Association between magnesium depletion score and the prevalence of kidney stones in the low primary income ratio: a cross-sectional study of NHANES 2007-2018.

INTRODUCTION: To explore the association between magnesium depletion score (MgDS) and the prevalence of kidney stones in the low primary income ratio (PIR). METHOD: A cross-sectional study was conducted using data from the National Health and Nutrition Examination Survey 2007-2018. Within the low PIR, people aged ≥20 years with complete information on MgDS and kidney stones questionnaires were enrolled. Multivariable logistic regression and stratified logistic regression analyses were performed to examine the association between MgDS and the prevalence of kidney stones and recurrence of kidney stones by confounding factors adjusted. Stratified and interaction analysis was conducted to find whether some factors modified the association. In addition, sensitive analyses were also conducted to observe the stability. The work has been reported in line with the STROCSS criteria, Supplemental Digital Content 1, http://links.lww.com/JS9/C781. RESULT: A total of 7,600 adults were involved in the study, and the individuals were classified into four groups: 0 points for MgDS (n=3,814), 1 point for MgDS (n=2,229), 2 points for MgDS (n=1,020), and ≥3 points for MgDS (n=537). The multivariable logistic regression suggested that a positive association between MgDS and the prevalence of kidney stones (OR=1.123, 95%CI 1.019 to 1.238) in the fully-adjusted model. Compared with the lowest group, people with ≥3 points of MgDS had a had a significant relationship with kidney stones (OR=1.417, 95%CI 1.013 to 1.983). No significant association was observed between the recurrence of kidney stones and MgDS. The result of the sensitive analysis showed the robustness of the main analysis. CONCLUSION: The prevalence of kidney stones is inversely associated with MgDS, which suggests that maintaining a higher MgDS is accompanied by higher prevalence rates of kidney stones in the low PIR.

Association Between Physical Activity and the Prevalence of Kidney Stones in American Adults: Results From a Multiyear National Survey.

OBJECTIVE: To investigate the association between physical activity (PA) and the prevalence of kidney stones. METHODS: A cross-section study was conducted using data from National Health and Nutrition Examination Survey 2007-2018. PA was evaluated based on the Global Physical Activity Questionnaire. Multivariable logistic regression was performed to elucidate the association between PA (patterns, intensity, duration, and frequency of moderate and vigorous PA) and the prevalence of kidney stones after adjusting for potential confounders. Stratified and interaction analyses were conducted to detect potential effect modifiers. In addition, PA was assessed using metabolic equivalent and physical volume, and followed the regression above. Water intake was obtained from the day 2 dietary recall and was included in the sensitivity analysis. RESULTS: A total of 34,390 participants were included in the analysis. The multivariable logistic regression revealed that individuals who engaged in moderate PA for 30-60 minutes per day had a significant inverse association with the prevalence of kidney stones in the fully adjusted model (odds ratio=0.804, 95% confidence interval 0.700 to 0.923), while no more significant finding was observed for other PA parameters. Interaction and stratified analyses indicated no covariate modifying the association. The results above were robust in the sensitivity analysis. CONCLUSION: The duration of moderate PA (30-60 min/d) is inversely associated with the prevalence of kidney stones, while no more significant association was observed between other PA parameters (including patterns, intensity, duration, and frequency of vigorous PA, frequency of moderate PA) and kidney stones.

Diagnostic Value of Lower Extremity Venous Duplication via Digital Subtraction Angiography Guided Venography.

INTRODUCTION: Lower limb venous anomalies, including duplicated veins, are common and have significant impacts on the outcomes and efficacy of venous surgery. Digital subtraction angiography (DSA) guided venography, serving as the tertiary diagnostic option for venous disorders, offers valuable informations to clinical practitioners. PATIENTS AND METHODS: A retrospective study was conducted on 195 patients with suspected venous disease, evaluating 259 limbs with venography imaging. Two experienced interventional vascularists evaluated the images to determine the incidence and characteristics of variances in the femoral, popliteal, great saphenous, and small saphenous veins. Moreover, blood samples were collected to assess the safety of the venography procedure by monitoring changes in renal function. RESULT: Duplication variations were found in the lower limb veins, with the highest prevalence in the femoral vein (11.28%, 22/195), followed by the great saphenous vein (4.1%, 8/195), and the popliteal vein (1.54%, 3/195). No severe contrast agent allergies or postoperative complications were reported. No statistically significant differences were found in creatinine and urea levels pre- and post-operation for patients without duplication variations, those with duplication of the great saphenous, femoral, or popliteal vein (P < .05). CONCLUSION: DSA-guided venography is effective in identifying venous variations in lower limb disease. DFV is the most common recurrent vein, while DPV is the least. Adequate preparation ensures safety, high spatial resolution, dynamic imaging, and low tissue interference.

The role of estrogen receptors (ERs)-Notch pathway in thyroid toxicity induced by Di-2-ethylhexyl phthalate (DEHP) exposure: Population data and in vitro studies.

BACKGROUND: This study aimed to assess the exposure level and risk of Di-2-ethylhexyl Phthalate (DEHP) among adults in Jilin Province, China, clarify the impact of DEHP on human thyroid function, and to explore the role of estrogen receptors (ERs)-Notch signaling pathway in the effect of DEHP metabolites on thyroid hormones based on population data and in vitro experiments. METHODS: 312 adults participated in this study. Urinary DEHP metabolites were determined by high performance liquid chromatography coupled to a tandem mass spectrometer (HPLC-MS/MS). Two pharmacokinetic models were used to evaluate the estimated daily intake (EDI) and hazard quotient (HQ) of the adults. Multiple linear regression and mediating effect models were used to evaluate the target associations. In cell experiments, thyroid follicular epithelial (Nthy-ori3-1) cells were exposed to mono (2-ethylhexyl) phthalate (MEHP) for testing. The inhibitions of ERα and Notch pathway were conducted by siRNA and Notch pathway inhibitor DAPT. RESULTS: The detection rate of five DEHP metabolites was 97.1∼100.0%. The HQ value of 0.3% of adults was higher than 1. The levels of urinary DEHP metabolites were significantly correlated with thyrotropin (TSH), thyrotropin-releasing hormone (TRH), total triiodothyronine (TT3), total thyroxine (TT4), free triiodothyronine (FT3) and free thyroxine (FT4) and gene (estrogen receptor α (ERα), Notch1, Dll4) levels. The ERα-Notch pathway played a mediating role in the association between DEHP metabolite levels and FT4. The cell results showed, the levels of FT3 and FT4 in cell supernatant decreased after MEHP exposure, and the downward trend was reversed after ERα and notch pathways were inhibited, notch pathway genes also decreased after ERα inhibition. CONCLUSION: Adults in the Jilin Province of China were widely exposed to DEHP. ERs-Notch pathway played an important role in the effect of DEHP metabolites on thyroid hormones.

Association between visceral adiposity index and kidney stones in American adults: A cross-sectional analysis of NHANES 2007-2018.

Objective: To explore the association between Visceral Adiposity Index (VAI) and kidney stones in an American adult population. Materials and methods: National Health and Nutrition Examination Survey (NHANES) datasets from 2007 to 2018 were used. Participants aged ≥20 years who reported kidney stone history and VAI were included. Weighted proportions, multivariable analysis, generalized additive model (GAM), and spline smoothing were used to evaluate the associations between VAI and kidney stones by adjusting gender, age, race, education, marital status, poverty income ratio, smoking, alcohol, high blood pressure, diabetes, congestive heart failure, cancer, vigorous activity, moderate activity, HEI2015 total score, and energy. Results: Totally 13,871 American adults were included. All the participants were divided by the VAI into four groups according to the quartile: Q1 (11.96-42.89), Q2 (42.90-74.45), Q3 (74.45-131.43), and Q4 (131.45-611.34). The mean ± standard deviation of the VAI in the four groups were Q1 (29.07 ± 8.22), Q2 (57.53 ± 8.81), Q3 (99.52 ± 16.25), and Q4 (225.92 ± 95.83). In the fully adjusted multivariable model, VAI was positively correlated with urolithiasis [odds ratio (OR) = 1.001; 95% confidence interval (CI) 1.000-1.001]. Compared with the first quartile of VAI, the population in the fourth quartile of VAI had a higher prevalence of kidney stones (OR = 1.329; 95% CI 1.104-1.600). Subgroup analysis detected no significant interaction effect after adjusting for covariates. Conclusion: The value of VAI is positively correlated with the prevalence of kidney stones, which suggest VAI can be used to assess the potential risk of the prevalence of kidney stones.

Association between sleep duration and kidney stones in 34 190 American adults: A cross-sectional analysis of NHANES 2007-2018.

OBJECTIVE: To explore the association between sleep duration and kidney stones among United States adults. PARTICIPANTS AND METHODS: This cross-sectional study is based on National Health and Nutrition Examination Surveys (NHANES) 2007-2018. Participants aged 20 years and above who self-reported history of kidney stones and sleep duration were included. Weighted proportions, multivariable analysis, and piecewise linear regression were used to evaluate the associations between sleep duration and kidney stones, while adjusting for gender, age, race, poverty income ratio, body mass index, education, marital status, trouble sleeping, smoking, alcohol and some comorbidities. Stratified logistic regression models were used in subgroup analyses and included all potential confounding factors above. RESULTS: Of the 34,190 participants, the overall weighted kidney stone prevalence was 9.73%, weighted mean age was 47.67 ± 16.99 years, and mean sleep duration was 7.15 ± 1.44 hours. The fully adjusted multivariable model demonstrated that people with normal (7-9 hours) and long (>9 hours) sleep duration had 17% and 20% lower odds of kidney stone prevalence than people with short sleep duration (<7 hours), respectively. However, fitting a smooth curve showed a nonlinear association between sleep duration and kidney stones. A piecewise linear regression model showed that one hour longer sleep duration was associated with 7% lower kidney stone prevalence for people with short sleep duration and with 22% higher prevalence for participants with long sleep duration. However, for people with normal sleep duration, increasing sleep duration was nonsignificantly associated with lower prevalence of kidney stones. Subgroup analysis showed no significant interaction effects. CONCLUSIONS: There is a curvilinear relationship between sleep duration and kidney stones. Normal sleep duration is associated with lower prevalence of kidney stones than short sleep duration. This study provides new insight into potential strategies for the prevention and treatment of kidney stones.

Association between urine cobalt and prevalence of kidney stones in Americans aged ≥ 20 years old.

To determine whether urine cobalt (Co) is associated with the prevalence of kidney stones, we conducted a cross-sectional study of participants (≥ 20 years) involved in the National Health and Nutrition Examination Survey (NHANES) between 2007 and 2018. The urine Co level was divided into four groups: 0.02-0.22, 0.22-0.36, 0.36-0.58, and 0.58-37.40 µg/L. The independent correlation between urine Co and prevalence of kidney stones was determined by logistic regression analyses. A total of 10,744 participants aged over 20 years that were not pregnant were eligible. Among them, 1041 participants reported ever having developed kidney stones. Patients with kidney stones developed significantly higher urine Co than the non-stone participants. The kidney stone patients were more likely to have been smoking ≥ 100 cigarettes in life; have hypertension, diabetes, and cancer; and engage in heavy activity. Multivariate logistic regression indicated a significantly positive relationship between the urine Co level and occurrence of kidney stones (OR 1.059, 95% CI 1.018-1.102, P = 0.00430). Moreover, the outcome remained unchanged after some sophisticated factors were adjusted (OR 1.059, 95% CI 1.001-1.120, P = 0.04635), and kidney stones were significantly related to a higher level of Co (OR (95% CI) = 0.22-0.36 µg/L: 1.111 (0.869, 1.421); 0.36-0.58 µg/L: 1.392 (1.095, 1.770); 0.58-37.40 µg/L: 1.712 (1.351, 2.170), and P for trend < 0.00001). So, urine Co concentration is positively associated with the prevalence of kidney stones. However, more high-quality prospective studies are needed to elucidate the causal correlation between Co level and kidney stones.

Association Between Healthy Eating Index-2015 and Kidney Stones in American Adults: A Cross-Sectional Analysis of NHANES 2007-2018.

Purpose: To explore the association between Healthy Eating Index (HEI)-2015 and kidney stones in an American adult population. Materials and Methods: National Health and Nutrition Examination Survey (NHANES) datasets from 2007 to 2018 were used. Participants aged ≥ 20 years who reported kidney stone history and dietary recall were included. Weighted proportions, multivariable analysis and spline smoothing were used to evaluate the associations between HEI-2015 and nephrolithiasis by adjusting gender, age, race, poverty income ratio, body mass index, education level, marital status, smoking, alcohol intake, energy level, vigorous activity, moderate activity, and some comorbidities. Results: Totally 30 368 American adults were included, with weighted mean age [standard deviation (SD)] of 47.69 (16.85) years. The overall mean HEI-2015 score (SD) was 50.82 (13.80). In the fully-adjusted multivariable model, HEI-2015 was negatively correlated with urolithiasis [odds ratio (OR) = 0.991; 95% confidence interval (CI) 0.988 to 0.994]. Compared with the first quartile of HEI-2015, the population in the fourth quartile of HEI-2015 had a lower prevalence of kidney stones (OR = 0.716; 95% CI 0.635 to 0.807). The association was modified by education and vigorous activity. Conclusions: HEI-2015 is inversely associated with the prevalence of kidney stones, which means better diet quality is associated with a lower risk of nephrolithiasis.

Risk factors for deterioration of renal function after percutaneous nephrolithotomy in solitary kidney patients with staghorn calculi.

BACKGROUND: Nowadays, it has not been reported in detail which factors have adverse effects on renal function after PNCL surgery in solitary kidney patients with staghorn calculi. To evaluate the risk factors that deteriorate the renal function in solitary kidney patients with staghorn calculi after percutaneous nephrolithotomy (PCNL). METHODS: A retrospective study was performed on solitary kidney patients with staghorn calculi between March 2014 and Jun 2019. Renal function-related indexes were collected pre-operatively, and at 1 and 6 months post-operatively. These pre- and post-operative indexes were compared to study the risk factors on renal function. RESULTS: Totally 71 solitary kidney patients with staghorn calculi were included with a male-to-female ratio of 53:18 and mean age of 54.3±10.2 years old. The mean pre-operative estimated glomerular filtration rate (eGFR) and serum creatinine were 55.1±18.9 mL/min/1.73 m2 and 130.9±41.0 µmol/L, respectively. The mean diameter of largest stones was 5.0±1.7 cm, and the stone-free rate was 71.8%. Univariate analysis showed urinary tract infection (UTI) was a significant risk factor for deteriorating renal function after PCNL. At 1 to 6 months after surgery, renal function deteriorated by both UTI and combined diseases. The surgical side at the right kidney, mild hydronephrosis, and surgical time without 20 min or beyond 40 min can deteriorate renal function. Multivariate analysis demonstrated UTI was the main factor leading to deteriorated renal function with increasing serum creatinine and declining eGFR. CONCLUSIONS: Preoperative UTI can deteriorate the renal function at 1 month after PCNL, and diabetes can deteriorate the postoperative renal function at 6 months after PCNL. Controlled perioperative UTI, diabetes and factors play a crucial role in protecting renal function after PCNL for solitary kidney patients with staghorn calculi.

Reevaluation of glypican-3 as a serological marker for hepatocellular carcinoma.

BACKGROUND: Glypican-3 (GPC3) is a novel histochemical marker of hepatocellular carcinoma (HCC). However, its utility as a serologic marker for HCC is not conclusive. METHODS: A total of 1037 subjects, including 155 patients with HCC, 180 with chronic hepatitis, 124 with liver cirrhosis, 442 with non-HCC cancer and 136 healthy controls, were analyzed for serum GPC3 (sGPC3) by an ELISA constructed with 2 monoclonal antibodies. RESULTS: The average level of sGPC3 in HCC patients was 99.94±267.2ng/ml, which was significantly higher than in patients with chronic hepatitis (10.45±46.02ng/ml, P<0.0001), liver cirrhosis (19.44±50.88ng/ml, P=0.0013), non-HCC cancer (20.50±98.33ng/ml, P<0.0001) and healthy controls (4.14±31.65ng/ml, P<0.0001). The sensitivity of sGPC3 in HCC diagnosis was 40.0%, whereas the specificity was 98.5%, 94.4% and 87.1% in healthy controls, chronic hepatitis patients and liver cirrhosis patients, respectively. In addition, 13.5% (28/207) of lung cancer patients and 13.2% (9/68) of thyroid cancer patients had positive results with sGPC3. CONCLUSION: Serum GPC3 is a potential marker for HCC. However, the presence of sGPC3 in patients with lung cancer and thyroid cancer might limit its application as a single marker in the diagnosis of HCC.

[Effects of Jianpi Huoxue Decoction on Kupffer cell signal pathway activation in rats with liver injury induced by Lieber-Decarli liquid diet and lipopolysaccharide].

OBJECTIVE: To observe the effects of Jianpi Huoxue Decoction, a compound Chinese herbal medicine, on Kupffer cell signal pathway activation in rats with liver injury induced by Lieber-Decarli liquid diet and lipopolysaccharide (LPS). METHODS: SD rats were divided into normal, control liquid diet, ethanol liquid diet and ethanol liquid diet plus Jianpi Huoxue Decoction group. Rats were administrated with Jianpi Huoxue Decoction or distilled water via gastrogavage for 4 weeks after administration with ethanol or control liquid diet for 2 weeks respectively. After that, rats in each group were stimulated with LPS via gastrogavage for 3.5 h and harvested. Alanine aminotransferase (ALT) in serum and triglyceride (TG) in liver were analyzed. Pathological changes in liver tissues were observed in HE staining section. Tumor necrosis factor-alpha(TNF-alpha) in portal vein plasma was assayed by ELISA. The protein expressions of CD68, Toll-like receptor 4 (TLR4), phosphorylation-I kappa B (P-I kappa B) and TNF-alpha in liver were evaluated with Western-blotting. RESULTS: After the treatment with Jianpi Huoxue Decoction, the pathologic changes in liver tissue were lightened, levels of ALT in serum, TG in liver and TNF-alpha in portal vein plasma were decreased, and the protein expressions of CD68, TLR4, P-IkappaB and TNF-alpha in liver were reduced. CONCLUSION: Jianpi Huoxue Decoction can inhibit Kupffer cell signal pathway activation in rats with liver injury induced by Lieber-Decarli liquid diet and LPS.

[Relationship between alcoholic liver injury and endotoxin leakage from gut and intervention effect of jianpi liqi huoxue decoction].

OBJECTIVE: To study the effects and mechanisms of Jianpi Liqi Huoxue Decoction (JLHD) in anti-alcoholic liver injury (ALI) through the pathological relation of ALI with changes of intestinal permeability and endotoxin leakage. METHODS: The liver injury model induced by Lieber-DeCarli alcoholic forage was established. Altogether 42 male SD rats were randomly divided into 4 groups, the normal group (n=6), the control group fed with non-alcohol diet (n=12), the model group fed with alcoholic diet (n=12) and the treated group fed with alcoholic diet and treated with JLHD (n=12). The medicine or distilled water was administered by gavage from the 3rd week to the end of the 6th week. Then after fasting for 5 h all the rats except those in the normal group were given lipopolysaccharide (LPS) 10 mg/kg by gavage, and the blood plasma from portal vein, serum from inferior cava vein as well as tissues of liver and intestine were prepared for detection of plasma LPS level in the portal vein to observe the change of intestinal permeability through LPS content in portal vein blood plasma, the pathological and ultrastructural changes of the small intestine by HE staining, the pathological change of liver and triglyceride (TG) content and gamma glutamyl transpeptidase (GGT) activity in liver, the changes of serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) activity, and plasma tumor necrosis factor-alpha (TNF-alpha) level. RESULTS: In rats after modeling, there were obvious fatty degeneration, significant increase of hepatic TG content and GGT activity, serum ALT and AST activity, as well as plasma TNF-alpha level, with high plasma LPS level indicating increased intestinal permeability, and seriously injured mucosa microvilla of small intestine. However, all the above abnormal changes were milder in the treated group than those in the model group. Meanwhile, the TNF-alpha content, endotoxin level and ALT activity were found to be positively correlated. CONCLUSION: JLHD could alleviate liver injury through inhibiting the alcohol induced increased intestinal permeability and lessening endotoxin leakage.

Intervention effects of Jianpi Liqi Huoxue Decoction on lipid peroxidative liver injury induced by alcohol.

OBJECTIVE: To study the intervention effects of Jianpi Liqi Huoxue Decoction ( JLHD) on lipid peroxidative liver injury induced by alcohol. METHODS: The rat alcoholic model of liver disease (ALD) induced by Lieber-DeCarli liquid diet was established. Thirty-two male SD rats were randomly divided into 4 groups: the normal group (n =5), the control group (n =9), the model group (n =9) and the JLHD group (n =9). From the 4th week after modeling, the rats were given JLHD or distilled water by gastrogavage respectively, and the samples of blood and liver tissues were taken out from the rats for determination by the end of the 8th week. The hepatic pathological changes were observed with HE staining; the liver injury related indices, including activity of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in serum, Y-glutamyl transpeptidase (Y-GT) activity and triglyceride (TG) content in liver tissues, as well as the lipid peroxidation related indices, including malonaldehyde (MDA) content and nitric oxide synthase (NOS) activity in liver tissue, serum Fe2+ level, and the anti-peroxidation capacity related indices, including superoxide dismutase (SOD) activity, glutathion (GSH) content and reactive oxygen species (anti-ROS) activity in liver tissues were determined. RESULTS: (1) There were obvious figures of fatty degeneration and inflammatory infiltration in liver tissues of the model group. As compared with the control group, in the model group, the activity of ALT and AST, and Fe2+ content in serum, Y-GT and NOS activity, TG and MDA content in liver tissues were significantly higher (P<0. 01), while the activity of SOD, GSH and anti-ROS in liver tissues were significantly lower (P<0.01). (2) The fatty degeneration and inflammatory infiltration of liver tissues in the JLHD group were significantly lessen as compared with those in the model group; and the abnormalities of all the indexes revealed in the model rats were restored to certain extent in the JLHD group, and especially significant were the levels of ALT activity, MDA content and Fe2+ , which were nearly normal. CONCLUSION: JLHD has significant effects against alcoholic liver injury, the acting mechanism of which is likely to be related with its anti-lipid peroxidative effect.