Nonalbuminuric Renal Impairment in Type 2 Diabetic Patients and in the General Population (National Evaluation of the Frequency of Renal Impairment cO-existing with NIDDM [NEFRON] 11)

OBJECTIVE Most diabetic patients with impaired renal function have a urinary albumin excretion rate in the normal range. In these patients, the etiology of renal impairment is unclear, and it is also unclear whether this nonalbumunuric renal impairment is unique to diabetes. RESEARCH DESIGN AND METHODS In this study, we examined the frequency and predictors of nonalbumunuric renal impairment (estimated glomerular filtration rate [eGFR] <60 ml/min per 1.73 m(2)) in a nationally representative cohort of 3,893 patients with type 2 diabetes and compared our findings with rates observed in the general population from the Australian Diabetes, Obesity and Lifestyle Study (AusDiab) survey (n = 11,247). RESULTS Of the 23.1% of individuals with type 2 diabetes who had eGFR <60 ml/min per 1.73 m(2) (95% CI 21.8-24.5%), more than half (55%) had a urinary albumin excretion rate that was persistently in the normal range. This rate of renal impairment was predictably higher than that observed in the general population (adjusted odds ratio 1.3, 95% CI 1.1-1.5, P < 0.01) but was solely due to chronic kidney disease associated with albuminuria. In contrast, renal impairment in the absence of albuminuria was less common in those with diabetes than in the general population, independent of sex, ethnicity, and duration of diabetes (0.6, 0.5-0.7, P < 0.001). CONCLUSIONS Nonalbuminuric renal impairment is not more common in those with diabetes. However, its impact may be more significant. New studies are required to address the pathogenesis, prevention, and treatment of nonalbuminuric renal disease

Aging in a Two-Dimensional Ising Model with Dipolar Interactions

Aging in a two-dimensional Ising spin model with both ferromagnetic exchange and antiferromagnetic dipolar interactions is established and investigated via Monte Carlo simulations. The behaviour of the autocorrelation function $C(t,t_w)$ is analyzed for different values of the temperature, the waiting time $t_w$ and the quotient $\delta=J_0/J_d$, $J_0$ and $J_d$ being the strength of exchange and dipolar interactions respectively. Different behaviours are encountered for $C(t,t_w)$ at low temperatures as $\delta$ is varied. Our results show that, depending on the value of $\delta$, the dynamics of this non-disordered model is consistent either with a slow domain dynamics characteristic of ferromagnets or with an activated scenario, like that proposed for spin glasses.Comment: 4 pages, RevTex, 5 postscript figures; acknowledgment added and some grammatical corrections in caption

New Dynamic Monte Carlo Renormalization Group Method

The dynamical critical exponent of the two-dimensional spin-flip Ising model is evaluated by a Monte Carlo renormalization group method involving a transformation in time. The results agree very well with a finite-size scaling analysis performed on the same data. The value of $z = 2.13 \pm 0.01$ is obtained, which is consistent with most recent estimates

Analytical and computational study of magnetization switching in kinetic Ising systems with demagnetizing fields

An important aspect of real ferromagnetic particles is the demagnetizing field resulting from magnetostatic dipole-dipole interaction, which causes large particles to break up into domains. Sufficiently small particles, however, remain single-domain in equilibrium. This makes such small particles of particular interest as materials for high-density magnetic recording media. In this paper we use analytic arguments and Monte Carlo simulations to study the effect of the demagnetizing field on the dynamics of magnetization switching in two-dimensional, single-domain, kinetic Ising systems. For systems in the ``Stochastic Region,'' where magnetization switching is on average effected by the nucleation and growth of fewer than two well-defined critical droplets, the simulation results can be explained by the dynamics of a simple model in which the free energy is a function only of magnetization. In the ``Multi-Droplet Region,'' a generalization of Avrami's Law involving a magnetization-dependent effective magnetic field gives good agreement with our simulations.Comment: 29 pages, REVTeX 3.0, 10 figures, 2 more figures by request. Submitted Phys. Rev.

A Monte Carlo study of the three-dimensional Coulomb frustrated Ising ferromagnet

We have investigated by Monte-Carlo simulation the phase diagram of a three-dimensional Ising model with nearest-neighbor ferromagnetic interactions and small, but long-range (Coulombic) antiferromagnetic interactions. We have developed an efficient cluster algorithm and used different lattice sizes and geometries, which allows us to obtain the main characteristics of the temperature-frustration phase diagram. Our finite-size scaling analysis confirms that the melting of the lamellar phases into the paramgnetic phase is driven first-order by the fluctuations. Transitions between ordered phases with different modulation patterns is observed in some regions of the diagram, in agreement with a recent mean-field analysis.Comment: 14 pages, 10 figures, submitted to Phys. Rev.

Dietary Salt Intake and Mortality in Patients With Type 2 Diabetes

OBJECTIVE: Many guidelines recommend that patients with type 2 diabetes should aim to reduce their intake of salt. However, the precise relationship between dietary salt intake and mortality in patients with type 2 diabetes has not been previously explored. RESEARCH DESIGN AND METHODS: Six hundred and thirty-eight patients attending a single diabetes clinic were followed in a prospective cohort study. Baseline sodium excretion was estimated from 24-h urinary collections (24hU(Na)). The predictors of all-cause and cardiovascular mortality were determined by Cox regression and competing risk modeling, respectively. RESULTS: The mean baseline 24hU(Na) was 184 ± 73 mmol/24 h, which remained consistent throughout the follow-up (intraindividual coefficient of variation [CV] 23 ± 11%). Over a median of 9.9 years, there were 175 deaths, 75 (43%) of which were secondary to cardiovascular events. All-cause mortality was inversely associated with 24hU(Na), after adjusting for other baseline risk factors (P < 0.001). For every 100 mmol rise in 24hU(Na), all-cause mortality was 28% lower (95% CI 6-45%, P = 0.02). After adjusting for the competing risk of noncardiovascular death and other predictors, 24hU(Na) was also significantly associated with cardiovascular mortality (sub-hazard ratio 0.65 [95% CI 0.44-0.95]; P = 0.03). CONCLUSIONS: In patients with type 2 diabetes, lower 24-h urinary sodium excretion was paradoxically associated with increased all-cause and cardiovascular mortality. Interventional studies are necessary to determine if dietary salt has a causative role in determining adverse outcomes in patients with type 2 diabetes and the appropriateness of guidelines advocating salt restriction in this setting

Phase diagram of an Ising model with long-range frustrating interactions: a theoretical analysis

We present a theoretical study of the phase diagram of a frustrated Ising model with nearest-neighbor ferromagnetic interactions and long-range (Coulombic) antiferromagnetic interactions. For nonzero frustration, long-range ferromagnetic order is forbidden, and the ground-state of the system consists of phases characterized by periodically modulated structures. At finite temperatures, the phase diagram is calculated within the mean-field approximation. Below the transition line that separates the disordered and the ordered phases, the frustration-temperature phase diagram displays an infinite number of ``flowers'', each flower being made by an infinite number of modulated phases generated by structure combination branching processes. The specificities introduced by the long-range nature of the frustrating interaction and the limitation of the mean-field approach are finally discussed.Comment: 32 pages, 7 figure

Violation of the fluctuation-dissipation theorem in glassy systems: basic notions and the numerical evidence

This review reports on the research done during the past years on violations of the fluctuation-dissipation theorem (FDT) in glassy systems. It is focused on the existence of a quasi-fluctuation-dissipation theorem (QFDT) in glassy systems and the currently supporting knowledge gained from numerical simulation studies. It covers a broad range of non-stationary aging and stationary driven systems such as structural-glasses, spin-glasses, coarsening systems, ferromagnetic models at criticality, trap models, models with entropy barriers, kinetically constrained models, sheared systems and granular media. The review is divided into four main parts: 1) An introductory section explaining basic notions related to the existence of the FDT in equilibrium and its possible extension to the glassy regime (QFDT), 2) A description of the basic analytical tools and results derived in the framework of some exactly solvable models, 3) A detailed report of the current evidence in favour of the QFDT and 4) A brief digression on the experimental evidence in its favour. This review is intended for inexpert readers who want to learn about the basic notions and concepts related to the existence of the QFDT as well as for the more expert readers who may be interested in more specific results.Comment: 120 pages, 37 figures. Topical review paper . Several typos and misprints corrected, new references included and others updated. to be published in J. Phys. A (Math. Gen.

Estimating glomerular filtration rate in diabetes: a comparison of cystatin-C-and creatinine-based methods

Abstract Aims/hypothesis: We compared the predictive performance of a GFR based on serum cystatin C levels with commonly used creatinine-based methods in subjects with diabetes. Subjects, materials and methods: In a crosssectional study of 251 consecutive clinic patients, the mean reference (plasma clearance of 99m Tc-diethylene-triaminepenta-acetic acid) GFR (iGFR) was 88±2 ml min . A regression equation describing the relationship between iGFR and 1/cystatin C levels was derived from a test population (n=125) to allow for the estimation of GFR by cystatin C (eGFR-cystatin C). The predictive performance of eGFR-cystatin C, the Modification of Diet in Renal Disease 4 variable formula (MDRD-4) and Cockcroft-Gault (C-G) formulas were then compared in a validation population (n=126). Results: There was no difference in renal function (ml min −1 1.73 m −