Background Bronchopulmonary dysplasia (BPD) remains the most frequently complication of extreme preterm infants. Multiple clinical factors and inflammatory markers have all been associated with BPD. Therefore, this study targeted to detect cytokines and fractional exhaled nitric oxide(FeNO) to evaluate their mechanism and possible predicted significance for BPD. Methods Preterm infants born at gestational age ≤ 32 weeks were recruited between January 2018 and October 2019. The clinical data of infant characteristics and maternal characteristics were collected. Our study detected a total of ten cytokines include IFN-γ, IL-10, IL-12p70, IL-13, IL-1β, IL-2, IL-4, IL-6, IL-8 and TNF-α on day 1–3, day 7–14, and day 21–28 after birth via Meso Scale Discovery (MSD) technology. FeNO levels were measured when the infants met discharge criteria. Results A total of 46 preterm infants were enrolled in this study, including 14 infants in BPD group and 32 infants in control group. The gestational age 【(27.5 ± 1.3) vs. (29.9 ± 1.3) weeks】and birth weight【(1021 ± 261)g vs. (1489 ± 357)g】of BPD group were lower than those of control group. Multivariate logistic regression analysis showed that gestational age < 30 weeks, birth weight < 1000 g, PDA, longer mechanical ventilation and invasive ventilation duration were high risk factors for BPD. The cytokines of IL-6, IL-8 on day 7–14 and IL-4, IL-6, IL-8, TNF-α on day 21–28 were also the high risk factors for BPD. Other risk factors for BPD included elevated Eosnophils on day 21–28 and FeNO. Conclusion The preterm infants with PDA, prolonged mechanical ventilation tended to develop BPD. The FeNO, Eosnophils, cytokines such as IL-4, IL-6, IL-8, TNF-α were high risk factors for BPD. Our study speculate that NO was related to BPD though Th2-cell-mediatedinflammatory responses such as IL-4. The cytokines may provide a certain predictive value for the occurrence of BPD.
Background Kidney function declines naturally with advancing age. Therefore, an age-adapted eGFR threshold has been proposed instead of the fixed threshold for CKD definition. The study aims to describe and compare the profile of CKD patients defined by these two criteria in a Chinese population. Method We recruited the adult participants with selected biochemical tests from the Chinese Physiological Constant and Health Condition (CPCHC) survey conducted from 2007 to 2011, with the GFR estimated by the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula. The age-adapted threshold of eGFR is 75, 60, and 45 mL/min/1.73 m2 for the population under 40 years old, 40 to 64 years old, and above 64 years, respectively. The fixed threshold is 60 mL/min/1.73 m2 for all ages. Result Among the recruited 23 438 participants, 480 were diagnosed with CKD by fixed-threshold criteria, while 391 were diagnosed with CKD by age-adapted criteria. Patients diagnosed by fixed-threshold criteria were significantly older (66.4 years old vs. 43.4 years old, p < 0.001), and had a higher prevalence of all CVD risk factors compared with the non-CKD population. At the same time, age-adapted criteria defined a younger patient group and were not significantly associated with diabetes or obesity. When adjusted by age and gender, fixed-threshold-defined CKD was not significantly associated with the number of coexisting CVD risk factors, while age-adapted-defined CKD was significantly associated. We also found that the CKD patients defined by age-adapted criteria matched well with the 2.5th percentile of eGFR in the Chinese individuals. When compared with their age-and gender-matched controls, patients included by age-adapted criteria but excluded by fixed-threshold criteria had a significantly higher prevalence of hypertension (23.2% vs. 7.7%, p < 0.001) and hyperuricemia (25.0% vs. 5.5%, p < 0.001), while patients included only by the fixed-threshold criteria were not significantly different in prevalence of CVD risk factors and CKD related disturbance except for hyperuricemia (41.2% vs. 14.0%, p < 0.001). Conclusion An age-adapted criterion is more closely associated with CVD risk factors and CKD-related diseases compared to fixed-threshold criteria.
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