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Showing 451 to 458 of 458 (0.034 seconds)Spelling suggestions: "subject:"hemoglobin A"" "subject:"1emoglobin A""
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Oxidační a karbonylový stres u onemocnění ledvin / Oxidative and carbonyl stress in kidney diseasesKratochvílová, Markéta January 2016 (has links)
Aims: 1. Determination of AGEs (Advanced Glycation End products) in patients with various types of nephropathy. 2. Association AGEs with nutritional parameters and anemia. 3. Influence of renal parameters on sRAGE (soluble form of Receptor for Advanced Glycation End products) levels. 4. Technics and proceeding methods of the podocytes cultivation. 5. Determination of urine podocytes. Methods: We determined fluorescent AGEs by spectrofluorometry, sRAGE by Enzyme-Linked ImmunoSorbent Assay (ELISA). Podocytes were passaged and identified immunocytochemically. Podocytes in urine were specified by flow cytometry method. Results: 1. We did not find significant differences in AGEs serum levels among various types of nephropathy, even though the pathogenesis differs. 2. The albumin and prealbumin levels positively and haemoglobin levels negatively correlate with AGEs in patients with CKD grade 1-5, without necessity of dialysis. 3. Serum sRAGE levels are increased in patients with decreased renal function independently on the course of renal disease. 4. We implemented the methods and technics of podocyte cultivation. 5. Urine podocytes observation and confirmation that podocyturia relates to disease activity. Conclusion: We confirmed that AGEs serum levels depend more on renal function than the type of...
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| 452 |
Oxidační a karbonylový stres u onemocnění ledvin / Oxidative and carbonyl stress in kidney diseasesKratochvílová, Markéta January 2016 (has links)
Aims: 1. Determination of AGEs (Advanced Glycation End products) in patients with various types of nephropathy. 2. Association AGEs with nutritional parameters and anemia. 3. Influence of renal parameters on sRAGE (soluble form of Receptor for Advanced Glycation End products) levels. 4. Technics and proceeding methods of the podocytes cultivation. 5. Determination of urine podocytes. Methods: We determined fluorescent AGEs by spectrofluorometry, sRAGE by Enzyme-Linked ImmunoSorbent Assay (ELISA). Podocytes were passaged and identified immunocytochemically. Podocytes in urine were specified by flow cytometry method. Results: 1. We did not find significant differences in AGEs serum levels among various types of nephropathy, even though the pathogenesis differs. 2. The albumin and prealbumin levels positively and haemoglobin levels negatively correlate with AGEs in patients with CKD grade 1-5, without necessity of dialysis. 3. Serum sRAGE levels are increased in patients with decreased renal function independently on the course of renal disease. 4. We implemented the methods and technics of podocyte cultivation. 5. Urine podocytes observation and confirmation that podocyturia relates to disease activity. Conclusion: We confirmed that AGEs serum levels depend more on renal function than the type of...
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| 453 |
Behavioral Activity and Hypoxia Tolerance of African Weakly Electric FishMucha, Stefan 16 February 2023 (has links)
In dieser Arbeit wurden die Morpho-Physiologie und das Verhalten zweier Arten Afrikanischer schwach elektrischer Fische, Marcusenius victoriae und Petrocephalus degeni, im Labor und in einem ihrer natürlichen Habitate im Lwamunda Sumpf in Uganda untersucht. Die zwei Hauptziele dieser Arbeit waren (i) tageszeitabhängige Verhaltensrhythmen (Aktivität, Habitatnutzung) im Labor und im Freiland zu untersuchen und (ii) die Ausprägung und Plastizität der morpho-physiologischen Merkmale von P. degeni zu untersuchen, die ihnen erlauben bei natürlich vorkommender, geringer Sauerstoffverfügbarkeit (Hypoxie) zu überleben.
Tageszeitabhängige Verhaltensrhythmen beider Arten wurden im Labor über 42 Stunden und im natürlichen Habitat dieser Fische für sechs Tage erfasst. In den Laborversuchen verbrachten beide Arten tagsüber annähernd 100% der Zeit in einem bereitgestellten Versteck und schwammen nachts heraus um aktiv ihre Umwelt zu erkunden. Im Habitat wurden die meisten Fische in strukturell komplexen Habitaten unter schwimmenden Pflanzen detektiert. Nachts schwammen die Fische aktiv in die offenen und ungeschützten Bereiche der Lagune, vermutlich um nach Futter zu suchen und zu interagieren. Die Begleitende in-situ Messung der Sauerstoffverfügbarkeit zeigte, dass beide Arten präsent und vermutlich sogar am aktivsten waren während Phasen extremer nächtlicher Hypoxie.
Zur Untersuchung der respiratorischen Merkmale von P. degeni wurden Respirometrieversuche mit hypoxie-akklimatisierten Tieren durchgeführt, Hämoglobin- und Laktatkonzentration im Blut gemessen, und morphologische Parameter an den ersten beiden Kiemenbögen erfasst. Die Fische zeigten niedrige Sauerstoffverbrauchsraten, welche sie bis zu einem sehr niedrigem äußeren Sauerstoffpartialdruck aufrechterhielten. Zusätzlich zeigten sie hohe Hämoglobin- und Laktatkonzentrationen im Blut. Bis zu 75 Tage Normoxie-Akklimatisierung führte zu reduzierter Hämoglobinkonzentration und kürzeren Kiemenfilamenten. / In this thesis, I investigated the morpho-physiology and behavior of two species of African mormyrid weakly electric fish, Marcusenius victoriae and Petrocephalus degeni, in the laboratory and in one of their natural habitats, the Lwamunda Swamp in Uganda. The two main objectives of this work were to (i) observe behavioral rhythms and habitat use patterns of both species under natural and laboratory conditions, and (ii) assess expression and plasticity of morpho-physiological traits that might enable P. degeni to survive naturally occurring low oxygen conditions (hypoxia).
Behavioral rhythms were recorded in the laboratory over 42 hours and in the habitat on six sampling days. In the laboratory, both species spent close to 100% of the time in their shelter during the day and actively explore their environment at night. In the swamp lagoon, fish were most often encountered in structurally complex habitats under floating vegetation and ventured into open and unsheltered areas of the lagoon at night, presumably to forage and interact. Concomitant in-situ oxygen measurements revealed that these fish were present, and presumably most active during periods of extreme nocturnal hypoxia in their swamp habitat.
To investigate respiratory traits of swamp-dwelling P. degeni, I conducted respirometry experiments and measured blood lactate and hemoglobin and gill morphometrics on the first two gill arches. Fish showed low routine oxygen consumption rates, which they maintained until a very low ambient oxygen partial pressure was reached. Additionally, they had high concentrations of hemoglobin and lactate in their blood. Up to 75 days of normoxia exposure reduced blood hemoglobin and gill filament length.
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| 454 |
N-Terminale Glykierung von Proteinen in Lebensmitteln und unter physiologischen BedingungenLöbner, Jürgen 06 March 2018 (has links) (PDF)
Kohlenhydrate und Proteine gehören neben Wasser und Fetten zu den quantitativ bedeutendsten Grundbestandteilen biologischer Systeme und der Lebensmittel. Unter milden Bedingungen in lebenden Organismen oder unter thermischer Belastung bei der Lebensmittelverarbeitung können reduzierende Kohlenhydrate amin-katalysiert durch die Abspaltung von Wasser und Fragmentierungen des Kohlenstoffgerüsts abgebaut werden, wobei die noch reaktiveren 1,2-Dicarbonylverbindungen entstehen. Aus der Reaktion der N-α-Aminogruppe und funktioneller Gruppen der Seitenketten von Aminosäuren mit Kohlenhydraten bzw. 1,2-Dicarbonylverbindungen können stabile Endprodukte entstehen.
In vivo können proteingebundene Maillard-Produkte (MRPs) aus der Reaktion mit Glucose (Amadori-Produkte) oder 1,2-Dicarbonylverbindungen (Advanced Glycation Endproducts: AGEs) entstehen. Beispielsweise ist das „N-terminale“ N-α-Fructosylderivat der β-Kette des Hämoglobins ein etablierter Parameter zur Diagnose von Diabetes mellitus (HbA1c-Wert). Diese nicht-enzymatische, posttranslationale Modifizierung von Proteinen wird allgemein als Glykierung bezeichnet und kann die Funktionalität von Proteinen beeinträchtigen. Deshalb wird untersucht, ob die Trübung der Augenlinsen, die Versteifung von Blutgefäßen oder Schädigungen von Nervenzellen durch eine erhöhte Glykierung verursacht werden. Diese Veränderungen treten im Alter und bei Stoffwechselkrankheiten wie Diabetes mellitus und Urämie auf, die durch eine erhöhte Glucosekonzentration bzw. die Anreicherung von 1,2-Dicarbonylverbindungen im Blut gekennzeichnet sind. Zwar gibt es Publikationen zum Vorkommen N-terminaler Amadori-Produkte an Hämoglobin und in Lebensmitteln, aber die Bildung N-terminaler AGEs wurde bisher nur in wenigen Studien untersucht. Deshalb waren die Bildung und das Vorkommen N-terminaler AGEs im physiologischen Modell, in Hämoglobin und in Backwaren Gegenstand der vorliegenden Arbeit.
In der vorliegenden Arbeit wurde erstmals systematisch die Sequenzabhängigkeit der Bildung der Fructosylderivate bzw. der CM-Derivate in Konkurrenz zu den Glyoxal-2(1H)-Pyrazinonen am N-Terminus von Peptiden unter physiologischen und backtechnologischen Bedingungen untersucht. Dabei wurde nachgewiesen, dass die Variation der C-terminalen Aminosäure in Dipeptiden den Glykierungsgrad und das Produktspektrum erheblich beeinflusst. Mit dem konsequenten Nachweis der N-terminalen von Glyoxal und Methylglyoxal ableitbaren Carboxyalkylderivate und 2(1H)-Pyrazinone in humanen Hämoglobin wurde die Relevanz der N-terminalen Glykierung in vivo untermauert. Damit wird eine umfassendere Beurteilung des Dicarbonylstresses und der Glykierung insbesondere bei Urämikern und Diabetikern ermöglicht. Am Beispiel von Backwaren wurde für Lebensmittel gezeigt, dass unter trockenen Reaktionsbedingungen die 2(1H)-Pyrazinone und in wasserhaltigen Systemen die Carboxyalkylderivate bevorzugt zu erwarten sind.
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| 455 |
N-Terminale Glykierung von Proteinen in Lebensmitteln und unter physiologischen BedingungenLöbner, Jürgen 26 January 2018 (has links)
Kohlenhydrate und Proteine gehören neben Wasser und Fetten zu den quantitativ bedeutendsten Grundbestandteilen biologischer Systeme und der Lebensmittel. Unter milden Bedingungen in lebenden Organismen oder unter thermischer Belastung bei der Lebensmittelverarbeitung können reduzierende Kohlenhydrate amin-katalysiert durch die Abspaltung von Wasser und Fragmentierungen des Kohlenstoffgerüsts abgebaut werden, wobei die noch reaktiveren 1,2-Dicarbonylverbindungen entstehen. Aus der Reaktion der N-α-Aminogruppe und funktioneller Gruppen der Seitenketten von Aminosäuren mit Kohlenhydraten bzw. 1,2-Dicarbonylverbindungen können stabile Endprodukte entstehen.
In vivo können proteingebundene Maillard-Produkte (MRPs) aus der Reaktion mit Glucose (Amadori-Produkte) oder 1,2-Dicarbonylverbindungen (Advanced Glycation Endproducts: AGEs) entstehen. Beispielsweise ist das „N-terminale“ N-α-Fructosylderivat der β-Kette des Hämoglobins ein etablierter Parameter zur Diagnose von Diabetes mellitus (HbA1c-Wert). Diese nicht-enzymatische, posttranslationale Modifizierung von Proteinen wird allgemein als Glykierung bezeichnet und kann die Funktionalität von Proteinen beeinträchtigen. Deshalb wird untersucht, ob die Trübung der Augenlinsen, die Versteifung von Blutgefäßen oder Schädigungen von Nervenzellen durch eine erhöhte Glykierung verursacht werden. Diese Veränderungen treten im Alter und bei Stoffwechselkrankheiten wie Diabetes mellitus und Urämie auf, die durch eine erhöhte Glucosekonzentration bzw. die Anreicherung von 1,2-Dicarbonylverbindungen im Blut gekennzeichnet sind. Zwar gibt es Publikationen zum Vorkommen N-terminaler Amadori-Produkte an Hämoglobin und in Lebensmitteln, aber die Bildung N-terminaler AGEs wurde bisher nur in wenigen Studien untersucht. Deshalb waren die Bildung und das Vorkommen N-terminaler AGEs im physiologischen Modell, in Hämoglobin und in Backwaren Gegenstand der vorliegenden Arbeit.
In der vorliegenden Arbeit wurde erstmals systematisch die Sequenzabhängigkeit der Bildung der Fructosylderivate bzw. der CM-Derivate in Konkurrenz zu den Glyoxal-2(1H)-Pyrazinonen am N-Terminus von Peptiden unter physiologischen und backtechnologischen Bedingungen untersucht. Dabei wurde nachgewiesen, dass die Variation der C-terminalen Aminosäure in Dipeptiden den Glykierungsgrad und das Produktspektrum erheblich beeinflusst. Mit dem konsequenten Nachweis der N-terminalen von Glyoxal und Methylglyoxal ableitbaren Carboxyalkylderivate und 2(1H)-Pyrazinone in humanen Hämoglobin wurde die Relevanz der N-terminalen Glykierung in vivo untermauert. Damit wird eine umfassendere Beurteilung des Dicarbonylstresses und der Glykierung insbesondere bei Urämikern und Diabetikern ermöglicht. Am Beispiel von Backwaren wurde für Lebensmittel gezeigt, dass unter trockenen Reaktionsbedingungen die 2(1H)-Pyrazinone und in wasserhaltigen Systemen die Carboxyalkylderivate bevorzugt zu erwarten sind.
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| 456 |
BIRTHWEIGHT AND SUSCEPTIBILITY TO CHRONIC DISEASEIssa 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.
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| 457 |
BIRTHWEIGHT AND SUSCEPTIBILITY TO CHRONIC DISEASEIssa 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.
|
| 458 |
BIRTHWEIGHT AND SUSCEPTIBILITY TO CHRONIC DISEASEIssa 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.
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