Letter Regarding "Association Between CKD, Obesity, Cardiometabolic Risk Factors, and Severe COVID-19 Outcomes".
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ABSTRACT:
SUBMITTER: Volbeda M
PROVIDER: S-EPMC10496060 | biostudies-literature | 2023 Sep
REPOSITORIES: biostudies-literature
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Letter Regarding "Association Between CKD, Obesity, Cardiometabolic Risk Factors, and Severe COVID-19 Outcomes".
Volbeda Meint M Jou-Valencia Daniela D van den Heuvel Marius C MC Moser Jill J van Meurs Matijs M Franssen Casper F M CFM
Kidney international reports 20230728 9
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Project description:IntroductionChronic kidney disease (CKD) is a risk factor for acquiring severe COVID-19, but underlying mechanisms are unknown. We aimed to study the risk associated with CKD for severe COVID-19 outcomes in relation to body mass index (BMI) and diabetes because they are common risk factors for both CKD and severe COVID-19.MethodsThis nationwide case-control study with data from mandatory national registries included 4684 patients (cases) admitted to the intensive care units (ICUs) requiring mechanical ventilation and 46,840 population-based controls matched by age, sex, and district of residency. Logistic regression was used to calculate odds ratios (ORs) with 95% confidence intervals (CIs) for associations between severe COVID-19 and exposures with adjustment for confounders, in subgroups by BMI, and matched by type 2 diabetes.ResultsThe median age was 64 years, and 27.7% were female. CKD was observed in 5.4% of the cases and 1.5% of the controls, whereas 1.9% and 0.3% had end-stage CKD, respectively. CKD was associated with severe COVID-19 (OR, 2.20 [95% CI, 1.85-2.62]), continuous renal replacement therapy (CRRT) in ICU (OR, 7.36 [95% CI, 5.39-10.05]), and death any time after ICU admission (OR, 2.51 [95% CI, 1.96-3.22]). The risk associated with CKD for severe COVID-19 did not differ significantly by weight but was higher in those without diabetes (OR, 2.76 [95% CI, 2.15-3.55]) than in those with diabetes (OR, 1.88 [95% CI, 1.37-2.59]).ConclusionCKD, especially end-stage CKD, is an important risk factor for severe COVID-19 and death after ICU admission also in patients with normal BMI and without type 2 diabetes.
| S-EPMC9840229 | biostudies-literature
Project description: Not available
| S-EPMC8245674 | biostudies-literature
Project description:ObjectivesTo investigate the combined association of obesity, diabetes mellitus (DM) and cardiovascular disease (CVD) with severe COVID-19 outcomes in adult and elderly inpatients.DesignCross-sectional study based on registry data from Brazil's influenza surveillance system.SettingPublic and private hospitals across Brazil.ParticipantsEligible population included 21 942 inpatients aged ≥20 years with positive reverse transcription-PCR test for SARS-CoV-2 until 9 June 2020.Main outcome measuresSevere COVID-19 outcomes were non-invasive and invasive mechanical ventilation use, intensive care unit (ICU) admission and death. Multivariate analyses were conducted separately for adults (20-59 years) and elders (≥60 years) to test the combined association of obesity (without and with DM and/or CVD) and degrees of obesity with each outcome.ResultsA sample of 8848 adults and 12 925 elders were included. Among adults, obesity with DM and/or CVD showed higher prevalence of invasive (prevalence ratio 3.76, 95% CI 2.82 to 5.01) and non-invasive mechanical ventilation use (2.06, 1.58 to 2.69), ICU admission (1.60, 1.40 to 1.83) and death (1.79, 1.45 to 2.21) compared with the group without obesity, DM and CVD. In elders, obesity alone (without DM and CVD) had the highest prevalence of ICU admission (1.40, 1.07 to 1.82) and death (1.67, 1.00 to 2.80). In both age groups, obesity alone and combined with DM and/or CVD showed higher prevalence in all outcomes than DM and/or CVD. A dose-response association was observed between obesity and death in adults: class I 1.32 (1.05 to 1.66), class II 1.41 (1.06 to 1.87) and class III 1.77 (1.35 to 2.33).ConclusionsThe combined association of obesity, diabetes and/or CVD with severe COVID-19 outcomes may be stronger in adults than in elders. Obesity alone and combined with DM and/or CVD had more impact on the risk of COVID-19 severity than DM and/or CVD in both age groups. The study also supports an independent relationship of obesity with severe outcomes, including a dose-response association between degrees of obesity and death in adults.
| S-EPMC8354760 | biostudies-literature
Project description:OBJECTIVE:The longitudinal associations between a dietary pattern (DP) and cardiometabolic risk factors and cardiovascular disease (CVD) incidence were investigated in a cohort of adults with severe obesity. METHODS:The analysis included 2,037 individuals with severe obesity (>34 and >38 kg/m(2) for men and women, respectively) from the Swedish Obese Subjects study repeatedly followed up for 10 years. Reduced rank regression was used to identify a DP characterized by dietary energy density, saturated fat intake, and fiber density. Mixed models examined relationships between repeated measures of DP z-scores and cardiometabolic risk factors. Cox proportional hazards models assessed relationships between DP scores and CVD incidence. RESULTS:An energy-dense, high-saturated-fat, and low-fiber DP was derived. A one-unit increase in the DP z-score between follow-ups was associated with an increase in weight [? (SE)] (1.71?±?0.10 kg), waist circumference (1.49?±?0.07 cm), BMI (0.60?±?0.34 kg/m2), serum cholesterol (0.06?±?0.01 mmol/l), and serum insulin (1.22?±?0.17 mmol/l; all P?<?0.0001), as well as in serum triglycerides (0.05?±?0.02 mmol/l; P?<?0.05), systolic blood pressure (1.05?±?0.27 mmHg; P?<?0.001), and diastolic blood pressure (0.55?±?0.16 mmHg; P?<?0.05). No significant association was observed between repeated measures of the DP z-scores and CVD incidence (HR?=?0.96; 95% CI?=?0.83-1.12). CONCLUSIONS:An energy-dense, high-saturated-fat, and low-fiber DP was longitudinally associated with increases in cardiometabolic risk factors in severe obesity but not with CVD incidence.
| S-EPMC6680188 | biostudies-literature
Project description: Not available
| S-EPMC9682865 | biostudies-literature
Project description:BackgroundObesity during adolescence is associated with cardiovascular mortality in adulthood. The adverse obesity-related cardiometabolic risk profile is already observed in adolescence. We aimed to examine possible gender differences in cardiometabolic risk factors and lifestyle behaviors among adolescents with severe obesity, hypothesizing that boys would have both a higher prevalence of the metabolic syndrome as well as less healthy lifestyle behaviors than girls.MethodsCross-sectional study of treatment-seeking adolescents with severe obesity who attended the Morbid Obesity Centre at Vestfold Hospital Trust and who were consecutively enrolled in the Vestfold Register of Obese Children between September 2009 and September 2015. A total of 313 adolescents aged 12 to 18 years were recruited, whereof 268 subjects (49% boys) completed a food and activity frequency questionnaire and were included in the analysis.ResultsMean (SD) age, BMI and BMI SDS were 15 (1.6) years, 38.6 (5.9) kg/m2 and 3.5 (0.6). Levels of LDL cholesterol, fasting insulin and glucose and diastolic blood pressure (DBP) did not differ between genders. Compared to girls, boys had significantly higher triglycerides (p = 0.037) and systolic blood pressure (SBP) (p = 0.003), as well as lower HDL cholesterol (p = 0.002). The metabolic syndrome was present in 27% of the boys and 19% of the girls (p = 0.140), and the prevalence of high DBP, dyslipidemia and dysglycemia also did not differ significantly between genders. The prevalence of high SBP was higher in boys than in girls (19% vs. 9%, p = 0.021). Gender was associated with a number of lifestyle habits, as a larger proportions of boys had higher screen time (p = 0.032), more regular breakfast eating (p = 0.023), higher intake of sugar sweetened soda (p = 0.036), and lower intake of vegetables than girls (p = 0.011). By contrast, physical activity level and intake of fruit and berries did not differ between genders.ConclusionsMale treatment-seeking adolescents with severe obesity had a more unfavorable set of metabolic and behavioral risk factors for cardiovascular disease than girls. Our results indicate that lifestyle behavioral markers should be thoroughly assessed in both genders, and possible gender-related differences in risk profile should be taken into account in future treatment programs.
| S-EPMC5813385 | biostudies-literature
Project description: Not available
| S-EPMC4964815 | biostudies-literature
Project description:BackgroundThe family environment has a crucial role in the development of childhood obesity and related cardiometabolic disorders. This study aims to investigate the association of parental obesity and cardiometabolic risk factors in their children.MethodsThis multicentric cross-sectional study was performed on 14400 students (aged 7-18 years) and one of their parents. Students were recruited by multistage, stratified cluster sampling from urban and rural areas of 30 provinces of Iran. Fasting venous blood was obtained from a random sample of 4200 students. Demographic, anthropometric and clinical variables were collected.ResultsData of 14002 students and results of blood samples of 3483 of them were complete and included in the current study. The prevalence of obesity in children, fathers, and mothers was 11.4%, 10.6%, and 24.2%, respectively. In students, the most commonly observed metabolic abnormality was low HDL-C (29.5%); the prevalence of metabolic syndrome and dyslipidemia was 5% and 55.7%, respectively. Significant correlations were observed between the body mass index (BMI) and waist circumference of parents and weight, height, BMI, and waist circumference, as well as systolic and diastolic blood pressure (BP) of their children (P< 0.05). In the multivariate model, the risk of excess weight (OR: 1.30, 95%CI: 1.17-1.44), obesity (OR: 1.36, 95%CI: 1.18-1.59), abdominal obesity (OR: 1.16, 95%CI: 1.05-1.29) and elevated BP (OR: 1.17, 95%CI: 1.04-1.31) were higher in those students whose parents had excess weight compared with other students. Parental obesity did not have significant association with metabolic syndrome and dyslipidemia in their children.ConclusionsParental history of obesity could be used as a practical approach for the early preventive measures and identification of children at risk of cardiometabolic complications.
| S-EPMC5894970 | biostudies-literature
Project description: Not available
| S-EPMC8772008 | biostudies-literature
Project description: Not available
| S-EPMC7305912 | biostudies-literature