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Salari N, Darvishi N, Bartina Y, Keshavarzi F, Hosseinian-Far M, Mohammadi M. Global prevalence of malnutrition in older adults: A comprehensive systematic review and meta-analysis. PUBLIC HEALTH IN PRACTICE 2025; 9:100583. [PMID: 39885903 PMCID: PMC11780955 DOI: 10.1016/j.puhip.2025.100583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2024] [Revised: 12/19/2024] [Accepted: 12/19/2024] [Indexed: 02/01/2025] Open
Abstract
Objectives Early detection and management of malnutrition is essential for the general health and well-being of the elderly. Various studies have reported different types of malnutrition prevalence in the elderly. the present study was aimed to determine the prevalence of malnutrition in the world' elderly through conducting a systematic review study and meta-analysis.Study Design: systematic review and meta-analysis. Methods In this review study, data was extracted by searching in national and international databases of SID, MagIran, Google scholar, ScienceDirect, Scopus, PubMed and Web of Science (WoS) without time limit until August 25, 2023. For analysis, Begg and Mazumdar test at a significance level of 0.1 and the corresponding Funnel plot were used. Data analysis was performed with Comprehensive Meta-Analysis software (Version 2). Results In the review of 98 studies with a total sample size of 79976, the prevalence of malnutrition in the world's elderly was obtained as 18.6 % (95 % confidence interval: 16.4-21.1 %), so that the highest prevalence of malnutrition was in the elderly of Africa with 35.7 %, followed by the America with 20.3 %. According to the subgroup analysis regarding the indicators of malnutrition in the elderly, the highest prevalence of malnutrition in the elderly was obtained as 39.9 % according the NRS-2002 index. Conclusion Therefore, in addition to raising awareness among families about malnutrition in the elderly and its negative effects on the quality of life of the elderly, it is necessary to take the necessary measures to provide more care for the elderly and also to pay serious attention to the importance of nutrition during old age.
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Affiliation(s)
- Nader Salari
- Department of Biostatistics, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Niloofar Darvishi
- Department of Psychiatric Nursing, Faculty of Nursing School, Tehran Medical Sciences, Islamic Azad University Science and Research Branch, Tehran, Iran
| | - Yalda Bartina
- Department of Translation Studies, Faculty of Literature, Istanbul University, Istanbul, Turkey
| | - Fatemeh Keshavarzi
- Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | | | - Masoud Mohammadi
- Research Center for Social Determinants of Health, Jahrom University of Medical Sciences, Jahrom, Iran
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Gao S, Yu F, Han Y. Association between Neutrophil Percentage-to-Albumin ratio and anemia risk: a population-based study. Sci Rep 2025; 15:16649. [PMID: 40360633 PMCID: PMC12075635 DOI: 10.1038/s41598-025-98708-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2024] [Accepted: 04/14/2025] [Indexed: 05/15/2025] Open
Abstract
Anemia remains a significant global health challenge, driven by complex inflammatory mechanisms. This study investigated the association between neutrophil percentage-to-albumin ratio (NPAR) and anemia risk, utilizing data from 24,938 participants in the National Health and Nutrition Examination Survey (2005-2018). Multivariable logistic regression analysis revealed a significant association between NPAR and anemia risk (OR = 1.16; 95% CI 1.13-1.18, p < 0.0001). Two-piecewise regression analysis identified a nonlinear relationship with a threshold at NPAR 11.96: below this threshold, an inverse association was observed (OR = 0.88; 95% CI 0.79-0.98, p = 0.0249), while above it, a positive association was evident (OR = 1.21; 95% CI 1.18-1.25, p < 0.0001). Subgroup analyses demonstrated stronger associations in males, non-Hispanic Whites, diabetic patients, and individuals who were married or living with a partner. These findings highlight the potential of NPAR as a novel biomarker for assessing anemia risk in clinical practice.
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Affiliation(s)
- Songting Gao
- Guali Branch of the First People's Hospital of Xiaoshan District, Hangzhou, 311200, Zhejiang, People's Republic of China
| | - Fuqin Yu
- Guali Branch of the First People's Hospital of Xiaoshan District, Hangzhou, 311200, Zhejiang, People's Republic of China
| | - Yueyuan Han
- The First People's Hospital of Xiaoshan District, Hangzhou, 311200, Zhejiang, People's Republic of China.
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Takizawa A, Shimada T, Chubachi S, Arai T, Miyakawa A, Iizuka H, Otake S, Sakurai K, Tanabe N, Yamada Y, Jinzaki M, Nakamura H, Asano K, Fukunaga K. Exploring the pathophysiology of anemia in COPD: Insights from chest CT and longitudinal clinical data. Respir Med 2025; 240:108046. [PMID: 40113102 DOI: 10.1016/j.rmed.2025.108046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2025] [Revised: 02/25/2025] [Accepted: 03/17/2025] [Indexed: 03/22/2025]
Abstract
BACKGROUND Although anemia has been associated with chronic obstructive pulmonary disease (COPD) severity, the underlying risk factors, such as chest imaging indicators, remain poorly understood. In this study, we aimed to investigate the relationship between anemia and clinical features, including pulmonary and extrapulmonary indicators on chest computed tomography (CT), and to clarify the pathophysiology of anemia in COPD. METHODS A total of 400 patients with COPD were prospectively followed for 3 years. Anemia was defined as hemoglobin <13 g/dl in males and <12 g/dl in females. Patients were categorized into the anemia and non-anemia groups, and their clinical characteristics were compared. RESULTS The anemia group exhibited lower percentage of predicted forced expiratory volume in 1 s (%FEV1) and body mass index (BMI) measurements, worse COPD assessment test (CAT) scores, and more frequent exacerbations. Imaging revealed more severe emphysema, lower cross-sectional areas of the pectoralis and erector spinae muscles, decreased subcutaneous fat, and more severe coronary artery calcification in this group. Additionally, echocardiography demonstrated a higher prevalence of pulmonary hypertension and reduced left ventricular ejection fraction in patients with anemia. Three-year longitudinal data analysis further showed that declining hemoglobin levels correlated with the worsening of nutritional status, a deterioration in bone mineral density (BMD), and an increase in CAT scores. CONCLUSION Anemia in COPD is a multifactorial comorbidity resulting in emphysema, decreased fat and muscle mass, and reduced BMD.
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Affiliation(s)
- Aya Takizawa
- Division of Pulmonary Medicine, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Takashi Shimada
- Division of Pulmonary Medicine, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Shotaro Chubachi
- Division of Pulmonary Medicine, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
| | - Tetsuya Arai
- Division of Pulmonary Medicine, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Akira Miyakawa
- Division of Pulmonary Medicine, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Hideto Iizuka
- Division of Pulmonary Medicine, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Shiro Otake
- Division of Pulmonary Medicine, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Kaori Sakurai
- Division of Pulmonary Medicine, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Naoya Tanabe
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yoshitake Yamada
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
| | - Masahiro Jinzaki
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
| | - Hidetoshi Nakamura
- Department of Respiratory Medicine, Saitama Medical University, Saitama, Japan
| | - Koichiro Asano
- Division of Pulmonary Medicine, Department of Medicine, Tokai University, School of Medicine, Kanagawa, Japan
| | - Koichi Fukunaga
- Division of Pulmonary Medicine, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
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Chiba Y, Takahashi R, Makino R, Yoshida M, Okamoto K, Nagasawa T, Kato I, Ito S, Tanaka T, Miyazaki M. Influence of infection control for COVID-19 on nutrition in relatively healthy Japanese HD patients: a retrospective observational study. Clin Exp Nephrol 2025:10.1007/s10157-025-02638-3. [PMID: 40019723 DOI: 10.1007/s10157-025-02638-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 01/31/2025] [Indexed: 03/01/2025]
Abstract
BACKGROUND Infection control for the novel coronavirus disease 2019 (COVID-19) has been linked to decreased physical activity and nutritional deterioration in the general population; however, the influence on hemodialysis (HD) patients is not well discussed. METHODS This multicenter retrospective study utilized the Geriatric Nutritional Risk Index (GNRI), Survival Index, and Nutritional Risk Index for Japanese HD patients (NRI-JH) to assess nutritional status and body composition over five observation periods. The primary endpoint was the body fluid removal rate (%) pre- and post-HD, whereas secondary endpoints included changes in GNRI, SI, body composition, and differences in NRI-JH. RESULTS We enrolled 139 HD patients in three facilities. The results showed a decrease in GNRI score, which indicates nutritional deterioration, between February 2020 and August 2020 (96.8 (93.2-98.9) vs. 93.8 (90.8-97.6)) (P = 0.0005). Multivariable analysis revealed that nutritional deterioration was associated with higher C-reactive protein and lower hemoglobin levels (P = 0.0004 and P = 0.0010, respectively), which were more noticeable in the urban facility. Furthermore, nutritional deterioration was linked to a decrease in soft lean and somatic cell mass and an increase in body fat mass, suggesting reduced physical activity. CONCLUSIONS Nutritional deterioration was observed shortly after the first COVID-19 outbreak, suggesting an association with decreased physical activity.
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Affiliation(s)
- Yuki Chiba
- Department of Nephrology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | | | - Rui Makino
- Department of Nephrology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Mai Yoshida
- Department of Nephrology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Koji Okamoto
- Department of Nephrology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Tasuku Nagasawa
- Department of Nephrology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | | | | | - Tetsuhiro Tanaka
- Department of Nephrology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Mariko Miyazaki
- Department of Nephrology, Tohoku University Graduate School of Medicine, Sendai, Japan.
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Fabozzo A, Lombardi V, Cibin G, Bergonzoni E, Lorenzoni G, Gregori D, Tessari C, Bacich D, D'Onofrio A, Toscano G, Gambino A, Tarzia V, Pradegan N, Gerosa G. Prognostic Assessment with the Malnutrition Universal Screening Tool in Heart Transplant Recipients: A Pilot Study and a Single-Center Experience. J Pers Med 2024; 14:1140. [PMID: 39728053 DOI: 10.3390/jpm14121140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2024] [Revised: 10/23/2024] [Accepted: 11/25/2024] [Indexed: 12/28/2024] Open
Abstract
Introduction and aims: Malnutrition is associated with increased morbidity and mortality in patients who undergo cardiac surgery. Nevertheless, objective assessment of malnourished patients undergoing heart transplantation (HT) is limited. We aimed to analyze the relationship between the malnutrition status and the early and late clinical outcomes of patients undergoing HT using a novel semi-quantitative tool. Methods: All patients aged ≥18 years who underwent HT between January 2015 and July 2020 in a single center were retrospectively evaluated and included in the study. The semi-quantitative Malnutrition Universal Screening Tool (MUST) score (already validated in heart failure) was calculated for each patient at the time of transplantation to assess their nutritional status. A propensity score weighting approach was performed to evaluate the association between the increase in MUST score and the risk of early complications and in-hospital mortality. A Cox regression analysis was performed to assess follow-up mortality. Results: A total of 168 HT patients (median age 58.4 years, IQR 49.5-65.2, men n = 128, 76%) were included within the study period. Their median preoperative BMI was 24.0 kg/m2 (IQR 21.2-27.9). Preoperative MUST scores of 0, 1, and ≥2 were found in 92 (55%), 24 (14%), and 52 (31%) patients, respectively. The median preoperative eGFR was 64.3 mL/min (IQR 49.0-83.2). An increase in MUST score (from 0 to 2) was not significantly related to major postoperative complications or in-hospital mortality. An analogous increase in MUST score was associated with increased follow-up mortality risk (hazard ratio 1.28, 95% CI 1.04-1.83, p = 0.024). Conclusions: Malnutrition assessed with the MUST score seems not to be associated with increased in-hospital mortality or major postoperative complications in patients who undergo HT, but according to our preliminary data it is related to patients' long-term mortality.
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Affiliation(s)
- Assunta Fabozzo
- Cardiac Surgery Unit, MCS and Heart Transplant Program, Padova University Hospital, 35128 Padova, Italy
| | - Valentina Lombardi
- Cardiac Surgery Unit, MCS and Heart Transplant Program, Padova University Hospital, 35128 Padova, Italy
| | - Giorgia Cibin
- Cardiac Surgery Unit, MCS and Heart Transplant Program, Padova University Hospital, 35128 Padova, Italy
| | - Emma Bergonzoni
- Cardiac Surgery Unit, MCS and Heart Transplant Program, Padova University Hospital, 35128 Padova, Italy
| | - Giulia Lorenzoni
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy
| | - Dario Gregori
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy
| | - Chiara Tessari
- Cardiac Surgery Unit, MCS and Heart Transplant Program, Padova University Hospital, 35128 Padova, Italy
| | - Daniela Bacich
- Cardiac Surgery Unit, MCS and Heart Transplant Program, Padova University Hospital, 35128 Padova, Italy
| | - Augusto D'Onofrio
- Cardiac Surgery Unit, MCS and Heart Transplant Program, Padova University Hospital, 35128 Padova, Italy
| | - Giuseppe Toscano
- Cardiac Surgery Unit, MCS and Heart Transplant Program, Padova University Hospital, 35128 Padova, Italy
| | - Antonio Gambino
- Cardiac Surgery Unit, MCS and Heart Transplant Program, Padova University Hospital, 35128 Padova, Italy
| | - Vincenzo Tarzia
- Cardiac Surgery Unit, MCS and Heart Transplant Program, Padova University Hospital, 35128 Padova, Italy
| | - Nicola Pradegan
- Cardiac Surgery Unit, MCS and Heart Transplant Program, Padova University Hospital, 35128 Padova, Italy
| | - Gino Gerosa
- Cardiac Surgery Unit, MCS and Heart Transplant Program, Padova University Hospital, 35128 Padova, Italy
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Wafula ST, Maiga-Ascofare O, Struck NS, Mathanga DP, Cohee LM, May J, Puradiredja DI, Lorenz E. Socioeconomic disparities in Plasmodium falciparum infection risk in Southern Malawi: mediation analyses. Sci Rep 2024; 14:27290. [PMID: 39516554 PMCID: PMC11549479 DOI: 10.1038/s41598-024-78512-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Accepted: 10/31/2024] [Indexed: 11/16/2024] Open
Abstract
This study investigated the mediators of the association between socioeconomic position (SEP) and Plasmodium falciparum (Pf) infection in Southern region of Malawi. We utilized data from the 2014 International Center of Excellence for Malaria Research (ICEMR) surveys from Malawi in which blood samples of all individuals from selected households in Blantyre, Thyolo and Chikhwawa were tested for Pf parasitemia. We assessed household SEP and potential mediators - housing quality, food security, education status of household heads, and use of long-lasting Insecticide-treated nets (LLINs) and nutritional status. We conducted causal mediation analyses to assess the proportion of SEP effect that is attributed to each mediator and combination of mediators. The mediation analysis shows that during the rainy season, improved housing and educational attainment explained 39.4% and 17.0% of the SEP effect on Pf infection, respectively, and collectively 66.4%. In the dry season, housing, educational attainment, and LLIN usage collectively mediated 33.4% of SEP's effect with individual contributions of 15.6%, 11.2%, and 3.8%, respectively. Nutrition also played a role, particularly for children, mediating 9.2% of SEP's effect in the rainy season and 3.7% in the dry season. The study concluded that multifaceted interventions targeting housing, education, LLIN usage, and nutrition are vital to reducing socioeconomic disparities in Pf infection risk in the Southern region of Malawi.
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Affiliation(s)
- Solomon T Wafula
- Department of Infectious Disease Epidemiology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany.
- Department of Disease Control and Environmental Health, School of Public Health, Makerere University, Kampala, Uganda.
| | - Oumou Maiga-Ascofare
- Department of Infectious Disease Epidemiology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
- German Center for Infection Research (DZIF), Partner Site Hamburg-Borstel-Luebeck-Riems, Hamburg, Germany
| | - Nicole S Struck
- Department of Infectious Disease Epidemiology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
- German Center for Infection Research (DZIF), Partner Site Hamburg-Borstel-Luebeck-Riems, Hamburg, Germany
| | - Don P Mathanga
- School of Global and Public Health, Kamuzu University of Health Sciences (KUHeS), Private Bag 360, Blantyre 3, Chichiri, Malawi
- Malaria Alert Centre (MAC), Kamuzu University of Health Sciences (KUHeS), Private Bag 360, Blantyre 3, Chichiri, Malawi
| | - Lauren M Cohee
- Malaria Research Program, Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, USA
- Liverpool School of Tropical Medicine, Liverpool, UK
| | - Jürgen May
- Department of Infectious Disease Epidemiology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
- German Center for Infection Research (DZIF), Partner Site Hamburg-Borstel-Luebeck-Riems, Hamburg, Germany
- University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Dewi I Puradiredja
- Department of Infectious Disease Epidemiology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Eva Lorenz
- Department of Infectious Disease Epidemiology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
- German Center for Infection Research (DZIF), Partner Site Hamburg-Borstel-Luebeck-Riems, Hamburg, Germany
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Kitao T, Sotomi Y, Tamaki S, Seo M, Yano M, Hayashi T, Nakagawa A, Nakagawa Y, Nakatani D, Yamada T, Yasumura Y, Sakata Y, OCVC‐Heart Failure Investigators. Verification of haemoglobin level to prevent worsening of prognosis in heart failure with preserved ejection fraction patients from the PURSUIT-HFpEF registry. ESC Heart Fail 2024; 11:3299-3311. [PMID: 38952180 PMCID: PMC11424383 DOI: 10.1002/ehf2.14927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 05/24/2024] [Accepted: 06/14/2024] [Indexed: 07/03/2024] Open
Abstract
AIMS Anaemia has been reported as poor predictor in heart failure with preserved ejection fraction (HFpEF). The aim of this study was to evaluate the impact of changes in haemoglobin (Hb) from discharge to 1 year after discharge on the prognosis using a lower cut-off value of Hb than the World Health Organization (WHO) criteria. METHODS AND RESULTS First, 547 HFpEF cases were divided into two groups, Hb < 11.0 g/dL (n = 218) and Hb ≥ 11.0 g/dL (n = 329), according to Hb at discharge, and further were divided according to Hb 1 year after discharge into Hb < 11.0 g/dL (G1, n = 113), Hb ≥ 11.0 g/dL (G2, n = 105), Hb < 11.0 g/dL (G3, n = 66), and Hb ≥ 11.0 g/dL (G4, n = 263), respectively. Major adverse cardiovascular events (MACE) was defined as composite of all-cause death and heart failure readmission after a visit 1 year after discharge. The cut-off value of Hb was analysed by the receiver operating characteristics curve that predicts MACE. We examined the incidence rate of MACE between G4 and other subgroups and verified predictors of improving or worsening anaemia and covarying factors with change in Hb. In multivariate Cox proportional hazard model, MACE was significantly higher in G3 with worsening anaemia from Hb ≥ 11.0 g/dL to <11.0 g/dL than G4 with persistently Hb ≥ 11 g/dL (adjusted hazard ratio (HR): 3.14 [95% confidence interval (CI), 1.76-5.60], P < 0.001). MACE was not significantly different between G2 with improving anaemia from Hb < 11.0 g/dL to ≥ 11.0 g/dL and G4 (adjusted HR: 1.37 [95% CI, 0.68-2.75], P = 0.38). In multivariate logistic regression analysis, independent predictors of improving anaemia were male [odds ratio (OR): 0.45], chronic obstructive pulmonary disease (OR: 10.3), prior heart failure hospitalization (OR: 0.38), and estimated glomerular filtration rate (OR: 1.04). Independent predictors of worsening anaemia were age (OR: 1.07), body mass index (BMI) (OR: 0.86), clinical frailty scale score (OR: 1.29), Hb at discharge (OR: 0.63), and use of angiotensin-converting-enzyme inhibitor or angiotensin II receptor blocker (OR: 2.76). In multivariate linear regression analysis, covarying factors with change in Hb were BMI (β = -0.098), serum albumin (β = 0.411), and total cholesterol (β = 0.179). CONCLUSIONS Change in haemoglobin after discharge using a lower cut-off value than WHO criteria has prognostic impact in patients with HFpEF.
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Affiliation(s)
- Takashi Kitao
- Department of CardiologyMinoh City HospitalOsakaJapan
| | - Yohei Sotomi
- Department of Cardiovascular MedicineOsaka University Graduate School of MedicineSuitaJapan
| | - Shunsuke Tamaki
- Department of CardiologyRinku General Medical CenterIzumisanoJapan
| | - Masahiro Seo
- Division of CardiologyOsaka General Medical CenterOsakaJapan
| | | | | | - Akito Nakagawa
- Department of Cardiovascular MedicineOsaka University Graduate School of MedicineSuitaJapan
| | - Yusuke Nakagawa
- Division of CardiologyKawanishi City Medical CenterKawanishiJapan
| | - Daisaku Nakatani
- Department of Cardiovascular MedicineOsaka University Graduate School of MedicineSuitaJapan
| | - Takahisa Yamada
- Division of CardiologyOsaka General Medical CenterOsakaJapan
| | | | - Yasushi Sakata
- Department of Cardiovascular MedicineOsaka University Graduate School of MedicineSuitaJapan
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Lonardo MS, Cacciapuoti N, Chiurazzi M, Di Lauro M, Guida B, Damiano S, Cataldi M. Combined use of handgrip strength and hemoglobin as markers of undernutrition in patients with stage 3-5 chronic kidney disease. Nutr Metab Cardiovasc Dis 2023; 33:2169-2178. [PMID: 37544868 DOI: 10.1016/j.numecd.2023.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 05/31/2023] [Accepted: 06/19/2023] [Indexed: 08/08/2023]
Abstract
BACKGROUND AND AIMS The early identification of undernourished patients with CKD could help instating appropriate nutritional intervention before the full development of the threatening condition known as Protein Energy Wasting (PEW). Handgrip strength (HGS) and blood hemoglobin (Hb) concentration are two parameters considered representative of nutritional status but not included among the criteria for PEW diagnosis. In the present work we investigated whether they could help identifying CKD patients at risk of undernutrition. METHODS AND RESULTS We performed a two-step cluster analysis to classify a cohort of 71 stage 3-5 CKD patients, none of which with PEW, according to their Hb concentration and dominant-hand HGS. Two clusters were finely separated using this method. When we compared the two groups for main body composition and nutritional variables by using t-test statistics or Mann-Whitney test, as appropriate, we found significant differences in PhA, ECW/TBW, ASMI, serum iron. Then we stratified our population by gender and performed cluster analysis as well. PhA, ECW/TBW were still significantly different in the two clusters both in M and in F, while serum iron concentration only in males and ASMI only in females. CONCLUSION These results suggest that either in male than in female Hb concentration and HGS may distinguish two subgroups of CKD patients with different nutritional status and disease severity. Patient belonging to either of these cluster can be easily identified by using the HGS/Hb ratio which represents the HGS normalized per gr Hb.
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Affiliation(s)
- Maria Serena Lonardo
- Department of Clinical Medicine and Surgery, Physiology Nutrition Unit, Federico II University of Naples, Italy.
| | - Nunzia Cacciapuoti
- Department of Clinical Medicine and Surgery, Physiology Nutrition Unit, Federico II University of Naples, Italy
| | - Martina Chiurazzi
- Department of Clinical Medicine and Surgery, Physiology Nutrition Unit, Federico II University of Naples, Italy
| | - Mariastella Di Lauro
- Department of Clinical Medicine and Surgery, Physiology Nutrition Unit, Federico II University of Naples, Italy
| | - Bruna Guida
- Department of Clinical Medicine and Surgery, Physiology Nutrition Unit, Federico II University of Naples, Italy
| | - Simona Damiano
- Department of Clinical Medicine and Surgery, Physiology Nutrition Unit, Federico II University of Naples, Italy
| | - Mauro Cataldi
- Department of Neuroscience, Reproductive Sciences and Dentistry, Division of Pharmacology, Federico II University of Naples, Italy
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9
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Widhalm HK, Keintzel M, Ohrenberger G, Widhalm K. The Urgent Need for Nutritional Medical Care in Geriatric Patients-Malnutrition in Nursing Homes. Nutrients 2023; 15:4367. [PMID: 37892441 PMCID: PMC10610431 DOI: 10.3390/nu15204367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 10/06/2023] [Accepted: 10/10/2023] [Indexed: 10/29/2023] Open
Abstract
Patients aged 65 and over who are accommodated in hospitals and nursing homes are at high risk of malnutrition and often show signs of it. The future relevance of this problem becomes clear, especially in view of the demographic development of the coming years and decades. In this study, the correlation between malnutrition, hypoalbuminemia, anemia, elevated CRP, and low transferrin levels, as well as mortality in seniors between 65 and 100 years, should be revealed. Therefore, the prevalence of disease-specific malnutrition (DRM), according to the criteria of the guidelines of the German Society of Nutritional Medicine (DGEM), and the prevalence of hypoalbuminemia were presented based on the data of 120 residents who were inpatients in a large Viennese nursing home between 01/2017 and 08/2020. Moreover, 86 of the inpatient residents were women and 34 were men, with a mean age of 84 years (SD: 8.7). In this examination, more than one-third of nursing home residents were malnourished. More than half of the residents were found to have low serum albumin or low transferrin saturation. However, no correlation between elevated CRP, low transferrin, or low serum albumin values and malnutrition could be established. Residents with low serum albumin or low transferrin levels, however, had a higher mortality rate. This study supports the urgent relevance of closer and individually personalized medical nutritional interventions, especially concerning hypoalbuminemic seniors aged 65 years and older.
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Affiliation(s)
- Harald K. Widhalm
- Clinical Division of Traumatology, Department of Orthopedics and Trauma Surgery, Medical University of Vienna, 1090 Vienna, Austria
| | - Maximilian Keintzel
- Clinical Division of Orthopedics, Department of Orthopedics and Trauma Surgery, Medical University of Vienna, 1090 Vienna, Austria;
- Austrian Academic Institute for Clinical Nutrition, 1090 Vienna, Austria;
| | | | - Kurt Widhalm
- Austrian Academic Institute for Clinical Nutrition, 1090 Vienna, Austria;
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10
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Lee DY, Shin S. Sarcopenia and Anemia in Elderly Koreans: A Nationwide Population-Based Study. Healthcare (Basel) 2023; 11:2428. [PMID: 37685462 PMCID: PMC10487604 DOI: 10.3390/healthcare11172428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 08/22/2023] [Accepted: 08/28/2023] [Indexed: 09/10/2023] Open
Abstract
Sarcopenia and anemia are common diseases in the elderly and are caused by various factors. In this study, the association between sarcopenia and anemia in an elderly Korean population was examined. The Korea Centers for Disease Control and Prevention's cross-sectional, nationally representative Korea National Health and Nutrition Examination Survey (KNHANES, 2008-2011) served as the source of the data for this study. Of the 2769 participants (1167 men and 1602 women) included in this study, a significant association was found between sarcopenia and anemia in the elderly in Korea. In Model 1, unadjusted for covariates, the prevalence of sarcopenia in all participants was 1.805 (95% CI 1.364-2.388) and 2.746 (95% CI 1.740-4.334) in men, and 1.494 (95% CI 1.045-2.138) in women. In Model 4, adjusted for all covariates, the prevalence of sarcopenia in all participants was 1.455 (95% CI 1.064-1.989) and 2.649 (95% CI 1.475-4.755) in men, but it was insignificant in women. While prior studies failed to consider variables such as exercise status and nutritional intake, this research incorporated these factors as covariates. Despite this comprehensive approach, this study still revealed an independent association between sarcopenia and anemia. Moreover, a significant association was uncovered among elderly men, with no corresponding association identified among women.
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Affiliation(s)
- Do-Youn Lee
- Research Institute of Human Ecology, Yeungnam University, Gyeongsan 38541, Republic of Korea;
- Neuromuscular Control Laboratory, Yeungnam University, Gyeongsan 38541, Republic of Korea
| | - Sunghoon Shin
- Research Institute of Human Ecology, Yeungnam University, Gyeongsan 38541, Republic of Korea;
- Neuromuscular Control Laboratory, Yeungnam University, Gyeongsan 38541, Republic of Korea
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Maezawa K, Nozawa M, Maruyama Y, Sakuragi E, Sugimoto M, Ishijima M. Comparison of anemia, renal function, and nutritional status in older women with femoral neck fracture and older women with osteoarthritis of the hip joint. J Orthop Sci 2023; 28:380-384. [PMID: 35000815 DOI: 10.1016/j.jos.2021.12.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 12/02/2021] [Accepted: 12/15/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND Several studies in older patients with femoral neck fracture found that preoperative anemia and malnutrition were associated with higher mortality and poorer physical function. Therefore, we compared nutritional status, Hb level, and renal function in women with femoral neck fracture and women of the same age with osteoarthritis of the hip joint. METHODS We enrolled 257 women aged 70 years and older who suffered femoral neck fracture (F group) or who were scheduled to undergo total hip arthroplasty for osteoarthritis of the hip joint (OA group). The F and OA groups were further divided into 2 groups on the basis of age, ie, 74 years old and younger (F70 and OA70) and 75 years old and older (F75 and OA75). To assess whether patients had undernutrition, mortality risk, anemia, and renal dysfunction, we assessed Geriatric Nutritional Risk Index (GNRI), Hb, and eGFR. RESULTS We found a significant difference in the mean Hb levels and GNRI scores between the F75 and OA75 and F70 and OA70. Moreover, we found a moderate correlation between Hb level and GNRI score in the F75 and OA75. With respect to the GNRI category, the percentage of patients at moderate or major risk was 42.1% in the F70 group and 57.6% in the F75 group but only 1.9% in the OA70 group and 4.3% in the OA75 group. CONCLUSION We found that women with femoral neck fracture had significantly lower Hb levels and lower GNRI scores than women with hip OA in the same age and that anemia and undernutrition were closely linked in women aged 75 and above. Moreover, we found that more than 40% of patients with a femoral neck fracture had a moderate to major risk on the basis of their GNRI scores.
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Affiliation(s)
- Katsuhiko Maezawa
- Department of Orthopaedic Surgery, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu City, Chiba, 279-0021, Japan.
| | - Masahiko Nozawa
- Department of Orthopaedic Surgery, Juntendo University Nerima Hospital, 3-1-10 Takanodai, Nerima-ku, Tokyo, 177-8521, Japan
| | - Yuichiro Maruyama
- Department of Orthopaedic Surgery, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu City, Chiba, 279-0021, Japan
| | - Emi Sakuragi
- Department of Orthopaedic Surgery, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu City, Chiba, 279-0021, Japan
| | - Munehiko Sugimoto
- Department of Orthopaedic Surgery, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Muneaki Ishijima
- Department of Orthopaedic Surgery, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
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Hwang JA, Shin J, Cho E, Ahn SY, Ko GJ, Kwon YJ, Kim JE. Risk factors associated with the discordance in kidney function decline rate in identical twins. PLoS One 2023; 18:e0284154. [PMID: 37053150 PMCID: PMC10101412 DOI: 10.1371/journal.pone.0284154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 03/26/2023] [Indexed: 04/14/2023] Open
Abstract
BACKGROUND The rate of kidney function decline is different for each individual regardless of any difference in the medical histories. This study set out to identify the risk factors for high discordance in kidney function decline in an identical twin cohort. METHODS This study included 333 identical twins from the Korean Genome and Epidemiology Study who were categorized into two groups according to the estimated glomerular filtration rate (eGFR) decline: the slow and rapid progressor groups. The mean differences of variables were compared between the two groups. We calculated the difference in the annual eGFR change between twins and analyzed the risk factors associated with high discordance in twins who had > 5 mL/min/1.73 m2 /yr of the intra-twin difference in the annual eGFR decline. Identical twins with diabetes and baseline eGFR < 60 mL/min/1.73 m2 were excluded. RESULTS The high discordance twins showed significant differences in body mass index; waist-to-hip ratio; total body fat percentage; and levels of blood hemoglobin, serum fasting glucose, albumin, triglyceride, and uric acid; however, there were no differences in low discordance twins. Multivariable logistic regression showed that blood hemoglobin level is the only significant factor associated with high discordance of eGFR decline in twins. CONCLUSIONS Blood hemoglobin level may play a role in the individual differences in kidney function decline.
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Affiliation(s)
- Jeong Ah Hwang
- Department of Internal Medicine, Korea University Guro Hospital, Seoul, Republic of Korea
| | - Jaeun Shin
- Department of Internal Medicine, Korea University Guro Hospital, Seoul, Republic of Korea
| | - Eunjung Cho
- Department of Internal Medicine, Korea University Guro Hospital, Seoul, Republic of Korea
| | - Shin Young Ahn
- Department of Internal Medicine, Korea University Guro Hospital, Seoul, Republic of Korea
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Gang-Jee Ko
- Department of Internal Medicine, Korea University Guro Hospital, Seoul, Republic of Korea
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Young Joo Kwon
- Department of Internal Medicine, Korea University Guro Hospital, Seoul, Republic of Korea
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Ji Eun Kim
- Department of Internal Medicine, Korea University Guro Hospital, Seoul, Republic of Korea
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
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Bhagwasia M, Rao AR, Banerjee J, Bajpai S, Raman AV, Talukdar A, Jain A, Rajguru C, Sankhe L, Goswami D, Shanthi GS, Kumar G, Varghese M, Dhar M, Gupta M, A-Koul P, Mohanty RR, Chakrabarti SS, Yadati SR, Dey S, Dey AB. Association Between Cognitive Performance and Nutritional Status: Analysis From LASI-DAD. Gerontol Geriatr Med 2023; 9:23337214231194965. [PMID: 37743872 PMCID: PMC10515514 DOI: 10.1177/23337214231194965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 07/05/2023] [Accepted: 07/27/2023] [Indexed: 09/26/2023] Open
Abstract
Malnutrition in low- and middle-income countries causes cognitive decline and other health problems. Harmonized Diagnostic Assessment of Dementia for Longitudinal Aging Study in India (LASI DAD) is an extensive study on late-life cognition and dementia. This study examines the link between nutrition and cognitive abilities in older adults using data from the LASI DAD. We conducted descriptive statistics on nutritional parameters (body-mass index, waist-hip ratio, and Mini-Nutritional Assessment), cognitive functions, and socio-demographic variables in 2,892 adults aged ≥60 years. Cognitive domains assessed included delayed recall, orientation, language, executive function, abstract reasoning, and attention. Cognitive impairment was defined as impaired performance in two or more domains. Mean age was 69.3 ± 7.1 years, 52.9% were female, and 57.5% were illiterate. Low body-mass index (adjusted OR: 1.88, p < .001), at risk of malnutrition (adjusted OR: 1.89, p < .001) and malnourished (adjusted OR: 2.86, p < .001) on Mini-Nutritional Assessment were associated with the presence of cognitive impairment. Better cognitive performance was associated with increased body mass index (adjusted OR: 0.74, p-.03), hemoglobin (adjusted OR: 0.91, p-.006), and serum albumin (adjusted OR: 0.38, p < .001). This study shows that nutritional status assessed by anthropometric measures and blood markers is strongly linked to cognitive performance in older adults.
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Affiliation(s)
| | | | | | - Swati Bajpai
- All India Institute of Medical Sciences, New Delhi, India
| | | | | | - Arvind Jain
- Dr S. N. Medical College, Jodhpur, Rajasthan, India
| | - Chhaya Rajguru
- Grant Medical College and J.J. Hospital, Mumbai, Maharashtra, India
| | - Lalit Sankhe
- Grant Medical College and J.J. Hospital, Mumbai, Maharashtra, India
| | | | | | - Govind Kumar
- Indira Gandhi Institute of Medical Science, Patna, Bihar, India
| | - Mathew Varghese
- National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Minakshi Dhar
- All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Monica Gupta
- Government Medical College and Hospital, Chandigarh, Punjab, India
| | - Parvaiz A-Koul
- Sher-e-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | | | | | | | - Sharmistha Dey
- All India Institute of Medical Sciences, New Delhi, India
| | - Aparajit Ballav Dey
- All India Institute of Medical Sciences, New Delhi, India
- Venu Geriatric Institute, New Delhi, India
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14
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Preoperative anemia is associated with increased radical cystectomy complications. Urol Oncol 2022; 40:382.e7-382.e13. [DOI: 10.1016/j.urolonc.2022.04.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Revised: 03/28/2022] [Accepted: 04/25/2022] [Indexed: 11/23/2022]
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Jeon D, Park BH, Lee HC, Park Y, Lee W, Lee JH, Song KB, Hwang DW, Kim SC, Choi J. The impact of pylorus preservation on the development of nonalcoholic fatty liver disease after pancreaticoduodenectomy: A historical cohort study. JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES 2022; 29:863-873. [PMID: 35434927 DOI: 10.1002/jhbp.1150] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 02/05/2022] [Accepted: 02/08/2022] [Indexed: 10/20/2024]
Abstract
BACKGROUND/PURPOSE The pathophysiology and associated factors of nonalcoholic fatty liver disease (NAFLD) after pancreaticoduodenectomy (PD) remain elusive. We aimed to investigate these factors, including the operation type, for NAFLD development after PD. METHODS This historical cohort study included 786 consecutive patients treated with either classic Whipple operation or pylorus-preserving pancreaticoduodenectomy (PPPD) in Korea between 2012 and 2018. De novo NAFLD was determined based on hepatic attenuation in nonenhanced computed tomography during follow-up. RESULTS Of the 786 patients, 216 (27.5%) had a newly developed NAFLD at 2 years after PD. The incidences of newly developed NAFLD at 0.5, 1, 1.5, and 2 years were 13 (1.7%), 41 (5.2%), 48 (6.1%), and 114 (14.5%), respectively. The Whipple group showed a significantly higher incidence of NAFLD than the PPPD group (40.3% vs 24.5%, P < .001). Seventeen patients (2.2%) had severe fatty liver with abnormal liver enzymes. Multivariable analysis revealed that Whipple operation (vs PPPD; adjusted odds ratio [AOR]: 1.92, P < .001) and high preoperative body mass index (vs normal; AOR: 1.71, P = .001) were independently associated with a higher risk of NAFLD. CONCLUSION The incidence of NAFLD was 27.5% at 2 years after PD. Undergoing Whipple operation and high preoperative body mass index were significantly associated with de novo NAFLD development.
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Affiliation(s)
- Dongsub Jeon
- Department of Gastroenterology, Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Bum Ho Park
- University of Ulsan College of Medicine, Seoul, Korea
| | - Han Chu Lee
- Department of Gastroenterology, Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Yejong Park
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Woohyung Lee
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jae Hoon Lee
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ki Byung Song
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Dae Wook Hwang
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Song Cheol Kim
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jonggi Choi
- Department of Gastroenterology, Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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16
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Yamane R, Yoshioka K, Hayashi K, Shimizu Y, Ito Y, Matsushita K, Yoshizaki M, Kajikawa G, Mizutani T, Watarai A, Tachi K, Goto H. Prevalence of nonalcoholic fatty liver disease and its association with age in patients with type 2 diabetes mellitus. World J Hepatol 2022; 14:1226-1234. [PMID: 35978658 PMCID: PMC9258257 DOI: 10.4254/wjh.v14.i6.1226] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 03/24/2022] [Accepted: 05/14/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) is a risk factor for nonalcoholic fatty liver disease (NAFLD). AIM To determine the prevalence and clinical correlates of NAFLD in a large cohort of patients with T2DM. METHODS Four hundred thirty-seven participants with T2DM who consulted at Meijo Hospital from April 2019 to September 2020 and underwent computed tomography (CT) were assessed. The mean age was 74 ± 13 years, and 269 were men. Hepatic attenuation minus splenic attenuation (CTL-S) less than 1 Hounsfield unit was considered fatty liver. NAFLD was defined as fatty liver in the absence of significant alcohol consumption and hepatitis virus infection. A multiple logistic regression was used to assess the independent factors associated with NAFLD. RESULTS NAFLD was identified in 25.2% of the participants. Young age (odds ratio [OR] = -0.945; 95% confidence interval [CI]: 0.922-0.969), higher hemoglobin levels (OR = 1.501, 95%CI: 1.278-1.764), lower high-density lipoprotein (HDL) cholesterol levels (OR = 0.971, 95%CI: 0.953-0.989), and the absence of dialysis (OR = 0.109, 95%CI: 0.014-0.856) were independent predictors of NAFLD. CONCLUSION NAFLD was detected with CT in 25.2% of the participants. NAFLD was associated with younger age, higher hemoglobin levels, lower HDL cholesterol levels, and an absence of dialysis.
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Affiliation(s)
- Ryosuke Yamane
- Department of Gastroenterology and Hepatology, Federation of National Public Service Personnel Mutual Aid Associations Meijo Hospital, Nagoya 460-0001, Aichi, Japan
| | - Kentaro Yoshioka
- Center for Liver Diseases, Federation of National Public Service Personnel Mutual Aid Associations Meijo Hospital, Nagoya 460-0001, Aichi, Japan.
| | - Kazuhiko Hayashi
- Department of Gastroenterology and Hepatology, Federation of National Public Service Personnel Mutual Aid Associations Meijo Hospital, Nagoya 460-0001, Aichi, Japan
| | - Yuko Shimizu
- Department of Gastroenterology and Hepatology, Federation of National Public Service Personnel Mutual Aid Associations Meijo Hospital, Nagoya 460-0001, Aichi, Japan
| | - Yuki Ito
- Department of Gastroenterology and Hepatology, Federation of National Public Service Personnel Mutual Aid Associations Meijo Hospital, Nagoya 460-0001, Aichi, Japan
| | - Komei Matsushita
- Department of Gastroenterology and Hepatology, Federation of National Public Service Personnel Mutual Aid Associations Meijo Hospital, Nagoya 460-0001, Aichi, Japan
| | - Michiyo Yoshizaki
- Department of Gastroenterology and Hepatology, Federation of National Public Service Personnel Mutual Aid Associations Meijo Hospital, Nagoya 460-0001, Aichi, Japan
| | - Go Kajikawa
- Department of Gastroenterology and Hepatology, Federation of National Public Service Personnel Mutual Aid Associations Meijo Hospital, Nagoya 460-0001, Aichi, Japan
| | - Taro Mizutani
- Department of Gastroenterology and Hepatology, Federation of National Public Service Personnel Mutual Aid Associations Meijo Hospital, Nagoya 460-0001, Aichi, Japan
| | - Atsuko Watarai
- Department of Diabetes and Endocrinology, Federation of National Public Service Personnel Mutual Aid Associations Meijo Hospital, Nagoya 460-0001, Aichi, Japan
| | - Kosuke Tachi
- Department of Gastroenterology and Hepatology, Federation of National Public Service Personnel Mutual Aid Associations Meijo Hospital, Nagoya 460-0001, Aichi, Japan
| | - Hidemi Goto
- Department of Gastroenterology and Hepatology, Federation of National Public Service Personnel Mutual Aid Associations Meijo Hospital, Nagoya 460-0001, Aichi, Japan
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Yoo JE, Kim D, Choi H, Kang YA, Han K, Lee H, Shin DW. Anemia, sarcopenia, physical activity, and the risk of tuberculosis in the older population: a nationwide cohort study. Ther Adv Chronic Dis 2021; 12:20406223211015959. [PMID: 34104377 PMCID: PMC8170360 DOI: 10.1177/20406223211015959] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Accepted: 04/20/2021] [Indexed: 01/17/2023] Open
Abstract
Background: The aim of this study was to investigate whether physical activity,
sarcopenia, and anemia are associated an with increased risk of tuberculosis
(TB) among the older population. Methods: We included 1,245,640 66-year-old subjects who participated in the National
Screening Program for Transitional Ages for Koreans from 2009 to 2014. At
baseline, we assessed common health problems in the older population,
including anemia and sarcopenia. The subjects’ performance in the timed
up-and-go (TUG) test was used to predict sarcopenia. The incidence of TB was
determined using claims data from the National Health Insurance Service
database. Results: The median follow-up duration was 6.4 years. There was a significant
association between the severity of anemia and TB incidence, with an
adjusted hazard ratio (aHR) of 1.28 [95% confidence interval (CI),
1.20–1.36] for mild anemia and 1.69 (95% CI, 1.51–1.88) for moderate to
severe anemia. Compared with those who had normal TUG times, participants
with slow TUG times (⩾15 s) had a significantly increased risk of TB (aHR
1.19, 95% CI, 1.07–1.33). On the other hand, both irregular (aHR 0.88, 95%
CI 0.83–0.93) and regular (aHR 0.84, 95% CI, 0.78–0.92) physical activity
reduced the risk of TB. Male sex, lower income, alcohol consumption,
smoking, diabetes, and asthma/chronic obstructive pulmonary disease
increased the risk of TB. Conclusion: The risk of TB among older adults increased with worsening anemia,
sarcopenia, and physical inactivity. Physicians should be aware of those
modifiable predictors for TB among the older population.
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Affiliation(s)
- Jung Eun Yoo
- Department of Family Medicine, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Republic of Korea
| | - Dahye Kim
- Department of Biostatistics, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hayoung Choi
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea
| | - Young Ae Kang
- Division of Pulmonology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Republic of Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Dongjak-gu, Seoul, Republic of Korea
| | - Hyun Lee
- Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang Medical Center, Hanyang University College of Medicine, 222-1 Wangsimni-ro, Seoul, Seongdong-gu 04763, Republic of Korea
| | - Dong Wook Shin
- Shin Department of Family Medicine/Supportive Care Center, Samsung Medical Center, Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, 81 Irwon-Ro, Seoul, Gangnam-gu 06351, Republic of Korea
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Vulser H, Lemogne C, Boutouyrie P, Côté F, Perier MC, Van Sloten T, Hoertel N, Danchin N, Limosin F, Jouven X, Empana JP. Depression, antidepressants and low hemoglobin level in the Paris Prospective Study III: A cross-sectional analysis. Prev Med 2020; 135:106050. [PMID: 32156564 DOI: 10.1016/j.ypmed.2020.106050] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 03/04/2020] [Accepted: 03/06/2020] [Indexed: 02/07/2023]
Abstract
Anemia is known to be associated with depression both in community and clinical populations. However, it is still unknown if this association depends or not on antidepressant intake. We investigated the respective association of depression and antidepressant intake with low hemoglobin level in a large community-based cohort. In 8640 volunteers aged 50 to 75 recruited between June 2008 and June 2012 in Paris (France), we assessed hemoglobin levels (g/dl), depressive symptoms and antidepressant intake. We examined the association of both depression and antidepressant intake with hemoglobin level, adjusting for numerous socio-demographic and health variables. We also assessed the association with specific antidepressant classes. Depression and antidepressant intake were independently associated with lower hemoglobin level (β = -0.074; p = .05 and β = -0.100; p = .02 respectively in the fully-adjusted model). Regarding antidepressant classes, selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) intake were associated with lower hemoglobin level (β = -0.11; p = .01). To conclude, both depression and antidepressant intake were associated with lower hemoglobin level. In particular, as SSRI or SNRIs intake was also related to lower hemoglobin level, these classes should be used with caution in depressed individuals at risk for anemia.
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Affiliation(s)
- Hélène Vulser
- Université de Paris, Paris Descartes Faculty of Medicine, Paris, France; AP-HP.Centre - Université de Paris, European Georges-Pompidou Hospital, Department of Psychiatry, Paris, France.
| | - Cédric Lemogne
- Université de Paris, Paris Descartes Faculty of Medicine, Paris, France; AP-HP.Centre - Université de Paris, European Georges-Pompidou Hospital, Department of Psychiatry, Paris, France; Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR_S1266, INSERM, Université de Paris, Paris, France
| | - Pierre Boutouyrie
- Université de Paris, Paris Descartes Faculty of Medicine, Paris, France; AP-HP.Centre - Université de Paris, European Georges-Pompidou Hospital, Department of Pharmacology, Paris, France
| | - Francine Côté
- Université de Paris, Paris Descartes Faculty of Medicine, Paris, France; AP-HP.Centre - Université de Paris, Necker Enfants Malades Hospital, Department of Hematology, Institut Imagine, INSERM U1183 CNRS ERL 8254, Laboratory of Excellence GR-Ex, Paris, France
| | - Marie-Cécile Perier
- Université de Paris, Paris Descartes Faculty of Medicine, Paris, France; Inserm, UMR-S970, Paris Cardiovascular Research Center, Team 4 Integrative Epidemiology of Cardiovascular disease, Paris, France
| | - Thomas Van Sloten
- Université de Paris, Paris Descartes Faculty of Medicine, Paris, France; Inserm, UMR-S970, Paris Cardiovascular Research Center, Team 4 Integrative Epidemiology of Cardiovascular disease, Paris, France; Cardiovascular Research Institute Maastricht and Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Nicolas Hoertel
- Université de Paris, Paris Descartes Faculty of Medicine, Paris, France; AP-HP.Centre - Université de Paris, European Georges-Pompidou Hospital, Department of Psychiatry, Paris, France; Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR_S1266, INSERM, Université de Paris, Paris, France
| | - Nicolas Danchin
- Université de Paris, Paris Descartes Faculty of Medicine, Paris, France; AP-HP.Centre - Université de Paris, European Georges-Pompidou Hospital, Department of Cardiology, Paris, France; Preventive and Clinical Investigation Center, Paris, France
| | - Frédéric Limosin
- Université de Paris, Paris Descartes Faculty of Medicine, Paris, France; AP-HP.Centre - Université de Paris, European Georges-Pompidou Hospital, Department of Psychiatry, Paris, France; Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR_S1266, INSERM, Université de Paris, Paris, France
| | - Xavier Jouven
- Université de Paris, Paris Descartes Faculty of Medicine, Paris, France; Inserm, UMR-S970, Paris Cardiovascular Research Center, Team 4 Integrative Epidemiology of Cardiovascular disease, Paris, France; AP-HP.Centre - Université de Paris, European Georges-Pompidou Hospital, Department of Cardiology, Paris, France
| | - Jean-Philippe Empana
- Université de Paris, Paris Descartes Faculty of Medicine, Paris, France; Inserm, UMR-S970, Paris Cardiovascular Research Center, Team 4 Integrative Epidemiology of Cardiovascular disease, Paris, France
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Cai W, Zhang F, Zhong L, Chen D, Guo H, Zhang H, Zhu B, Liu X. Correlation between CYP1A1 polymorphisms and susceptibility to glyphosate-induced reduction of serum cholinesterase: A case-control study of a Chinese population. PESTICIDE BIOCHEMISTRY AND PHYSIOLOGY 2020; 162:23-28. [PMID: 31836050 DOI: 10.1016/j.pestbp.2019.07.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2019] [Revised: 07/02/2019] [Accepted: 07/13/2019] [Indexed: 06/10/2023]
Abstract
Glyphosate (GLP) is one of the most common herbicides worldwide. The serum cholinesterase (ChE) may be affected when exposed to glyphosate. Reduction of serum ChE by herbicides is probably related to cytochrome P450 (CYP450) family polymorphisms. We suspect that the abnormal ChE caused by GLP could be correlated with the CYP family members. To determine whether CYP1B1 (rs1056827 and rs1056836) and CYP1A1 (rs1048943) gene polymorphisms and individual susceptibility to GLP-induced ChE abnormalities were interrelated in the Chinese Han population, we performed this genetic association study on a total of 230 workers previously exposed to GLP, including 115 cases with reduced serum ChE and 115 controls with normal serum ChE. Two even groups of cases and controls were enrolled. The CYP1A1 and CYP1B1 polymorphisms in both groups were genotyped using TaqMan. Subjects with the CYP1A1 rs619586 genotypes showed an increased risk of GLP-induced reduction of serum ChE, which was more evident in the following subgroups: female, > 35 years old, history of GLP exposure time <10 years and >10 years, nonsmoker and nondrinker. The results show that CYP1A1 rs619586 was significantly associated with the GLP-induced reduction in serum ChE and could be a biomarker of susceptibility for Chinese GLP exposed workers. Because of a large number of people exposed to glyphosate, this study has a significance in protecting their health.
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Affiliation(s)
- Wenyan Cai
- Suzhou Municipal Hospital, Suzhou Affiliated Hosptial of Nanjing Medical University, Suzhou, Jiangsu 215001, China; Institute of Occupational Disease Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu 210009, China
| | - Feng Zhang
- Institute of Occupational Disease Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu 210009, China
| | - Lixin Zhong
- Institute of Occupational Disease Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu 210009, China
| | - Dongya Chen
- Department of Toxicology and Function Assessment, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu 210009, China
| | - Haoran Guo
- Institute of Occupational Disease Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu 210009, China; Institute of Occupational Disease Prevention, Jiangyin Municipal Center for Disease Control and Prevention, Jiangyin, Jiangsu 214434, China
| | - Hengdong Zhang
- Institute of Occupational Disease Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu 210009, China
| | - Baoli Zhu
- Institute of Occupational Disease Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu 210009, China.
| | - Xin Liu
- Institute of Occupational Disease Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu 210009, China.
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20
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Romano C, Corsetti G, Flati V, Pasini E, Picca A, Calvani R, Marzetti E, Dioguardi FS. Influence of Diets with Varying Essential/Nonessential Amino Acid Ratios on Mouse Lifespan. Nutrients 2019; 11:nu11061367. [PMID: 31216646 PMCID: PMC6628056 DOI: 10.3390/nu11061367] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 05/20/2019] [Accepted: 06/13/2019] [Indexed: 12/13/2022] Open
Abstract
An adequate intake of essential (EAA) and non-essential amino acids (NEAA) is crucial to preserve cell integrity and whole-body metabolism. EAA introduced with diet may be insufficient to meet the organismal needs, especially under increased physiological requirements or in pathological conditions, and may condition lifespan. We therefore examined the effects of iso-caloric and providing the same nitrogenous content diets, any diet containing different stoichiometric blends of EAA/NEAA, on mouse lifespan. Three groups of just-weaned male Balb/C mice were fed exclusively with special diets with varying EAA/NEAA ratios, ranging from 100%/0% to 0%/100%. Three additional groups of mice were fed with different diets, two based on casein as alimentary proteins, one providing the said protein, one reproducing the amino acidic composition of casein, and the third one, the control group, was fed by a standard laboratory diet. Mouse lifespan was inversely correlated with the percentage of NEAA introduced with each diet. Either limiting EAA, or exceeding NEAA, induced rapid and permanent structural modifications on muscle and adipose tissue, independently of caloric intake. These changes significantly affected food and water intake, body weight, and lifespan. Dietary intake of varying EAA/NEAA ratios induced changes in several organs and profoundly influenced murine lifespan. The balanced content of EAA provided by dietary proteins should be considered as the preferable means for “optimal” nutrition and the elevated or unbalanced intake of NEAA provided by food proteins may negatively affect the health and lifespan of mice.
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Affiliation(s)
- Claudia Romano
- Division of Human Anatomy and Physiopathology, Department of Clinical and Experimental Sciences, University of Brescia, 25124 Brescia, Italy.
| | - Giovanni Corsetti
- Division of Human Anatomy and Physiopathology, Department of Clinical and Experimental Sciences, University of Brescia, 25124 Brescia, Italy.
| | - Vincenzo Flati
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, 67100 L'Aquila, Italy.
| | - Evasio Pasini
- Istituti Clinici Scientifici Maugeri - IRCCS Lumezzane - Cardiac Rehabilitation Division, 25065 Lumezzane (Brescia), Italy.
| | - Anna Picca
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, 00168 Rome, Italy.
- Institute of Internal Medicine and Geriatrics, Università Cattolica del Sacro Cuore, 00168 Rome, Italy.
| | - Riccardo Calvani
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, 00168 Rome, Italy.
- Institute of Internal Medicine and Geriatrics, Università Cattolica del Sacro Cuore, 00168 Rome, Italy.
| | - Emanuele Marzetti
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, 00168 Rome, Italy.
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21
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Gong W, Zhu S, Chen C, Yin Q, Li X, Du G, Zhou Y, Qin X. The Anti-depression Effect of Angelicae Sinensis Radix Is Related to the Pharmacological Activity of Modulating the Hematological Anomalies. Front Pharmacol 2019; 10:192. [PMID: 30894817 PMCID: PMC6414447 DOI: 10.3389/fphar.2019.00192] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Accepted: 02/14/2019] [Indexed: 12/31/2022] Open
Abstract
Angelicae Sinensis Radix (AS), a well-known herb in traditional Chinese medicine (TCM), has been wildly used for replenishing the blood and promoting circulation, in Asia for thousands of years. It has been confirmed that AS also possesses the pharmacological activity of anti-depression. At the same time, recent studies suggested that depression is associated with anemia, and depression could be ameliorated via modulating the blood system. However, it is still unknown whether the anti-depression effect of AS is related to its pharmacological activity of modulating the blood system. In the current study, hematological examination and metabonomic techniques were performed to explore potential anti-depression mechanisms of AS, related to the function of modulating the blood system in a chronic unpredictable mild stress (CUMS) model. The results demonstrated that AS could significantly improve CUMS-induced depressive symptom, hematological anomalies, and hypoxia symptoms. The analysis of metabonomics demonstrated that 26 potential biomarkers in depression could be regulated by the administration of AS. Among them, eight biomarkers participate in the metabolic pathways of amino acid and sphingolipid, and energy metabolism could also be regulated in an anemia model through the administration of AS, as reported in previous literatures. Further results proved that AS modulated energy metabolism in depression through the inhibition of the expression of pyruvate dehydrogenase lipoamide kinase isozyme 1 (PDK-1) and lactate dehydrogenase A (LDHA). These results suggested that the modulation of the blood system was involved in the anti-depression effect of AS. The mechanism may be associated with the promotion of the body’s energy metabolism, the stabilization of cell membranes, the promotion of serum protein synthesis, and the enhancement of immunity.
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Affiliation(s)
- Wenxia Gong
- Modern Research Center for Traditional Chinese Medicine, Shanxi University, Taiyuan, China
| | - Shiwei Zhu
- Modern Research Center for Traditional Chinese Medicine, Shanxi University, Taiyuan, China
| | - Congcong Chen
- Modern Research Center for Traditional Chinese Medicine, Shanxi University, Taiyuan, China
| | - Qicai Yin
- Modern Research Center for Traditional Chinese Medicine, Shanxi University, Taiyuan, China
| | - Xiao Li
- Modern Research Center for Traditional Chinese Medicine, Shanxi University, Taiyuan, China
| | - Guanhua Du
- Modern Research Center for Traditional Chinese Medicine, Shanxi University, Taiyuan, China.,Institute of Materia Medica, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yuzhi Zhou
- Modern Research Center for Traditional Chinese Medicine, Shanxi University, Taiyuan, China
| | - Xuemei Qin
- Modern Research Center for Traditional Chinese Medicine, Shanxi University, Taiyuan, China
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22
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Emiroglu C, Görpelioglu S, Aypak C. The Relationship between Nutritional Status, Anemia and Other Vitamin Deficiencies in the Elderly Receiving Home Care. J Nutr Health Aging 2019; 23:677-682. [PMID: 31367734 DOI: 10.1007/s12603-019-1215-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
AIM The aim of this study was to evaluate the prevalence of anemia and other vitamin deficiencies among elderly home care patients and to evaluate the causes of anemia and effect of malnutrition as a contributing factor. METHODS Anemia was defined according to the World Health Organization. Hemogram, serum iron, iron binding capacity, ferritin and transferrin saturation values, serum vitamin B12, folic acid and vitamin D levels were evaluated. It was tried to differentiate as absolute iron deficiency anemia, anemia of chronic disease, anemia of unknown cause and vitamin B12 deficiency anemia. Malnutrition was evaluated by Mini Nutritional Assessment test. RESULTS Total of 472 patients (mean age 81,4±7,4 years) were included in the study. Anemia was detected in 179 (%37,9) patients, 22,7% of males and 45,5 % of female. Prevalence of iron deficiency anemia, vitamin B12, folic acid and vitamin D deficiencies were found 43%, 46%, 19% and 91% respectively. 22,8% of all patients were malnourished, 17,5% were under malnutrition risk. In patients with anemia 16,2% chronic disease anemia and 37,4% unknown anemia were detected. CONCLUSIONS With or without malnutrition, iron deficiency anemia, vitamin B12 deficiency and vitamin D deficiency were common in the home care elderly patients.
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Affiliation(s)
- C Emiroglu
- C. Emiroglu , Medical Doctor, Specialist of Family Medicine, University of Health Sciences, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ziraat Mahallesi, Şehit Ömer Halisdemir Cad. No:20, Dışkapı Altındağ Ankara Turkey, E-mail address: , Phone Number: 90 535 336 6038
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23
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Sinha S, Patro N, Patro IK. Maternal Protein Malnutrition: Current and Future Perspectives of Spirulina Supplementation in Neuroprotection. Front Neurosci 2018; 12:966. [PMID: 30618587 PMCID: PMC6305321 DOI: 10.3389/fnins.2018.00966] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 12/03/2018] [Indexed: 12/30/2022] Open
Abstract
Malnutrition has been widely recognized as a grave burden restricting the progress of underdeveloped and developing countries. Maternal, neonatal and postnatal nutritional immunity provides an effective approach to decrease the risk of malnutrition associated stress in adulthood. Particularly, maternal nutritional status is a critical contributor for determining the long-term health aspects of an offspring. Maternal malnutrition leads to increased risk of life, poor immune system, delayed motor development and cognitive dysfunction in the children. An effective immunomodulatory intervention using nutraceutical could be used to enhance immunity against infections. The immune system in early life possesses enormous dynamic capacity to manage both genetic and environment driven processes and can adapt to rapidly changing environmental exposures. These immunomodulatory stimuli or potent nutraceutical strategy can make use of early life plasticity to target pathways of immune ontogeny, which in turn could increase the immunity against infectious diseases arising from malnutrition. This review provides appreciable human and animal data showing enduring effects of protein deprivation on CNS development, oxidative stress and inflammation and associated behavioral and cognitive impairments. Relevant studies on nutritional supplementation and rehabilitation using Spirulina as a potent protein source and neuroprotectant against protein malnutrition (PMN) induced deleterious changes have also been discussed. However, there are many futuristic issues that need to be resolved for proper modulation of these therapeutic interventions to prevent malnutrition.
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Affiliation(s)
- Shrstha Sinha
- School of Studies in Neuroscience, Jiwaji University, Gwalior, India.,School of Studies in Zoology, Jiwaji University, Gwalior, India
| | - Nisha Patro
- School of Studies in Neuroscience, Jiwaji University, Gwalior, India
| | - Ishan K Patro
- School of Studies in Neuroscience, Jiwaji University, Gwalior, India.,School of Studies in Zoology, Jiwaji University, Gwalior, India
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24
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Wang MC, Huang CE, Lin MH, Yang YH, Lu CH, Chen PT, Wu YY, Tsou HY, Hsu CC, Chen CC. Impacts of demographic and laboratory parameters on key hematological indices in an adult population of southern Taiwan: A cohort study. PLoS One 2018; 13:e0201708. [PMID: 30071080 PMCID: PMC6072090 DOI: 10.1371/journal.pone.0201708] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2017] [Accepted: 07/20/2018] [Indexed: 12/14/2022] Open
Abstract
Studies in Caucasians have shown that values of hematological indices could be affected by a wide variety of factors. However, parallel work in other ethnical populations, particularly from the Asia-Pacific region, is lacking. Therefore, we designed this study to explore the association between clinical/laboratory parameters and hemogram levels. Adult individuals who came to our hospital for health exams were screened. Information on demographics and laboratory profiles was obtained. We analyzed the impacts of these parameters on the variation of hemogram. Overall, 26,497 adults were included in the current analysis after excluding those with abnormal hemogram. Multivariate regression analysis showed increasing age and male gender negatively affected the number of platelets, whereas a higher serum apolipoprotein B level was associated with an elevated platelet count. Gender and serum albumin level were the major determinants of variation in hemoglobin level. A modestly increased white cell count was seen in men as well as individuals with elevated apolipoprotein B levels, but it was inversely correlated with changes in age and serum albumin levels. Conversely, some variables, although statistically significantly associated with the hematological indices, only provided a trivial explanation for the heterogeneity observed. We further established predictive models for the approximate estimation of hematological indices in healthy adults. Our data indicate that age, gender, and serum levels of apolipoprotein B and albumin affect hematological indices in various ways. We also demonstrate that variation in hemogram could be successfully predicted by a number of clinical and laboratory parameters.
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Affiliation(s)
- Ming-Chung Wang
- Division of Hematology and Oncology, Department of Medicine, Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Cih-En Huang
- Division of Hematology and Oncology, Department of Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Meng-Hung Lin
- Center of Excellence for Chang Gung Research Datalink, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Yao-Hsu Yang
- Center of Excellence for Chang Gung Research Datalink, Chang Gung Memorial Hospital, Chiayi, Taiwan
- Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University College of Public Health, Taipei, Taiwan
- School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Chang-Hsien Lu
- Division of Hematology and Oncology, Department of Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ping-Tsung Chen
- Division of Hematology and Oncology, Department of Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yu-Ying Wu
- Division of Hematology and Oncology, Department of Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Hsing-Yi Tsou
- Division of Hematology and Oncology, Department of Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Chia-Chen Hsu
- Division of Hematology and Oncology, Department of Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Chih-Cheng Chen
- Division of Hematology and Oncology, Department of Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan
- School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- * E-mail:
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25
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The impact of treatment for iron deficiency and iron deficiency anemia on nutritional status, physical performance, and cognitive function in geriatric patients. Eur Geriatr Med 2018; 9:493-500. [PMID: 34674483 DOI: 10.1007/s41999-018-0065-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 05/02/2018] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Iron deficiency in older people is common and affects physical and cognitive performance. The effects of iron deficiency on nutrition and cognitive status are well established. However, there are few studies demonstrating the impact of iron deficiency treatment on functional and cognitive outcomes in the geriatric population. The aim of this study was to determine whether iron replacement treatment was associated with an improvement in the nutritional, cognitive, and functional status of older patients with iron deficiency (ID) and iron deficiency anemia (IDA). METHODS Geriatric patients with iron deficiency and iron deficiency anemia presenting to the geriatric clinic were included in the study. Comprehensive geriatric assessment (CGA) and blood samples to investigate iron deficiency were performed at baseline and 6 month later. 81 patients were included in the study and were evaluated at follow-up in the 6th month. The CGA included the following tests: the Katz Index of Independence in Activities of Daily Living Scale (Katz ADL), the Lawton-Brody Instrumental Activities of Daily Living Scale (IADL), the Mini-Mental State Examination (MMSE), and the Mini Nutritional Assessment Short-Form (MNA-SF), as well as the assessments of hand grip strength and walking speed. RESULTS Of the 81 participating patients, 69.1% were women and 30.9% were men. The mean age was 76.8 ± 7.28 years. Follow-up after iron supplementation treatment was performed with a mean of 6.23 ± 1.58 months. Improvements occurred in the following geriatric and laboratory assessments: Lawton-Brody (IADL), MNA-SF, MMSE, hand grip strength, and walking speed evaluations and the levels of hemoglobin, iron, total iron-binding capacity, transferrin saturation, and ferritin. CONCLUSIONS It was shown that iron replacement treatment has a positive impact on functional and cognitive status and nutritional parameters in older patients with ID and IDA.
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26
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Corsetti G, Pasini E, Romano C, Calvani R, Picca A, Marzetti E, Flati V, Dioguardi FS. Body Weight Loss and Tissue Wasting in Late Middle-Aged Mice on Slightly Imbalanced Essential/Non-essential Amino Acids Diet. Front Med (Lausanne) 2018; 5:136. [PMID: 29868589 PMCID: PMC5966530 DOI: 10.3389/fmed.2018.00136] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Accepted: 04/23/2018] [Indexed: 12/27/2022] Open
Abstract
Objective: Inadequate protein intake can impair protein balance thus leading to skeletal muscle atrophy, impaired body growth, and functional decline. Foods provide both non-essential (NEAAs) and essential amino acids (EAAs) that may convey different metabolic stimuli to specific organs and tissues. In this study, we sought to evaluate the impact of six diets, with various EAA/NEAA blends, on body composition and the risk of developing tissue wasting in late middle-aged male mice. Methods: Six groups of late middle-aged male mice were fed for 35 days with iso-nutrients, iso-caloric, and iso-nitrogenous special diets containing different EAA/NEAA ratios ranging from 100/0% to 0/100%. One group fed with standard laboratory rodent diet (StD) served as control. Preliminarily, we verified the palatability of the diets by recording the mice preference, and by making accessible all diets simultaneously, in comparison to StD. Body weight, food and water consumption were measured every 3 days. Blood and urine samples, as well as heart, kidneys, liver, spleen, triceps surae, retroperitoneal WAT, and BAT were harvested and weighed. Results: Mice consuming NEAA-based diets, although showing increased food and calorie intake, suffered the most severe weight loss. Interestingly, the diet containing a EAA/NEAA-imbalance, with moderate NEAAs prevalence, was able to induce catabolic stimuli, generalized body wasting, and systemic metabolic alterations comparable to those observed with diet containing NEAA alone. In addition, complete depletion of retroperitoneal white adipose tissue and a severe loss (>75%) of brown adipose tissue were observed together with muscle wasting. Conversely, EAA-containing diets induced significant decreases in body weight by reducing primarily fat reserves, but at the same time they improved the clinical parameters. On these basis we can deduce that tissue wasting was caused by altered AA quality, independent of reduced nitrogen or caloric intake. Conclusion: Our results indicate that diets containing an optimized balance of AA composition is necessary for preserving overall body energy status. These findings are particularly relevant in the context of aging and may be exploited for contrasting its negative correlates, including body wasting.
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Affiliation(s)
- Giovanni Corsetti
- Division of Human Anatomy and Physiopathology, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Evasio Pasini
- Cardiac Rehabilitation Division, IRCCS Istituti Clinici Scientifici Maugeri (ICS Maugeri), Lumezzane, Italy
| | - Claudia Romano
- Division of Human Anatomy and Physiopathology, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Riccardo Calvani
- Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of the Sacred Heart, Rome, Italy
| | - Anna Picca
- Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of the Sacred Heart, Rome, Italy
| | - Emanuele Marzetti
- Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of the Sacred Heart, Rome, Italy
| | - Vincenzo Flati
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Francesco S Dioguardi
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
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27
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Lee CH, Lin C, Wang CY, Huang TC, Wu YY, Chien WC, Chen JH. Premorbid BMI as a prognostic factor in small-cell lung cancer-a single institute experience. Oncotarget 2018; 9:24642-24652. [PMID: 29872494 PMCID: PMC5973860 DOI: 10.18632/oncotarget.24935] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Accepted: 03/05/2018] [Indexed: 02/07/2023] Open
Abstract
Numerous evidence has indicated that excess weight is associated with an increased risk of mortality in patients in several cancer types including breast, colorectal, pancreatic, endometrial, and prostate cancer However, with respect to non-small cell lung cancer and upper aero-digestive cancer, evidence suggests that low body mass index (BMI) may increase the risk of mortality of these cancers, but a definitive link between premorbid BMI and overall survival in small cell lung cancer patients has yet to be fully explored. To investigate this possibility, we conducted a retro-spective of 173 small-cell lung cancer patients. Multivariate Cox analysis indicated that pretreatment overweight (BM I ≥ 23) was an independent prognostic factor for overall survival (OS) (Hazard ratio, = 0.58, 95% CI = 0.39–0.87, p = 0.008). In addition, meta-regression revealed that per-formance status (≤ 2) marginally interacted with increased BMI (p = 0.068). However, subgroup analysis showed that patients with a BMI ≥ 23 and performance status ≤ 2 had the best OS (Hazard ratio: 0.31, 95% CI: 0.16–0.61, p = 0.001). Premorbid BMI and performance status level are easy to measure and may provide physicians an additional measurement to predict a small-cell lung cancer patient’s survival. The data from the present study indicates that a, further large scale prospective study is warranted to better assess the association of pretreatment BMI and OS in small-cell lung cancer.
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Affiliation(s)
- Cho-Hao Lee
- Division of Hematology and Oncology Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Chin Lin
- School of Public Health, National Defense Medical Center, Taipei, Taiwan, Republic of China.,Department of Research and Development, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Chieh-Yung Wang
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Tzu-Chuan Huang
- Division of Hematology and Oncology Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Yi-Ying Wu
- Division of Hematology and Oncology Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Wu-Chien Chien
- School of Public Health, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Jia-Hong Chen
- Division of Hematology and Oncology Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China.,Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan, Republic of China
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28
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Phan K, Kim JS, Xu J, Di Capua J, Lee NJ, Kothari P, Vig KS, Dowdell J, Cho SK. Nutritional Insufficiency as a Predictor for Adverse Outcomes in Adult Spinal Deformity Surgery. Global Spine J 2018; 8:164-171. [PMID: 29662747 PMCID: PMC5898673 DOI: 10.1177/2192568217708777] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
STUDY DESIGN Retrospective analysis of prospectively collected data. OBJECTIVE The effect of malnutrition on outcomes after general surgery has been well reported in the literature. However, there is a paucity of data on the effect of malnutrition on postoperative complications during adult deformity surgery. The study attempts to explore and quantify the association between hypoalbuminemia and postoperative complications. METHODS A retrospective cohort analysis was performed on the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database from 2010 to 2014. Patients (≥18 years of age) from the NSQIP database undergoing adult deformity surgery were separated into cohorts based serum albumin (<3.5 or >3.5 g/dL). Chi-square and multivariate logistic regression models were used to identify independent risk factors. RESULTS A total of 2236 patients met the inclusion criteria for the study, of which 2044 (91.4%) patients were nutritionally sufficient while 192 (8.6%) patients were nutritionally insufficient. Multivariate logistic regressions revealed nutritional insufficiency as a risk factors for mortality (odds ratio [OR] = 15.67, 95% confidence interval [CI] = 6.01-40.84, P < .0001), length of stay ≥5 days (OR = 2.22, 95% CI = 1.61-3.06, P < .0001), any complications (OR = 1.82, 95% CI = 1.31-2.51, P < .0001), pulmonary complications (OR = 2.29, 95% CI = 1.29-4.06, P = .005), renal complications (OR = 2.71, 95% CI = 1.05-7.00, P = .039), and intra-/postoperative red blood cell transfusion (OR = 1.52, 95% CI = 1.08-2.12, P = .015). CONCLUSIONS This study demonstrates that preoperative hypoalbuminemia is a significant and independent risk factor for postoperative complications, 30-day mortality, and increased length of hospital in patients undergoing adult deformity surgery surgery. Nutritional status is a modifiable risk factor that can potentially improve surgical outcomes after adult deformity surgery.
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Affiliation(s)
- Kevin Phan
- University of New South Wales, Sydney, New South Wales, Australia
- Prince of Wales Private Hospital, Sydney, New South Wales, Australia
| | - Jun S. Kim
- Icahn School of Medicine at Mount Sinai, New York NY, USA
| | - Joshua Xu
- Prince of Wales Private Hospital, Sydney, New South Wales, Australia
| | - John Di Capua
- Icahn School of Medicine at Mount Sinai, New York NY, USA
| | - Nathan J. Lee
- Icahn School of Medicine at Mount Sinai, New York NY, USA
| | - Parth Kothari
- Icahn School of Medicine at Mount Sinai, New York NY, USA
| | | | - James Dowdell
- Icahn School of Medicine at Mount Sinai, New York NY, USA
| | - Samuel K. Cho
- Icahn School of Medicine at Mount Sinai, New York NY, USA
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Corona LP, de Oliveira Duarte YA, Lebrão ML. Markers of nutritional status and mortality in older adults: The role of anemia and hypoalbuminemia. Geriatr Gerontol Int 2017; 18:177-182. [PMID: 28782162 DOI: 10.1111/ggi.13137] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 03/27/2017] [Accepted: 06/13/2017] [Indexed: 11/28/2022]
Abstract
AIM The aim of the present study was to analyze the impact of anemia and hypoalbuminemia on mortality in a 5-year period. METHODS This was longitudinal population-based observational survey part of the Saúde, Bem-Estar e Envelhecimento study (Health, Well-being and Aging), carried out with 1256 older adults from the third wave of the cohort, followed for 5 years, when they were contacted for the fourth wave, in Sao Paulo, Brazil. Anemia was defined when hemoglobin was <12 g/dL for women and <13 g/dL for men, and hypoalbuminemia when serum albumin was <3.5 g/dL. Survival functions were estimated according to nutritional status in four groups: (i) without nutritional alteration; (ii) anemia only; (iii) hypoalbuminemia only; and (iv) anemia and hypoalbuminemia. Hazard ratios were calculated, following the Cox proportional hazards model, controlling for baseline covariates. All analyses considered sample weights, and were carried out using the Stata 12. RESULTS After the 5-year period, 12.3% of the participants died, and 8.2% were lost to follow up. Those who died had lower hemoglobin and albumin concentrations (13.4 g/dL and 3.7 g/dL) compared with survivors (14.3d/dL and 3.9 g/dL; P < 0.001). The crude death rate was 27.6/1000 person-years for participants in group i, 124.3 in group ii, 116.0 in group iii and 222.8 in group iv (P < 0.001). In the final Cox models, group 2 and 3 had a similar effect (hazard ratio 2.23, P = 0.020; 2.53, P = 0.005; respectively) and group 4 had a higher risk (hazard ratio 3.36; P = 0.004). CONCLUSIONS Anemia and hypoalbuminemia are important markers for death in older adults, and have an additive effect on mortality. Because they are common and cost-effective biomarkers, their use should be encouraged in geriatric evaluation for all health professionals and in population settings, such as primary care. Geriatr Gerontol Int 2018; 18: 177-182.
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Affiliation(s)
| | | | - Maria Lúcia Lebrão
- Department of Epidemiology, School of Public Health, University of Sao Paulo, São Paulo, SP, Brazil
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30
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Godil A, Mallick MSA, Adam AM, Haq A, Khetpal A, Afzal R, Salim M, Shahid N. Prevalence and Severity of Depression in a Pakistani Population with at least One Major Chronic Disease. J Clin Diagn Res 2017; 11:OC05-OC10. [PMID: 28969176 PMCID: PMC5620817 DOI: 10.7860/jcdr/2017/27519.10329] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Accepted: 05/11/2017] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Diabetes, anaemia, hypertension and asthma are major contributors to morbidity in our society. Depression is the commonest psychological malady diagnosed in hospital settings. There tends to be some overlap between certain chronic systemic illnesses and depressive disorders, this point towards the need to determine relationships between them, if any. AIM To determine the prevalence and compare the severity of depression among individuals diagnosed with four of the most common chronic diseases in our community. MATERIALS AND METHODS This cross-sectional study was carried out among patients with chronic diseases visiting a tertiary care hospital in Karachi, Pakistan from August 2015 to August 2016. The Beck Depression Inventory-II*, a 21-item self-report instrument was used to assess the severity of depression. Categorical variables were compared using Chi-square test while intergroup comparisons were performed using one way ANOVA test. Logistic regression was employed to estimate the odds of Category B depression (moderate and severe levels of depression) in chronic diseases. RESULTS The prevalence of anaemia, hypertension, diabetes and asthma was 90%, 47%, 26% and 23% respectively. Predictors of Category B depression were anaemia (OR=4.21, 95% CI: 1.30-13.56) and diabetes (OR=2.03, 95% CI: 1.09-3.77). Asthma predicted Category B depression in males (OR=1.26, 95% CI: 0.29-5.42) but not in females (OR=0.77, 95% CI: 0.39-1.52). Individuals with hypertension were less likely to report Category B depression than non-hypertensive (OR=0.72, 95% CI 0.43-1.21). Female gender had a greater influence to develop Category B depression than males (OR= 2.96, 95% CI: 1.93-4.55). CONCLUSION Our study points towards a strong correlation between depression and chronic diseases especially anaemia and diabetes. This cautions medical practitioners against treatment of depressive disorders and chronic diseases as separate, independent entities.
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Affiliation(s)
- Ansab Godil
- Medical Student, Department of Medicine, Dow University of Health Sciences, Karachi, Sindh, Pakistan
| | - Muhammad Saad Ali Mallick
- Medical Student, Department of Medicine, Dow University of Health Sciences, Karachi, Sindh, Pakistan
| | - Arsalan Majeed Adam
- Medical Student, Department of Medicine, Dow University of Health Sciences, Karachi, Sindh, Pakistan
| | - Amna Haq
- Medical Student, Department of Medicine, Dow University of Health Sciences, Karachi, Sindh, Pakistan
| | - Akash Khetpal
- Medical Student, Department of Medicine, Dow University of Health Sciences, Karachi, Sindh, Pakistan
| | - Razna Afzal
- Medical Student, Department of Medicine, Dow University of Health Sciences, Karachi, Sindh, Pakistan
| | - Maliha Salim
- Medical Student, Department of Medicine, Dow University of Health Sciences, Karachi, Sindh, Pakistan
| | - Naureen Shahid
- Medical Student, Department of Medicine, Dow University of Health Sciences, Karachi, Sindh, Pakistan
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31
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Cheng YL, Sung SH, Cheng HM, Hsu PF, Guo CY, Yu WC, Chen CH. Prognostic Nutritional Index and the Risk of Mortality in Patients With Acute Heart Failure. J Am Heart Assoc 2017. [PMID: 28649089 PMCID: PMC5669149 DOI: 10.1161/jaha.116.004876] [Citation(s) in RCA: 194] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Background Nutritional status has been related to clinical outcomes in patients with heart failure. We assessed the association between nutritional status, indexed by prognostic nutritional index (PNI), and survival in patients hospitalized for acute heart failure. Methods and Results A total of 1673 patients (age 76±13 years, 68% men) hospitalized for acute heart failure in a tertiary medical center were analyzed. PNI was calculated as 10×serum albumin (g/dL)+0.005×total lymphocyte count (per mm3). National Death Registry was linked to identify the clinical outcomes of all‐cause and cardiovascular death. With increasing tertiles of PNI, age and N‐terminal probrain natriuretic peptide decreased, and body mass index, estimated glomerular filtration rate, and hemoglobin increased. During a mean follow‐up duration of 31.5 months, a higher PNI tertile was related to better survival free from all‐cause and cardiovascular mortality in the total study population and in participants with either reduced or preserved left ventricular ejection fraction. After accounting for age, sex, estimated glomerular filtration rate, left ventricular ejection fraction, serum sodium level, and on‐admission systolic blood pressure, PNI was independently associated with cardiovascular death and total mortality (hazard ratio per 1 SD of the natural logarithm of the PNI: 0.76 [95% CI, 0.66–0.87] and 0.79 [95% CI, 0.73–0.87], respectively). In subgroup analyses stratified by age, sex, left ventricular ejection fraction, body mass index, or estimated glomerular filtration rate, PNI was consistently related to mortality. Conclusions PNI is independently associated with long‐term survival in patients hospitalized for acute heart failure with either reduced or preserved left ventricular ejection fraction.
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Affiliation(s)
- Yu-Lun Cheng
- Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Shih-Hsien Sung
- Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan .,Department of Medicine, National Yang-Ming University, Taipei, Taiwan.,Institute of Public Health, National Yang-Ming University, Taipei, Taiwan
| | - Hao-Min Cheng
- Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan.,Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan.,Department of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Pai-Feng Hsu
- Healthcare and Management Center, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Medicine, National Yang-Ming University, Taipei, Taiwan.,Institute of Public Health, National Yang-Ming University, Taipei, Taiwan
| | - Chao-Yu Guo
- Institute of Public Health, National Yang-Ming University, Taipei, Taiwan
| | - Wen-Chung Yu
- Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan.,Department of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Chen-Huan Chen
- Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan.,Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan.,Department of Medicine, National Yang-Ming University, Taipei, Taiwan.,Institute of Public Health, National Yang-Ming University, Taipei, Taiwan
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Ischemic Stroke Mortality Is More Strongly Associated with Anemia on Admission Than with Underweight Status. J Stroke Cerebrovasc Dis 2017; 26:1369-1374. [DOI: 10.1016/j.jstrokecerebrovasdis.2017.02.016] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2016] [Revised: 02/07/2017] [Accepted: 02/09/2017] [Indexed: 01/04/2023] Open
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Noh JH, Lee JW, Nam YJ, Choi KY. Is Intraoperative Use of QuikClot Combat Gauze Effective for Hemostasis after Total Knee Arthroplasty? Clin Orthop Surg 2017; 9:43-49. [PMID: 28261426 PMCID: PMC5334026 DOI: 10.4055/cios.2017.9.1.43] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Accepted: 10/11/2016] [Indexed: 11/29/2022] Open
Abstract
Background To assess the hemostatic effect of QuikClot Combat Gauze (QCG) compared to that of standard gauze during cruciate-retaining total knee arthroplasty (TKA). Methods Sixty knees underwent TKA using a pneumatic tourniquet in this prospective randomized study. After implantation of the femoral and tibial components and hardening of the bone cement, the tourniquet was deflated and QCG (group 1) or standard gauze (group 2) was packed into the joint cavity for 5 minutes for hemostasis. Perioperative bleeding volume and blood transfusion volume were compared between two groups. Results The mean intraoperative bleeding volume was 64.7 ± 12.7 mL in group 1 and 63.9 ± 9.2 mL in group 2 (p = 0.808). The mean postoperative blood drainage was 349.0 ± 170.6 mL in group 1 and 270.1 ± 136.3 mL in group 2 (p = 0.057). The average postoperative blood transfusion volume was 323.7 ± 325.9 mL in group 1 and 403.6 ± 274.8 mL in group 2 (p = 0.314). Conclusions QCG was not significantly effective for reducing perioperative bleeding volume or the blood transfusion rate compared with standard gauze during TKA.
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Affiliation(s)
- Jung Ho Noh
- Department of Orthopaedic Surgery, Kangwon National University Hospital, Chuncheon, Korea
| | - Jae Woo Lee
- Department of Orthopaedic Surgery, Kangwon National University Hospital, Chuncheon, Korea
| | - Young Joon Nam
- Department of Orthopaedic Surgery, Kangwon National University Hospital, Chuncheon, Korea
| | - Ki Yong Choi
- Department of Orthopaedic Surgery, Kangwon National University Hospital, Chuncheon, Korea
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Kagansky M, Rimon E. Is There a Difference in Metabolic Outcome Between Different Enteral Formulas? JPEN J Parenter Enteral Nutr 2017; 31:320-3. [PMID: 17595442 DOI: 10.1177/0148607107031004320] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Despite appropriate enteral nutrition, many elderly patients do not reach a good metabolic outcome. Two nutrition formulas are commonly used in Israel with no evidence-based medicine to indicate preference of one over the other. METHODS We describe a 2-month observational study of patients fed by 1 of the 2 formulas. The first (Osmolite, Abbott Company, Abbott Park, IL) is without fiber, and the second (Easy Fiber, Easyline Company Givataim, Israel) in addition to containing fiber is also richer in protein, vitamins, and minerals. The formula was selected by the primary care physician before enrollment in the study and was not influenced by the investigators. Routine blood tests as well as body weight were monitored at the start of enteral feeding and during the 2 months following as part of the regular follow-up. RESULTS Fifty-seven patients were fed with the regular formula and 77 with the enriched one. No statistically significant differences were noted between the groups during the follow-up period, in body weight, cholesterol levels, total lymphocyte count, renal function tests, or electrolyte balance. However, in the enriched formula group there was a significant decrease in glucose (p < .05), and increase in albumin (p < .05) and hemoglobin (p = .01) levels. CONCLUSIONS Enteral feeding with enriched formula appears to improve albumin and hemoglobin levels as well as diabetic control, thus it may be more appropriate than the nonfiber diet for use in long-term care patients.
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Affiliation(s)
- Michael Kagansky
- Hebrew University and Hadassah Medical School, Jerusalem, Israel
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35
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Park S, Park S, Lee SH, Suh B, Keam B, Kim TM, Kim DW, Kim YW, Heo DS. Nutritional status in the era of target therapy: poor nutrition is a prognostic factor in non-small cell lung cancer with activating epidermal growth factor receptor mutations. Korean J Intern Med 2016; 31:1140-1149. [PMID: 27017943 PMCID: PMC5094922 DOI: 10.3904/kjim.2015.062] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Revised: 05/15/2015] [Accepted: 05/28/2015] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND/AIMS Pretreatment nutritional status is an important prognostic factor in patients treated with conventional cytotoxic chemotherapy. In the era of target therapies, its value is overlooked and has not been investigated. The aim of our study is to evaluate the value of nutritional status in targeted therapy. METHODS A total of 2012 patients with non-small cell lung cancer (NSCLC) were reviewed and 630 patients with activating epidermal growth factor receptor (EGFR) mutation treated with EGFR tyrosine kinase inhibitor (TKI) were enrolled for the final analysis. Anemia, body mass index (BMI), and prognostic nutritional index (PNI) were considered as nutritional factors. Hazard ratio (HR), progression-free survival (PFS) and overall survival (OS) for each group were calculated by Cox proportional analysis. In addition, scores were applied for each category and the sum of scores was used for survival analysis. RESULTS In univariable analysis, anemia (HR, 1.29; p = 0.015), BMI lower than 18.5 (HR, 1.98; p = 0.002), and PNI lower than 45 (HR, 1.57; p < 0.001) were poor prognostic factors for PFS. Among them, BMI and PNI were independent in multi-variable analysis. All of these were also significant prognostic values for OS. The higher the sum of scores, the poorer PFS and OS were observed. CONCLUSIONS Pretreatment nutritional status is a prognostic marker in NSCLC patients treated with EGFR TKI. Hence, baseline nutritional status should be more carefully evaluated and adequate nutrition should be supplied to these patients.
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Affiliation(s)
- Sehhoon Park
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Seongyeol Park
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Se-Hoon Lee
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
- Correspondence to Se-Hoon Lee, M.D. Department of Internal Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea Tel: +82-2-2072-2199 Fax: +82-2-762-9662 E-mail:
| | - Beomseok Suh
- Department of Family Medicine and Health Promotion Center, Seoul National University Hospital, Seoul, Korea
| | - Bhumsuk Keam
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Tae Min Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Dong-Wan Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Young Whan Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Dae Seog Heo
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
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Prevalence of anemia and malnutrition and their association in elderly nursing home residents. Aging Clin Exp Res 2016; 28:857-62. [PMID: 26572155 DOI: 10.1007/s40520-015-0490-5] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Accepted: 10/27/2015] [Indexed: 12/15/2022]
Abstract
PURPOSE Malnutrition is one of the most important geriatric syndromes in the elderly. The aim of this study was to investigate the association between anemia and malnutrition in elderly nursing home residents. MATERIALS AND METHODS Local nursing home residents over 60 years old in the Izmir were included in the study. Blood samples were taken from study participants for hemogram, iron, ferritin, total iron-binding capacity, vitamin B12 and folic acid analysis. WHO criteria were used to define anemia. Causes of anemia were classified as iron deficiency, vitamin B12 or folic acid deficiency, anemia of chronic disease or other hematologic causes. Anemia was defined as the dependent variable and malnutrition was defined as the independent variable. Correlation between MNA scores and Hb levels was determined using Pearson correlation analysis. The slope of causality between malnutrition and anemia was determined using the χ (2) test and logistic regression analysis. RESULTS The study included 257 elderly nursing home residents with a mean age of 78.5 ± 7.8 years. The overall prevalence of anemia was 54.9 %; 35.8 % of the study participants were at risk of malnutrition and 8.2 % were malnourished. Anemia risk was 2.12-fold higher in participants at risk of malnutrition and 5.05-fold higher in those with malnutrition. In the participants with malnutrition or malnutrition risk, the most common cause of anemia was anemia of chronic disease (57.1 and 46.5 %, respectively). CONCLUSION The prevalence of anemia among elderly nursing home residents is high in Turkey. Malnutrition and malnutrition risk increase the incidence of anemia.
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Edem VF, Akintunde K, Adelaja YA, Nwozo SO, Charles-Davies M. Zinc, lead, and cadmium levels in serum and milk of lactating women in Ibadan, Nigeria. Toxicol Ind Health 2016; 33:28-35. [DOI: 10.1177/0748233716661073] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Zinc (Zn) is known to interact with lead (Pb) and cadmium (Cd) reversing their toxicity and reducing their concentrations. However, lactating women are at high risk of developing Zn deficiency, which may result in Pb and Cd intoxication or increased exposure of breast-fed infants to Pb and Cd from breast milk. The aim of this study was to determine Zn, Pb, and Cd concentrations and examine their relationship in serum and breast milk of lactating women in Ibadan, Nigeria. Ninety-two lactating women were recruited into this study. Anthropometric measurements were assessed by standard methods while serum and breast milk concentrations of Zn, Pb, and Cd were assessed by atomic absorption spectrophotometry. Data analyzed statistically by Student’s t test, Pearson’s correlation coefficient, and a multiple regression model were significant at p < 0.05. Zn deficiency was observed in 12 (17.1%) of lactating women. Breast milk levels of Zn, Pb, and Cd were significantly higher than their levels in serum, whereas the ratios Zn:Pb and Zn:Cd in milk were significantly less than serum ratios. Significant negative correlation was observed between milk Pb and serum Zn:Pb while milk Cd correlated positively with milk Zn. Significant positive correlations were observed between serum Zn and serum Zn:Pb, serum Zn and serum Zn:Cd, as well as serum Zn:Cd and serum Zn:Pb. Serum Cd and serum Zn were significantly negatively related. Significant negative correlations between serum Pb and serum Zn:Pb as well as milk Zn:Pb. Serum Cd and serum Zn:Pb as well as serum Zn:Cd correlated negatively. Milk Cd and Zn/Cd positively related with milk Pb while milk Zn was a negatively related with milk Pb in a multiple regression model ( R2 = 0.333; p = 0.023). Breast milk may be contaminated by toxic metals. However, Zn supplementation in deficient mothers may protect maternal and infant health.
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Affiliation(s)
| | | | | | - Sarah O Nwozo
- Department of Biochemistry, University of Ibadan, Ibadan, Nigeria
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Zhang B, Shen C, Jin J, Song Y, Zhao Z, Zhang X, Wang G, Fan Y, Mi Y, Hu S, Cui Y, Zhou L, He Z, Yu W, Han W. Pretreatment serum pseudocholinesterase level as a novel prognostic biomarker for upper tract urothelial carcinoma. Int Urol Nephrol 2016; 48:1993-1999. [PMID: 27554671 DOI: 10.1007/s11255-016-1401-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2016] [Accepted: 08/17/2016] [Indexed: 11/28/2022]
Abstract
PURPOSE Pretreatment serum pseudocholinesterase (PChE) has been reported to be a prognostic predictor in several cancers. However, the prognostic significance of serum PChE level in patients with upper tract urothelial carcinoma (UTUC) remains unknown. METHODS A total of 180 patients who underwent radical nephroureterectomy (RNU) for UTUC were included in this retrospective analysis. The associations of pretreatment serum PChE levels with clinicopathological characteristics and clinical outcomes were assessed. RESULTS The median (IQR) pretreatment serum PChE level was 6385 (5449-7260) IU/L, and an optimal cutoff value of 5336 IU/L was set according to ROC analysis. Decreased pretreatment serum PChE levels were significantly correlated with older patient age, higher preoperative chronic kidney disease (CKD) stage and pT stage (all P < 0.05). On multivariate analysis, adjusting for preoperative variables, decreased pretreatment serum PChE levels independently predicted higher pT stage (P = 0.011). Moreover, Kaplan-Meier curves suggested that patients with PChE levels <5336 IU/L were predicted to have a shorter overall survival (OS) and cancer-specific survival (CSS) than those with PChE levels ≥5336 IU/L (both P < 0.001). On multivariate analysis, decreased pretreatment serum PChE levels were significantly associated with shorter OS (HR 0.553; 95 %CI 0.322-0.951; P = 0.032) and CSS (HR 0.484; 95 %CI 0.269-0.870; P = 0.015). CONCLUSIONS Decreased pretreatment serum PChE level is an independent predictor for higher pT stage, shorter OS and CSS in patients with UTUC. Pretreatment serum PChE levels may act as a simple and effective parameter to predict prognosis for UTUC patients after RNU.
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Affiliation(s)
- Bo Zhang
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Beijing, People's Republic of China
| | - Cheng Shen
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Beijing, People's Republic of China
| | - Jie Jin
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Beijing, People's Republic of China
| | - Yi Song
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Beijing, People's Republic of China
| | - Zheng Zhao
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Beijing, People's Republic of China
| | - Xiaochun Zhang
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Beijing, People's Republic of China
| | - Gang Wang
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Beijing, People's Republic of China
| | - Yu Fan
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Beijing, People's Republic of China
| | - Yue Mi
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Beijing, People's Republic of China
| | - Shuai Hu
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Beijing, People's Republic of China
| | - Yun Cui
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Beijing, People's Republic of China
| | - Liqun Zhou
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Beijing, People's Republic of China
| | - Zhisong He
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Beijing, People's Republic of China
| | - Wei Yu
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Beijing, People's Republic of China.
| | - Wenke Han
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Beijing, People's Republic of China.
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Vulser H, Wiernik E, Hoertel N, Thomas F, Pannier B, Czernichow S, Hanon O, Simon T, Simon JM, Danchin N, Limosin F, Lemogne C. Association between depression and anemia in otherwise healthy adults. Acta Psychiatr Scand 2016; 134:150-60. [PMID: 27238642 DOI: 10.1111/acps.12595] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/28/2016] [Indexed: 12/11/2022]
Abstract
OBJECTIVE It remains debated whether anemia is associated with depression, independently of physical health factors. We report a large-scale cross-sectional study examining this association in adults free of chronic disease and medication from the general population. METHOD Hemoglobin levels were measured among 44 173 healthy participants [63% men; mean [standard deviation] age = 38.4 (11.1) years] from the 'Investigations Préventives et Cliniques' (IPC) cohort study. Depression was measured with the Questionnaire of Depression 2nd version, Abridged. Logistic regression analyses were performed to examine the association between anemia and depression, while adjusting for a wide range of sociodemographic characteristics and health-related factors (i.e., sex, age, living status, education level, occupational status, alcohol intake, smoking status, physical activity, and body mass index). RESULTS Depressed participants were significantly more likely to have anemia compared to non-depressed participants, even after adjustment for sociodemographic and health-related variables [odds ratio = 1.36; 95% confidence interval = (1.18; 1.57)]. Anemia prevalence increased with depression severity, suggesting a dose-response relationship (P for trend <0.001). CONCLUSION In healthy adults from the general population, we found a significant and robust association between depression and anemia. Further studies are needed to assess the longitudinal relationship between both conditions and determine the mechanisms underlying this association.
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Affiliation(s)
- H Vulser
- Faculty of Medicine, Paris Descartes University, Sorbonne Paris Cité, Paris, France.,Department of Psychiatry, Western Paris University Hospital Group, AP-HP, Paris, France
| | - E Wiernik
- Centre for Research in Epidemiology and Population Health, U1018, Inserm, Villejuif, France.,Versailles St-Quentin University, Versailles, France
| | - N Hoertel
- Faculty of Medicine, Paris Descartes University, Sorbonne Paris Cité, Paris, France.,Department of Psychiatry, Western Paris University Hospital Group, AP-HP, Paris, France.,Centre of Psychiatry and Neuroscience, U894, Inserm, Paris, France
| | - F Thomas
- Research Department, IPC Center, Paris, France
| | - B Pannier
- Research Department, IPC Center, Paris, France.,Department of Cardiology, Manhes Hospital, Fleury-Mérogis, France
| | - S Czernichow
- Versailles St-Quentin University, Versailles, France.,Population-based Epidemiologic Cohorts, UMS 11, Inserm, Villejuif, France.,Department of Nutrition, Ambroise Paré Hospital, AP-HP, Boulogne-Billancourt, France
| | - O Hanon
- Faculty of Medicine, Paris Descartes University, Sorbonne Paris Cité, Paris, France.,Department of Geriatrics, Broca Hospital, AP-HP, Paris, France
| | - T Simon
- Pierre and Marie Curie University, Paris, France.,Department of Pharmacology, St Antoine Hospital, AP-HP, Paris, France
| | - J-M Simon
- Department of Radiation Oncology, Pitié-Salpêtrière Hospital Group, AP-HP, Paris, France
| | - N Danchin
- Faculty of Medicine, Paris Descartes University, Sorbonne Paris Cité, Paris, France.,Department of Cardiology, Western Paris University Hospital Group, AP-HP, Paris, France
| | - F Limosin
- Faculty of Medicine, Paris Descartes University, Sorbonne Paris Cité, Paris, France.,Department of Psychiatry, Western Paris University Hospital Group, AP-HP, Paris, France.,Centre of Psychiatry and Neuroscience, U894, Inserm, Paris, France
| | - C Lemogne
- Faculty of Medicine, Paris Descartes University, Sorbonne Paris Cité, Paris, France.,Department of Psychiatry, Western Paris University Hospital Group, AP-HP, Paris, France.,Centre of Psychiatry and Neuroscience, U894, Inserm, Paris, France
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Association between hematologic parameters and functional impairment among geriatric inpatients: Data of a prospective cross-sectional multicenter study (“GeriPrävalenz2013”). Maturitas 2016; 90:37-41. [DOI: 10.1016/j.maturitas.2016.04.020] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Revised: 04/14/2016] [Accepted: 04/25/2016] [Indexed: 11/19/2022]
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Röhrig G, Rücker Y, Becker I, Schulz RJ, Lenzen-Großimlinghaus R, Willschrei P, Gebauer S, Modreker M, Jäger M, Wirth R. Association of anemia with functional and nutritional status in the German multicenter study "GeriAnaemie2013". Z Gerontol Geriatr 2016; 50:532-537. [PMID: 27364876 DOI: 10.1007/s00391-016-1092-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Revised: 02/25/2016] [Accepted: 05/19/2016] [Indexed: 12/23/2022]
Abstract
OBJECTIVES Anemia and malnutrition are risk factors for frailty in older people but data from multicenter studies among German geriatric inpatients are lacking. This analysis evaluated data from the multicenter study "GerAnaemie2013" commissioned by the German Geriatric Society. PATIENTS AND METHODS The study involved an analysis of the 579 geriatric inpatients recruited in the context of the German multicenter study "GeriAnaemie2013". Study parameters: Barthel index (BI), handgrip strength, nutritional data (e.g. loss of appetite, loss of weight and decreased food intake). INCLUSION CRITERIA in-patient age ≥70 years, exclusion criteria: current cancer disease or cancer-associated treatment. Anemia was defined according to the World Health Organization (WHO) criteria. RESULTS The mean age of patients was 81.9 years, overall prevalence of anemia 55.1 %, mean hemoglobin (Hb) level 11.9 g/dl, average BI 50.8 points and 30.3 % of all patients were at risk of malnutrition. While univariate analysis revealed a significantly lower BI in anemic patients, this association was no longer seen in multivariate analysis. Regression analysis revealed that a drug intake of > 5 drugs/day doubles the chance of suffering from anemia with an adjusted odds ratio (OR) of 2.17 (confidence interval (CI) 1.28-3.68, p = 0.004) as well as a serum albumin level below 3.5 g/dl with an adjusted OR of 2.11 (range 1.40-3.19, p < 0.001). CONCLUSION Polymedication and low serum albumin were independent risk factors for anemia in geriatric patients, probably reflecting disease severity.
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Affiliation(s)
- Gabriele Röhrig
- Ageing Clinical Research, Department II of Internal Medicine, University Hospital Cologne, Herderstrasse 52, 50937, Cologne, Germany.
- Department of Geriatrics, St. Marien-Hospital, Kerpener Straße 62, 50937, Cologne, Germany.
| | - Ymkje Rücker
- Ageing Clinical Research, Department II of Internal Medicine, University Hospital Cologne, Herderstrasse 52, 50937, Cologne, Germany
| | - Ingrid Becker
- Institute of Medical Statistics, Informatics and Epidemiology, Cologne, Germany
| | | | | | - Peter Willschrei
- Clinic for Geriatric Medicine, Kliniken Essen Mitte, Essen, Germany
| | | | - Mirja Modreker
- Clinic for Geriatric Medicine and Geriatric Rehabilitation, Helios Kliniken Schwerin, Schwerin, Germany
| | - Martin Jäger
- Clinic for Geriatric Medicine, St. Vinzenz-Hospital Dinslaken, Dinslaken, Germany
| | - Rainer Wirth
- St. Marien-Hospital Borken, Department for Geriatric Medicine, Borken, Germany
- Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nürnberg, Germany
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Kato S, Lindholm B, Yuzawa Y, Tsuruta Y, Nakauchi K, Yasuda K, Sugiura S, Morozumi K, Tsuboi N, Maruyama S. High Ferritin Level and Malnutrition Predict High Risk of Infection-Related Hospitalization in Incident Dialysis Patients: A Japanese Prospective Cohort Study. Blood Purif 2016; 42:56-63. [PMID: 27093060 DOI: 10.1159/000445424] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Accepted: 03/11/2016] [Indexed: 11/19/2022]
Abstract
AIMS The aim of the study was to clarify the relationship between serum ferritin and infectious risks. METHODS We evaluated all hospital admissions due to infections, clinical biomarkers and nutrition status in 129 incident Japanese dialysis patients during a median follow-up of 38 months. RESULTS Kaplan-Meier analysis revealed that the period without infections requiring hospitalization was significantly shorter in ferritin > median (82.0 ng/ml) group than in the ferritin < median group (log-rank test 4.44, p = 0.035). High ferritin was associated with significantly increased relative risk of hospitalization for infection (Cox hazard model 1.52, 95% CI 1.06-2.17). The number of hospitalization days was gradually longer in patients with high ferritin levels and malnutrition. CONCLUSION Although serum ferritin levels were low, and doses of iron administered to dialysis patients in Japan are generally lower than in Western countries, an elevated ferritin level was associated with increased risk of infection, particularly in patients with poor nutritional status.
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Affiliation(s)
- Sawako Kato
- Division of Renal Medicine and Baxter Novum, Karolinska Institutet, Stockholm, Sweden
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Schreiber FS, Becker I, Deckert P, Elsbernd H, Isensee C. Malnutrition and Laboratory Markers in Geriatric Patients. A Comparison of Neurologic-psychiatric, Internal and Trauma Surgical Diseases. J Nutr Health Aging 2016; 20:458-61. [PMID: 26999248 DOI: 10.1007/s12603-015-0575-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVES There is minimal information on malnutrition in neurologic-psychiatric patients compared to internal and trauma-surgical patients. The aim of the present study was to explore if there is a correlation of these different disease groups with the nutritional assessment and biochemical markers. DESIGN Cross - sectional study. SETTING AND PARTICIPANTS The study was done in a department of geriatric medicine with subspecialisation in neurologic diseases and stroke unit. 338 patients (m / f = 136 / 202, mean age 81.4 ± 7.3 years) were evaluated. MEASUREMENTS The nutritional status was evaluated by using the short form of the Mini Nutritional Assessment (MNA-SF) and seven biochemical markers (hemoglobin, iron, ferritin, vitamin B 12, folic acid, albumin and cholinesterase) were measured. RESULTS There were 74 (22%) patients with MNA ≤ 7 points (malnutrition), 148 (44%) patients with an MNA 8 - 11 points (risk of malnutrition) and 116 (34%) patients with an MNA ≥ 12 points (good nutritional status). The mean MNA score of the three major disease groups trauma-surgery, internal medicine and neurology-psychiatry was 9.1 ± 3.2 vs. 9.9 ± 3.1 vs. 10.0 ± 2.8 (p=0.236). There were significant differences of laboratory markers between the disease groups. A deficit of albumin, cholinesterase and hemoglobin was found more often in trauma-surgical and internal patients than in neurological-psychiatric patients (albumin: 21.4%, 15.7%, 5.3%; p=0.001; cholinesterase 16.7%, 16.9%, 6.3%; p=0.007; hemoglobin 78.6%, 61.4%, 50.0%; p=0.002). CONCLUSIONS Following Mini Nutritional Assessment, the additional measurement of albumin, cholinesterase and hemoglobin allowed a more precise grading of malnutrition. There were significant differences between the disease groups. A deficit of albumin, cholinesterase and hemoglobin was found more often in multimorbid trauma-surgical and internal patients than in neurologic-psychiatric patients.
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Affiliation(s)
- F S Schreiber
- Franz Stefan Schreiber M.D. Department of Geriatrics, St. Marien Hospital, Teaching Hospital of the University of Aachen Medical School, Hospitalstrasse 44, 52353 Düren, Germany, Phone: 01149 - 2421 - 805657, Fax: 01149 - 2421 - 8057079,
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Frangos E, Trombetti A, Graf CE, Lachat V, Samaras N, Vischer UM, Zekry D, Rizzoli R, Herrmann FR. Malnutrition in Very Old Hospitalized Patients: A New Etiologic Factor of Anemia? J Nutr Health Aging 2016; 20:705-13. [PMID: 27499303 DOI: 10.1007/s12603-015-0641-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Anemia and malnutrition are highly prevalent, frequently concomitant and associated with negative outcomes and mortality in the elderly. OBJECTIVES To evaluate the association between these two entities, and test the hypothesis that protein-energy deficit could be etiology of anemia. DESIGN Prospective case-control study. SETTING Geriatric and Rehabilitation Hospital, Geneva University Hospitals, Switzerland. PARTICIPANTS 392 patients (mean age 84.8 years old, 68.6% female). MAIN OUTCOME MEASURES Hematological (hemoglobin (Hb)), chemical (iron work up, cyanocobalamin, folates, renal function, C-Reactive Protein (CRP)) and nutrition (albumin, prealbumin) parameters, and mini nutritional assessment short form (MNA-SF). RESULTS The prevalence of anemia (defined as Hb<120 g/l) was 39.3%. Anemic patients were more frequently malnourished or at risk of malnutrition according to the MNA-SF (p=0.047), with lower serum albumin (p <0.001) and prealbumin (p <0.001) levels. Thirty-eight percent of these patients had multiple causes and 14.3% had no cause found for anemia. Among the latter 90.9% of patients with unexplained anemia had albumin levels lower than 35g/l. After exclusion of iron,vitamin B12 and folic acid deficits, anemic patients had lower albumin (p<0.001) and prealbumin (p 0.007) levels. Albumin level explained 84.5% of the variance in anemia. In multivariate analysis albumin levels remain associated with Hb only in anemic patients, explaining 6.4% of Hb variance (adj R2) and 14.7% (adj R2) after excluding inflammatory parameters (CRP>10). CONCLUSIONS Albumin levels are strongly associated with anemia in the elderly. Screening for undernutrition should be included in anemia assessment in those patients. Further prospective studies are warranted in order to explore the effect of protein and energy supplementation on hemoglobin level.
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Affiliation(s)
- E Frangos
- Dr. Emilia Frangos, Clinique de Joli-Mont, 45 avenue Trembley, 1211 Genève 19, E-mail: Phone : +41.22.717.03.30; Fax : +41.22.788.00.79
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Koie T, Ohyama C, Hatakeyama S, Imai A, Yoneyama T, Hashimoto Y, Yoneyama T, Tobisawa Y, Hosogoe S, Yamamoto H, Kitayama M, Hirota K. Significance of preoperative butyrylcholinesterase as an independent predictor of biochemical recurrence-free survival in patients with prostate cancer treated with radical prostatectomy. Int J Clin Oncol 2015. [PMID: 26223693 DOI: 10.1007/s10147-015-0880-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Butyrylcholinesterase (BChE) is an alpha-glycoprotein found in the nervous system and liver. Its serum level is reduced in many clinical conditions, such as liver damage, inflammation, injury, infection, malnutrition, and malignant disease. In this study, we analyzed the potential prognostic significance of preoperative BChE levels in patients with prostate cancer (PCa) undergoing radical prostatectomy (RP). METHODS We retrospectively evaluated 535 patients with PCa who underwent RP from 1996-2014 at a single institution. Serum BChE was routinely measured in all patients before operation. Covariates included age, preoperative laboratory data [prostate-specific antigen (PSA), hemoglobin, total protein, albumin, BChE, lactate dehydrogenase, C-reactive protein], clinical T, biopsy Gleason score, D'Amico risk classification, and RP with/without neoadjuvant therapy. Univariate and multivariate analyses were performed to identify clinical factors associated with biochemical recurrence-free survival (BRFS). Univariate analyses were performed using the Kaplan-Meier and log-rank methods, and multivariate analysis was performed using a Cox proportional hazard model. RESULTS The median BChE level was 255 U/L (normal range 168-470 U/L). The median age of the enrolled patients was 68 years, and the median PSA level at diagnosis of PCa was 8.39 ng/mL. The median follow-up period was 65 months. The 5-year BRFS rate was 72.9 %. The 5-year BRFS rates in the BChE ≥ 168 and ≤ 167 U/L groups were 77.7 and 55.0 %, respectively (P < 0.001). In univariate analysis, BChE, cT, biopsy Gleason score, and D'Amico risk classification were significantly associated with BRFS. Multivariate analysis revealed that BChE was significantly associated with BRFS. CONCLUSIONS This study validated preoperative serum BChE levels as an independent prognostic factor for PCa after RP.
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Affiliation(s)
- Takuya Koie
- Department of Urology, Hirosaki University, Graduate School of Medicine, 5 Zaifucho, Hirosaki, 036-8562, Japan.
| | - Chikara Ohyama
- Department of Urology, Hirosaki University, Graduate School of Medicine, 5 Zaifucho, Hirosaki, 036-8562, Japan
| | - Shingo Hatakeyama
- Department of Urology, Hirosaki University, Graduate School of Medicine, 5 Zaifucho, Hirosaki, 036-8562, Japan
| | - Atsushi Imai
- Department of Urology, Hirosaki University, Graduate School of Medicine, 5 Zaifucho, Hirosaki, 036-8562, Japan
| | - Takahiro Yoneyama
- Department of Urology, Hirosaki University, Graduate School of Medicine, 5 Zaifucho, Hirosaki, 036-8562, Japan
| | - Yasuhiro Hashimoto
- Department of Urology, Hirosaki University, Graduate School of Medicine, 5 Zaifucho, Hirosaki, 036-8562, Japan
| | - Tohru Yoneyama
- Department of Urology, Hirosaki University, Graduate School of Medicine, 5 Zaifucho, Hirosaki, 036-8562, Japan
| | - Yuki Tobisawa
- Department of Urology, Hirosaki University, Graduate School of Medicine, 5 Zaifucho, Hirosaki, 036-8562, Japan
| | - Shogo Hosogoe
- Department of Urology, Hirosaki University, Graduate School of Medicine, 5 Zaifucho, Hirosaki, 036-8562, Japan
| | - Hayato Yamamoto
- Department of Urology, Hirosaki University, Graduate School of Medicine, 5 Zaifucho, Hirosaki, 036-8562, Japan
| | - Masato Kitayama
- Department of Anesthesiology, Hirosaki University, Graduate School of Medicine, 5 Zaifucho, Hirosaki, Japan
| | - Kazuyoshi Hirota
- Department of Anesthesiology, Hirosaki University, Graduate School of Medicine, 5 Zaifucho, Hirosaki, Japan
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Nutritional status and survival among old adults: an 11-year population-based longitudinal study. Eur J Clin Nutr 2015; 70:320-5. [PMID: 26153193 DOI: 10.1038/ejcn.2015.109] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Revised: 05/19/2015] [Accepted: 06/04/2015] [Indexed: 01/04/2023]
Abstract
BACKGROUND/OBJECTIVES The impact of nutritional status on survival among community-dwelling older adults is unclear. We aimed to investigate the prevalence and association of poor nutritional status, including malnutrition and risk for malnutrition defined by the Mini-Nutritional Assessment-Short Form (MNA-SF) with survival, and to explore the role of relevant biomarkers (hemoglobin, albumin and C-reactive protein) in this association. SUBJECTS/METHODS This study included 3041 participants aged ⩾ 60 in the Swedish National study on Aging and Care-Kungsholmen. On the basis of the total score in MNA-SF, nutritional status for each participant was assessed as normal (score 12-14), risk for malnutrition (8-11) or malnutrition (<8). Over an 11-year follow-up, survival status was observed. Data were analysed using logistic regression, flexible parametric survival and Laplace models. RESULTS Of all the participants, 51 (1.7%) had malnutrition and 751 (24.7%) were at risk for malnutrition. The multi-adjusted hazard ratio (95% confidence interval) of mortality was 2.40 (1.56-3.67; P<0.001) for malnutrition and 1.49 (1.29-1.71; P<0.001) for risk for malnutrition. The median ages at death of participants with malnutrition and risk for malnutrition were ~3 and 1.5 years shorter than those with normal nutritional status, respectively, whereas malnutrition or risk for malnutrition together with abnormal biomarker (hemoglobin and albumin) levels was related to 1 year more shortened survival. CONCLUSIONS Malnutrition and risk for malnutrition are highly prevalent and significantly associated with a shorter survival. Poor nutritional status in combination with abnormalities in the biomarkers is associated with even more shortened survival.
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Röhrig G, Becker I, Polidori MC, Schulz RJ, Noreik M. Association of anemia and hypoalbuminemia in German geriatric inpatients: Relationship to nutritional status and comprehensive geriatric assessment. Z Gerontol Geriatr 2015; 48:619-24. [PMID: 25877770 DOI: 10.1007/s00391-015-0872-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2014] [Revised: 02/12/2015] [Accepted: 02/13/2015] [Indexed: 12/13/2022]
Abstract
BACKGROUND Anemia and hypoalbuminemia (HA) are acknowledged independent risk factors for morbidity and mortality in geriatric patients and are associated with nutritional status and frailty. Data exist regarding the association between albumin and frailty, anemia and frailty as well as frailty and nutritional status; however, there is a lack of information on the association between HA, anemia and nutritional status in older people. PATIENTS AND METHODS This study retrospectively analyzed 626 patients admitted to a German geriatrics department (average age 81.1 years, 68.2% female and 31.8% male) for anemia and HA. Data from the comprehensive geriatric assessment (CGA) and from the mini-nutritional assessment (MNA) were available in all patients. RESULTS Patients with anemia suffered significantly more often from HA (p<0.001) than patients without anemia, with an odds ratio (OR) of 1.99 (95% confidence interval CI: 1.2-3.2) and of 5.41 (CI 95%: 2.3-12.6) in patients at risk for malnutrition and in malnourished patients, respectively. A moderately significant association was seen between hemoglobin (Hb) and albumin values (Pearson's correlation r=0.330; p<0.001) as well as between albumin values and the Barthel index (Spearman's correlation r=0.210; p<0.001). CONCLUSION Anemia appears to be a risk factor for HA in inpatients with malnutrition and the observed association between albumin and Hb warrants further research. Geriatric inpatients with anemia should be evaluated in terms of the presence of malnutrition risk and HA.
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Affiliation(s)
- G Röhrig
- University of Cologne, Medical Faculty and St. Marien-Hospital, University Hospital Cologne, Kerpener Strasse 62, 50937, Cologne, Germany.
| | - I Becker
- Institute of Medical Statistics, Informatics and Epidemiology, University of Cologne, Cologne, Germany
| | - M C Polidori
- University of Cologne, Medical Faculty, Cologne, Germany
| | - R-J Schulz
- Department of Geriatric Medicine, St. Marien-Hospital, Cologne, Germany
| | - M Noreik
- Department of Geriatric Medicine, St. Marien-Hospital, Cologne, Germany
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Crimmins EM. Physiological Differences Across Populations Reflecting Early Life and Later Life Nutritional Status and Later Life Risk for Chronic Disease. JOURNAL OF POPULATION AGEING 2015; 8:51-69. [PMID: 25750688 DOI: 10.1007/s12062-014-9109-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- Eileen M Crimmins
- Davis School of Gerontology, University of Southern California, Los Angeles, CA 90089-0191 USA, , 1-213-740-1707 Phone
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Song P, Li L, Man Q, Wang C, Meng L, Zhang J. Case-control study of anaemia among middle-aged and elderly women in three rural areas of China. BMJ Open 2014; 4:e004751. [PMID: 25138800 PMCID: PMC4139636 DOI: 10.1136/bmjopen-2013-004751] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2013] [Revised: 07/07/2014] [Accepted: 07/21/2014] [Indexed: 01/23/2023] Open
Abstract
OBJECTIVES To propose a feasible suggestion to reduce the high prevalence of anaemia in middle-aged and elderly women by investigating risk factors, particularly nutritional factors, and analysing the effect on anaemia in three different rural areas of China. DESIGN A case-control study. SETTING Three counties of China. PARTICIPANTS Women aged 50-75 years in the three counties. MAIN OUTCOME MEASURES Adjusted OR (95% CI) of anaemia associated with diet, lifestyle and blood biochemical indices. RESULTS Compared with controls, women with anaemia had lower body mass index (22.1 (3.2) kg/m(2) vs 23.2 (3.5) kg/m(2); p<0.001), a higher experience of shortage of food (45.0% vs 36.5%; p<0.001), less soy food intake (0.5 (0.3, 26.7) g/day vs 5.6 (0.4, 27.8) g/day; p<0.048), lower serum iron (13.4 (5.4) μmol/L vs 16.4 (5.7) μmol/L; p<0.001), lower ferritin (109.6 (85.6) ng/mL vs 131.0 (92.0) ng/mL; p<0.001), lower transferrin saturation levels (22.5 (9.5)% vs 26.8 (9.6)%; p<0.001) and higher levels of free erythrocyte protoporphyrin (42.4 (21.2) μg/dL vs 39.6 (17.8) μg/dL; p<0.001). Anaemia was significantly associated with BMI(OR=0.90, 95% CI (0.87 to 0.92)), food shortage experience (OR=1.39, 95% CI (1.15 to 1.69)), total protein (OR=0.66, 95%CI (0.54 to 0.80)), Albumin (OR=0.72, 95%CI (0.59 to 0.87)) in univariate analysis. Multivariate analysis showed that body mass index, experience of food shortage, total protein and albumin were independently related to anaemia. CONCLUSIONS Among middle-aged and elderly women in rural China, the nutrition status of anaemic cases is far below that of controls. Lower body mass index and a greater experience of food shortage are closely related to anaemia. Improving the blood protein status by consuming protein-sufficient foods such as soy food is a feasible approach for elderly anaemic women. Further research is needed on the effect of chronic inflammation and infectious disease on anaemia in elderly women in rural China.
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Affiliation(s)
- Pengkun Song
- Elderly and Clinical Nutrition Laboratory, Institute of Nutrition and Food Safety, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Lixiang Li
- Elderly and Clinical Nutrition Laboratory, Institute of Nutrition and Food Safety, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Qingqing Man
- Elderly and Clinical Nutrition Laboratory, Institute of Nutrition and Food Safety, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Chunrong Wang
- Elderly and Clinical Nutrition Laboratory, Institute of Nutrition and Food Safety, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Liping Meng
- Elderly and Clinical Nutrition Laboratory, Institute of Nutrition and Food Safety, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jian Zhang
- Elderly and Clinical Nutrition Laboratory, Institute of Nutrition and Food Safety, Chinese Center for Disease Control and Prevention, Beijing, China
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Koie T, Ohyama C, Yamamoto H, Hatakeyama S, Imai A, Yoneyama T, Hashimoto Y, Kitayam M, Hirota K. Significance of preoperative butyrylcholinesterase as an independent predictor of survival in patients with muscle-invasive bladder cancer treated with radical cystectomy. Urol Oncol 2014; 32:820-5. [PMID: 24951323 DOI: 10.1016/j.urolonc.2014.03.010] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Revised: 03/10/2014] [Accepted: 03/10/2014] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Butyrylcholinesterase (BChE) is an alpha-glycoprotein found in the nervous system and liver. Its serum level is reduced in many clinical conditions, such as liver damage, inflammation, injury, infection, malnutrition, and malignant disease. In this study, we analyzed the potential prognostic significance of preoperative BChE levels in patients with muscle-invasive bladder cancer (MIBC) undergoing radical cystectomy (RC). METHODS AND MATERIALS We retrospectively evaluated 327 patients with MIBC who underwent RC from 1996 to 2013 at a single institution. Serum BChE level was routinely measured before operation in all patients. Covariates included age, gender, preoperative laboratory data (anemia, BChE, lactate dehydrogenase, and C-reactive protein), clinical T (cT) and N stage (cN), tumor grade, and RC with/without neoadjuvant chemotherapy. Univariate and multivariate analyses were performed to identify clinical factors associated with overall survival (OS) and disease-free survival (DFS). Univariate analyses were performed using the Kaplan-Meier and log-rank methods, and the multivariate analysis was performed using a Cox proportional hazard model. RESULTS The median BChE level was 187 U/l (normal range: 168-470 U/l). The median age of the enrolled patients was 69 years, and the median follow-up period was 51 months. The 5-year OS and DFS rates were 69.6% and 69.3%, respectively. The 5-year OS rates were 90.1% and 51.3% in the BChE ≥ 168 and<168 U/l groups, respectively (P<0.001). The 5-year DFS rates were 83.5% and 55.4% in the BChE ≥ 168 and ≤167 U/l groups, respectively (P<0.001). In the univariate analysis, BChE, cT, cN, and RC with/without neoadjuvant chemotherapy were significantly associated with both OS and DFS. Multivariate analysis revealed that BChE was the factor most significantly associated with OS, and BChE, cT, and cN were significantly associated with DFS. CONCLUSIONS This study validated preoperative serum BChE levels as an independent prognostic factor for MIBC after RC.
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Affiliation(s)
- Takuya Koie
- Department of Urology, Hirosaki University, Graduate School of Medicine, Hirosaki, Japan.
| | - Chikara Ohyama
- Department of Urology, Hirosaki University, Graduate School of Medicine, Hirosaki, Japan
| | - Hayato Yamamoto
- Department of Urology, Hirosaki University, Graduate School of Medicine, Hirosaki, Japan
| | - Shingo Hatakeyama
- Department of Urology, Hirosaki University, Graduate School of Medicine, Hirosaki, Japan
| | - Atsushi Imai
- Department of Urology, Hirosaki University, Graduate School of Medicine, Hirosaki, Japan
| | - Takahiro Yoneyama
- Department of Urology, Hirosaki University, Graduate School of Medicine, Hirosaki, Japan
| | - Yasuhiro Hashimoto
- Department of Urology, Hirosaki University, Graduate School of Medicine, Hirosaki, Japan
| | - Masato Kitayam
- Department of Anesthesiology, Hirosaki University, Graduate School of Medicine, Hirosaki, Japan
| | - Kazuyoshi Hirota
- Department of Anesthesiology, Hirosaki University, Graduate School of Medicine, Hirosaki, Japan
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