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Regression of albuminuria and its association with incident cardiovascular outcomes and mortality in type 1 diabetes: the FinnDiane Study.

https://arctichealth.org/en/permalink/ahliterature297930
Source
Diabetologia. 2018 05; 61(5):1203-1211
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
05-2018
Author
Fanny J Jansson
Carol Forsblom
Valma Harjutsalo
Lena M Thorn
Johan Wadén
Nina Elonen
Aila J Ahola
Markku Saraheimo
Per-Henrik Groop
Author Affiliation
Folkhälsan Institute of Genetics, Folkhälsan Research Center, Biomedicum Helsinki, Haartmaninkatu 8, FIN - 00290, Helsinki, Finland.
Source
Diabetologia. 2018 05; 61(5):1203-1211
Date
05-2018
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adult
Albuminuria - mortality - therapy
Cardiovascular Diseases - complications - mortality - therapy - urine
Diabetes Mellitus, Type 1 - complications - mortality - therapy
Diabetic Nephropathies - complications - mortality - therapy
Disease Progression
Female
Finland
Follow-Up Studies
Humans
Incidence
Male
Middle Aged
Risk factors
Time Factors
Treatment Outcome
Abstract
Our aim was to assess regression of albuminuria and its clinical consequences in type 1 diabetes.
The analysis included 3642 participants from the Finnish Diabetic Nephropathy (FinnDiane) Study with a 24 h urine sample and a history of albuminuria available at baseline. A total of 2729 individuals had normal AER, 438 a history of microalbuminuria and 475 a history of macroalbuminuria. Regression was defined as a change from a higher category of albuminuria pre-baseline to a lower category in two out of the three most recent urine samples at baseline. The impact of regression on cardiovascular events (myocardial infarction, stroke, coronary procedure) and mortality was analysed over a follow-up of 14.0 years (interquartile range 11.9-15.9).
In total, 102 (23.3%) individuals with prior microalbuminuria and 111 (23.4%) with prior macroalbuminuria had regressed at baseline. For individuals with normal AER as a reference, the age-adjusted HRs (95% CI) for cardiovascular events were 1.42 (0.75, 2.68) in individuals with regression from microalbuminuria, 2.62 (1.95, 3.54) in individuals with sustained microalbuminuria, 3.15 (2.02, 4.92) in individuals with regression from macroalbuminuria and 5.49 (4.31, 7.00) in individuals with sustained macroalbuminuria. Furthermore, for all-cause and cardiovascular mortality rates, HRs in regressed individuals were comparable with those with sustained renal status at the achieved level (i.e. those who did not regress but remained at the most advanced level of albuminuria noted pre-baseline).
Progression of diabetic nephropathy confers an increased risk for cardiovascular disease and premature death. Notably, regression reduces the risk to the same level as for those who did not progress.
PubMed ID
29423580 View in PubMed
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Variability of fish consumption within the 10 European countries participating in the European Investigation into Cancer and Nutrition (EPIC) study.

https://arctichealth.org/en/permalink/ahliterature18550
Source
Public Health Nutr. 2002 Dec;5(6B):1273-85
Publication Type
Article
Date
Dec-2002
Author
A A Welch
E. Lund
P. Amiano
M. Dorronsoro
M. Brustad
M. Kumle
M. Rodriguez
C. Lasheras
L. Janzon
J. Jansson
R. Luben
E A Spencer
K. Overvad
A. Tjønneland
F. Clavel-Chapelon
J. Linseisen
K. Klipstein-Grobusch
V. Benetou
X. Zavitsanos
R. Tumino
R. Galasso
H B Bueno-De-Mesquita
M C Ocké
U R Charrondière
N. Slimani
Author Affiliation
Strangeways Research Laboratory, Department of Public Health and Primary Care, University of Cambridge, Wort's Causeway, UK. ailsa.welch@srl.cam.ac.uk
Source
Public Health Nutr. 2002 Dec;5(6B):1273-85
Date
Dec-2002
Language
English
Publication Type
Article
Keywords
Adult
Aged
Animals
Cross-Sectional Studies
Crustacea
Diet
Diet Surveys
Europe
Female
Fishes
Humans
Male
Mental Recall
Middle Aged
Population Surveillance - methods
Prospective Studies
Research Support, Non-U.S. Gov't
Shellfish
Abstract
OBJECTIVE: To describe and compare the consumption of total fish (marine foods) and the fish sub-groups - white fish, fatty fish, very fatty fish, fish products and crustacea, in participants from the European Investigation into Cancer and Nutrition (EPIC) study. DESIGN: Cross-sectional analysis of dietary intake using a computerised standardised 24-hour recall interview. Crude means, means and standard errors adjusted by age, season and day of the week were calculated, stratified by centre and gender. SETTING: Twenty-seven redefined centres in the 10 European countries participating in the EPIC study. SUBJECTS: In total, 35 955 subjects (13 031 men and 22 924 women), aged 35-74 years, selected from the main EPIC cohort. RESULTS: A six- to sevenfold variation in total fish consumption exists in women and men, between the lowest consumption in Germany and the highest in Spain. Overall, white fish represented 49% and 45% of the intake of total fish in women and men, respectively, with the greatest consumption in centres in Spain and Greece and the least in the German and Dutch centres. Consumption of fatty fish reflected that of total fish. However, the greatest intake of very fatty fish was in the coastal areas of northern Europe (Denmark, Sweden and Norway) and in Germany. Consumption of fish products was greater in northern than in southern Europe, with white fish products predominating in centres in France, Italy, Spain, The Netherlands and Norway. Intake of roe and roe products was low. The highest consumption of crustacea was found in the French, Spanish and Italian centres. The number of fish types consumed was greater in southern than in northern Europe. The greatest variability in consumption by day of the week was found in the countries with the lowest fish intake. CONCLUSIONS: Throughout Europe, substantial geographic variation exists in total fish intake, fish sub-groups and the number of types consumed. Day-to-day variability in consumption is also high.
PubMed ID
12639232 View in PubMed
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