Identification of Two Forms of Human Plasma Renalase, and Their Association With All-Cause Mortality.
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ABSTRACT:
SUBMITTER: Chang J
PROVIDER: S-EPMC7056858 | biostudies-literature | 2020 Mar
REPOSITORIES: biostudies-literature
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Identification of Two Forms of Human Plasma Renalase, and Their Association With All-Cause Mortality.
Chang J J Guo X X Rao V V Gromisch E S ES Chung S S Kluger H M HM Cha C C Gorelick F F Testani J J Safirstein R R Crowley S S Peixoto A J AJ Desir G V GV
Kidney international reports 20191216 3
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Project description:ImportanceDizziness is a highly prevalent complaint with wide-ranging causes and resultant morbidity. Whether symptomatic dizziness and its various manifestations are associated with all-cause and cause-specific mortality is unknown.ObjectiveTo examine the associations of symptomatic dizziness and its manifestations with all-cause and cause-specific mortality.Design, setting, and participantsThis cohort study is a mortality follow-up study based on the 1999-2004 National Health and Nutrition Examination Survey. The study cohort included adults 40 years and older who completed questions about symptomatic dizziness, including problems with dizziness, balance, falling, and positional dizziness, within the past 12 months. Respondents were linked to mortality data through December 31, 2019. Data were analyzed from February to August 2023.ExposureSelf-reported symptomatic dizziness.Main outcomes and measuresAll-cause and cause-specific (cardiovascular disease, diabetes, cancer, and unintentional injuries) mortality. Cox proportional hazard regression models were used to examine associations between symptomatic dizziness and all-cause and cause-specific mortality while adjusting for demographics and medical history.ResultsIn this nationally representative cohort of 9000 middle-aged and older US adults (mean [SD] age, 61.8 [13.8] years; 4570 [50.8%] female), prevalence of symptomatic dizziness was 23.8%. Specifically, 18.3% reported problems with dizziness, 14.5% reported problems with balance, 5.7% reported problems with falling, and 3.8% reported dizziness when turning in bed (positional dizziness). At a median (range) of 16.2 (0.1-20.6) years of follow-up, all-cause mortality for adults with symptomatic dizziness was higher than for those without (45.6% vs 27.1%). Symptomatic dizziness was associated with elevated risk for cause-specific mortality from diabetes (hazard ratio [HR], 1.66; 95% CI, 1.23-2.25), cardiovascular disease (HR, 1.33; 95% CI, 1.12-1.55), and cancer (HR, 1.21; 95% CI, 0.99-1.47) but not unintentional injuries (HR, 0.98; 95% CI, 0.51-1.88). Reporting problems with balance or falling was associated with increased all-cause mortality (balance: HR, 1.27; 95% CI, 1.17-1.39; and falling: HR, 1.52; 95% CI, 1.33-1.73), cardiovascular disease-specific mortality (balance: HR, 1.41; 95% CI, 1.20-1.66; and falling: HR, 1.49; 95% CI, 1.15-1.94), and diabetes-specific mortality risks (balance: HR, 1.74; 95% CI, 1.26-2.39; and falling: HR, 2.01; 95% CI, 1.26-3.18). There was no association between positional dizziness and mortality (HR, 0.98; 95% CI, 0.82-1.19).Conclusions and relevanceIn this cohort study, symptomatic dizziness was associated with increased risk for all-cause and diabetes-, cardiovascular disease-, and cancer-specific mortality. The imprecision of the effect size estimate for cancer-specific mortality prevents making a definitive conclusion. Future studies are needed to determine whether symptomatic dizziness indicates underlying health conditions contributing to mortality or if early intervention for imbalance and falls can reduce mortality risk.
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Project description:BackgroundNeurofilament light chain (NfL) is released into the blood during neuronal damage. NfL is linked to mortality in neurological disorders, remaining unexplored in population studies. We investigated whether initial (v1) and annualized change (δ) in plasma NfL can predict all-cause mortality in middle-aged dementia-free urban adults.MethodsLongitudinal data were from 694 participants in the Healthy Aging in Neighborhoods of Diversity Across the Life Span study (HANDLS, mean agev1: 47.8 years, 42% male, 55.8% African American). Plasma NfL was measured prospectively at three visits. Analyses included Cox proportional hazards models for all-cause mortality risk and 4-way decomposition testing for interaction and mediation.ResultsUnlike men, women exhibited a direct association between δNfL (above vs. below median) and all-cause mortality risk in both the minimally (HR = 3.91, 95% CI 1.10-13.9, p = 0.036) and fully adjusted models (HR = 4.92, 95% CI 1.26-19.2, p = 0.022), and for δNfL (per unit increase) in the full model (HR = 1.65, 95% CI 1.04-2.61, p = 0.034). In both models, and among women, 1 standard deviation of NfLv1 was associated with an increased all-cause mortality risk (reduced model: HR = 2.01, 95% CI 1.24-3.25, p = 0.005; full model: HR = 1.75, 95% CI 1.02-2.98, p = 0.041). Only few interactions were detected for cardio-metabolic risk factors. Notably, NfLv1 was shown to be a better prognostic indicator at normal hsCRP values among women, while HbA1c and δNfL interacted synergistically to determine mortality risk, overall.ConclusionsThese findings indicate that plasma NfL levels at baseline and over time can predict all-cause mortality in women and interacts with hsCRP and HbA1c to predict that risk.
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Project description:Importance:Higher plasma concentrations of vitamin B12 have been associated with mortality in elderly and hospitalized populations, including patients with chronic kidney disease, but the association of plasma concentrations of vitamin B12 with mortality in the general population remains unclear. Objective:To investigate the association of plasma concentrations of vitamin B12 with all-cause mortality. Design, Setting, and Participants:This longitudinal cohort study used post hoc analysis to examine data from participants of the Prevention of Renal and Vascular End-stage Disease Study in Groningen, the Netherlands. Participants included individuals who completed the second screening visit beginning January 1, 2001, excluding those who were missing values of vitamin B12 plasma concentrations or used vitamin B12 supplementation. Follow-up time was defined between the beginning of the second screening round to end of follow-up on January 1, 2011. Data analysis was conducted from October 2, 2018, to February 22, 2019. Exposures:Plasma vitamin B12 concentration level. Main Outcomes and Measures:Death as recorded by the Central Bureau of Statistics of Groningen, the Netherlands. Results:A total of 5571 participants (mean [SD] age, 53.5 [12.0] years; 2830 [50.8%] men) were included in analyses. Median (interquartile range) plasma concentration of vitamin B12 was 394.42 (310.38-497.42) pg/mL. During the median (interquartile range) of 8.2 (7.7-8.9) years of follow-up, 226 participants (4.1%) died. According to quartiles of the distribution of plasma vitamin B12 concentration levels, mortality rates were 33.8 deaths per 10 000 person-years for the quartile with the lowest plasma concentration of vitamin B12 and 65.7 deaths per 10 000 person-years for the quartile with the highest plasma concentration of vitamin B12. After adjustment for multiple clinical and laboratory variables, Cox regression analyses found a significant association between higher vitamin B12 plasma concentration level and increased risk of all-cause mortality (hazard ratio per 1-SD increase, 1.25 [95% CI, 1.06-1.47]; P = .006). Conclusions and Relevance:These findings suggest that higher levels of plasma concentrations of vitamin B12 were associated with increased risk of all-cause mortality after adjusting for age, sex, renal function, and other clinical and laboratory variables. The mechanisms underlying this association remain to be established.
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Project description:PurposeAn increased risk of cardiovascular mortality and morbidity has been linked with metabolic syndrome (MetS), described as the secondary risk reduction target. These patients are predisposed to high complication levels such as unstable angina-pectoris (USAP) by MetS. As with the role of renalase in the regulation of blood pressure (BP), the study was carried out to determine the levels of renalase circulation in patients with USAP and MetS (USAP+MetS), as well as the association of renalase gene (RNLS) rs10887800 polymorphism and USAP and MetS susceptibility.Patients and methodsA total of 134 patients with USAP+MetS and 134 control subjects were recruited in this case-control study.ResultsRenalase was found to have a significantly higher level in USAP+MetS patients (23.28 ± 4.09 µg/dL) than in healthy ones (20.81 ± 2.73 µg/dL) (P < 0.001). Also, it was shown that renalase sensitivity and specificity values for the early diagnosis of USAP and MetS seemed to be 53.7% and 76.9, respectively. Moreover, the value for renalase area under curve (AUC) was 0.654 (95% CI: 0.58-0.72). The frequency of rs10887800 AG and GG genotypes of RNLS gene was significantly higher in USAP+MetS patients than in control subjects, suggesting that this genotype might be a risk factor against USAP+MetS (OR = 2.114 [95% CI 1.113-4.016]; P = 0.022) and (OR = 2.057 [95% CI 1.011-4.186]; P = 0.047), respectively.ConclusionThe present results showed that renalase serum levels increased in USAP and MetS patients. Moreover, the RNLS rs10887800 was reported to be associated with a higher risk of USAP+MetS.
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