 common NCDs at baseline were included.The Life’s Essential 8 composite measure consists of four health behaviours(diet,physical activity,nicotine exposure,and sleep)and four health factors(body mass index,non-high density lipoprotein cholesterol,blood glucose,and blood pressure),and the maximum CVH score was 100 points.CVH score was categorized into low,moderate,and high groups.Participants were followed up for 44 NCDs diagnosis across 10 human system disorders according to the International Classification of Diseases 10th edition(ICD-10)code using linkage to national health records until 2022.Cox proportional hazard models were used in this study.The hazard ratios(HRs)and PAFs of 44 NCDs associated with CVH score were examined.Results:During the median follow-up of 10.85 years,58,889 incident NCD cases were documented.Significant linear dose-response associations were found between higher CVH score and lower risk of 25(56.8%)of 44 NCDs.Low-moderate CVH(<80 points)score accounted for the largest proportion of incident cases in diabetes(PAF:80.3%),followed by gout(59.6%),sleep disorder(55.6%),chronic liver disease(45.9%),chronic kidney disease(40.9%),ischemic heart disease(40.8%),chronic obstructive pulmonary disease(40.0%),endometrium cancer(35.8%),lung cancer(34.0%),and heart failure(34.0%)as the top 10.Among the eight modifiable factors,overweight/obesity explained the largest number of cases of incident NCDs in endocrine,nutritional,and metabolic diseases(35.4%),digestive system disorders(21.4%),mental and behavioral disorders(12.6%),and cancer(10.3%);however,the PAF of ideal sleep duration ranked first in nervous system(27.5%)and neuropsychiatric disorders(9.9%).Conclusions:Improving CVH score based on Life’s Essential 8 may lower risk of 25 common NCDs.Among CVH metrics,avoiding overweight/obesity may be especially important to prevent new cases of metabolic diseases,NCDs in digestive system,mental and behavioral disorders,and cancer.展开更多
目的评估癌症、心脑血管疾病、糖尿病及慢性呼吸系统疾病(以下简称“四大慢病”)的主要危险因素及相关危险因素暴露的疾病负担。方法本研究数据来源于2019年全球疾病负担研究(Global Burden of Disease Study,GBD)数据库,通过获取2019...目的评估癌症、心脑血管疾病、糖尿病及慢性呼吸系统疾病(以下简称“四大慢病”)的主要危险因素及相关危险因素暴露的疾病负担。方法本研究数据来源于2019年全球疾病负担研究(Global Burden of Disease Study,GBD)数据库,通过获取2019年我国居民四大慢病的死亡病例数和伤残调整寿命年(disability-adjusted life years,DALYs),分析四大慢病归因于相关危险因素暴露的比例。结果烟草暴露是造成恶性肿瘤疾病负担最主要的危险因素,导致的DALYs占比达31.4%;心脑血管疾病的首要危险因素是高收缩压,导致的DALYs占比达55.6%。四大慢病的共同危险因素有烟草暴露、空气污染和高身体质量指数,其中烟草暴露在恶性肿瘤和慢性呼吸系统疾病中归因风险比例最高,饮食相关危险因素、饮酒和体力活动不足与恶性肿瘤、心脑血管疾病及糖尿病密切相关。对主要恶性肿瘤疾病负担的归因分析结果显示,烟草暴露归因风险比例最高的是肺癌,其次是食管癌、胃癌、肝癌及结直肠癌。结论烟草暴露、空气污染和高身体质量指数是我国居民癌症等四大慢病的共同危险因素,能为四大慢病高风险人群筛选提供重要依据。展开更多
目的:探讨身体锻炼联合多感官刺激对心理健康的影响。方法:在知网、万方、PubMed、Web of Science、Scopus 5个电子数据库进行系统检索,筛选后纳入11项研究,使用Cochrane偏倚风险工具2.0进行相关研究的方法学质量评价,采用半定量的系统...目的:探讨身体锻炼联合多感官刺激对心理健康的影响。方法:在知网、万方、PubMed、Web of Science、Scopus 5个电子数据库进行系统检索,筛选后纳入11项研究,使用Cochrane偏倚风险工具2.0进行相关研究的方法学质量评价,采用半定量的系统综述总结归纳相关文章。结果:身体锻炼联合多感官刺激能显著抑制消极情绪和促进注意力恢复,并在一定程度上改善积极情绪和心脏自主神经功能。结论:多感官刺激能产生“多感官整合”,与单一感官刺激相比,身体锻炼联合多感官刺激能促进心理健康效益。建议未来研究优化多感官刺激的核心技术,采用神经影像技术深入探讨潜在机制,增加高质量随机对照实验,并进一步探索锻炼强度、不同刺激方式、个体差异等因素的作用。展开更多
文摘Chronic kidney disease affects people worldwide. Approximately 1 out of 3 adults with diabetes have kidney disease. Among several etiological factors for CKD, diabetes mellitus (DM) and hypertension are the main factors. These factors not only cause CKD but are also responsible for several complications related to CKD. In this article, we have reviewed Diabetic Nephropathy (DN) in terms of etiology, pathophysiology, diagnosis, management, current guidelines for diabetic nephropathy management, and some of the research study findings. Diabetic nephropathy (DN) is the chief factor for end-stage renal disease (ESRD) development across the globe. The primary cause of DN is Diabetes Mellitus, which is an autoimmune lifestyle disorder having several etiological factors. Checking for urine albuminuria, estimated GFR (eGFR), and blood glucose are unswerving tests for DN diagnosis and subsequent monitoring. Controlling hyperglycemia, blood pressure, and proteinuria are critical in stopping the progression of DKD. Clinical practice and evidence-based medicine demonstrated that early diagnosis followed by treatment can prevent or halt DKD progression.
基金Science and Technology Commission of Shanghai Municipality(No.19140902400)Shanghai Municipal Health Commission(No.2022XD017)+1 种基金Clinical Research Plan of SHDC(No.SHDC2020CR4006)Shanghai Municipal Human Resources and Social Security Bureau(No.2020074)
文摘Background:Life’s Simple 7,the former construct of cardiovascular health(CVH)has been used to evaluate adverse non-communicable chronic diseases(NCDs).However,some flaws have been recognized in recent years and Life’s Essential 8 has been established.In this study,we aimed to analyze the association between CVH defined by Life’s Essential 8 and risk of 44 common NCDs and further estimate the population attributable fractions(PAFs)of low-moderate CVH scores in the 44 NCDs.Methods:In the UK Biobank,170,726 participants free of 44 common NCDs at baseline were included.The Life’s Essential 8 composite measure consists of four health behaviours(diet,physical activity,nicotine exposure,and sleep)and four health factors(body mass index,non-high density lipoprotein cholesterol,blood glucose,and blood pressure),and the maximum CVH score was 100 points.CVH score was categorized into low,moderate,and high groups.Participants were followed up for 44 NCDs diagnosis across 10 human system disorders according to the International Classification of Diseases 10th edition(ICD-10)code using linkage to national health records until 2022.Cox proportional hazard models were used in this study.The hazard ratios(HRs)and PAFs of 44 NCDs associated with CVH score were examined.Results:During the median follow-up of 10.85 years,58,889 incident NCD cases were documented.Significant linear dose-response associations were found between higher CVH score and lower risk of 25(56.8%)of 44 NCDs.Low-moderate CVH(<80 points)score accounted for the largest proportion of incident cases in diabetes(PAF:80.3%),followed by gout(59.6%),sleep disorder(55.6%),chronic liver disease(45.9%),chronic kidney disease(40.9%),ischemic heart disease(40.8%),chronic obstructive pulmonary disease(40.0%),endometrium cancer(35.8%),lung cancer(34.0%),and heart failure(34.0%)as the top 10.Among the eight modifiable factors,overweight/obesity explained the largest number of cases of incident NCDs in endocrine,nutritional,and metabolic diseases(35.4%),digestive system disorders(21.4%),mental and behavioral disorders(12.6%),and cancer(10.3%);however,the PAF of ideal sleep duration ranked first in nervous system(27.5%)and neuropsychiatric disorders(9.9%).Conclusions:Improving CVH score based on Life’s Essential 8 may lower risk of 25 common NCDs.Among CVH metrics,avoiding overweight/obesity may be especially important to prevent new cases of metabolic diseases,NCDs in digestive system,mental and behavioral disorders,and cancer.
文摘目的评估癌症、心脑血管疾病、糖尿病及慢性呼吸系统疾病(以下简称“四大慢病”)的主要危险因素及相关危险因素暴露的疾病负担。方法本研究数据来源于2019年全球疾病负担研究(Global Burden of Disease Study,GBD)数据库,通过获取2019年我国居民四大慢病的死亡病例数和伤残调整寿命年(disability-adjusted life years,DALYs),分析四大慢病归因于相关危险因素暴露的比例。结果烟草暴露是造成恶性肿瘤疾病负担最主要的危险因素,导致的DALYs占比达31.4%;心脑血管疾病的首要危险因素是高收缩压,导致的DALYs占比达55.6%。四大慢病的共同危险因素有烟草暴露、空气污染和高身体质量指数,其中烟草暴露在恶性肿瘤和慢性呼吸系统疾病中归因风险比例最高,饮食相关危险因素、饮酒和体力活动不足与恶性肿瘤、心脑血管疾病及糖尿病密切相关。对主要恶性肿瘤疾病负担的归因分析结果显示,烟草暴露归因风险比例最高的是肺癌,其次是食管癌、胃癌、肝癌及结直肠癌。结论烟草暴露、空气污染和高身体质量指数是我国居民癌症等四大慢病的共同危险因素,能为四大慢病高风险人群筛选提供重要依据。
文摘目的:探讨身体锻炼联合多感官刺激对心理健康的影响。方法:在知网、万方、PubMed、Web of Science、Scopus 5个电子数据库进行系统检索,筛选后纳入11项研究,使用Cochrane偏倚风险工具2.0进行相关研究的方法学质量评价,采用半定量的系统综述总结归纳相关文章。结果:身体锻炼联合多感官刺激能显著抑制消极情绪和促进注意力恢复,并在一定程度上改善积极情绪和心脏自主神经功能。结论:多感官刺激能产生“多感官整合”,与单一感官刺激相比,身体锻炼联合多感官刺激能促进心理健康效益。建议未来研究优化多感官刺激的核心技术,采用神经影像技术深入探讨潜在机制,增加高质量随机对照实验,并进一步探索锻炼强度、不同刺激方式、个体差异等因素的作用。
