6 research outputs found
Prediction Models for BMI and NAFLD
Nonalcoholic fatty liver disease (NAFLD) is closely associated with obesity. Disulfide bondâforming oxidoreductase Aâlike protein (DsbAâL) is known to be a key molecule in protection against obesity and obesityâinduced inflammation. In the present study, we used a modeling and simulation approach in an attempt to develop body mass index (BMI) and BMIâbased NAFLD prediction models incorporating the DsbAâL polymorphism to predict the BMI and NAFLD in 341 elderly subjects. A nonlinear mixedâeffect model best represented the sigmoidal relationship between the BMI and the logit function of the probability of NAFLD prevalence. The final models for BMI and NAFLD showed that DsbAâL rs1917760 polymorphism, age, and gender were associated with the BMI, whereas gender, patatinâlike phospholipase 3 rs738409 polymorphism, HbA1c, and highâdensity and lowâdensity lipoprotein cholesterol levels were associated with the risk of NAFLD. This information may aid in the geneticâbased prevention of obesity and NAFLD in the general elderly population
Influence of the PNPLA3 rs738409 Polymorphism on Non-Alcoholic Fatty Liver Disease and Renal Function among Normal Weight Subjects.
In normal weight subjects (body mass index < 25 kg/m2), non-alcoholic fatty liver disease (NAFLD) is likely to coexist with metabolic diseases. The patatin-like phospholipase 3 (PNPLA3) polymorphism rs738409 (c.444C>G) is associated with the risk of NAFLD and/or renal dysfunction; however, the influence of the weight status on the associations remains unknown. We aimed to clarify the associations of the PNPLA3 polymorphism with the risk of NAFLD and/or renal dysfunction, while also paying careful attention to the weight status of the subjects. Cross-sectional and retrospective longitudinal studies with 5.5 ± 1.1 years of follow-up were conducted in 740 and 393 Japanese participants (61.2 ± 10.5 and 67.5 ± 6.0 years), respectively, during a health screening program. Among 591 subjects who did not have a habitual alcohol intake and/or hepatitis B or C virus infections, the PNPLA3 G/G genotype was associated with the risk for NAFLD in normal weight subjects [odds ratio (95% CI): 3.06 (1.11-8.43), P < 0.05]. Among all subjects, carriers of the PNPLA3 G/G genotype with a normal weight had a lower eGFR than those of the C/C genotype [partial regression coefficient (SE): -3.26 (1.48), P < 0.05]. These associations were replicated in the longitudinal analyses. Among the overweight subjects, none of the genotypes were significantly associated in the cross-sectional and longitudinal analyses; however, the power of the analyses was small, especially in the analyses among overweight subjects. The findings of this study suggest that carriers of the PNPLA3 G/G genotype with a normal weight status should nevertheless be carefully monitored for the presence of NAFLD and/or renal dysfunction
Clinical characteristics of the subjects for the analyses regarding the risk of NAFLD.
<p>The data are the means ± standard deviation, median (range) for skewed variables, or the numbers of subjects (%) for categorical variables.</p><p><sup>a</sup> Fisherâs exact test.</p><p><sup>b</sup> MannâWhitney U test (otherwise, Studentâs t-test was used).</p><p>NAFLD, non-alcoholic fatty liver disease; BMI, body mass index; BP, blood pressure; eGFR, estimated glomerular filtration rate; LDL-C, low-density lipoprotein cholesterol; HDL-C, high-density lipoprotein cholesterol; TG, triglyceride; AST, aspartate aminotransferase; ALT, alanine aminotransferase; GGT, gamma-glutamyl transferase; PNPLA3, patatin-like phospholipase 3.</p><p>Clinical characteristics of the subjects for the analyses regarding the risk of NAFLD.</p
The longitudinal changes in the prevalence of NAFLD stratified by the <i>PNPLA3</i> genotype among normal weight subjects.
<p>The prevalence of NAFLD is shown as solid, dashed-dotted and dotted lines in the subjects with the <i>PNPLA3</i> C/C, C/G and G/G genotypes, respectively. NAFLD, non-alcoholic fatty liver disease; PNPLA3, patatin-like phospholipase 3.</p
Influence of the PNPLA3 rs738409 Polymorphism on Non-Alcoholic Fatty Liver Disease and Renal Function among Normal Weight Subjects
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Mechanical Cardiopulmonary Resuscitation and Hospital Survival Among Adult Patients With Nontraumatic OutâofâHospital Cardiac Arrest Attending the Emergency Department: A Prospective, Multicenter, Observational Study in Japan (SOSâKANTO [Survey of Survivors after OutâofâHospital Cardiac Arrest in Kanto Area] 2012 Study)
Background: Mechanical cardiopulmonary resuscitation (mCPR) for patients with outâofâhospital cardiac arrest attending the emergency department has become more widespread in Japan. The objective of this study is to determine the association between the mCPR in the emergency department and clinical outcomes. Methods and Results: In a prospective, multicenter, observational study, adult patients with outâofâhospital cardiac arrest with sustained circulatory arrest on hospital arrival were identified. The primary outcome was survival to hospital discharge. The secondary outcomes included a return of spontaneous circulation and successful hospital admission. Multivariate analyses adjusted for potential confounders and withinâinstitution clustering effects using a generalized estimation equation were used to analyze the association of the mCPR with outcomes. Between January 1, 2012 and March 31, 2013, 6537 patients with outâofâhospital cardiac arrest were eligible; this included 5619 patients (86.0%) in the manual CPR group and 918 patients (14.0%) in the mCPR group. Of those patients, 28.1% (1801/6419) showed return of spontaneous circulation in the emergency department, 20.4% (1175/5754) had hospital admission, 2.6% (168/6504) survived to hospital discharge, and 1.2% (75/6419) showed a favorable neurological outcome at 1 month after admission. Multivariate analyses revealed that mCPR was associated with a decreased likelihood of survival to hospital discharge (adjusted odds ratio, 0.40; 95% confidence interval, 0.20â0.78; P=0.005), return of spontaneous circulation (adjusted odds ratio, 0.71; 95% confidence interval, 0.53â0.94; P=0.018), and hospital admission (adjusted odds ratio, 0.57; 95% confidence interval, 0.40â0.80; P=0.001). Conclusions: After accounting for potential confounders, the mCPR in the emergency department was associated with decreased likelihoods of good clinical outcomes after adult nontraumatic outâofâhospital cardiac arrest. Further studies are needed to clarify circumstances in which mCPR may benefit these patients