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Background. β 2 -Microglobulin (β 2 -M) is recognized as a surrogate marker of middle-molecule uraemic toxins and is a key component in the genesis of dialysis-associated amyloidosis. Few studies have evaluated the association of β 2 -M levels with clinical outcome in dialyzed patients. Methods. The prognostic implication of serum β 2 -M levels for the survival of haemodialysis patients was examined in 490 prevalent haemodialysis patients (60.1 ± 11.8 years, haemodialysis duration of 87.4 ± 75.7 months, 288 males and 202 females; 24% diabetics). The patients were divided into two groups according to their serum β 2 -M levels: lower β 2 -M group (n = 245) with serum β 2 -M <32.2 mg/L (the median serum β 2 -M) and higher β 2 -M group (n = 245) with that ≥32.2 mg/L. Results. During the follow-up period of 40 ± 15 months, there were 91 all-cause deaths, and out of them, 36 were from cardiovascular diseases. Kaplan-Meier analysis revealed that all-cause mortality in the higher β 2 -M group was significantly higher compared to that in the lower β 2 -M group (P < 0.001). Multivariate Cox proportional hazards analyses showed that serum β 2 -M level was a significant predictor for all-cause mortality (hazard ratio, 1.05; 95% CI, 1.01-1.08; P = 0.005), and for non-cardiovascular mortality (hazard ratio, 1.06; 95% CI, 1.02-1.10; P = 0.006), after adjustment for age, gender, haemodialysis duration, the presence of diabetes, serum albumin and serum C-reactive protein.Conclusion. These results demonstrate that the serum β 2 -M level is a significant predictor of mortality in haemodialysis patients, independent of haemodialysis duration, diabetes, malnutrition and chronic inflammation, suggesting the clinical importance of lowering serum β 2 -M in these patients.

Aims/Introduction: This study aimed to reveal lifestyle changes and their impact on glycemic control and weight control in patients with diabetes during the coronavirus disease 2019 (COVID-19) pandemic in Japan. Materials and Methods: We retrospectively analyzed 1,402 outpatients with diabetes at a clinic in Osaka, Japan, who responded to an interview sheet regarding lifestyle changes during the COVID-19 pandemic between 28 March and 30 May 2020. The association of lifestyle changes with hemoglobin A1c (HbA1c) and weight changes from February to May 2020 was investigated using the linear regression model. We also investigated the association with clinically important change of HbA1c (by ≥0.3%) and bodyweight (by ≥3%), using the cumulative link model. Results: Leisure time and other outside physical activities were decreased in one-quarter of patients during the COVID-19 pandemic, whereas the amount of meals and snacks was decreased and increased in approximately 10%, respectively. The change in leisure time physical activities was inversely associated with HbA1c and weight changes, whereas the quantitative change of meals with the decline in eating out and that of snacks were positively associated with HbA1c and weight changes (all P < 0.05). The quantitative change of meals without the decline in eating out was also positively associated with weight change (P = 0.012). The cumulative link model for clinically important HbA1c and weight change showed broadly similar associations, except for that between snacks and bodyweight (P = 0.15). Conclusions: A considerable number of outpatients with diabetes experienced lifestyle changes during the COVID-19 pandemic. The lifestyle changes were associated with HbA1c and weight changes.

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