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Jie Jin Wang - One of the best experts on this subject based on the ideXlab platform.
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retinal arteriolar tortuosity is associated with retinopathy and early Kidney Dysfunction in type 1 diabetes
American Journal of Ophthalmology, 2012Co-Authors: Muhammad Bayu Sasongko, Tien Yin Wong, Kim C Donaghue, Ning Cheung, Alicia J Jenkins, Paul Benitezaguirre, Jie Jin WangAbstract:Purpose To examine the association of retinal vessel tortuosity with diabetic retinopathy and early nephropathy in type 1 diabetes. Design Cross-sectional. Methods A total of 1159 participants with type 1 diabetes aged 12 to 20 years, attending diabetes clinics in Children's Hospital at Westmead, Sydney, Australia between 1990 and 2002, were included. Retinal photography and clinical examinations were performed during the baseline visit to assess diabetic retinopathy and albumin excretion rate (AER). Retinal vessel tortuosity was measured from digitized retinal photographs using a semi-automated computer program by a single grader masked to participants' characteristics. Diabetic retinopathy was defined as ETDRS level ≥21 (mild nonproliferative retinopathy) and early Kidney Dysfunction was defined as AER ≥7.5 μg/min. Results Of 944 patients (81.4%), 85 (9.0%) had signs of retinopathy only, 250 (26.5%) had early Kidney Dysfunction only, and 85 (9.0%) had both retinopathy and early Kidney Dysfunction. In multivariate analysis, higher arteriolar tortuosity was associated with retinopathy (odds ratio [OR] 2.01, 95% confidence interval [CI] 1.23-3.29, the highest quartile vs the remaining 3 quartiles), early Kidney Dysfunction (OR 1.56, 95% CI 1.06-2.28, per standard deviation [SD] increase), or coexistence of both complications (OR 1.96, 95% CI 1.21-3.24, the highest quartile vs the remaining 3 quartiles). Conclusions Greater retinal arteriolar tortuosity was independently associated with retinopathy and early stage of nephropathy in type 1 diabetes. These findings may offer the potential of quantitative measurement of retinal vessel tortuosity for diabetic complication risk assessment.
Michael G Shlipak - One of the best experts on this subject based on the ideXlab platform.
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racial differences in the association of pentraxin 3 with Kidney Dysfunction the multi ethnic study of atherosclerosis
Nephrology Dialysis Transplantation, 2011Co-Authors: Ruth F Dubin, Carmen A Peralta, Michael G Shlipak, Nancy S Jenny, Ian H De BoerAbstract:Background. Pentraxin-3 (PTX3), an inflammatory marker thought to be related to vascular inflammation, is elevated in advanced chronic Kidney disease (CKD). Whether PTX3 is associated with mild to moderate Kidney Dysfunction is unknown. Methods. We tested associations of proteins in the pentraxin family [PTX3, C-reactive protein (CRP) and serum amyloid protein (SAP)] with estimated glomerular filtration rate by cystatin C (eGFRcys) and microalbuminuria among 2824 participants in the Multi-Ethnic Study of Atherosclerosis. Associations were tested using multivariable linear regression with adjustment for demographics (age, gender, annual income), comorbidities (diabetes, hypertension, smoking, body mass index, low-density lipoprotein, high-density lipoprotein, triglycerides, ACE inhibitor and statin use) and systemic inflammation [interleukin-6 (IL-6)]. Results. Among the 2824 participants, mean age was 62 years and mean eGFRcys was 94 mL/min/1.73 m 2 ; 25% were white, 25% Chinese, 25% African-American and 25% Hispanic. Among all participants after full adjustment, higher PTX3 was associated with lower eGFRcys independently of IL-6 (β −3.0 mL/min/1.73 m 2 per unit increase in lnPTX3, P < 0.001). In contrast, CRP and SAP were associated with eGFRcys in demographic adjusted models, but these associations were attenuated after adjustment for comorbidities and IL-6 (lnCRP β −0.06, P = 0.9; lnSAP β −0.35, P =0.7). Therewas asignificant interaction with race/ethnicity (P < 0.001) in the association of PTX3 and eGFRcys. After adjustment for demographics, comorbidities and IL-6, this association was significant in blacks (β −5.7 mL/min/1.73 m 2 per unit increase in lnPTX3, P = 0.002) but not in Hispanics (β −2.4, P = 0.1), Chinese (β −0.91, P = 0.5) or whites (β −0.26, P = 0.9). PTX3 and CRP, but not SAP, had correlations with microalbuminuria in unadjusted models (Spearman coefficients PTX3 0.05, P = 0.005; CRP 0.07, P < 0.001; SAP 0.013, P = 0.5), but these were attenuated after full adjustment. Conclusions. Endovascular inflammation may be an important mechanism associated with early Kidney Dysfunction, particularly among blacks. This mechanism appears to be independent of IL-6-regulated pathways.
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the differential association of Kidney Dysfunction with small and large arterial elasticity the multiethnic study of atherosclerosis
American Journal of Epidemiology, 2009Co-Authors: Carmen A Peralta, Ronit Katz, Magdalena Madero, Mark J Sarnak, Holly Kramer, Michael H Criqui, Michael G ShlipakAbstract:Vascular remodeling may be a mechanism linking chronic Kidney disease to cardiovascular disease. Whether early Kidney Dysfunction is associated with small and large arterial remodeling is not well understood. Using multivariable linear regression, back-transforming beta-coefficients to relative difference, the authors studied the association of cystatin C, creatinine-based estimated glomerular filtration rate (GFR), and albuminuria with small (SAE) and large (LAE) arterial elasticity and aortic distensibility among 6,282 participants in the Multiethnic Study of Atherosclerosis at baseline (2000-2002). Compared with the lowest quintile, higher quintiles of cystatin C were incrementally associated with lower SAE: third quintile relative difference = -5% (95% confidence interval (CI): -8, -2); fourth quintile relative difference = -10% (95% CI: -13, -8); and highest quintile relative difference = -16% (95% CI: -20, -12). By use of creatinine, the association was observed only among those with chronic Kidney disease (estimated GFR, <60 mL/minute/1.73 m(2)): relative difference = -9% (95% CI: -13, -4). Albuminuria was significantly associated with lower SAE: relative difference = -6% (95% CI: -10, -1). Cystatin C was associated with lower LAE only at the highest quintile (relative difference = -3%, 95% CI: -6, 0) compared with the lowest quintile. By use of creatinine, chronic Kidney disease was not independently associated with LAE (P = 0.912). Cystatin C, estimated GFR, and albuminuria were not associated with aortic distensibility (P = 0.26, 0.48, 0.45). Early Kidney Dysfunction is significantly associated with decreased arterial elasticity in smaller arteries and, to a lesser degree, in larger arteries.
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cystatin c concentration as a predictor of systolic and diastolic heart failure
Journal of Cardiac Failure, 2008Co-Authors: Andrew E Moran, Ronit Katz, Mark J Sarnak, Linda F Fried, Bruce M Psaty, David S Siscovick, Stephen L Seliger, N L Smith, John S Gottdiener, Michael G ShlipakAbstract:Abstract Background Risk factors for heart failure (HF) may differ according to ejection fraction (EF). Higher cystatin C, a marker of Kidney Dysfunction, is associated with incident HF, but previous studies did not determine EF at diagnosis. We hypothesized that Kidney Dysfunction would predict diastolic HF (DHF) better than systolic HF (SHF) in the Cardiovascular Health Study. Methods and Results Cystatin C was measured in 4453 participants without HF at baseline. Incident HF was categorized as DHF (EF ≥ 50%) or SHF (EF Conclusions Cystatin C levels are linearly associated with the incidence of systolic HF, whereas only the highest concentrations of cystatin C predict diastolic HF.
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cystatin c concentration as a risk factor for heart failure in older adults
Annals of Internal Medicine, 2005Co-Authors: Mark J Sarnak, Ronit Katz, Catherine Stehmanbreen, Linda F Fried, Nancy S Jenny, Bruce M Psaty, Anne B Newman, David S Siscovick, Michael G ShlipakAbstract:Cystatin C, a cysteine proteinase inhibitor produced by all nucleated cells, is a new and promising marker of Kidney Dysfunction. Its serum concentration is an independent risk factor for onset of ...
Muhammad Bayu Sasongko - One of the best experts on this subject based on the ideXlab platform.
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retinal arteriolar tortuosity is associated with retinopathy and early Kidney Dysfunction in type 1 diabetes
American Journal of Ophthalmology, 2012Co-Authors: Muhammad Bayu Sasongko, Tien Yin Wong, Kim C Donaghue, Ning Cheung, Alicia J Jenkins, Paul Benitezaguirre, Jie Jin WangAbstract:Purpose To examine the association of retinal vessel tortuosity with diabetic retinopathy and early nephropathy in type 1 diabetes. Design Cross-sectional. Methods A total of 1159 participants with type 1 diabetes aged 12 to 20 years, attending diabetes clinics in Children's Hospital at Westmead, Sydney, Australia between 1990 and 2002, were included. Retinal photography and clinical examinations were performed during the baseline visit to assess diabetic retinopathy and albumin excretion rate (AER). Retinal vessel tortuosity was measured from digitized retinal photographs using a semi-automated computer program by a single grader masked to participants' characteristics. Diabetic retinopathy was defined as ETDRS level ≥21 (mild nonproliferative retinopathy) and early Kidney Dysfunction was defined as AER ≥7.5 μg/min. Results Of 944 patients (81.4%), 85 (9.0%) had signs of retinopathy only, 250 (26.5%) had early Kidney Dysfunction only, and 85 (9.0%) had both retinopathy and early Kidney Dysfunction. In multivariate analysis, higher arteriolar tortuosity was associated with retinopathy (odds ratio [OR] 2.01, 95% confidence interval [CI] 1.23-3.29, the highest quartile vs the remaining 3 quartiles), early Kidney Dysfunction (OR 1.56, 95% CI 1.06-2.28, per standard deviation [SD] increase), or coexistence of both complications (OR 1.96, 95% CI 1.21-3.24, the highest quartile vs the remaining 3 quartiles). Conclusions Greater retinal arteriolar tortuosity was independently associated with retinopathy and early stage of nephropathy in type 1 diabetes. These findings may offer the potential of quantitative measurement of retinal vessel tortuosity for diabetic complication risk assessment.
Tien Yin Wong - One of the best experts on this subject based on the ideXlab platform.
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retinal arteriolar tortuosity is associated with retinopathy and early Kidney Dysfunction in type 1 diabetes
American Journal of Ophthalmology, 2012Co-Authors: Muhammad Bayu Sasongko, Tien Yin Wong, Kim C Donaghue, Ning Cheung, Alicia J Jenkins, Paul Benitezaguirre, Jie Jin WangAbstract:Purpose To examine the association of retinal vessel tortuosity with diabetic retinopathy and early nephropathy in type 1 diabetes. Design Cross-sectional. Methods A total of 1159 participants with type 1 diabetes aged 12 to 20 years, attending diabetes clinics in Children's Hospital at Westmead, Sydney, Australia between 1990 and 2002, were included. Retinal photography and clinical examinations were performed during the baseline visit to assess diabetic retinopathy and albumin excretion rate (AER). Retinal vessel tortuosity was measured from digitized retinal photographs using a semi-automated computer program by a single grader masked to participants' characteristics. Diabetic retinopathy was defined as ETDRS level ≥21 (mild nonproliferative retinopathy) and early Kidney Dysfunction was defined as AER ≥7.5 μg/min. Results Of 944 patients (81.4%), 85 (9.0%) had signs of retinopathy only, 250 (26.5%) had early Kidney Dysfunction only, and 85 (9.0%) had both retinopathy and early Kidney Dysfunction. In multivariate analysis, higher arteriolar tortuosity was associated with retinopathy (odds ratio [OR] 2.01, 95% confidence interval [CI] 1.23-3.29, the highest quartile vs the remaining 3 quartiles), early Kidney Dysfunction (OR 1.56, 95% CI 1.06-2.28, per standard deviation [SD] increase), or coexistence of both complications (OR 1.96, 95% CI 1.21-3.24, the highest quartile vs the remaining 3 quartiles). Conclusions Greater retinal arteriolar tortuosity was independently associated with retinopathy and early stage of nephropathy in type 1 diabetes. These findings may offer the potential of quantitative measurement of retinal vessel tortuosity for diabetic complication risk assessment.
Hirohito Sone - One of the best experts on this subject based on the ideXlab platform.
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assessment of Kidney Dysfunction with cystatin c and creatinine based estimated glomerular filtration rate and predicting type 2 diabetes toranomon hospital health management center study 21
Diabetes Research and Clinical Practice, 2016Co-Authors: Yoriko Heianza, Shigeko Hara, Kazumi Saito, Hiroshi Tsuji, Shiro Tanaka, Satoru Kodama, Tetsuro Kobayashi, Yasuji Arase, Hirohito SoneAbstract:Abstract Objective Whether early stages of Kidney Dysfunction assessed by the estimated glomerular filtration rate from cystatin C measurements (eGFRCysC) rather than from creatinine measurements (eGFRCr) would more precisely reflect the risk of developing type 2 diabetes (T2D) has not been clarified. We compared the risk of developing T2D associated with renal Dysfunction indicated by eGFRCysC or eGFRCr measurements. Methods Studied were 2131 Japanese individuals without diabetes. Hazard ratios (HRs) for the development of T2D over 3–5 y were calculated across categories of eGFRCysC and eGFRCr, respectively. Results Reduced levels of eGFRCysC were associated with a step-wise increase in the cumulative incidence rate of T2D ( p =0.007). In comparison with the eGFRCysC >85th percentile group (≥117.4ml/min/1.73m 2 ), the lowest group, which was the eGFRCysC 2 ), had an adjusted HR of 2.30 (95% CI 1.13, 4.68) for T2D. Compared with the eGFRCr >85th percentile group, the lowest eGFRCr group ( 2 had a significantly increased risk of T2D. Clustering of both low eGFRCysC and low eGFRCr further elevated the HR for T2D compared with the presence of either. Conclusions Although eGFRCr in ranges indicating chronic Kidney disease reflected an elevated risk of developing diabetes, earlier stages of Kidney Dysfunction indicated by reduced eGFRCysC, which could not be captured by reduced eGFRCr, would be a marker for an elevated risk of developing T2D.
