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Serum magnesium, mortality, and cardiovascular disease in chronic kidney disease and end-stage renal disease patients: a systematic review and meta-analysis.
Xiong, J, He, T, Wang, M, Nie, L, Zhang, Y, Wang, Y, Huang, Y, Feng, B, Zhang, J, Zhao, J
Journal of nephrology. 2019;(5):791-802
Abstract
BACKGROUND Previous studies reported that magnesium deficiency was associated with vascular calcifications, atherosclerosis and cardiovascular disease, which might play an independent pathogenic role in chronic kidney disease (CKD) and end-stage renal disease (ESRD) patients. However, the results of these studies were somewhat underpowered and inconclusive. METHODS Literature was identified by searching PubMed, EMBASE, Web of Science and the Cochrane Central Register of Controlled Trials (CENTRAL). We included studies that investigated the association between serum magnesium with mortality risk in CKD and ESRD patients. Unadjusted and adjusted hazard ratios (HRs) with 95% confidence intervals (95% CIs) were pooled. RESULTS Twenty studies involving 200,934 participants were included, and the results showed that there was a strong association between hypomagnesemia and the risk of all-cause mortality in patients with CKD and ESRD (HR 1.32; 95% CI 1.19-1.47; p < 0.00001) (hypomagnesemia vs. normal magnesium or hypermagnesemia) after multivariable adjusted. On the contrary, hypermagnesemia was inversely associated with all-cause mortality in patients with CKD and ESRD (HR 0.86; 95% CI 0.79-0.94; p = 0.001) (per unit increase). Moreover, a significant association between hypermagnesemia and decreased risk of cardiovascular mortality was observed (HR 0.71; 95% CI 053-0.97, p = 0.03) in the adjusted model. In addition, subgroup analysis found that hypomagnesemia was strongly associated with increased all-cause mortality in hemodialysis patients (HR 1.29; 95% CI 1.12-1.50; p = 0.0005) (hypomagnesemia vs. normal magnesium or hypermagnesemia). CONCLUSIONS Our results indicate that hypomagnesemia is significantly associated with cardiovascular and all-cause mortality in patients with CKD and ESRD. Further studies evaluating benefits of magnesium correction in CKD and dialysis patients with hypomagnesemia should be performed.
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Circulating Proprotein Convertase Subtilisin/Kexin Type 9 (PCSK9) Concentration and Risk of Cardiovascular Events - Systematic Review and Meta-Analysis of Prospective Studies.
Xiao, Y, Peng, C, Huang, W, Zhang, J, Gao, Y, Kim, JH, Yeoh, EK, Su, X
Circulation journal : official journal of the Japanese Circulation Society. 2017;(8):1150-1157
Abstract
BACKGROUND Previous studies have not found a consistent association between circulating proprotein convertase subtilisin/kexin type 9 (PCSK9) and the risk of cardiovascular events. The aim of this meta-analysis was to evaluate this association in prospective studies.Methods and Results:A systematic search of prospective studies published through October 2016 was carried out in order to identify studies that met pre-specified inclusion criteria. After independent data extraction, summary relative risks were calculated using random-effects models. On meta-analysis of 6 cohort and 1 nested case-control study, circulating PCSK9 concentration as a continuous variable was not significantly associated with the risk of cardiovascular events (overall RR, 1.12; 95% CI: 0.98-1.29; P=0.09), with significant heterogeneity (I2=55.1%, Pheterogeneity=0.038). The highest but not middle categories of circulating PCSK9 was significantly associated with the risk of cardiovascular events. On subgroup analysis of study design, mean age at baseline, sample size, follow-up time, and pre-existing disease, there was no significant association between PCSK9 and cardiovascular events. Sensitivity analysis with various exclusion and inclusion criteria did not materially change the results. CONCLUSIONS Circulating PCSK9 concentration as a continuous variable was not significantly associated with the risk of cardiovascular events. More well-designed studies are needed to clarify the role of PCSK9 in cardiovascular risk.
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Salt sales survey: a simplified, cost-effective method to evaluate population salt reduction programs--a cluster-randomized trial.
Ma, Y, He, FJ, Li, N, Hao, J, Zhang, J, Yan, LL, Wu, Y
Hypertension research : official journal of the Japanese Society of Hypertension. 2016;(4):254-9
Abstract
Twenty-four-hour urine collection, as a gold standard method of measuring salt intake, is costly and resource consuming, which limits its use in monitoring population salt reduction programs. Our study aimed to determine whether a salt sales survey could serve as an alternative method. This was a substudy of China Rural Health Initiative-Sodium Reduction Study (CRHI-SRS), in which 120 villages were randomly allocated (1:1:2) into a price subsidy+health education (PS+HE) group, a HE-only group or a control group. Salt substitutes (SS) were supplied to shops in the intervention groups; 24-h urine was collected from 2567 randomly selected adults at the end of the trial to evaluate the effects of the intervention. Ten villages were randomly selected from each group (that is, 30 villages in total), and 166 shops from these villages were invited to participate in the monthly salt sales survey. The results showed that during the intervention period, mean monthly sales of SS per shop were 38.0 kg for the PS+HE group, 19.2 kg for the HE only and 2.2 kg for the control group (P<0.05), which was consistent with the results from the 24-h urine sodium and potassium data. The intervention effects of CRHI-SRS on sodium and potassium intake estimated from SS sales were 101% and 114%, respectively, of those observed from the 24-h urine data. Furthermore, the salt sales survey cost only 14% of the cost of the 24-h urine method and had greater statistical power. The results indicate that a salt sales survey could serve as a simple, sensitive and cost-effective method to evaluate community-based salt reduction programs in which salt is mainly added by the consumers.
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Nut consumption in relation to cardiovascular disease risk and type 2 diabetes: a systematic review and meta-analysis of prospective studies.
Zhou, D, Yu, H, He, F, Reilly, KH, Zhang, J, Li, S, Zhang, T, Wang, B, Ding, Y, Xi, B
The American journal of clinical nutrition. 2014;(1):270-7
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Abstract
BACKGROUND Many prospective cohort studies have investigated the association between nut consumption and risk of coronary artery disease (CAD), stroke, hypertension, and type 2 diabetes (T2D). However, results have been inconsistent. OBJECTIVE We aimed to investigate the association between nut consumption and risk of CAD, stroke, hypertension, and T2D. DESIGN PubMed and EMBASE databases were searched up to October 2013. All prospective cohort studies of nut consumption and risk of CAD, stroke, hypertension, and T2D were included. Summary RRs with 95% CIs were estimated by using a fixed- or random-effects model. RESULTS A total of 23 prospective studies (9 studies for CAD, 4 studies for stroke, 4 studies for hypertension, and 6 studies for T2D) from 19 publications were included in the meta-analysis. There were 179,885 participants and 7236 CAD cases, 182,730 participants and 5669 stroke cases, 40,102 participants and 12,814 hypertension cases, and 342,213 participants and 14,400 T2D cases. The consumption of each 1 serving of nuts/d was significantly associated with incident CAD (RR: 0.81; 95% CI: 0.72, 0.91; P < 0.001) and hypertension (RR: 0.66; 95% CI: 0.44, 1.00; P = 0.049). However, there was no association between the consumption of each 1 serving of nuts/d and risk of stroke (RR: 0.90; 95% CI: 0.71, 1.14) or T2D (RR: 0.80; 95% CI: 0.57, 1.14). CONCLUSIONS A higher consumption of nuts was associated with reduced risk of CAD and hypertension but not stroke or T2D. Large randomized controlled trials are warranted to confirm the observed associations.
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Dietary stearic acid and risk of cardiovascular disease: intake, sources, digestion, and absorption.
Kris-Etherton, PM, Griel, AE, Psota, TL, Gebauer, SK, Zhang, J, Etherton, TD
Lipids. 2005;(12):1193-200
Abstract
Individual FA have diverse biological effects, some of which affect the risk of cardiovascular disease (CVD). In the context of food-based dietary guidance designed to reduce CVD risk, fat and FA recommendations focus on reducing saturated FA (SFA) and trans FA (TFA), and ensuring an adequate intake of unsaturated FA. Because stearic acid shares many physical properties with the other long-chain SFA but has different physiological effects, it is being evaluated as a substitute for TFA in food manufacturing. For stearic acid to become the primary replacement for TFA, it is essential that its physical properties and biological effects be well understood.