Global ETD Search

1	Retrospektive Analyse des Therapieverlaufs und kardiovaskulären Risikoprofils bei Patienten mit Rheumatoider Arthritis unter immunsuppressiver Therapie / Retrospective analysis of the course of therapy and cardiovascular risk profile in patients with rheumatoid arthritis under immunosuppressive therapy Gebauer, Katrin 12 June 2018 (has links) No description available. 610 Rheumatoide Arthritis Kardiovaskuläres Risiko rheumatoid arthritis cardiovascular risk DAS28 DMARD biologic myocardial infarction stroke Framingham score PROCAM score Medizin (PPN619874732) Rheumatologie (PPN619875887)
2	Perfil dos riscos cardiovasculares em motoristas profissionais de transporte de cargas da Rodovia BR-116 no trecho Paulista-Régis Bittencourt / Cardiovascular risk profile observed in professional truck drivers who work on Highway BR116 within the area of the state of São Paulo-Régis Bittencourt Cavagioni, Luciane Cesira 14 December 2006 (has links) Introdução: As doenças cardiovasculares constituem a principal causa demorbimortalidade nacional. Nesse sentido realizou-se estudo com o objetivo de caracterizar o perfil para riscos cardiovasculares em motoristas profissionais de transporte de cargas que trafegam pela Br-116. Casuística e Método: Estudo transversal, descritivo e exploratório com 258 motoristas profissionais de transporte de cargas com obtenção de informações socioeconômicas; avaliações antropométricas: índice de massa corporal (IMC), circunferência abdominal e medida da pressão arterial; realização de exames laboratoriais: triglicérides, colesterol total e frações, proteína C reativa e creatinina. Analisou-se o risco para doenças cardiovasculares pelo Escore de Risco de Framingham, consumo de bebidas alcoólicas pelo Alcohol Use Disorders Identification-AUDIT, distúrbios psiquiátricos comuns pelo Self Report Questionnaire-SRQ-20, Síndrome Metabólica e angina pectoris pelo Teste de Rose. Os dados foram processados no sistema SPSS v.7.5. O nível de significância adotado foi p<0,05, utilizou-se análise univariada e multivariada. Resultados: A caracterização os motoristas estudados mostrou idade 37,5±10,1 anos, 91% de etnia branca, renda mensal 1.431,3±644,4 reais, 19% tabagistas, 55% referiram ingestão de bebidas alcoólicas, 74% não realizavam atividade físicas, 14% relataram uso de medicamentos inibidores do sono, tempo profissão de 14±10 anos e percorriam 782,9±229,6 km/dia, dirigiam 10 horas por dia e repousavam 06 horas diárias. Verificou-se pelos dados antropométricos que 46% tinham sobrepeso, 36% obesidade e 58% circunferência abdominal alterada (_94 cm). Os exames laboratoriais mostraram 33% com nível de colesterol total _ 200mg/dL, 10% LDL-c _ 160 mg/dL; HDL-c < 40 mg/dL 23%, triglicérides acima de 150 mg/dL 38%, glicemia _ 110mg/dL 7% e proteína C reativa > 0,5 mg/dL 19%, creatinina >1,5 mg/dL 1%. A prevalência da hipertensão arterial foi de 37% e da Síndrome metabólica 24%. O Questionnaire Rose foi positivo em 8,0% dos motoristas, Escore de Risco de Framingham médio/alto em 9%, presença de distúrbios psiquiátricos comuns em 33% e AUDIT 16% no escore que sugere intervenção e aconselhamento. A análise de regressão logística indicou associação independente para as seguintes variáveis (OD Odds ratio, IC intervalo de confiança a 95%): 1-Síndrome Metabólica: IMC (OR=1,40 IC 1,192-1,661); hábito de verificar o colesterol total (OR= 0,102 IC 0,017-0,589); e escore de risco de Framingham médio/alto (OR= 26,389 IC 2,520-276,374). 2-Hipertensão arterial: IMC (OR=1,183 IC 1,065-1,314); glicemia (OR=1,039 IC 1,004-1,076); e hábito de ingerir medicamento para inibir o sono (OR= 0,322 IC 0,129-0,801). 3- Colesterol Total (_ 200 mg/dL): LDL-c (OR=1,157 IC 1,100-1,216);triglicérides (OR=1,012 IC 1,004-1,021) 4- Glicemia (_ 110 mg/dL): IMC (OR=1,153 IC 1,024-1,298); maior tempo de profissão (OR=1,154 IC 1,057-1,259) 5-Proteína C reativa (>0,5 mg/dL): escore de risco de Framingham médio/alto (OR=4,692 IC 1,912-11,515). Conclusão: Verificou-se presença expressiva de fatores de risco cardiovasculares, nesse sentido os profissionais de saúde devem implementar estratégias para estimular mudanças de estilos de vida nos motoristas de transporte de cargas, visando a prevenção primária e secundária / Introduction: Cardiovascular diseases are the main cause of morbidity and mortality in Brazil. Therefore, a study aiming at characterizing the cardiovascular risk profile observed in professional truck drivers who work on Highway Br-116 was carried out. Population and Method: An exploring, descriptive and transversal study with 258 professional truck drivers, social economical information, both body mass index (BMI) and waist circumference evaluations, blood pressure measurement, as well as laboratory test performance: triglycerides, total and fraction cholesterol, and C reactive protein. The risk for cardiovascular diseases was assessed by Framingham scores; alcohol intake by Alcohol Use Disorders Identification-AUDIT; common psychiatric disorders by Self Report Questionnaire-SRQ-20; and angine pectoris by Rose´s test Data were processed in the SPSS system v.7.5, considering that the significance level adopted was 0,05, and univaried and multivaried analyses were used. Results: The characterization of the drivers studied revealed age of 37.5±10.1 years, 91% of them were white, monthly income 1.431,3 ± 644,4 reais (Brazilian currency), 19% were smokers, 55% referred alcohol intake, 74% did not make physical exercises, 14% referred using sleeping inhibitor drugs, professional time 14±10 years and used to drive 782,9±229,6 Km/day. It was observed that 46% of them were overweight and 36% were obese and 58% had altered waist circumference (_ 94 cm) by the anthropometric data. The lab tests showed 33% with total cholesterol level _200 mg/dL, 10% LDLc _160 mg/dL, HDL-c <40 mg/dL 23%, triglycerides over 150 mg/dL 38%, glycemy _110mg/dL 7%, and C reactive protein >0.5 mg/dL 19%. The prevalence of hypertension was 37% and of Metabolic Syndrome, 24%. Roses test was positive for 8% of the drivers, Medium/High Framingham scores for 9%, presence of common psychiatric disturbs in 33% and 16% with AUDIT score suggesting intervention and advisory. The logistical regression analysis indicated independent association for the following variables: (OR Odds ratio, CI confidence interval at 95%): 1- Metabolic Syndrome: BMI (OR=1,40 CI 1,192-1,661); the habit of checking the total cholesterol (0,102 IC 0,017-0,589); Medium/high Framingham score (OR=26,389 IC 2,520-276,374); 2-Hypertension: BMI (OR=1,183 IC 1,065-1,314); glycemy (OR=1,039 IC 1,004-1,076); the habit of taking sleeping pills (OR=0,322 IC 0,129-0,801). 3- Total Cholesterol (_ 200 mg/dL): LDL-c (OR=1,157 IC 1,100-1,216); triglycerides (OR=1,012 IC 1,004-1,021). 4- Glycemy (_ 110 mg/dL): BMI (OR=1,153 IC 1,024-1,298); professional time (OR=1,154 IC 1,057-1,259). 5- C reactive protein (>0,5 mg/dL): Medium/high Framingham score (OR=4,692 IC 1,912-11,515). Conclusion: It was observed an expressive presence of cardiovascular risk factors. Therefore health professionals should implement strategies to stimulate changes in truck drivers lifestyle, aiming at primary and secondary prevention Escore de risco de framingham Fatores de riscos Metabolic syndrome Occupational health (truck drivers) Risk factors Risky framingham score Saúde ocupacional (caminhoneiros) Síndrome metabólica
3	Perfil dos riscos cardiovasculares em motoristas profissionais de transporte de cargas da Rodovia BR-116 no trecho Paulista-Régis Bittencourt / Cardiovascular risk profile observed in professional truck drivers who work on Highway BR116 within the area of the state of São Paulo-Régis Bittencourt Luciane Cesira Cavagioni 14 December 2006 (has links) Introdução: As doenças cardiovasculares constituem a principal causa demorbimortalidade nacional. Nesse sentido realizou-se estudo com o objetivo de caracterizar o perfil para riscos cardiovasculares em motoristas profissionais de transporte de cargas que trafegam pela Br-116. Casuística e Método: Estudo transversal, descritivo e exploratório com 258 motoristas profissionais de transporte de cargas com obtenção de informações socioeconômicas; avaliações antropométricas: índice de massa corporal (IMC), circunferência abdominal e medida da pressão arterial; realização de exames laboratoriais: triglicérides, colesterol total e frações, proteína C reativa e creatinina. Analisou-se o risco para doenças cardiovasculares pelo Escore de Risco de Framingham, consumo de bebidas alcoólicas pelo Alcohol Use Disorders Identification-AUDIT, distúrbios psiquiátricos comuns pelo Self Report Questionnaire-SRQ-20, Síndrome Metabólica e angina pectoris pelo Teste de Rose. Os dados foram processados no sistema SPSS v.7.5. O nível de significância adotado foi p<0,05, utilizou-se análise univariada e multivariada. Resultados: A caracterização os motoristas estudados mostrou idade 37,5±10,1 anos, 91% de etnia branca, renda mensal 1.431,3±644,4 reais, 19% tabagistas, 55% referiram ingestão de bebidas alcoólicas, 74% não realizavam atividade físicas, 14% relataram uso de medicamentos inibidores do sono, tempo profissão de 14±10 anos e percorriam 782,9±229,6 km/dia, dirigiam 10 horas por dia e repousavam 06 horas diárias. Verificou-se pelos dados antropométricos que 46% tinham sobrepeso, 36% obesidade e 58% circunferência abdominal alterada (_94 cm). Os exames laboratoriais mostraram 33% com nível de colesterol total _ 200mg/dL, 10% LDL-c _ 160 mg/dL; HDL-c < 40 mg/dL 23%, triglicérides acima de 150 mg/dL 38%, glicemia _ 110mg/dL 7% e proteína C reativa > 0,5 mg/dL 19%, creatinina >1,5 mg/dL 1%. A prevalência da hipertensão arterial foi de 37% e da Síndrome metabólica 24%. O Questionnaire Rose foi positivo em 8,0% dos motoristas, Escore de Risco de Framingham médio/alto em 9%, presença de distúrbios psiquiátricos comuns em 33% e AUDIT 16% no escore que sugere intervenção e aconselhamento. A análise de regressão logística indicou associação independente para as seguintes variáveis (OD Odds ratio, IC intervalo de confiança a 95%): 1-Síndrome Metabólica: IMC (OR=1,40 IC 1,192-1,661); hábito de verificar o colesterol total (OR= 0,102 IC 0,017-0,589); e escore de risco de Framingham médio/alto (OR= 26,389 IC 2,520-276,374). 2-Hipertensão arterial: IMC (OR=1,183 IC 1,065-1,314); glicemia (OR=1,039 IC 1,004-1,076); e hábito de ingerir medicamento para inibir o sono (OR= 0,322 IC 0,129-0,801). 3- Colesterol Total (_ 200 mg/dL): LDL-c (OR=1,157 IC 1,100-1,216);triglicérides (OR=1,012 IC 1,004-1,021) 4- Glicemia (_ 110 mg/dL): IMC (OR=1,153 IC 1,024-1,298); maior tempo de profissão (OR=1,154 IC 1,057-1,259) 5-Proteína C reativa (>0,5 mg/dL): escore de risco de Framingham médio/alto (OR=4,692 IC 1,912-11,515). Conclusão: Verificou-se presença expressiva de fatores de risco cardiovasculares, nesse sentido os profissionais de saúde devem implementar estratégias para estimular mudanças de estilos de vida nos motoristas de transporte de cargas, visando a prevenção primária e secundária / Introduction: Cardiovascular diseases are the main cause of morbidity and mortality in Brazil. Therefore, a study aiming at characterizing the cardiovascular risk profile observed in professional truck drivers who work on Highway Br-116 was carried out. Population and Method: An exploring, descriptive and transversal study with 258 professional truck drivers, social economical information, both body mass index (BMI) and waist circumference evaluations, blood pressure measurement, as well as laboratory test performance: triglycerides, total and fraction cholesterol, and C reactive protein. The risk for cardiovascular diseases was assessed by Framingham scores; alcohol intake by Alcohol Use Disorders Identification-AUDIT; common psychiatric disorders by Self Report Questionnaire-SRQ-20; and angine pectoris by Rose´s test Data were processed in the SPSS system v.7.5, considering that the significance level adopted was 0,05, and univaried and multivaried analyses were used. Results: The characterization of the drivers studied revealed age of 37.5±10.1 years, 91% of them were white, monthly income 1.431,3 ± 644,4 reais (Brazilian currency), 19% were smokers, 55% referred alcohol intake, 74% did not make physical exercises, 14% referred using sleeping inhibitor drugs, professional time 14±10 years and used to drive 782,9±229,6 Km/day. It was observed that 46% of them were overweight and 36% were obese and 58% had altered waist circumference (_ 94 cm) by the anthropometric data. The lab tests showed 33% with total cholesterol level _200 mg/dL, 10% LDLc _160 mg/dL, HDL-c <40 mg/dL 23%, triglycerides over 150 mg/dL 38%, glycemy _110mg/dL 7%, and C reactive protein >0.5 mg/dL 19%. The prevalence of hypertension was 37% and of Metabolic Syndrome, 24%. Roses test was positive for 8% of the drivers, Medium/High Framingham scores for 9%, presence of common psychiatric disturbs in 33% and 16% with AUDIT score suggesting intervention and advisory. The logistical regression analysis indicated independent association for the following variables: (OR Odds ratio, CI confidence interval at 95%): 1- Metabolic Syndrome: BMI (OR=1,40 CI 1,192-1,661); the habit of checking the total cholesterol (0,102 IC 0,017-0,589); Medium/high Framingham score (OR=26,389 IC 2,520-276,374); 2-Hypertension: BMI (OR=1,183 IC 1,065-1,314); glycemy (OR=1,039 IC 1,004-1,076); the habit of taking sleeping pills (OR=0,322 IC 0,129-0,801). 3- Total Cholesterol (_ 200 mg/dL): LDL-c (OR=1,157 IC 1,100-1,216); triglycerides (OR=1,012 IC 1,004-1,021). 4- Glycemy (_ 110 mg/dL): BMI (OR=1,153 IC 1,024-1,298); professional time (OR=1,154 IC 1,057-1,259). 5- C reactive protein (>0,5 mg/dL): Medium/high Framingham score (OR=4,692 IC 1,912-11,515). Conclusion: It was observed an expressive presence of cardiovascular risk factors. Therefore health professionals should implement strategies to stimulate changes in truck drivers lifestyle, aiming at primary and secondary prevention Escore de risco de framingham Fatores de riscos Saúde ocupacional (caminhoneiros) Síndrome metabólica Metabolic syndrome Occupational health (truck drivers) Risk factors Risky framingham score
4	BIRTHWEIGHT AND SUSCEPTIBILITY TO CHRONIC DISEASE Issa Al Salmi Unknown Date (has links) The thesis examines the relationship of birthweight to risk factors and markers, such as proteinuria and glomerular filtration rate, for chronic disease in postnatal life. It made use of the Australian Diabetes, Obesity and Lifestyle Study (AusDiab). The AusDiab study is a cross sectional study where baseline data on 11,247 participants were collected in 1999-2000. Participants were recruited from a stratified sample of Australians aged ≥ 25 years, residing in 42 randomly selected urban and non-urban areas (Census Collector Districts) of the six states of Australia and the Northern Territory. The AusDiab study collected an enormous amount of clinical and laboratory data. During the 2004-05 follow-up AusDiab survey, questions about birthweight were included. Participants were asked to state their birthweight, the likely accuracy of the stated birthweight and the source of their stated birthweight. Four hundred and twelve chronic kidney disease (CKD) patients were approached, and 339 agreed to participate in the study. The patients completed the same questionnaire. Medical records were reviewed to check the diagnoses, causes of kidney trouble and SCr levels. Two control subjects, matched for gender and age, were selected for each CKD patient from participants in the AusDiab study who reported their birthweight. Among 7,157 AusDiab participants who responded to the questionnaire, 4,502 reported their birthweights, with a mean (standard deviation) of 3.4 (0.7) kg. The benefit and disadvantages of these data are discussed in chapter three. The data were analysed for the relationship between birthweight and adult body size and composition, disorders of glucose regulation, blood pressure, lipid abnormalities, cardiovascular diseases and glomerular filtration rate. Low birthweight was associated with smaller body build and lower lean mass and total body water in both females and males. In addition low birthweight was associated with central obesity and higher body fat percentage in females, even after taking into account current physical activity and socioeconomic status. Fasting plasma glucose, post load glucose and glycosylated haemoglobin were strongly and inversely correlated with birthweight. In those with low birthweight (< 2.5 kg), the risks for having impaired fasting glucose, impaired glucose tolerance, diabetes and all abnormalities combined were increased by 1.75, 2.22, 2.76 and 2.28 for females and by 1.40, 1.32, 1.98 and 1.49 for males compared to those with normal birthweight (≥ 2.5 kg), respectively. Low birthweight individuals were at higher risk for having high blood pressure ≥ 140/90 mmHg and ≥ 130/85 mmHg compared to those with normal birthweight. People with low birthweight showed a trend towards increased risk for high cholesterol (≥ 5.5 mmol/l) compared to those of normal birthweight. Females with low birthweight had increased risk for high low density lipoprotein cholesterol (≥ 3.5 mmol/l) and triglyceride levels (≥ 1.7 mmol/l) when compared to those with normal birthweight. Males with low birthweight exhibited increased risk for low levels of high density lipoprotein cholesterol (<0.9 mmol/l) than those with normal birthweight. Females with low birthweight were at least 1.39, 1.40, 2.30 and 1.47 times more likely to have angina, coronary artery disease, stroke and overall cardiovascular diseases respectively, compared to those ≥ 2.5 kg. Similarly, males with low birthweight were 1.76, 1.48, 3.34 and 1.70 times more likely to have angina, coronary artery disease, stroke and overall cardiovascular diseases compared to those ≥ 2.5 kg, respectively. The estimated glomerular filtration rate was strongly and positively associated with birthweight, with a predicted increase of 2.6 ml/min (CI 2.1, 3.2) and 3.8 (3.0, 4.5) for each kg of birthweight for females and males, respectively. The odd ratio (95% confidence interval) for low glomerular filtration rate (<61.0 ml/min for female and < 87.4 male) in people of low birthweight compared with those of normal birthweight was 2.04 (1.45, 2.88) for female and 3.4 (2.11, 5.36) for male. One hundred and eighty-nineCKD patients reported their birthweight; 106 were male. Their age was 60.3(15) years. Their birthweight was 3.27 (0.62) kg, vs 3.46 (0.6) kg for their AusDiab controls, p<0.001 and the proportions with birthweight<2.5 kg were 12.17% and 4.44%, p<0.001. Among CKD patients, 22.8%, 21.7%, 18% and 37.6% were in CKD stages 2, 3, 4 and 5 respectively. Birthweights by CKD stage and their AusDiab controls were as follows: 3.38 (0.52) vs 3.49 (0.52), p=0.251 for CKD2; 3.28 (0.54) vs 3.44 (0.54), p=0.121 for CKD3; 3.19 (0.72) vs 3.43 (0.56), p= 0.112 for CKD4 and 3.09 (0.65) vs 3.47 (0.67), p<0.001 for CKD5. The results demonstrate that in an affluent Western country with a good adult health profile, low birthweight people were predisposed to higher rates of glycaemic dysregulation, high blood pressure, dyslipidaemia, cardiovascular diseases and lower glomerular filtration rate in adult life. In all instances it would be prudent to adopt policies of intensified whole of life surveillance of lower birthweight people, anticipating this risk. The general public awareness of the effect of low birthweight on development of chronic diseases in later life is of vital importance. The general public, in addition to the awareness of people in medical practice of the role of low birthweight, will lead to a better management of this group of our population that is increasingly surviving into adulthood. birth weight birthweight birth weight and renal volume BIRTH WEIGHT QUESTIONNAIRE chronic disease Barker Hypothesis Foetal development DOHaD gestational age Anthropometric Characteristics body composition Height weight body mass index Waist Circumference hip circumference Waist-hip Ratio obesity Central Obesity Fatness Lean Body Mass Lean Mass Fat Mass body fat mass Body Fat Percentage body fatness Body Surface Area diabetes Fasting Glucose fasting insulin level glucose tolerance Impaired Fasting Glucose Impaired Glucose Tolerance Glycosylated Hemoglobin HbA1c IFG glucose control glycaemic control Metabolic Syndrome Syndrome X blood pressure Systolic Blood-pressure Diastolic Blood-pressure Systolic Hypertension high blood pressure Hypertension Dyslipidaemia Dyslipidemia Total Cholesterol Triglyceride Low Density Lipoprotein Cholesterol Ldl Cholesterol High Density Lipoprotein Hdl Cholesterol Fibrinogen angina Angina-pectoris Stroke coronary artery disease cardiovascular disease Framingham Framingham Heart Study Framingham Score coronary heart disease Glomerular Filtration glomerular filtration rate Glomerular Hyperfiltration Glomerular Injury Glomerular Number Nephrogenesis Nephron Endowment Nephron Number NKF-K/DQQI Classification Chronic Kidney Disease (ckd) Chronic Kidney Failure Kidney Failure CKD STAGES end-stage renal disease (ESRD) end-stage renal failure Cockcroft-gault MDRD formula Serum Creatinine Urinary Creatinine albuminuria Albuminuria:creatinine Ratio Kidney Development Kidney dysfunction low birth weight low birth weight Pre-term Birth AusDiab Study case control longitudinal observational study
5	BIRTHWEIGHT AND SUSCEPTIBILITY TO CHRONIC DISEASE Issa Al Salmi Unknown Date (has links) The thesis examines the relationship of birthweight to risk factors and markers, such as proteinuria and glomerular filtration rate, for chronic disease in postnatal life. It made use of the Australian Diabetes, Obesity and Lifestyle Study (AusDiab). The AusDiab study is a cross sectional study where baseline data on 11,247 participants were collected in 1999-2000. Participants were recruited from a stratified sample of Australians aged ≥ 25 years, residing in 42 randomly selected urban and non-urban areas (Census Collector Districts) of the six states of Australia and the Northern Territory. The AusDiab study collected an enormous amount of clinical and laboratory data. During the 2004-05 follow-up AusDiab survey, questions about birthweight were included. Participants were asked to state their birthweight, the likely accuracy of the stated birthweight and the source of their stated birthweight. Four hundred and twelve chronic kidney disease (CKD) patients were approached, and 339 agreed to participate in the study. The patients completed the same questionnaire. Medical records were reviewed to check the diagnoses, causes of kidney trouble and SCr levels. Two control subjects, matched for gender and age, were selected for each CKD patient from participants in the AusDiab study who reported their birthweight. Among 7,157 AusDiab participants who responded to the questionnaire, 4,502 reported their birthweights, with a mean (standard deviation) of 3.4 (0.7) kg. The benefit and disadvantages of these data are discussed in chapter three. The data were analysed for the relationship between birthweight and adult body size and composition, disorders of glucose regulation, blood pressure, lipid abnormalities, cardiovascular diseases and glomerular filtration rate. Low birthweight was associated with smaller body build and lower lean mass and total body water in both females and males. In addition low birthweight was associated with central obesity and higher body fat percentage in females, even after taking into account current physical activity and socioeconomic status. Fasting plasma glucose, post load glucose and glycosylated haemoglobin were strongly and inversely correlated with birthweight. In those with low birthweight (< 2.5 kg), the risks for having impaired fasting glucose, impaired glucose tolerance, diabetes and all abnormalities combined were increased by 1.75, 2.22, 2.76 and 2.28 for females and by 1.40, 1.32, 1.98 and 1.49 for males compared to those with normal birthweight (≥ 2.5 kg), respectively. Low birthweight individuals were at higher risk for having high blood pressure ≥ 140/90 mmHg and ≥ 130/85 mmHg compared to those with normal birthweight. People with low birthweight showed a trend towards increased risk for high cholesterol (≥ 5.5 mmol/l) compared to those of normal birthweight. Females with low birthweight had increased risk for high low density lipoprotein cholesterol (≥ 3.5 mmol/l) and triglyceride levels (≥ 1.7 mmol/l) when compared to those with normal birthweight. Males with low birthweight exhibited increased risk for low levels of high density lipoprotein cholesterol (<0.9 mmol/l) than those with normal birthweight. Females with low birthweight were at least 1.39, 1.40, 2.30 and 1.47 times more likely to have angina, coronary artery disease, stroke and overall cardiovascular diseases respectively, compared to those ≥ 2.5 kg. Similarly, males with low birthweight were 1.76, 1.48, 3.34 and 1.70 times more likely to have angina, coronary artery disease, stroke and overall cardiovascular diseases compared to those ≥ 2.5 kg, respectively. The estimated glomerular filtration rate was strongly and positively associated with birthweight, with a predicted increase of 2.6 ml/min (CI 2.1, 3.2) and 3.8 (3.0, 4.5) for each kg of birthweight for females and males, respectively. The odd ratio (95% confidence interval) for low glomerular filtration rate (<61.0 ml/min for female and < 87.4 male) in people of low birthweight compared with those of normal birthweight was 2.04 (1.45, 2.88) for female and 3.4 (2.11, 5.36) for male. One hundred and eighty-nineCKD patients reported their birthweight; 106 were male. Their age was 60.3(15) years. Their birthweight was 3.27 (0.62) kg, vs 3.46 (0.6) kg for their AusDiab controls, p<0.001 and the proportions with birthweight<2.5 kg were 12.17% and 4.44%, p<0.001. Among CKD patients, 22.8%, 21.7%, 18% and 37.6% were in CKD stages 2, 3, 4 and 5 respectively. Birthweights by CKD stage and their AusDiab controls were as follows: 3.38 (0.52) vs 3.49 (0.52), p=0.251 for CKD2; 3.28 (0.54) vs 3.44 (0.54), p=0.121 for CKD3; 3.19 (0.72) vs 3.43 (0.56), p= 0.112 for CKD4 and 3.09 (0.65) vs 3.47 (0.67), p<0.001 for CKD5. The results demonstrate that in an affluent Western country with a good adult health profile, low birthweight people were predisposed to higher rates of glycaemic dysregulation, high blood pressure, dyslipidaemia, cardiovascular diseases and lower glomerular filtration rate in adult life. In all instances it would be prudent to adopt policies of intensified whole of life surveillance of lower birthweight people, anticipating this risk. The general public awareness of the effect of low birthweight on development of chronic diseases in later life is of vital importance. The general public, in addition to the awareness of people in medical practice of the role of low birthweight, will lead to a better management of this group of our population that is increasingly surviving into adulthood. birth weight birthweight birth weight and renal volume BIRTH WEIGHT QUESTIONNAIRE chronic disease Barker Hypothesis Foetal development DOHaD gestational age Anthropometric Characteristics body composition Height weight body mass index Waist Circumference hip circumference Waist-hip Ratio obesity Central Obesity Fatness Lean Body Mass Lean Mass Fat Mass body fat mass Body Fat Percentage body fatness Body Surface Area diabetes Fasting Glucose fasting insulin level glucose tolerance Impaired Fasting Glucose Impaired Glucose Tolerance Glycosylated Hemoglobin HbA1c IFG glucose control glycaemic control Metabolic Syndrome Syndrome X blood pressure Systolic Blood-pressure Diastolic Blood-pressure Systolic Hypertension high blood pressure Hypertension Dyslipidaemia Dyslipidemia Total Cholesterol Triglyceride Low Density Lipoprotein Cholesterol Ldl Cholesterol High Density Lipoprotein Hdl Cholesterol Fibrinogen angina Angina-pectoris Stroke coronary artery disease cardiovascular disease Framingham Framingham Heart Study Framingham Score coronary heart disease Glomerular Filtration glomerular filtration rate Glomerular Hyperfiltration Glomerular Injury Glomerular Number Nephrogenesis Nephron Endowment Nephron Number NKF-K/DQQI Classification Chronic Kidney Disease (ckd) Chronic Kidney Failure Kidney Failure CKD STAGES end-stage renal disease (ESRD) end-stage renal failure Cockcroft-gault MDRD formula Serum Creatinine Urinary Creatinine albuminuria Albuminuria:creatinine Ratio Kidney Development Kidney dysfunction low birth weight low birth weight Pre-term Birth AusDiab Study case control longitudinal observational study
6	BIRTHWEIGHT AND SUSCEPTIBILITY TO CHRONIC DISEASE Issa Al Salmi Unknown Date (has links) The thesis examines the relationship of birthweight to risk factors and markers, such as proteinuria and glomerular filtration rate, for chronic disease in postnatal life. It made use of the Australian Diabetes, Obesity and Lifestyle Study (AusDiab). The AusDiab study is a cross sectional study where baseline data on 11,247 participants were collected in 1999-2000. Participants were recruited from a stratified sample of Australians aged ≥ 25 years, residing in 42 randomly selected urban and non-urban areas (Census Collector Districts) of the six states of Australia and the Northern Territory. The AusDiab study collected an enormous amount of clinical and laboratory data. During the 2004-05 follow-up AusDiab survey, questions about birthweight were included. Participants were asked to state their birthweight, the likely accuracy of the stated birthweight and the source of their stated birthweight. Four hundred and twelve chronic kidney disease (CKD) patients were approached, and 339 agreed to participate in the study. The patients completed the same questionnaire. Medical records were reviewed to check the diagnoses, causes of kidney trouble and SCr levels. Two control subjects, matched for gender and age, were selected for each CKD patient from participants in the AusDiab study who reported their birthweight. Among 7,157 AusDiab participants who responded to the questionnaire, 4,502 reported their birthweights, with a mean (standard deviation) of 3.4 (0.7) kg. The benefit and disadvantages of these data are discussed in chapter three. The data were analysed for the relationship between birthweight and adult body size and composition, disorders of glucose regulation, blood pressure, lipid abnormalities, cardiovascular diseases and glomerular filtration rate. Low birthweight was associated with smaller body build and lower lean mass and total body water in both females and males. In addition low birthweight was associated with central obesity and higher body fat percentage in females, even after taking into account current physical activity and socioeconomic status. Fasting plasma glucose, post load glucose and glycosylated haemoglobin were strongly and inversely correlated with birthweight. In those with low birthweight (< 2.5 kg), the risks for having impaired fasting glucose, impaired glucose tolerance, diabetes and all abnormalities combined were increased by 1.75, 2.22, 2.76 and 2.28 for females and by 1.40, 1.32, 1.98 and 1.49 for males compared to those with normal birthweight (≥ 2.5 kg), respectively. Low birthweight individuals were at higher risk for having high blood pressure ≥ 140/90 mmHg and ≥ 130/85 mmHg compared to those with normal birthweight. People with low birthweight showed a trend towards increased risk for high cholesterol (≥ 5.5 mmol/l) compared to those of normal birthweight. Females with low birthweight had increased risk for high low density lipoprotein cholesterol (≥ 3.5 mmol/l) and triglyceride levels (≥ 1.7 mmol/l) when compared to those with normal birthweight. Males with low birthweight exhibited increased risk for low levels of high density lipoprotein cholesterol (<0.9 mmol/l) than those with normal birthweight. Females with low birthweight were at least 1.39, 1.40, 2.30 and 1.47 times more likely to have angina, coronary artery disease, stroke and overall cardiovascular diseases respectively, compared to those ≥ 2.5 kg. Similarly, males with low birthweight were 1.76, 1.48, 3.34 and 1.70 times more likely to have angina, coronary artery disease, stroke and overall cardiovascular diseases compared to those ≥ 2.5 kg, respectively. The estimated glomerular filtration rate was strongly and positively associated with birthweight, with a predicted increase of 2.6 ml/min (CI 2.1, 3.2) and 3.8 (3.0, 4.5) for each kg of birthweight for females and males, respectively. The odd ratio (95% confidence interval) for low glomerular filtration rate (<61.0 ml/min for female and < 87.4 male) in people of low birthweight compared with those of normal birthweight was 2.04 (1.45, 2.88) for female and 3.4 (2.11, 5.36) for male. One hundred and eighty-nineCKD patients reported their birthweight; 106 were male. Their age was 60.3(15) years. Their birthweight was 3.27 (0.62) kg, vs 3.46 (0.6) kg for their AusDiab controls, p<0.001 and the proportions with birthweight<2.5 kg were 12.17% and 4.44%, p<0.001. Among CKD patients, 22.8%, 21.7%, 18% and 37.6% were in CKD stages 2, 3, 4 and 5 respectively. Birthweights by CKD stage and their AusDiab controls were as follows: 3.38 (0.52) vs 3.49 (0.52), p=0.251 for CKD2; 3.28 (0.54) vs 3.44 (0.54), p=0.121 for CKD3; 3.19 (0.72) vs 3.43 (0.56), p= 0.112 for CKD4 and 3.09 (0.65) vs 3.47 (0.67), p<0.001 for CKD5. The results demonstrate that in an affluent Western country with a good adult health profile, low birthweight people were predisposed to higher rates of glycaemic dysregulation, high blood pressure, dyslipidaemia, cardiovascular diseases and lower glomerular filtration rate in adult life. In all instances it would be prudent to adopt policies of intensified whole of life surveillance of lower birthweight people, anticipating this risk. The general public awareness of the effect of low birthweight on development of chronic diseases in later life is of vital importance. The general public, in addition to the awareness of people in medical practice of the role of low birthweight, will lead to a better management of this group of our population that is increasingly surviving into adulthood. birth weight birthweight birth weight and renal volume BIRTH WEIGHT QUESTIONNAIRE chronic disease Barker Hypothesis Foetal development DOHaD gestational age Anthropometric Characteristics body composition Height weight body mass index Waist Circumference hip circumference Waist-hip Ratio obesity Central Obesity Fatness Lean Body Mass Lean Mass Fat Mass body fat mass Body Fat Percentage body fatness Body Surface Area diabetes Fasting Glucose fasting insulin level glucose tolerance Impaired Fasting Glucose Impaired Glucose Tolerance Glycosylated Hemoglobin HbA1c IFG glucose control glycaemic control Metabolic Syndrome Syndrome X blood pressure Systolic Blood-pressure Diastolic Blood-pressure Systolic Hypertension high blood pressure Hypertension Dyslipidaemia Dyslipidemia Total Cholesterol Triglyceride Low Density Lipoprotein Cholesterol Ldl Cholesterol High Density Lipoprotein Hdl Cholesterol Fibrinogen angina Angina-pectoris Stroke coronary artery disease cardiovascular disease Framingham Framingham Heart Study Framingham Score coronary heart disease Glomerular Filtration glomerular filtration rate Glomerular Hyperfiltration Glomerular Injury Glomerular Number Nephrogenesis Nephron Endowment Nephron Number NKF-K/DQQI Classification Chronic Kidney Disease (ckd) Chronic Kidney Failure Kidney Failure CKD STAGES end-stage renal disease (ESRD) end-stage renal failure Cockcroft-gault MDRD formula Serum Creatinine Urinary Creatinine albuminuria Albuminuria:creatinine Ratio Kidney Development Kidney dysfunction low birth weight low birth weight Pre-term Birth AusDiab Study case control longitudinal observational study

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