Resting energy expenditure based on equation estimation can predict renal outcomes in patients with type 2 diabetes mellitus and biopsy-proven diabetic kidney disease

The aim of this study was to investigate the relationship between resting energy expenditure (REE) based on equation estimation and renal outcomes in patients with diabetes kidney disease (DKD). A total of 124 patients were enrolled from a retrospective cohort of Type 2 Diabetes mellitus (T2DM) patients with biopsy-proven DKD. Renal outcome defined as End-Stage Renal Disease (ESRD). To compare the predictive ability of different REE estimation equations on ESRD. Patients’ REE was assessed according to the estimating equation with the best predictive power, and then the relationship between REE and ESRD risk was fitted using a restricted cubic spline curve (RCS) plot and REE cutoff values were obtained. Grouping using cutoff values, and ultimately evaluate the relationship between REE and the risk of ESRD using a Multivariate Cox regression model. The strongest predictive validity for renal outcomes was the NDCKD-equation. The patients were divided into the higher-REE group (n = 78) and the lower-REE group (n = 46), based on the cutoff value. During the follow-up, 30 of 124 patients (24.2%) proceeded to ESRD. Multivariate Cox regression models showed that the risk of ESRD in patients with lower REE was 6.08 times increased compared with that in those with higher REE (HR = 6.08; 95% CI, 1.28–28.80, p = 0.023). These findings suggested that the lower REE was an independent risk factor for unfavorable renal outcomes in patients with DKD.</p

Table_1_Family functioning and delinquency among Chinese adolescents: Mediating effects of positive behavior recognition according to the humanistic perspective.docx

BackgroundEmpirical research on the relationship between family functioning and delinquency has been sparse, although many studies have focused on the influence of family functioning on adolescent development. The current research aimed to fill this gap by exploring the influences of family functioning on adolescent delinquency and the mechanisms connecting the processes.MethodsWe derived the baseline data from a prospective observational school-based cohort Chengdu Positive Child Development (CPCD) project. Students responded to a questionnaire containing validated measures of family functioning, positive behavior recognition, and delinquent behavior. We utilized structural equation modeling and maximum likelihood estimation to test the relationships.ResultsAcross 8811 Chinese adolescents, the incidence of delinquency behaviors among Chinese adolescents was relatively low. Family functioning and positive behavior recognition negatively predict delinquency (p ConclusionsThis study demonstrated that family functioning was a protective factor against adolescent delinquency and revealed that positive behavior recognition was a critical mediating mechanism linking family functioning to delinquency.</p

Table_3_Family functioning and delinquency among Chinese adolescents: Mediating effects of positive behavior recognition according to the humanistic perspective.docx

BackgroundEmpirical research on the relationship between family functioning and delinquency has been sparse, although many studies have focused on the influence of family functioning on adolescent development. The current research aimed to fill this gap by exploring the influences of family functioning on adolescent delinquency and the mechanisms connecting the processes.MethodsWe derived the baseline data from a prospective observational school-based cohort Chengdu Positive Child Development (CPCD) project. Students responded to a questionnaire containing validated measures of family functioning, positive behavior recognition, and delinquent behavior. We utilized structural equation modeling and maximum likelihood estimation to test the relationships.ResultsAcross 8811 Chinese adolescents, the incidence of delinquency behaviors among Chinese adolescents was relatively low. Family functioning and positive behavior recognition negatively predict delinquency (p ConclusionsThis study demonstrated that family functioning was a protective factor against adolescent delinquency and revealed that positive behavior recognition was a critical mediating mechanism linking family functioning to delinquency.</p

Table_2_Family functioning and delinquency among Chinese adolescents: Mediating effects of positive behavior recognition according to the humanistic perspective.docx

BackgroundEmpirical research on the relationship between family functioning and delinquency has been sparse, although many studies have focused on the influence of family functioning on adolescent development. The current research aimed to fill this gap by exploring the influences of family functioning on adolescent delinquency and the mechanisms connecting the processes.MethodsWe derived the baseline data from a prospective observational school-based cohort Chengdu Positive Child Development (CPCD) project. Students responded to a questionnaire containing validated measures of family functioning, positive behavior recognition, and delinquent behavior. We utilized structural equation modeling and maximum likelihood estimation to test the relationships.ResultsAcross 8811 Chinese adolescents, the incidence of delinquency behaviors among Chinese adolescents was relatively low. Family functioning and positive behavior recognition negatively predict delinquency (p ConclusionsThis study demonstrated that family functioning was a protective factor against adolescent delinquency and revealed that positive behavior recognition was a critical mediating mechanism linking family functioning to delinquency.</p

Table_1_Lower bile acids as an independent risk factor for renal outcomes in patients with type 2 diabetes mellitus and biopsy-proven diabetic kidney disease.docx

AimsAbnormalities of glucolipid metabolism are critical mechanisms involved in the progression of diabetic kidney disease (DKD). Bile acids have an essential role in regulating glucolipid metabolism. This study investigated the clinicopathological characteristics of DKD patients with different bile acid levels and explored the relationship between bile acids and renal outcomes of DKD patients.MethodsWe retrospectively reviewed and evaluated the histopathological features and clinical features of our cohort of 184 patients with type 2 diabetes mellitus and biopsy-proven DKD. Patients were divided into the lower bile acids group (≤2.8 mmol/L) and higher bile acids group (>2.8 mmol/L) based on the cutoff value of bile acids obtained using the time-dependent receiver-operating characteristic curve. Renal outcomes were defined as end-stage renal disease (ESRD). The influence of bile acids on renal outcomes and correlations between bile acids and clinicopathological indicators were evaluated.ResultsBile acids were positively correlated with age (r = 0.152; P = 0.040) and serum albumin (r = 0.148; P = 0.045) and negatively correlated with total cholesterol (r = -0.151; P = 0.041) and glomerular class (r = -0.164; P =0.027). During follow-up, 64 of 184 patients (34.78%) experienced progression to ESRD. Lower levels of proteinuria, serum albumin, and bile acids were independently associated with an increased risk of ESRD (hazard ratio, R=5.319; 95% confidence interval, 1.208–23.425).ConclusionsBile acids are an independent risk factor for adverse renal outcomes of DKD patients. The serum level of bile acids should be maintained at more than 2.8 mmol/L in DKD patients. Bile acid analogs or their downstream signaling pathway agonists may offer a promising strategy for treating DKD.</p

Image_1_Lower bile acids as an independent risk factor for renal outcomes in patients with type 2 diabetes mellitus and biopsy-proven diabetic kidney disease.tif

AimsAbnormalities of glucolipid metabolism are critical mechanisms involved in the progression of diabetic kidney disease (DKD). Bile acids have an essential role in regulating glucolipid metabolism. This study investigated the clinicopathological characteristics of DKD patients with different bile acid levels and explored the relationship between bile acids and renal outcomes of DKD patients.MethodsWe retrospectively reviewed and evaluated the histopathological features and clinical features of our cohort of 184 patients with type 2 diabetes mellitus and biopsy-proven DKD. Patients were divided into the lower bile acids group (≤2.8 mmol/L) and higher bile acids group (>2.8 mmol/L) based on the cutoff value of bile acids obtained using the time-dependent receiver-operating characteristic curve. Renal outcomes were defined as end-stage renal disease (ESRD). The influence of bile acids on renal outcomes and correlations between bile acids and clinicopathological indicators were evaluated.ResultsBile acids were positively correlated with age (r = 0.152; P = 0.040) and serum albumin (r = 0.148; P = 0.045) and negatively correlated with total cholesterol (r = -0.151; P = 0.041) and glomerular class (r = -0.164; P =0.027). During follow-up, 64 of 184 patients (34.78%) experienced progression to ESRD. Lower levels of proteinuria, serum albumin, and bile acids were independently associated with an increased risk of ESRD (hazard ratio, R=5.319; 95% confidence interval, 1.208–23.425).ConclusionsBile acids are an independent risk factor for adverse renal outcomes of DKD patients. The serum level of bile acids should be maintained at more than 2.8 mmol/L in DKD patients. Bile acid analogs or their downstream signaling pathway agonists may offer a promising strategy for treating DKD.</p

Graft survival for patients with different histological causes of proteinuria.

<p>IgAN has the best graft outcome, with a 5-year graft survival of 71.1%, while graft survival was very poor in patients with TG, TA/IF, and CR. TG, transplant glomerulopathy; IgAN, IgA nephropathy; AR, acute rejection; CR, chronic rejection; TA/IF, tubular atrophy and interstitial fibrosis; FSGS, Focal segmental glomerulosclerosis.</p

Histologic findings of patients with different histologies.

*<p>, p<0.05 vs AR group;</p>#<p>, p<0.05 vs IgAN group.</p

Risk factors correlated with the graft survival in patients with post-transplant proteinuria.

<p>Degrees of interstitial inflammation (A) and renal tubular atrophy (B) and levels of hemoglobin (C) were strongly correlated with graft survival. i 0–3, mononuclear cell interstitial inflammation grade 0–3; ct 0–3, tubular atrophy grade 0–3. <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0036654#pone.0036654-Racusen2" target="_blank">[21]</a></p

Definition of the diagnosis terms.

<p>Definition of the diagnosis terms.</p