Creatinine

肌酐
  • 文章类型: Journal Article
    运动疗法可以有效管理慢性肾脏病(CKD)危险因素,改善肾功能和身体素质,但挑战在于选择适合患者病情的正确运动类型。
    对包括PubMed在内的数据库进行电子搜索,科克伦图书馆,EMBASE,WebofScience,VIP,万方,并执行了CNKI。使用随机效应模型。平均差被用作连续变量的效应大小,提供95%置信区间(CI)。
    本研究共纳入36项随机对照试验。与常规治疗(CT)相比,三种运动疗法与CT的结合在增强六分钟步行测试(6MWT)能力方面产生了显着的益处,24小时尿蛋白量(24hUTP),收缩压(SBP),舒张压(DBP)。抗阻运动疗法(RT)+CT比CT更有效地降低血肌酐(Scr),体重指数(BMI),和血红蛋白A1c(HbA1c)和改善估计的肾小球滤过率(eGFR)。在提高峰值摄氧量(VO2峰值)方面,只涉及两种锻炼方式,有氧运动疗法(AT)和联合(阻力-有氧)运动疗法(CBT),两者都比CT更有效。总体疗效排名显示,RT在增强eGFR和6MWT方面具有明显的益处,减少Scr,BMI,SBP,DBP,和HbA1c,虽然AT更适合提高VO2峰值,CBT具有降低24hUTP的更大潜力。
    运动疗法结合CT在许多情况下具有明显的优势,但是没有一种运动方式对所有指标都是普遍有效的。
    UNASSIGNED: Exercise therapy can effectively manage chronic kidney disease (CKD) risk factors and improve renal function and physical fitness, but the challenge lies in choosing the right exercise type tailored to patients\' condition.
    UNASSIGNED: An electronic search of databases including PubMed, The Cochrane Library, EMBASE, Web of Science, VIP, WanFang, and CNKI was performed. The random effects model was used. Mean difference was employed as the effect size for continuous variables, with 95% confidence interval (CI) provided.
    UNASSIGNED: A total of 36 RCTs were included in this study. Compared to conventional therapy (CT), the combination of three exercise therapies with CT resulted in notable benefits in enhancing six minutes walk test (6MWT) capacity, 24-h urinary protein quantity (24hUTP), systolic blood pressure (SBP), diastolic blood pressure (DBP). Resistance exercise therapy (RT) + CT were more effective than CT to reduce serum creatinine (Scr), body mass index (BMI), and hemoglobin A1c (HbA1c) and improve estimated glomerular filtration rate (eGFR). In terms of improving peak oxygen uptake (VO2 peak), only two exercise modalities were involved, aerobic exercise therapy (AT) and combined (Resistance-Aerobic) exercise therapy (CBT), both of which were more efficacious than CT. The efficacy ranking overall demonstrated clear benefits for RT in enhancing eGFR and 6MWT, decreasing Scr, BMI, SBP, DBP, and HbA1c, while AT was more suitable for boosting VO2 peak, and CBT had greater potential for reducing 24hUTP.
    UNASSIGNED: Exercise therapy combined with CT offers significant advantages over CT in many cases, but no single exercise modality is universally effective for all indicators.
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  • 文章类型: Journal Article
    尽管对成人高尿酸血症(HUA)进行了广泛的研究,仍然缺乏研究这种情况下,在青年。因此,我们的目的是调查HUA在美国年轻人中的患病率,以及识别相应的危险因素。
    这项研究采用了美国国家健康和营养调查(NHANES)在2017年1月至2020年3月之间进行的1,051名13-20岁青年的全国代表性子样本。单变量和多变量技术被用来检查HUA和肥胖之间的关联,膳食营养素,肝肾功能,葡萄糖和脂质代谢,炎症,以及青少年人口中的其他指标。
    该研究涵盖了1,051名13-20岁的青年,包括538名男孩和513名女孩。HUA的总体患病率为7%(1,051人中有74人)。单因素分析显示,HUA组表现出更大的年龄,体重指数(BMI),腰围(WC),臀围(HC),腰臀比(WHR)。此外,HUA组的肥胖患病率明显高于非HUA组(均p<0.05)。关于生化指标,尿素氮的水平,肌酐(Cr),丙氨酸氨基转移酶(ALT),谷氨酸草酸转氨酶(AST),γ-谷氨酰转移酶(GGT),总胆固醇(TC),甘油三酯(TG),和HSC反应蛋白(HsCRP)在HUA组明显高于非HUA组(均p<0.05)。使用二元物流回归的进一步分析表明,BMI(p=0.024,OR1.158,95CI1.019-1.316),ALT(p=0.020,OR1.032,95CI1.005-1.059),和Cr(p=0.016,OR1.028,95CI1.005-1.051)被确定为HUA的危险因素,在控制了年龄之后,性别,BMI,WC,HC,WHR,ALT,AST,GGT,TG,TC,Cr,HsCRP,其他指标。有趣的是,单因素和多因素分析均未发现膳食营养素与HUA风险之间存在关联(均P>0.05)。
    高BMI仍然是美国13-20岁青年HUA的主要危险因素,应密切监测ALT和Cr水平以及血清尿酸。
    UNASSIGNED: Despite extensive research on hyperuricemia (HUA) in adults, there remains a dearth of studies examining this condition in youth. Consequently, our objective was to investigate the prevalence of HUA among youth in the United States, as well as identify the corresponding risk factors.
    UNASSIGNED: This study employed a nationally representative subsample of 1,051 youth aged 13-20 from the US National Health and Nutrition Examination Survey (NHANES) conducted between January 2017 and March 2020. Univariate and multivariate techniques were utilized to examine the association between HUA and obesity, dietary nutrients, liver and kidney function, glucose and lipid metabolism, inflammation, and other indicators in the adolescent population.
    UNASSIGNED: The study encompassed a cohort of 1,051 youth aged 13-20 years, comprising 538 boys and 513 girls. The overall prevalence of HUA was found to be 7% (74 out of 1,051). Univariate analysis revealed that the HUA group exhibited greater age, body mass index (BMI), waist circumference (WC), hip circumference (HC), and waist-to-hip ratio (WHR). Additionally, the prevalence of obesity was significantly higher in the HUA group compared to the non- HUA group (all p < 0.05). Regarding biochemical indicators, the levels of urea nitrogen, creatinine (Cr), alanine aminotransferase (ALT), glutamic oxalic aminotransferase (AST), gamma-glutamyl transferase (GGT), total cholesterol (TC), triglyceride (TG), and HS C reactive protein (Hs CRP) were found to be significantly higher in the HUA group compared to the non-HUA group (all p < 0.05). Further analysis using binary logistics regression showed that BMI (p = 0.024, OR1.158, 95%CI1.019-1.316), ALT (p = 0.020, OR1.032, 95%CI1.005-1.059), and Cr (p = 0.016, OR1.028, 95%CI1.005-1.051) were identified as risk factors for HUA, after controlling for age, gender, BMI, WC, HC, WHR, ALT, AST, GGT, TG, TC, Cr, Hs CRP, and other indicators. Interestingly, neither univariate nor multivariate analysis found any association between dietary nutrients and the risk of HUA (all p > 0.05).
    UNASSIGNED: High BMI remains a major risk factor for HUA in US youth aged 13-20 years, and ALT and Cr levels should be closely monitored along with serum uric acid.
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  • 文章类型: Journal Article
    背景:据报道,肌肉减少症在虚弱综合征中起重要作用。血清肌酐/血清胱抑素C比率(Scr/CysC比率)最近被认为是评估肌肉减少症的有价值的指标。然而,很少有研究探讨血清肌酐/胱抑素C比值与虚弱之间的关系.这项研究的目的是调查居住在社区中的老年人的血清肌酐/血清胱抑素C比率与虚弱之间的关系。
    方法:A纳入了2011年中国健康与退休纵向研究(CHARLS)浪潮中1926名≥60岁的社区居住老年人。参与者的虚弱状态是使用39项虚弱指数(FI)确定的,将个人分类为“稳健”(FI≤0.1),“脆弱前”(0.1结果:在调整了潜在的混杂因素后,研究显示,Scr/CysC比值Q1四分位数的参与者虚弱的几率增加(Q1vs.与Q4四分位数组相比,Q4:OR=1.880,95%CI1.126-3.139,p=0.016)。在完全调整的逻辑回归模型中,Scr/CysC比值的Q2四分位数中的男性参与者与较高的前期虚弱几率显着相关(Q2与Q4:OR=1.693,95CI1.040-2.758,p=0.034)。然而,在女性中未观察到这种相关性(OR=0.984,95%CI0.589-1.642,p=0.950,).此外,该研究观察到,随着年龄的增长,男性和女性的虚弱指数和虚弱发生率都有增加。
    结论:在社区居住的老年人中,研究发现,在男性人群中,血清肌酐与胱抑素C比值降低与虚弱患病率增加相关.
    BACKGROUND: Sarcopenia has been reported to play an important role in frailty syndrome. The serum creatinine/serum cystatin C ratio (Scr/Cys C ratio) has recently been recognized as a valuable indicator for assessing sarcopenia. However, few studies have examined the association between serum creatinine/serum cystatin C ratio and frailty. The objective of this study is to investigate the relationship between the serum creatinine/serum cystatin C ratio and frailty among older adults residing in the community.
    METHODS: A Total of 1926 community-dwelling older adults aged ≥ 60 years in the 2011 waves of the China Health and Retirement Longitudinal Study (CHARLS) were included. The participants\' frailty status was determined using a 39 item frailty index (FI), which classified individuals as \"robust\" (FI ≤ 0.1), \"pre-frailty\" (0.1 < FI < 0.25), or \"frailty\" (FI ≥ 0.25). The Scr/Cys C ratio was determined by dividing the serum creatinine level (mg/dL) by the cystatin C level (mg/L). The one-way analysis of variance(ANOVA) and Chi-squared test (χ2)were applied to compare the differences between the 3 groups. Both linear regression and logistic regression models were used to further investigate the relationship between Scr/Cys C ratio and frailty.
    RESULTS: After adjusting for potential confounding factors, the study revealed that participants in the Q1 quartile of Scr/Cys C ratio had increased odds of frailty (Q1vs.Q4: OR = 1.880, 95% CI 1.126-3.139, p = 0.016) compared with those in the Q4 quartile group. In fully adjusted logistic regression models, male participants in the Q2 quartile of Scr/Cys C ratio were significantly correlated with higher odds of pre-frailty (Q2 vs.Q4: OR = 1.693, 95%CI 1.040-2.758, p = 0.034). However, this correlation was not observed in females (OR = 0.984, 95% CI 0.589-1.642, p = 0.950,). Additionally, the study observed an increase in both the frailty index and the incidence of frailty as age increased in both males and females.
    CONCLUSIONS: Among community-dwelling older adults, lower Serum creatinine to cystatin C ratio were found to be associated with increased odds of frailty prevalence in males.
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  • 文章类型: English Abstract
    Objective: To investigate the association of urinary cadmium levels with peripheral leukocyte classification counts among middle-aged and older adults aged 40 to 89 years in selected areas of China. Methods: The research was based on the survey of the impact of soil quality of agricultural land on human health in typical areas conducted in 2019-2020. A total of 5 600 middle-aged and older adults aged 40 to 89 years were included by using a multi-stage stratified random sampling method. Baseline characteristics of the subjects were collected and physical examinations were performed. Random midstream urine was collected to measure urinary cadmium and urinary creatinine and fasting venous blood was collected to measure the leukocyte count, neutrophil count, lymphocyte count, monocyte count and eosinophil count. The linear mixed effect model was used to analyse the association of urinary cadmium levels with leukocyte classification counts, and the dose-response relationship between them was analyzed by using the restricted cubic spline (RCS) function. Results: The age of the subjects was (63.17±12.02) years; 2 851 (50.91%) were males; and the M (Q1, Q3) of urinary creatinine-corrected urinary cadmium levels was 2.69 (1.52, 4.69) μg/g·creatinine. After adjusting for confounding factors, the results of linear mixed effects model analysis showed that for each 1-unit increase in urinary creatinine-corrected urinary cadmium level, the percentage change [% (95%CI)] of leukocyte count and lymphocyte count was -1.70% (-2.61%, -0.79%) and -1.57% (-2.86%, -0.26%), respectively. RCS function showed a negative linear relationship between urinary creatinine-corrected urinary cadmium levels and leukocyte counts and lymphocyte counts, respectively (all Pnon-linear>0.05). Conclusion: Urinary cadmium levels are negatively associated with leukocyte count and lymphocyte count among middle-aged and older adults aged 40 to 89 years in selected areas of China.
    目的: 探讨我国部分地区40~89岁中老年人尿镉水平与外周血白细胞分类计数的关联。 方法: 本研究基于2019—2020年“典型地区农用地土壤质量对人群健康影响调查”项目,采用多阶段分层随机抽样方法,共纳入5 600名40~89岁的中老年人。收集研究对象的基线特征,进行体格检查;采集随机中段尿以检测尿镉和尿肌酐;采集空腹静脉血以检测白细胞计数、中性粒细胞计数、淋巴细胞计数、单核细胞计数和嗜酸性粒细胞计数。采用线性混合效应模型分析尿镉水平与外周血白细胞分类计数的关联,并采用限制性立方样条函数探索二者之间的剂量-反应关系。 结果: 研究对象的年龄为(63.17±12.02)岁;男性为2 851名(50.91%);尿肌酐校正后尿镉水平的M(Q1,Q3)为2.69(1.52,4.69)μg/g·肌酐。校正相关混杂因素后,线性混合效应模型分析结果显示,尿肌酐校正后尿镉水平每增加1个单位,白细胞计数和淋巴细胞计数的变化百分比[%(95%CI)]分别为-1.70%(-2.61%,-0.79%)和-1.57%(-2.86%,-0.26%)。限制性立方样条函数分析结果显示,尿肌酐校正后尿镉水平与白细胞计数、淋巴细胞计数分别呈负向线性关系(均P非线性>0.05)。 结论: 我国部分地区40~89岁中老年人尿肌酐校正后尿镉水平与白细胞计数、淋巴细胞计数呈负向关联。.
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  • 文章类型: English Abstract
    先前的研究已经建立了白蛋白尿和各种炎症反应之间的联系,强调C-反应蛋白增加1mg/L,白蛋白尿的可能性增加2%。最近的研究表明,全身免疫炎症指数(SII)与尿蛋白排泄增加之间呈正相关。此外,全身炎症反应指数(SIRI)水平升高也与蛋白尿患病率升高相关.全身炎症综合指数(AISI)提供了更全面的炎症指标,与SII和SIRI相比,提供对全身炎症状态的广泛评估。然而,AISI与蛋白尿之间的具体关系尚不清楚.这项研究旨在探索美国成年人的这种关联。
    我们分析了2007-2018年国家健康与营养检查调查(NHANES)的数据,不包括孕妇和18岁以下的个人。AISI数据缺失的案件,尿白蛋白浓度,和其他协变量也被排除。使用以下公式计算AISI:AISI=(血小板计数×中性粒细胞计数×单核细胞计数)/淋巴细胞计数。白蛋白尿定义为尿白蛋白与肌酐之比超过30mg/g。连续变量以平均值±标准误差的形式表示,和分类变量的百分比。我们使用加权t检验和卡方检验进行基线比较。我们应用加权多变量逻辑回归和广义加性模型(GAM)来探索AISI和蛋白尿之间的关联,并评估潜在的非线性关系。
    该研究包括32273名参与者,平均年龄(46.75±0.24)岁。该队列包括48.73%的男性和51.27%的女性。蛋白尿的患病率为9.64%。log2AISI的平均对数值为7.95±0.01,分为三位数:四分位数1(Q1)(4.94至7.49),第二季度(7.49至8.29),和第三季度(8.29至10.85)。随着log2AISI的增加,高血压的患病率也是如此,糖尿病,充血性心力衰竭,和蛋白尿,均显示有统计学意义的增加(P<0.001)。同样,使用抗高血压药,降脂,降糖药物也更为普遍(P<0.001)。在三组年龄方面观察到统计学上的显着差异,种族和民族,正规教育,酒精消费,吸烟状况,收缩压和舒张压,身体质量指数,估计肾小球滤过率,HbA1c,丙氨酸氨基转移酶,天冬氨酸转氨酶,白蛋白,肌酐,尿酸,高密度脂蛋白胆固醇(P<0.05)。然而,各组间总胆固醇或性别比例无显著差异.log2AISI和蛋白尿之间的关联使用加权多变量逻辑回归评估,并且详细的结果呈现在表2中。在模型1中,不调整协变量,log2AISI每增加一个单位与蛋白尿风险增加32%相关(比值比[OR]=1.32,95%置信区间[CI]:1.27~1.38,P<0.001).模型2根据年龄进行了调整,性别,种族,和教育水平,并表现出类似的趋势,log2AISI每增加一个单位与31%的风险增加相关(OR=1.31,95%CI:1.26-1.37,P<0.001)。模型3,对所有协变量进行了进一步调整,显示log2AISI每增加一个单位与蛋白尿风险增加20%相关(OR=1.20,95%CI:1.15-1.26,P<0.001)。该研究还将log2AISI从连续变量转换为分类变量进行分析。与Q1相比,在调整所有协变量后,Q3的白蛋白尿风险,显著升高(OR=1.37,95%CI:1.22~1.55,P<0.001)。与Q1相比,Q2也显示出更高的风险(OR=1.13,95%CI:1.06-1.36,P=0.004)。趋势测试表明log2AISI增加与蛋白尿风险增加之间存在剂量效应关系。GAM揭示了log2AISI和蛋白尿之间的非线性关系,男女之间有明显的趋势。基于转折点的分段回归显示出女性的显着影响,尽管节段之间的斜率差异不显著。在男人中,观察到显著的阈值效应;低于7.25的log2AISI,log2AISI的增加并没有增加蛋白尿的风险,但是在这个门槛之上,风险显著增加。作为敏感性分析的一部分,通过将结局变量更改为大量白蛋白尿并校正所有协变量进行加权多变量逻辑回归.分析表明,log2AISI每增加一个单位,发生大量白蛋白尿的风险增加了31%(OR=1.31,95%CI:1.15-1.49,P<0.001)。与Q1相比,Q3的蛋白尿风险增加了69%(OR=1.69,95%CI:1.27-2.25,P<0.001),在第二季度,它增加了40%(OR=1.40,95%CI:1.03-1.92,P=0.030)。亚组分析和交互作用结果显示,AISI与蛋白尿风险之间的正相关性在男性中比在女性中强。同样,与血压正常的人相比,高血压患者的关联性更强,与正常体重的人相比,超重的人更高。此外,吸烟者和饮酒者比不吸烟者和不饮酒者显示AISI与蛋白尿风险之间有更强的正相关。这些结果表明性,血压,身体质量指数,吸烟,饮酒与AISI相互作用,影响蛋白尿的风险。
    在美国成年人中,AISI与蛋白尿风险增加之间存在强烈的正相关。随着log2AISI的增加,白蛋白尿的风险也是如此。然而,需要通过大规模前瞻性研究进一步验证这一结论.
    UNASSIGNED: Prior studies have established a connection between albuminuria and various inflammatory reactions, highlighting that an increase in C-reactive protein by 1 mg/L increases the likelihood of albuminuria by 2%. Recent investigations indicate a positive correlation between the systemic immune-inflammation index (SII) and increased urinary protein excretion. In addition, elevated levels of the systemic inflammatory response index (SIRI) also correlate with a higher prevalence of albuminuria. The aggregate index of systemic inflammation (AISI) offers a more comprehensive indicator of inflammation, providing an extensive assessment of systemic inflammatory status compared to SII and SIRI. Yet, the specific relationship between AISI and albuminuria remains unclear. This study aims to explore this association in U.S. adults.
    UNASSIGNED: We analyzed data from the National Health and Nutrition Examination Survey (NHANES) for 2007-2018, excluding pregnant women and individuals under 18. Cases with missing data on AISI, urinary albumin concentration, and other covariates were also excluded. AISI was computed using the formula: AISI=(platelet count×neutrophil count×monocyte count)/lymphocyte count. Albuminuria was defined as the urinary albumin-to-creatinine ratio exceeding 30 mg/g. Continuous variables were presented in the form of the mean±standard error, and categorical variables in percentages. We utilized weighted t-tests and chi-square tests for baseline comparisons. We applied weighted multivariable logistic regression and generalized additive models (GAM) to explore the association between AISI and albuminuria and to assess potential nonlinear relationships.
    UNASSIGNED: The study included 32273 participants, with an average age of (46.75±0.24) years old. The cohort comprised 48.73% males and 51.27% females. The prevalence of albuminuria was 9.64%. The average logarithmic value of log2AISI was 7.95±0.01, and were categorized into tertiles as follows: Quartile 1 (Q1) (4.94 to 7.49), Q2 (7.49 to 8.29), and Q3 (8.29 to 10.85). As log2AISI increased, so did the prevalence of hypertension, diabetes, congestive heart failure, and albuminuria, all showing statistically significant increases (P<0.001). Similarly, the use of antihypertensive, lipid-lowering, and hypoglycemic drugs was also more prevalent (P<0.001). Statistically significant differences were observed across the three groups concerning age, race and ethnicity, formal education, alcohol consumption, smoking status, systolic and diastolic blood pressures, body mass index, estimated glomerular filtration rate, HbA1c, alanine aminotransferase, aspartate aminotransferase, albumin, creatinine, uric acid, and high-density lipoprotein cholesterol (P<0.05). However, no significant differences were noted in the total cholesterol or the sex ratios among the groups. The association between log2AISI and albuminuria was assessed using weighted multivariable logistic regression, and the detailed results are presented in Table 2. In model 1, without adjusting for covariates, each unit increase in log2AISI was associated with a 32% increase in the risk of albuminuria (odds ratio [OR]=1.32, 95% confidence interval [CI]: 1.27-1.38, P<0.001). Model 2 was adjusted for age, gender, race, and education level, and showed a similar trend, with each unit increase in log2AISI associated with a 31% increased risk (OR=1.31, 95% CI: 1.26-1.37, P<0.001). Model 3, which was further adjusted for all covariates, revealed that each unit increase in log2AISI was associated with a 20% increase in the risk of albuminuria (OR=1.20, 95% CI: 1.15-1.26, P<0.001). The study also transformed log2AISI from a continuous to a categorical variable for analysis. Compared with Q1, the risk of albuminuria in Q3, after adjusting for all covariates, significantly increased (OR=1.37, 95% CI: 1.22-1.55, P<0.001). Q2 also demonstrated a higher risk compared with Q1 (OR=1.13, 95% CI: 1.06-1.36, P=0.004). The trend test indicated a dose-effect relationship between increasing log2AISI and the rising risk of albuminuria. GAM revealed a nonlinear relationship between log2AISI and albuminuria, with distinct trends noted between sexes. Segmented regression based on turning points showed significant effects among women, although the slope difference between the segments was not significant. In men, a significant threshold effect was observed; below the log2AISI of 7.25, increases in log2AISI did not enhance the risk of albuminuria, but above this threshold, the risk significantly increased. As part of a sensitivity analysis, weighted multivariable logistic regression was performed by changing the outcome variable to macroalbuminuria and adjusting for all covariates. The analysis showed that for every unit increase in log2AISI, the risk of developing macroalbuminuria increased by 31% (OR=1.31, 95% CI: 1.15-1.49, P<0.001). Compared with Q1, the risk of albuminuria in Q3 increased by 69% (OR=1.69, 95% CI: 1.27-2.25, P<0.001), and in Q2, it increased by 40% (OR=1.40, 95% CI: 1.03-1.92, P=0.030). Subgroup analysis and interaction results showed that the positive association between AISI and proteinuria risk was stronger in men than in women. Similarly, the association was stronger in people with hypertension compared with those with normal blood pressure, and higher in overweight people compared with those of normal weight. Furthermore, smokers and drinkers showed a stronger positive association between AISI and the risk of proteinuria than non-smokers and non-drinkers do. These results suggest that sex, blood pressure, body mass index, smoking, and alcohol consumption interact with AISI to influence the risk of proteinuria.
    UNASSIGNED: There is a robust positive association between AISI and increased risks of albuminuria in US adults. As log2AISI increases, so does the risk of albuminuria. However, further validation of this conclusion through large-scale prospective studies is warranted.
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  • 文章类型: Journal Article
    背景:由于胆碱之间的密切关系,左旋肉碱,甜菜碱及其肠道微生物代谢产物,包括三甲胺(TMA)和三甲胺N-氧化物(TMAO),和肌酐,对这些化合物的体内研究越来越感兴趣。
    方法:在本研究中,建立了快速稳定同位素稀释(SID)-UHPLC-MS/MS法同时测定胆碱,左旋肉碱,甜菜碱,TMA,血浆中的TMAO和肌酐,大鼠的肝脏和粪便。该方法使用质量控制(QC)样品在低,中等和高水平。第二,我们应用该方法量化了刺梨果汁(RRTJ)对血浆的影响,肝脏,和粪便中的胆碱含量,左旋肉碱,甜菜碱,TMA,TMAO,高脂饮食诱导的高脂血症大鼠的肌酐,演示该方法的实用性。
    结果:检测限(LOD)为0.04-0.027µM,定量限(LOQ)为0.009-0.094µM。血浆中每种代谢物的线性范围为胆碱1.50-96µM;左旋肉碱:2-128µM;甜菜碱:3-192µM;TMA:0.01-40.96µM;TMAO:0.06-61.44µM和肌酐:1-64µM(R2≥0.9954)。肝脏中每种代谢物的线性范围为胆碱:12-768µM;左旋肉碱:1.5-96µM;甜菜碱:10-640µM;TMA:0.5-32µM;TMAO:0.02-81.92µM和肌酐:0.2-204.8µM(R2≥0.9938)。粪便中每种代谢物的线性范围为胆碱:1.5-96µM;L-肉碱:0.01-40.96µM;甜菜碱:1.5-96µM;TMA:1-64µM;TMAO:0.02-81.92µM和肌酸酐:0.02-81.92µM(R2≥0.998)。对于所有分析物,日内和日间变异系数<8%。样品经过多次冻融循环(3次冻融循环)稳定,在室温下24小时,24小时在4°C和20天-80°C样品是稳定的。平均回收率为89%~99%。该方法用于定量高脂血症大鼠的TMAO及其相关代谢产物和肌酐水平。结果表明,高脂饮食导致大鼠TMAO及其相关代谢产物和肌酐的紊乱,经刺梨汁(RRTJ)干预后得到有效改善。
    结论:一种测定胆碱的方法,左旋肉碱,甜菜碱,TMA,血浆中的TMAO和肌酐,建立了肝脏和粪便样本,这很简单,节省时间,高精度,准确性和恢复性。
    BACKGROUND: Due to the close correlation between choline, L-carnitine, betaine and their intestinal microbial metabolites, including trimethylamine (TMA) and trimethylamine N-oxide (TMAO), and creatinine, there has been an increasing interest in the study of these compounds in vivo.
    METHODS: In this study, a rapid stable isotope dilution (SID)-UHPLC-MS/MS method was developed for the simultaneous determination of choline, L-carnitine, betaine, TMA, TMAO and creatinine in plasma, liver and feces of rats. The method was validated using quality control (QC) samples spiked at low, medium and high levels. Second, we applied the method to quantify the effects of Rosa Roxburghii Tratt juice (RRTJ) on plasma, liver, and fecal levels of choline, L-carnitine, betaine, TMA, TMAO, and creatinine in high-fat diet-induced hyperlipidemic rats, demonstrating the utility of the method.
    RESULTS: The limits of detection (LOD) were 0.04-0.027 µM and the limits of quantification (LOQ) were 0.009-0.094 µM. The linear ranges for each metabolite in plasma were choline1.50-96 µM; L-carnitine: 2-128 µM; betaine: 3-192 µM; TMA: 0.01-40.96 µM; TMAO: 0.06-61.44 µM and creatinine: 1-64 µM (R2 ≥ 0.9954). The linear ranges for each metabolite in liver were Choline: 12-768 µM; L-carnitine: 1.5-96 µM; betaine: 10-640 µM; TMA: 0.5-32 µM; TMAO: 0.02-81.92 µM and creatinine: 0.2-204.8 µM (R2 ≥ 0.9938). The linear ranges for each metabolite in feces were choline: 1.5-96 µM; L-carnitine: 0.01-40.96 µM; Betaine: 1.5-96 µM; TMA: 1-64 µM; TMAO: 0.02-81.92 µM and Creatinine: 0.02-81.92 µM (R2 ≥ 0.998). The intra-day and inter-day coefficients of variation were < 8 % for all analytes. The samples were stabilized after multiple freeze-thaw cycles (3 freeze-thaw cycles), 24 h at room temperature, 24 h at 4 °C and 20 days at -80 °C. The samples were stable. The average recovery was 89 %-99 %. This method was used to quantify TMAO and its related metabolites and creatinine levels in hyperlipidemic rats. The results showed that high-fat diet led to the disorder of TMAO and its related metabolites and creatinine in rats, which was effectively improved after the intervention of Rosa Roxburghii Tratt juice(RRTJ).
    CONCLUSIONS: A method for the determination of choline, L-carnitine, betaine, TMA, TMAO and creatinine in plasma, liver and feces samples was established, which is simple, time-saving, high precision, accuracy and recovery.
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  • 文章类型: English Abstract
    OBJECTIVE: To investigate the role of serum adenosine deaminase (ADA) combined with globulin (GLB), creatinine (CREA), β2-microglobulin (β2-MG) and hemoglobin (HGB) in the initial screening of multiple myeloma (MM), in order to reduce missed diagnosis and misdiagnosis of MM.
    METHODS: A retrospective analysis was performed on 62 newly diagnosed multiple myeloma (NDMM) patients who were admitted to the Department of Hematology of the First Affiliated Hospital of Chengdu Medical College from April 2018 to December 2021, and 33 patients with benign hematologic diseases and 30 healthy subjects were selected as the control group. The expression of ADA in pan-cancer was analyzed using TCGA and GTEx databases. The general data and laboratory indicators of the subjects were collected, and the differences of ADA activity and other laboratory indicators in each group were compared. The relationship between serum ADA activity and clinical data of NDMM patients was analyzed. The changes of ADA activity before and after chemotherapy in NDMM patients and the differences of ADA activity in NDMM patients with different DS and ISS stages were compared. Multivariate logistic regression was used to analyze the risk factors of NDMM. The receiver operating characteristic(ROC) curve was used to evaluate the diagnostic efficacy of ADA and other laboratory indicators in MM. Bioinformatics method was used to analyze the co-expression networks and enrichment pathways of ADA.
    RESULTS: ADA level was significantly upregulated in tissues of 14 types of cancer in TCGA database, and ADA was highly expressed in 11 types of cancer in TCGA combined with GTEx databases. The serum levels of ADA, GLB, uric acid (UA), cystatin C (CysC) and β2-MG in the NDMM group were significantly higher than those in benign hematologic disease group and healthy control group ( P < 0.05), while the levels of ALB and the value of albumin to globulin ratio (A∶G) in the NDMM group were significantly lower than those in the other two groups ( P < 0.001). There were significant differences in DS stage (P =0.036), ISS stage (P =0.019) and the levels of CREA (P =0.036), UA (P =0.034), β2-MG (P =0.019) in NDMM patients with different ADA activity levels. After primary chemotherapy, ADA activity and β2-MG concentration were decreased in NDMM patients ( P < 0.01). The comparison results of patients in different stages showed that ADA activity of patients in DS stage I+II was significantly lower than that of patients in DS stage III (P <0.05), and ADA activity of patiens in ISS stage I+II was significantly lower than that of patients in ISS stage III ( P < 0.01). Multivariate logistic regression analysis showed that increased GLB, increased ADA activity, increased CREA, increased β2-MG and decreased HGB were independent risk factors for NDMM. The area under the curve (AUC) of ADA in the diagnosis of MM was 0.847, and the AUC of ADA combined with GLB, CREA, β2-MG and HGB in the diagnosis of MM was 0.940. The results of co-expression network and enrichment pathway analysis showed that ADA bounded to 20 proteins and it was significantly associated with the metabolic pathways of purine, pyrimidine, nicotinate and nicotinamide.
    CONCLUSIONS: The detection of ADA activity in serum is of positive significance for the auxiliary diagnosis, therapeutic evaluation and monitoring the progress of NDMM patients. ADA combined with GLB, CREA, β2-MG and HGB can improve the detection rate of MM, and reduce missed diagnosis and misdiagnosis to a certain extent.
    UNASSIGNED: 血清ADA联合GLB、CREA、β2-MG、HGB在初诊多发性骨髓瘤中的临床意义.
    UNASSIGNED: 研究血清腺苷脱氨酶(ADA)联合球蛋白(GLB)、肌酐(CREA)、β2-微球蛋白(β2-MG)、血红蛋白(HGB)对多发性骨髓瘤(MM)的初筛作用,减少MM的漏诊及误诊。.
    UNASSIGNED: 回顾性分析2018年4月至2021年12月成都医学院第一附属医院血液科收治的62例初诊多发性骨髓瘤(NDMM)患者的资料,并以33例良性血液病患者和30例健康体检者作为对照组。用TCGA和GTEx数据库分析ADA在泛癌中的表达。收集受试者的一般资料及实验室检测指标,比较各组ADA活性及其他实验室指标水平的差异。分析血清ADA活性与NDMM患者临床资料的关系。比较NDMM患者化疗前后ADA活性的变化以及不同DS、ISS分期NDMM患者中ADA活性的差异。多因素Logistic回归分析NDMM发生的危险因素。采用ROC曲线评价ADA及其联合其他实验室指标对MM的诊断效能。生物信息学分析ADA的共表达网络和富集途径。.
    UNASSIGNED: TCGA 数据库中有14种癌组织中ADA水平显著上调,TCGA联合GTEx 数据库中ADA 在11种癌症中高表达。NDMM组外周血清ADA、GLB、UA、CysC、β2-MG水平明显高于良性血液病组及健康对照组( P < 0.05),ALB、A∶G明显低于良性血液病组及健康对照组( P < 0.001)。不同ADA活性水平的NDMM患者的DS分期(P =0.036)、ISS分期(P =0.019)、CREA(P =0.036)、UA(P =0.034)、β2-MG(P =0.019)水平具有统计学差异。NDMM患者初次化疗后ADA活性及β2MG浓度有所下降( P < 0.01)。不同DS分期和ISS分期患者比较结果显示,DS I+II期患者ADA活性明显低于Ⅲ期患者( P < 0.05),ISS I+II期患者ADA活性也明显低于Ⅲ期患者( P < 0.01)。多因素Logistic回归分析结果显示,GLB增高、ADA活性增加、CREA增高、β2-MG增高、HGB降低是NDMM的独立危险因素。ADA诊断MM的曲线下面积为0.847,其联合GLB、CREA、β2-MG、HGB诊断MM的曲线下面积为0.940。共表达网络和富集途径分析结果显示,ADA与20种蛋白质结合,并与嘌呤代谢、嘧啶代谢、烟酸和烟酰胺代谢通路显著相关。.
    UNASSIGNED: 检测血清中的ADA活性,对MM患者的辅助诊断、疗效评估以及监测疾病的发展有着积极的意义。ADA联合GLB、CREA、β2-MG、HGB可提高MM的初筛检出率,可在一定程度上减少漏诊及误诊。.
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  • 文章类型: Journal Article
    背景:随着全球老龄化进程的加速,中老年人肌肉减少症带来的健康挑战日益突出.然而,关于空气污染对肌肉减少症的不利影响的现有证据有限,特别是在西太平洋地区。本研究旨在利用全国代表性数据库探索多种空气污染物与肌肉减少症和相关生物标志物的关系。
    方法:完全,2011年,中国健康与退休纵向研究(CHARLS)招募了6585名45岁以上的参与者,其中3443人进行了随访,直到2015年。空气污染物是根据基于高分辨率卫星的时空模型估算的。在横截面分析中,我们使用广义线性回归,非条件逻辑回归分析和限制性三次样条(RCS)方法,以评估多种空气污染物对肌肉减少症和相关替代生物标志物(血清肌酐和胱抑素C)的单次暴露和非线性影响。几种流行的混合分析技术,如贝叶斯核机回归(BKMR),加权分位数和(WQS)回归,进一步使用基于分位数的g计算(Qgcomp)来检验多种空气污染物的综合影响。采用Logistic回归分析空气污染与肌肉减少症的纵向关联。
    结果:PM2.5,PM10和NO2的四分位数间距增加与肌肉减少症的风险增加显着相关,调整后的优势比(AOR)为1.09[95%置信区间(CI):1.01,1.20],1.24(95%CI:1.14,1.35)和1.18(95%CI:1.08,1.28),分别。我们的发现还表明,五种空气污染物与肌肉减少指数显着相关。此外,采用混合分析方法,我们证实了空气污染混合物对肌肉减少症风险和相关生物标志物的显着综合影响,PM10和PM2.5被确定为综合效应的主要贡献者。暴露-反应(E-R)关系的结果,亚组分析,纵向分析和敏感性分析均显示空气污染对肌少症风险和相关易感人群的不利影响。
    结论:在中国中老年人中,单一暴露和共同暴露于多种空气污染物与肌肉减少症呈正相关。我们的研究提供了新的证据,表明空气污染混合物与肌肉减少症相关的生物标志物显着相关。
    BACKGROUND: As the global aging process accelerates, the health challenges posed by sarcopenia among middle-aged and older adults are becoming increasingly prominent. However, the available evidence on the adverse effects of air pollution on sarcopenia is limited, particularly in the Western Pacific region. This study aimed to explore relationships of multiple air pollutants with sarcopenia and related biomarkers using the nationally representative database.
    METHODS: Totally, 6585 participants aged over 45 years were enrolled from the China Health and Retirement Longitudinal Study (CHARLS) in 2011 and 3443 of them were followed up until 2015. Air pollutants were estimated from high-resolution satellite-based spatial-temporal models. In the cross-sectional analysis, we used generalized linear regression, unconditional logistic regression analytical and restricted cubic spline (RCS) methods to assess the single-exposure and non-linear effects of multiple air pollutants on sarcopenia and related surrogate biomarkers (serum creatinine and cystatin C). Several popular mixture analysis techniques such as Bayesian kernel machine regression (BKMR), weighted quantile sum (WQS) regression, and quantile-based g-computation (Qgcomp) were further used to examinate the combined effects of multiple air pollutants. Logistic regression was used to further analyze the longitudinal association between air pollution and sarcopenia.
    RESULTS: Each interquartile range increase in PM2.5, PM10 and NO2 was significantly associated with an increased risk of sarcopenia, with adjusted odds ratios (aORs) of 1.09 [95 % confidence interval (CI): 1.01, 1.20], 1.24 (95 % CI: 1.14, 1.35) and 1.18 (95 % CI: 1.08, 1.28), respectively. Our findings also showed that five air pollutants were significantly associated with the sarcopenia index. In addition, employing a mixture analysis approach, we confirmed significant combined effects of air pollution mixtures on sarcopenia risk and associated biomarkers, with PM10 and PM2.5 identified as major contributors to the combined effect. The results of the exposure-response (E-R) relationships, subgroup analysis, longitudinal analysis and sensitivity analysis all showed the unfavorable impact of air pollution on sarcopenia risk and related vulnerable populations.
    CONCLUSIONS: Single-exposure and co-exposure to multiple air pollutants were positively associated with sarcopenia among middle-aged and older adults in China. Our study provided new evidence that air pollution mixture was significantly associated with sarcopenia related biomarkers.
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  • 文章类型: Journal Article
    心血管疾病(CVD)是2型糖尿病(T2DM)患者死亡的主要原因。缩孔综合征(SPS)定义为eGFRcystatinC/eGFR肌酐比值<0.70并预测高CVD死亡率。Framingham风险评分(FRS)用于评估个人10年CVD风险。本研究调查了T2DM患者FRS与eGFR胱抑素C/eGFR肌酐比值之间的相关性。
    新诊断为T2DM的18-80岁患者纳入本回顾性研究。采用有序logistic回归分析探讨T2DM危险因素与FRS的关系。使用广义线性模型计算比值比(OR)和95%置信区间(CI)。
    本研究包括270名患者。只有27例患者(10%)符合SPS的诊断标准。有序logistic回归分析显示SPS与FRS风险无相关性(OR=1.99,95CI=0.94~4.23,p=0.07),而eGFR胱抑素C/eGFR肌酐(OR=0.86,95CI=0.77-0.97,p=0.01)与FRS风险呈显著负相关.与eGFR胱抑素C/eGFR肌酐>0.85相比,eGFR胱抑素C/eGFR肌酐≤0.85增加FRS风险(OR=1.95,95CI=1.18-3.21,p<0.01)。在对混杂因素进行调整后,当作为连续变量时,eGFRcystatinC/eGFR肌酐比值升高与FRS风险降低相关(OR=0.87,95CI=0.77-0.99,p=0.03).eGFRcystatinC/eGFR肌酐≤0.85患者的FRS风险是eGFRcystatinC/eGFR肌酐>0.85患者的1.86倍(OR=1.86,95CI=1.08~3.21,p=0.03)。
    在当前的研究中,SPS和FRS之间未发现显著关联.然而,较低的eGFRcystatinC/eGFR肌酐和eGFRcystatinC/eGFR肌酐≤0.85与T2DM患者CVD风险显著增加相关.
    UNASSIGNED: Cardiovascular disease (CVD) is the leading cause of mortality in type 2 diabetes mellitus (T2DM) patients. Shrunken pore syndrome (SPS) is defined as eGFRcystatin C/eGFRcreatinine ratio <0.70 and predicts high CVD mortality. The Framingham Risk Score (FRS) is used to estimate an individual\'s 10-year CVD risk. This study investigated the association between FRS and eGFRcystatin C/eGFRcreatinine ratio in T2DM patients.
    UNASSIGNED: Patients aged 18-80 years who were newly diagnosed with T2DM were included in this retrospective study. Ordinal logistic regression analysis was used to investigate the association between risk factors of T2DM and FRS. A Generalized Linear Model was used to calculate odds ratios (OR) and 95% confidence intervals (CI).
    UNASSIGNED: There were 270 patients included in the study. Only 27 patients (10%) met the diagnostic criteria of SPS. Ordinal logistic regression analysis showed that SPS was not correlated with FRS risk (OR = 1.99, 95%CI = 0.94-4.23, p = 0.07), whereas eGFRcystatin C/eGFRcreatinine (OR = 0.86, 95%CI = 0.77-0.97, p = 0.01) showed a significant negative association with FRS risk. Compared with eGFRcystatin C/eGFRcreatinine>0.85, eGFRcystatin C/eGFRcreatinine≤0.85 increased FRS risk (OR = 1.95, 95%CI = 1.18-3.21, p < 0.01). After adjustment for confounding factors, increased eGFRcystatin C/eGFRcreatinine ratio was associated with decreased FRS risk when considered as a continuous variable (OR = 0.87, 95%CI = 0.77-0.99, p = 0.03). The FRS risk in patients with eGFRcystatin C/eGFRcreatinine≤0.85 is 1.86 times higher than that in patients with eGFRcystatin C/eGFRcreatinine>0.85 (OR = 1.86, 95%CI = 1.08-3.21, p = 0.03).
    UNASSIGNED: In the current study, no significant association between SPS and FRS was identified. However, lower eGFRcystatin C/eGFRcreatinine and eGFRcystatin C/eGFRcreatinine≤0.85 were associated with a significantly increased CVD risk in T2DM.
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  • 文章类型: Journal Article
    背景:肾气丸(SQP)可用于治疗各种肾脏相关疾病,但其确切的作用机制尚不清楚。我们旨在分析SQP在肾间质纤维化(RIF)中的作用和机制。
    方法:按照机构动物护理和使用委员会指南进行单侧输尿管梗阻(UUO)手术后,所有大鼠被分配到假手术组,UUO组,UUO+SQP1.5g/kg,UUO+SQP3g/kg,和UUO+SQP6g/kg组。SQP治疗4周后,肾脏的外观,血清肌酐(SCr),监测各组血尿素氮(BUN)水平。病理损伤,细胞外基质(ECM),和Notch1通路相关蛋白水平使用H&E染色测量,Masson染色,免疫组织化学,和蛋白质印迹,分别。
    结果:SQP可以明显改善UUO大鼠的肾脏外观以及SCr和BUN水平(SCr:67.6±4.64μM,59.66±4.96μM,48.76±4.44μM,UUO为40.43±3.02μM,低,中等,和高SQP治疗组;BUN:9.09±0.97mM,7.72±0.61mM,5.42±0.42mM,4.24±0.34mM对于UUO,低,中等,和高SQP治疗组;P<.05)。SQP还能有效减轻UUO大鼠肾组织损伤(P<0.05)。此外,我们发现SQP显著抑制胶原蛋白I,α-SMA,胶原蛋白IV,TGF-B1、Notch1和Jag1蛋白在UUO大鼠肾脏中的表达(P<0.05)。
    结论:我们的数据阐明SQP可以缓解RIF,其机制可能与Notch1/Jag1通路有关。DOI:10.52547/ijkd.7703。
    Shenqi pill (SQP) can be used to treat various kidney related diseases, but its exact mechanism of action remains unclear. We intended to analyze the role and mechanism of SQP on renal interstitial fibrosis (RIF).
    After performing unilateral ureteral obstruction (UUO) surgery following the Institutional Animal Care and Use Committee guidelines, all rats were assigned into the sham group, UUO group, UUO + SQP 1.5 g/kg, UUO + SQP 3 g/kg, and UUO + SQP 6 g/kg groups. After treatment with SQP for 4 weeks, the appearance of kidney, serum creatinine (SCr), and blood urea nitrogen (BUN) levels were monitored in each group. The pathological injury, extracellular matrix (ECM), and Notch1 pathway-related protein levels were measured using H&E staining, Masson staining, immunohistochemistry, and Western blot, respectively.
    SQP could obviously ameliorate the appearance of the kidney as well as the levels of SCr and BUN in UUO rats (SCr: 67.6 ± 4.64 μM, 59.66 ± 4.96 μM, 48.76 ± 4.44 μM, 40.43 ± 3.02 μM for UUO, low, medium, and high SQP treatment groups; BUN: 9.09 ± 0.97 mM, 7.72 ± 0.61 mM, 5.42 ± 0.42 mM, 4.24 ± 0.34 mM for UUO, low, medium, and high SQP treatment groups; P < .05). SQP also effectively mitigated renal tissue injury in UUO rats (P < .05). Moreover, we uncovered that SQP significantly inhibited Collagen I, α-SMA, Collagen IV, TGF-B1, Notch1, and Jag1 protein expressions in UUO rats kidney (P < .05).
    Our data elucidated that SQP can alleviate RIF, and the mechanism may be related to the Notch1/Jag1 pathway. DOI: 10.52547/ijkd.7703.
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