Search Results (318)

Background/Objectives: The association between chronic kidney disease (CKD) and body size phenotypes in metabolically diverse but apparently healthy adult populations remains inadequately understood. This study investigated the association between CKD and body size phenotypes in a nationally representative sample of healthy Korean adults. Methods: Data from 8227 participants in the 2019–2021 Korean National Health and Nutrition Examination Survey were analyzed. Participants were categorized into four body size phenotypes by combining BMI status (normal weight or obese) with metabolic health status (healthy or abnormal)—MHNW (Metabolically Healthy Normal Weight), MANW (Metabolically Abnormal Normal Weight), MHO (Metabolically Healthy Obese), or MAO (Metabolically Abnormal Obese). CKD was defined based on the urine albumin-to-creatinine ratio and estimated glomerular filtration rate (eGFR). To assess the association between CKD and body size phenotypes, multivariable logistic regression analyses were performed. Results: CKD prevalence was 4.4%. MANW and MAO made up 12.6% and 26.4% of the CKD group, compared to 5.0% and 13.2% of the non-CKD group. CKD prevalence by phenotype was observed as follows: MHNW, 3.2%; MANW, 10.5%; MHO, 4.0%; and MAO, 8.5%. CKD odds were highest in the MAO group (OR: 3.770, 95% CI: 2.648–5.367), followed by the MANW (OR: 2.492, 95% CI: 1.547–4.016) and MHO (OR: 1.974, 95% CI: 1.358–2.870) groups. MAO individuals carried a higher CKD risk than MHO individuals (OR: 1.897, 95% CI: 1.221–2.945). Conclusions: Among apparently healthy adults, body size phenotypes—particularly those with metabolic abnormalities—were significantly associated with the presence of CKD. These findings highlight the need to assess both metabolic health and body composition for effective CKD prevention and management. Full article

CKD is a leading cause of illness in older cats, but early detection is challenging due to the limitations of conventional biomarkers. This study evaluated the clinical utility of the UAC for identifying early-stage renal dysfunction in cats and proposed a diagnostic matrix incorporating the UAC with other biomarkers. Blood and urine samples from 59 healthy cats and 190 cats with CKD were analyzed, and UAC levels were compared with symmetric dimethylarginine (SDMA), creatinine, and blood urea nitrogen (BUN). UAC values were significantly elevated in cats with CKD, including those in stage 1. Receiver operating characteristic analysis identified a UAC cut-off of 16.3 mg/g, yielding 100% specificity and 43.7% sensitivity for early-stage CKD classification. The UAC showed significant correlations with other renal biomarkers and was incorporated into a multi-parameter matrix to support disease staging. These findings suggest that the UAC may be a promising supplementary biomarker for evaluating renal function in cats and could aid clinical decision-making when interpreted in conjunction with established diagnostic parameters. Full article

Background and Objectives: Non-invasive imaging biomarkers for the early detection of chronic kidney allograft injury are needed to improve long-term transplant outcomes. T1 mapping by magnetic resonance imaging (MRI) has emerged as a promising method to assess renal structure and function. This study aimed to determine the potential of MRI as a diagnostic tool for evaluating graft function and structural changes in kidney grafts 1 year after transplantation. Materials and Methods: Thirty-four kidney transplant recipients were prospectively recruited, with 27 completing the follow-up at one year. Renal MRI at 3T was performed to acquire T1, T2, and apparent diffusion coefficient (ADC) maps. Clinical parameters, including estimated glomerular filtration rate (eGFR), albumin-to-creatinine ratio (ACR), protein-to-creatinine ratio (PCR), and histological IF/TA scores, were collected. MRI parameters were compared across the groups stratified by clinical and histological markers. Diagnostic accuracy was assessed using receiver operating characteristic (ROC) analysis. Results: At 1 year, T1 corticomedullary differentiation (CMD) values were significantly higher in patients with elevated ACR (≥3 mg/mmol), PCR (≥15 mg/mmol), and mild to moderate or severe IF/TA, reflecting a reduction in the corticomedullary gradient. T1 CMD demonstrated moderate-to-good diagnostic performance in detecting ACR (AUC 0.791), PCR (AUC 0.730), and IF/TA (AUC 0.839). No significant differences were observed in T2 or ADC values across these groups. T1 CMD also showed a significant positive correlation with ACR but not with eGFR, suggesting a closer association with structural rather than functional deterioration. Conclusions: T1 mapping, particularly T1 CMD, shows promise as a non-invasive imaging biomarker for detecting chronic allograft injury and monitoring renal function 1 year after kidney transplantation. Full article

This study was performed to assess the effects of grape pomace feeding on the immunoglobulin concentration in mammary gland secretions and the biochemical parameters of sows’ blood. This study presents unique results of sow blood parameters obtained during the first day postpartum. Sixteen gestating sows were included in the experiment. The experimental group (DGP) received a supplement of dried grape pomace in the amount of 1% of the basal diet from the 7th day antepartum until the end of lactation. Blood, colostrum, and milk were taken from the sows. On the 1st day postpartum, in the sows’ blood, higher values of total proteins and globulins, as well as lower values of aspartate aminotransferase, creatinine, and the albumin/globulin ratio, were recorded in DGP. There were no significant differences in the concentration of immunoglobulins in the blood of sows between the groups. Also, differences in the concentrations of immunoglobulins in the colostrum and milk of sows throughout lactation were not statistically significant. It can be stated that the feeding of dried grape pomace did not have a negative effect on the biochemical parameters of the sows’ blood, colostrum, and milk. In addition, there is a potential suggestion that the addition of dried grape pomace could have a positive effect on the antioxidant status of sows. Full article

Background/Objectives: The role of glycogen metabolism in diabetic kidney disease (DKD) remains unclear. This study investigated the therapeutic potential of asiatic acid (AA) on glycogen metabolism in DKD and its underlying mechanisms. Methods: A DKD mouse model was established using a high-fat diet and streptozotocin, followed by AA treatment for 8 weeks. Network pharmacology and molecular docking identified STBD1 as a potential target of AA, and its overexpression in mice was performed. Results: AA reduced blood glucose levels and the urinary albumin-to-creatinine ratio (UACR) and downregulated TGFβ-1, KIM-1, and PDK4. Additionally, AA treatment reversed abnormal glycogen accumulation and restored STBD1 expression. Network pharmacology and molecular docking identified STBD1 as a potential target of AA, and its overexpression in mice demonstrated similar beneficial effects. Gene enrichment analysis revealed that STBD1 is involved in key metabolic pathways related to DKD. Conclusions: These findings suggest that AA alleviates renal damage in DKD, possibly through modulation of STBD1, highlighting its therapeutic potential and the critical role of STBD1 in renal glycophagy. Full article

This study aimed to investigate the effects of dietary ISF:SF ratio on reproductive performance, biochemical parameters, colostrum composition, and fecal microbial composition in gestating sows. A total of 30 multiparous sows were randomly allocated to three dietary treatment groups: 8% inulin diet (ISF:SF 1.14, Inulin group), 8% cotton fiber diet (ISF:SF 6.61, Cotton group), and 4% inulin + 4% cotton fiber diet (ISF:SF 2.37, Inulin + Cotton group). The results showed that, compared to the other groups, the Inulin group had a significantly higher number of piglets born alive, as well as increased plasma concentrations of acetic acid, butyric acid, hexanoic acid, and total short-chain fatty acids (SCFAs) (p < 0.05). Sows in the Inulin group had significantly lower fecal scores than those in the other groups from days 81 to 85 and from days 106 to 110 of gestation (p < 0.05). On day 90 of gestation, the serum levels of albumin, urea, uric acid, calcium, and phosphorus in the Inulin group were significantly lower than those in the other groups (p < 0.05). Additionally, the serum levels of triacylglycerol in the Inulin + Cotton Fiber group were significantly higher than those in the other groups (p < 0.05). However, there were no significant differences in serum concentrations of total protein, creatinine, glucose, cholesterol, HDL-cholesterol, or LDL-cholesterol among the treatments (p > 0.05). On day 110 of gestation, the serum content of urea, uric acid, calcium, and phosphorus in the Inulin group was significantly lower than those in the other groups (p < 0.05). Furthermore, the plasma levels of uric acid, triacylglycerol, and HDL-cholesterol in the Inulin + Cotton Fiber group were significantly higher than those in the Cotton Fiber group (p < 0.05), while the creatinine levels in the Inulin group were higher than those in the other groups (p < 0.05). No differences were observed in the composition and immune performance of colostrum (p > 0.05). Microbial sequencing analysis showed that dietary inulin supplementation to increase the proportion of soluble fiber significantly decreased the abundance of Firmicutes, Clostridia, Clostridiales, Lachnospiraceae, Streptococcaceae, and Streptococcus (p < 0.05). The abundance of short-chain fatty acid-producing microorganisms—Bacteroidetes, Bacteroidia, Bacteroidales, and Muribaculaceae—was significantly increased (p < 0.05). The results indicated that inulin supplementation decreased the dietary ISF:SF ratio, significantly alleviated constipation in sows, increased the number of piglets born alive, regulated intestinal microecology, and increased the plasma concentrations of short-chain fatty acids (SCFAs), including acetic, propionic, and butyric acids. Full article

Microalbuminemia, characterized by a urinary albumin concentration between 20 and 200 mg/L, is a critical marker in assessing the risk of chronic kidney disease (CKD), diabetic nephropathy, and various other chronic conditions. Previously, we developed and validated the MyACR point-of-care (PoC) device, which facilitates the monitoring of CKD progression through real-time data transmission, thus enhancing patient management. This device utilizes a spectrophotometric dye-binding assay to measure albumin and creatinine concentrations in urine samples, providing an albumin-to-creatinine ratio (ACR) result. In the present study, we introduced a refined version of the PoC device, MyμAlbumin, designed to offer a simple, accurate, specific, sensitive, and rapid method for detecting microalbumin in urine as an early indicator of CKD and related diseases. The measurement is based on a specific immunoturbidimetric assay in a microcuvette, using a total solution volume of 125 µL (n = 5 for each validation test). The MyμAlbumin device demonstrated excellent performance, achieving high accuracy (%DMV ≤ 4.67) and precision (%CV < 5) and a strong correlation (R² > 0.995) with laboratory spectrophotometry (dye-binding assay) and reference hospital-based immunoturbidimetric assay. Its high sensitivity (LOQ = 5 mg/L) positions MyμAlbumin as a highly viable and cost-effective tool for clinical use. Additionally, the device supports real-time, seamless data transmission, making it ideal for integration into remote healthcare settings. Full article

Background: GLP-1 receptor agonists (GLP-1 RAs) lower glucose and reduce cardiovascular events in type 2 diabetes, with noted renal benefits. Few studies directly compare GLP-1 RAs. This study aims to compare the effects of semaglutide and dulaglutide on renal function decline and proteinuria reduction in diabetic patients. Methods: The present study was conducted at Wanfang Hospital, Taipei Medical University. Diabetic patients using either semaglutide or dulaglutide for more than 1 year in the outpatient department from 1 January 2022 to 30 September 2024 were enrolled retrospectively. The outcome events in the present study included a decline in the estimated glomerular filtration rate (eGFR), an increase in the urine albumin–creatinine ratio (UACR), and patient death. Results: A total of 268 patients on dulaglutide and 747 on semaglutide were included. Baseline eGFR levels were similar in both groups. After 12 months, eGFR levels did not significantly decline in both groups. However, the dulaglutide group showed significantly higher UACR increases than the semaglutide group (p < 0.01). More death events also occurred in the dulaglutide group (p < 0.01). Multivariate logistic regression revealed a higher risk of UACR increase with dulaglutide (p < 0.01). Subgroup analysis found dulaglutide associated with higher UACR in patients younger than 60, males, those with hypertension, without heart failure, those using angiotensin receptor blockers, biguanides, and statins, and those not using sodium-glucose cotransporter-2 inhibitors. Conclusions: Dulaglutide and semaglutide had comparable effects on slowing eGFR decline. However, dulaglutide was less effective in reducing UACR, particularly in the subgroups mentioned above. Full article

Background/Objectives: Insulin resistance is a key factor in the development and progression of metabolic dysfunction-associated steatotic liver disease (MASLD), but accurately measuring it in patients with type 2 diabetes (T2D) remains challenging. This study examines the relationship between a recently proposed insulin resistance index and the presence of liver steatosis and fibrosis in individuals with T2D. Methods: This cross-sectional study utilized data from the 2017–2020 National Health and Nutrition Examination Survey. Patients with T2D who did not have chronic viral hepatitis or significant alcohol intake were included. The insulin sensitivity (IS) index was calculated using a formula incorporating body mass index, urine albumin-to-creatinine ratio, triglycerides, and gamma-glutamyl transferase. Liver stiffness and steatosis were assessed through transient elastography. MASLD was defined as a controlled attenuation parameter (CAP) of ≥274 decibels/meter (dB/m), while significant liver fibrosis was defined as a liver stiffness measurement (LSM) of ≥8 kPa. Multivariable logistic regression models, adjusted for potential confounders, were used to evaluate the association between IS and these liver outcomes. Results: A total of 1084 patients with T2D were analyzed. The prevalence of MASLD and significant liver fibrosis was 74.1% (95% CI 68.7–78.9) and 25.4% (95% CI 21.2–30.2), respectively. After adjusting for age, sex, waist circumference, and race/ethnicity, lower IS scores (indicating higher insulin resistance) were independently associated with increased odds of both MASLD (quartile 1 vs. quartile 4: OR 2.66, 95% CI 1.23–5.71) and significant liver fibrosis (quartile 1 vs. quartile 4: OR 3.30, 95% CI 1.45–7.51). These findings remained consistent across subgroups stratified by age, sex, and obesity status. Conclusions: This novel IS model, derived from commonly available clinical and biochemical markers, is independently associated with liver steatosis and fibrosis. Its application may help identify patients with more advanced MASLD, facilitating early intervention and risk stratification. Full article

Objectives: Systemic inflammation, coagulopathy, and multiorgan dysfunction are common in critically ill patients and contribute significantly to mortality. Serum albumin and D-dimer are routinely used biomarkers that reflect nutritional status and coagulation activity, respectively. This study aimed to investigate the prognostic value of the albumin-to-D-dimer ratio (ADR) in predicting 30-day mortality among patients admitted to the intensive care unit (ICU) and undergoing mechanical ventilation. Methods: This retrospective cohort study included 162 adult patients who underwent invasive mechanical ventilation in the ICU of a tertiary care center between January 2021 and December 2023. Demographic data, comorbidities, and laboratory values—such as serum albumin, D-dimer, lactate, CRP, BUN, creatinine, INR, and platelet count—were recorded within the first 24 h of ICU admission. The albumin-to-D-dimer ratio (ADR) was calculated by dividing serum albumin (g/dL) by D-dimer (μg/mL). The patients were stratified into tertiles based on ADR values: low (<0.95), intermediate (0.95–1.45), and high (>1.45). The association between the ADR and 30-day mortality was analyzed using multivariate logistic regression and receiver operating characteristic (ROC) curve analysis. Results: Of the 162 patients included in the study, 61 (37.7%) died within 30 days. The patients who died had significantly lower ADR values at ICU admission compared to survivors (1.02 ± 0.43 vs. 1.56 ± 0.52, p < 0.001). In the multivariate logistic regression model, a lower ADR remained an independent predictor of 30-day mortality (OR: 0.39; 95% CI: 0.26–0.58; p < 0.001), even after adjusting for age, lactate, creatinine, INR, and other relevant clinical variables. ROC curve analysis demonstrated that the ADR had the highest discriminative performance among all the evaluated parameters, with an AUC of 0.802 (95% CI: 0.728–0.875; p < 0.001). The optimal cut-off value for the ADR was identified as <1.05, yielding a sensitivity of 78.7% and a specificity of 71.4% in predicting 30-day mortality. Conclusions: The ADR is independently associated with 30-day mortality in mechanically ventilated ICU patients and may serve as a useful early prognostic marker. However, given the retrospective, single-center nature of this study, these findings should be interpreted with caution. Further prospective, multicenter studies are needed to validate the clinical utility of the ADR. Full article

Albuminuria is a sensitive biomarker of kidney dysfunction, and the albumin/creatinine ratio (ACR) is an essential measure for monitoring diabetic kidney disease (DKD). Abnormal levels can indicate a propensity for progressive renal failure and other complications such as cardiovascular diseases. This study employed UV/Visible spectroscopy to analyze aqueous urine samples spiked with bovine serum albumin (BSA) and creatinine at clinically relevant concentrations (0–30 mg/L for albumin and 600–1800 mg/L for creatinine) using a multivariate method. UV/Visible spectra of co-spiked samples recorded in triplicate revealed distinct bands at 229 nm and 249 nm, corresponding to BSA and creatinine, respectively, alongside other amino acid bands. Partial Least Squares Regression (PLS-R) analysis for BSA yielded a Root Mean Square Error of Calibration (RMSEC) and Cross-Validation (RMSECV) values of 66.93 and 73.92 mg/L, respectively. For creatinine, RMSEC and RMSECV values were 244.32 and 275.65 mg/L, respectively. Prediction models for both BSA and creatinine compared to ELISA demonstrated a robust performance with R²_PRED values of 0.96 and 0.95, respectively, indicating strong model reliability. The Limit of Detection (LOD) for co-spiked samples was 19.82 mg/L for BSA and 58.43 mg/L for creatinine. The significance of the achieved Limit of Detection (LOD) lies in its ability to measure concentrations well below the normal physiological ranges of 0–30 mg/L for albumin and 600–1800 mg/L for creatinine. These results demonstrate the proof of concept of applying an UV/Visible-spectroscopy-based method as a rapid, cost-effective point-of-care (PoC) tool for ACR measurements, offering promising applications in the early diagnosis, monitoring, and prognosis of diabetic kidney disease and associated cardiovascular complications. The next stage will involve a pilot trial to evaluate the technology’s potential using clinical patients. Full article

Background/Objectives: While sodium–glucose cotransporter 2 (SGLT2) inhibitors have demonstrated additional non-glycemic benefits for renal protection in individuals with type 2 diabetes, less evidence is available for those with type 1 diabetes (T1D). To determine whether the adjunctive use of the SGLT2 inhibitor ipragliflozin confers kidney protection in individuals with T1D, we retrospectively analyzed data from a real-world cohort examined at 25 centers in Japan. Methods: We enrolled 359 subjects aged 20–74 years with T1D (IPRA group: 159 ipragliflozin users; control [CTRL] group: 200 non-users). The primary outcome was changes in the estimated glomerular filtration rate (eGFR) from baseline to 24 months after the initiation of ipragliflozin. The secondary outcomes were all other changes, including the urinary albumin–creatinine ratio (UACR) and urinary protein–creatinine ratio (UPCR). Results: The IPRA group’s eGFR decline slopes were 0.79 mL/min/1.73 m²/year milder than the CTRL group’s after propensity score matching, but this difference was not significant. The subjects complicated by chronic kidney disease (CKD) defined as UACR ≥ 30 mg/g and/or UPCR ≥ 0.5 g/g and/or eGFR < 60 mL/min/1.73 m² showed changes in UPCR (g/g) from baseline to 24 months that were significantly lower in the IPRA group (−0.27 ± 1.63) versus the CTRL group (0.18 ± 0.36) (p = 0.016). No significant increase in adverse events (including severe hypoglycemia and hospitalization due to ketosis/ketoacidosis or cardiovascular diseases) was observed in the IPRA group. Conclusions: Adjunctive treatment with ipragliflozin exerted potential renal benefits by decreasing proteinuria in T1D subjects with CKD. Further investigations are required to determine whether its additional benefits exceed the increased risk of ketoacidosis. Full article

Backround/Objectives: This study aimed to create a scoring system that can predict the mortality for hip fractures in the elderly, which have high mortality and morbidity rates, by using blood parameters and demographic data at admission. Methods: Patients admitted to the hospital due to a hip fracture between January 2016 and March 2021 were included in the study. A scoring system was created using the patient’s age and sex at first admission and hemoglobin, albumin and creatinine levels, neutrophil–lymphocyte ratio and monocyte–lymphocyte ratios. The scoring system was created by determining different cut-off values for each of these seven parameters. A total mortality score was determined for each patient using this scoring system. The 3-year follow-up for patients’ mortality during follow-up was recorded separately for each patient. Following the inclusion and exclusion criteria, the data of 1075 patients were included in the study. Results: All parameters listed in the methodology section were statistically significantly different between the patients who survived and those who died in the three years after hip fracture surgery (p = 0.0001). The total scores obtained using the mortality scoring system created by combining these parameters were also statistically significantly different between the two groups (p = 0.0001). If the mortality score is >11.5, the probability of the patient with a hip fracture dying within the first three years is 63.9%. Conclusion: The Akçaalan Mortality Score can provide predictive data for preoperative prediction to determine the 3-year mortality of elderly patients with hip fractures and may be helpful in terms of surgical timing. The name of this scoring system comes from the lastname of the corresponding author. Full article

Background/Objectives: Low vitamin D status seems to be associated with increased cardiometabolic risk, and was found to attenuate cardiometabolic benefits of statins in men. The aim of the current study was to investigate whether a different vitamin D status determines the pleiotropic effects of statins in women. Methods: This pilot, single-center, prospective, matched-cohort study included 78 women with hypercholesterolemia requiring statin therapy, assigned into one of three age-, plasma lipid-, and body mass index-matched groups: women with vitamin D deficiency (group I), women with vitamin D insufficiency (group II), and women with normal vitamin D homeostasis (group III). Throughout the study (16 weeks), all patients were treated with atorvastatin. The outcome of interest included plasma lipids, glucose homeostasis markers (fasting glucose, HOMA-IR and glycated hemoglobin), plasma levels of 25-hydroxyvitamin D, creatine kinase, uric acid, high-sensitivity C-reactive protein, homocysteine, fibrinogen, urinary albumin-to-creatinine ratio (UACR), and computed values of a 10-year risk of atherosclerotic events. Results: Compared to the control group (group III), group I was characterized by higher values of HOMA-IR, glycated hemoglobin, uric acid, hsCRP, homocysteine, fibrinogen, a UACR, and a 10-year risk of atherosclerotic events, whereas group II had higher values of hsCRP, homocysteine and a UACR. Atorvastatin reduced plasma levels of total and LDL cholesterol and a 10-year risk of atherosclerotic events in all study groups, but this effect was weakest in group I and strongest in group III. In group III, the drug decreased uric acid, hsCRP, homocysteine, fibrinogen, and the UACR. In the remaining groups, its effect was limited to a small decrease in only hsCRP (group I) or in hsCRP and homocysteine (group II). In group I, atorvastatin treatment was associated with an increase in HOMA-IR, glycated hemoglobin, and creatine kinase. Conclusions: Low vitamin D status may exert an unfavorable effect on the lipid-dependent and lipid-independent effects of atorvastatin in middle-aged or elderly women. Full article

Bilirubin, albumin, and uric acid are established endogenous antioxidant biomarkers, whereas the antioxidant role of creatinine has not yet been fully clarified. As a byproduct of creatine metabolism, creatinine may reflect underlying metabolic activity and redox balance, particularly under conditions of oxidative stress such as cigarette smoking. This study aimed to evaluate the associations between serum creatinine and other antioxidant biomarkers and lung cancer risk, stratified by smoking status. We analyzed 83,371 cancer-free men from the Korean Cancer Prevention Study II (KCPS II) cohort. During a mean follow-up of 13.5 years, 533 incident lung cancer cases were identified. Serum creatinine, total bilirubin, albumin, and uric acid were measured. Smoking status classified participants as never-, former, and ever-smokers, with ever-smokers including both current and former smokers. Cox proportional hazards regression models estimated hazard ratios (HRs) and 95% confidence intervals (CIs), stratified by smoking status. Biomarkers were also analyzed by quartiles and linear trends. A single standard deviation increase in serum creatinine was significantly and inversely associated with lung cancer risk among former smokers (HR: 0.774, 95% CI: 0.620 to 0.967) and ever-smokers (HR: 0.823, 95% CI: 0.716 to 0.945). Total bilirubin also showed significant inverse associations in former smokers (HR: 0.826, 95% CI: 0.705 to 0.967) and ever-smokers (HR: 0.785, 95% CI: 0.708 to 0.870). Albumin was inversely associated only with ever-smokers (HR: 0.878, 95% CI: 0.807 to 0.955), while uric acid showed inverse associations with both former smokers (HR: 0.832, 95% CI: 0.699 to 0.989) and ever-smokers (HR: 0.847, 95% CI: 0.760 to 0.944). None of the biomarkers showed significant associations among never-smokers. Serum creatinine and other endogenous antioxidant biomarkers were inversely associated with lung cancer risk, particularly in individuals with a history of smoking exposure. Full article