Prognostic value of serum lactate level for mortality in patients with acute kidney injury.

BACKGROUND: Serum lactate is associated with mortality in diverse kinds of patients. This study aimed to investigate whether serum lactate level may independently predict mortality in acute kidney injury (AKI) patients. METHODS: A total of 4461 AKI patients were collected from the Medical Information Mart for Intensive Care (MIMIC III) database and followed up for 365 days. According to serum lactate tertiles, participants were divided into three groups (Q1-Q3) by: Q1 ≤ 1.60 mg/dl, Q2 = 1.61-2.70 mg/dl, and Q3 ≥ 2.71 mg/dl. We calculated the hazard ratio (HR) and 95% confidence intervals (Cls) for mortality across each tertile of lactate by using the Q1 as reference and constructed four models to adjust for the HR of mortality. RESULTS: Nonsurvivors had significantly higher lactate compared with patients in the survival group. Mortality rate gradually elevated with the increase in serum lactate level (Q1: 29.30%, Q2: 33.40%, Q3: 37.40%). When compared with Q1 after adjustment of all confounders, the HRs of Q3 still was 1.20 (95% Cl 1.05-1.37). CONCLUSIONS: This study demonstrated that high serum lactate levels were an independent predictor of mortality in AKI patients.

Prognostic value of C-reactive protein to albumin ratio for mortality in acute kidney injury.

BACKGROUND: Inflammation plays an important role in the development of acute kidney injury (AKI). However, there are few studies exploring the prognostic influence of C-reactive protein to albumin ratio (CAR) among AKI patients. In this study, we investigated whether CAR could be a useful marker to predict the mortality of AKI. METHODS: A total of 358 AKI patients were extracted from the Medical Information Mart for Intensive Care III (MIMIC III) database. C-reactive protein (CRP) and albumin were measured at ICU admission. The clinical outcome was 365-day mortality. Cox proportional hazards model and Kaplan-Meier survival analysis were conducted to evaluate the association between CAR and outcome. RESULTS: Compared with patients in the survival group, nonsurvivors had higher CAR levels. The area under the receiver operating characteristic (ROC) curve of CAR was higher than that of CRP and albumin for mortality (0.64 vs. 0.63, 0.59, respectively). The cut-off point of CAR for mortality was 7.23. In Cox proportional-hazard regression analysis, CAR (hazards ratio (HR) =2.04, 95% confidence interval (CI) =1.47-2.85, p < 0.001 for higher CAR) and Simplified Acute Physiology Score II (HR = 1.02, 95%CI = 1.00-1.03, p = 0.004) were independent predictors of 365-day mortality. CONCLUSIONS: Our study demonstrated that a higher level of CAR was associated with 365-day mortality in AKI patients.

Association between serum malondialdehyde levels and depression during early methamphetamine withdrawal.

Some evidence suggested that malondialdehyde (MDA) as a marker of oxidative stress played an important part in modulating the activities of depression. Methamphetamine (METH) dependence often lead to depression that may associate with MDA. In this study, our purpose was to explore the association between serum MDA levels and depression during METH withdrawal. 179 METH-dependent patients were recruited in this study and 144 (80.4%) finished the assessment. We measured serum MDA at 532 nm spectrophotometrically at admission. The short form of the Beck Depression Inventory (BDI-13) was used to evaluate depression symptoms. Patients were identified to have depression symptoms with the BDI score ≥ 8. As a result, 89 (61.8%) of the remaining 144 METH-dependent patients were identified to have depression symptoms. Patients with depression symptoms showed significantly higher serum MDA levels than non-depression patients (3.42 ± 1.60 nmol/ml vs. 2.43 ± 1.25 nmol/ml; p < 0.001). After controlling for potential confounding variables in our logistic model, serum MDA levels were independently associated with the development of depression during early METH withdrawal (OR =1.952, 95% CI, 1.414-2.694, p < 0.001). Furthermore, our study found a positive association between Beck Depression Inventor (BDI) score in early METH abstinence and serum MDA levels (r =0.185; p = 0.026). Our results indicated that higher serum MDA levels were related to higher risk of depression symptoms during early METH withdrawal.

Brain-derived neurotrophic factor levels and depression during methamphetamine withdrawal.

BACKGROUND: Depression symptoms is highly comorbid with methamphetamine (METH) dependence. Except for the role in the pathophysiology of depression symptoms, brain-derived neurotrophic factor (BDNF) is also involved in the METH dependence. The present study aims to explore whether BDNF plays a role in the development of depression symptoms during METH withdrawal. METHODS: We recruited 179 patients with METH dependence who were followed up for two weeks. Ultimately, 131 (73.2%) patients finished the follow-up. Besides, 90 healthy controls were also recruited. Serum BDNF levels were measured by DuoSet ELISA Development System upon admission. The short form (13 items) of the Beck Depression Inventory (BDI) and Amphetamine Withdrawal Questionnaire (AWQ) were used to measure the depression and withdrawal symptoms. Patients with BDI score ≥ 8 were identified to have depression symptoms. RESULTS: Of the 131 patients, 64 (48.9%) were identified to have depression symptoms at the two-week endpoint. Patients with depression symptoms showed significantly lower BDNF levels than those with no depression symptoms. Serum BDNF levels (≤ 1251.0pg/ml) were independently associated with the development of depression symptoms during METH withdrawal (OR = 3.50, 95% CI, 1.14-10.73, p = 0.028). LIMITATIONS: BDNF levels were tested in serum but not in brain and the baseline BDI and AWQ scores between the depression and non-depression groups were not matched. Besides, the follow-up time was relatively short. CONCLUSIONS: Our study demonstrated that patients with serum BDNF levels ≤ 1251.0pg/ml had higher risk of depression symptoms during METH withdrawal.

The levels of triglyceride and total cholesterol in methamphetamine dependence.

The serum triglyceride (TG) and total cholesterol (TC) levels have been reported altered in the traditional drug-dependence (such as marijuana and heroin). However, studies assessing the relationships among serum TC, TG, and methamphetamine (MA)-dependence have not been described well. In this study, our aim is to explore the serum TG and TC levels in large sample of MA-dependent patients. A retrospective study was conducted in 938 MA-dependent patients who were recruited between February 2, 2008 and March 11, 2013, with social characteristics and drug-dependence history (duration of MA use, routes of drug administration, and daily dose were collected). Then, the serum levels of TC, TG, glucose (GLU), body mass index (BMI), and blood pressure were measured among the participants. Meanwhile, 985 age- and gender-matched healthy people in the physical examination center were selected as control group. Compared with the control group, significant decreases of TC, TG, GLU, and BMI were observed in MA-dependent patients (P < 0.05). Besides, we found that the daily dose of MA use was associated with TC (ß = -0.079, P = 0.015) and the duration of MA use was independently related to BMI (ß = -0.071, P = 0.031). This study demonstrated that the levels of TC, TG, GLU, and BMI factors altered in the MA-dependent patients. In addition, there is a negative association between MA dependence and TC and BMI.

Association Between Serum Levels of Vitamin D and the Risk of Post-Stroke Anxiety.

Low levels of serum vitamin D are common in patients with mood disorders and stroke. It has been shown that low levels of serum vitamin D indicate a risk of depression in post-stroke subjects. Our aim was to determine the relationship between vitamin D and post-stroke anxiety (PSA).A consecutive series of 226 first acute ischemic stroke patients were recruited and followed up for 1 month. Serum levels of vitamin D were measured within 24 hours of admission. Patients with significant clinical symptoms of anxiety and a Hamilton anxiety scale score >7 were diagnosed as having PSA. In addition, 100 healthy subjects were recruited as controls and underwent measurements of serum vitamin D.A total of 60 patients (26.55%) showed anxiety at 1 month. Both PSA patients and non-PSA patients had lower serum levels of vitamin D than healthy subjects. A significant relationship was found between PSA and serum levels of vitamin D. Low serum levels of vitamin D (≤38.48 nmol/L) were independently associated with the development of PSA (OR: 2.49, 95% CI: 1.21-5.13, P = 0.01).Serum vitamin D status is related to the occurrence of anxiety in post-stroke patients and may be an independent risk factor of PSA after 1 month.

The Body Mass Index, Blood Pressure, and Fasting Blood Glucose in Patients With Methamphetamine Dependence.

Methamphetamine (MA) is a prevalently abused psychostimulant in the world. Previously published studies and case reports indicated potential associations between MA and body mass index (BMI) and cardiovascular factors (eg, blood pressure and fasting blood glucose). However, these associations have not been studied clearly. This study aimed to investigate BMI and cardiovascular factors in the MA-dependent patients.A total of 1019 MA-dependent patients were recruited between February 2, 2008 and March 11, 2013. A case report was used to gather information on sociocharacteristics and drug-dependent history. Meanwhile, a number of 1019 age- and sex-matched controls' information were collected from the physical examination center. We measured BMI, blood pressure, and fasting blood glucose among the participants.MA-dependent patients had significantly lower BMI (20.4 ±â€Š0.1 vs 23.9 ±â€Š0.1 kg/m, P < 0.001), lower fasting blood glucose (5.0 ±â€Š0.01 vs 5.2 ±â€Š0.01 mmol/L, P < 0.001) and higher systolic blood pressure (122.1 ±â€Š0.4 vs 114.8 ±â€Š0.4 mmHg, P < 0.001) compared with the control group after adjustment of possible confounders. Additional, we only found the duration of MA use was independently associated with BMI (B = -0.08, P = 0.04).This study demonstrated that MA dependence was associated with BMI and cardiovascular factors. In addition, we found a negative association between duration of MA use and BMI.