Clinical Trial Service Unit

About: Clinical Trial Service Unit is a based out in . It is known for research contribution in the topics: Population & Stroke. The organization has 428 authors who have published 1387 publications receiving 181920 citations.

Lipids in chronic kidney disease

Abstract: Patients with chronic kidney disease (CKD) develop premature cardiovascular disease. In the general population (without CKD), there are strong associations between cholesterol fractions and the risk of coronary disease and weaker associations with stroke. Randomised trials in the general population demonstrate that lowering blood cholesterol (chiefly with a statin) reduces the risk of vascular events. Patients with CKD differ significantly from the general population. They have markedly disturbed lipid metabolism manifesting as elevated triglyceride concentrations, reduced HDL cholesterol concentrations and a preponderance of small, dense LDL particles that are potentially more atherogenic; the observed association between lipids and vascular disease is bizarre, and is confounded by co-morbidity; the nature of the vascular disease appears less strongly associated with classical atherosclerosis. Randomised trials are required to determine the relevance of blood lipids to the development of vascular disease in CKD patients, but the results of such studies have been inconclusive to date. CKD patients are at risk of end-stage renal disease. Lipids may be involved in the progression of renal disease. Modifying them may delay the progression of CKD. The current data are based on effects on markers of progression (e.g. proteinuria). The ongoing SHARP (Study of Heart and Renal Protection) trial should provide reliable information about the effects of statins on both vascular and renal risk.

Cohort Profile: The Chennai prospective study of mortality among 500 000 adults in Tamil Nadu, South India

Abstract: A prospective study of half a million adults living in the city of Chennai (formerly Madras) arose out of discussions at the 1994 International Cancer Congress in Delhi about how to assess the effects of tobacco on health in different parts of India. Chennai is the capital of the South Indian state of Tamil Nadu, and it is India’s fourth most populous city. Two large-scale epidemiological studies of tobacco and other factors were established: a case-control study 1 that could provide reasonably reliable results quickly, and a prospective cohort study that could provide more robust results over a longer period. (A parallel prospective study of 100000 adults, not included in this profile, is in progress in the nearby rural area of Villupuram; Figure 1.) The case-control analyses, 1 which involved 43000 adult deaths during 1995–97 and 35000 controls who had been living with a case, indicated that smoking is a cause of, among other things, about half of all tuberculosis (TB) deaths among men. The prospective cohort study, which recruited half a million participants between 1998 and 2001, is described here.

Stabilization of Homocysteine in Unseparated Blood over Several Days: A Solution for Epidemiological Studies

Abstract: Increased blood homocysteine is a potentially modifiable risk factor for cardiovascular disease. In a recent metaanalysis of individual participant data from prospective epidemiologic studies, a 25% lower homocysteine concentration was associated with an 11% lower risk for ischemic heart disease and a 19% lower risk for stroke (1). Blood homocysteine is easily lowered by folic acid supplementation, and several large-scale randomized trials are currently underway to assess the effects of homocysteine-lowering vitamin supplements on the risk of vascular disease. If such trials demonstrate benefit, there will be increasing interest in homocysteine determinations to assess vascular disease risk. In addition, further large-scale epidemiologic studies may be required to investigate the association between homocysteine and cardiovascular disease in a wider range of populations. These would be facilitated by simple and cost-effective methods for blood collection and analysis. One of the chief constraints in homocysteine measurements is the continuing production and release of homocysteine by red blood cells after venipuncture, which causes an artificial increase in plasma concentration of ∼10% per hour (2)(3). It has been recommended, therefore, that blood samples for homocysteine measurements be drawn into tubes containing EDTA, chilled, or placed on ice immediately after collection and that the plasma be separated from the red cells within 1 h. Such procedures can be difficult to implement in large-scale epidemiologic studies or other situations in which samples have to be collected remotely (e.g., in multiple clinics or in people’s homes) and transported to a central laboratory. Use of NaF or acidic citrate has been advocated for stabilization of homocysteine in whole blood at ambient temperature …

Metabolic syndrome biomarkers and prostate cancer risk in the UK Biobank.

Abstract: We investigated the association between metabolic syndrome (MetS) and its components and risk of prostate cancer (PCa) in a cohort of men enrolled in the UK Biobank. Our study cohort included 220 622 PCa-free men with baseline measurements of triglycerides (TGs), HDL-cholesterol (HDL), glycated hemoglobin (HbA1c), blood pressure (BP), and waist circumference (WC). Multivariable Cox proportional hazards regression was used to analyze associations with PCa for: individual metabolic components (TG, HDL, HbA1c, BP, WC), combinations of two and three components, and MetS overall (three or more components). We conducted mediation analyses to examine potential hormonal and inflammatory pathways (total testosterone [TT], C-reactive protein [CRP], insulin-like growth factor 1 [IGF-1]) through which MetS components may influence PCa risk. A total of 5409 men in the study developed PCa during a median follow-up of 6.9 years. We found no significant association between MetS and PCa risk (hazard ratio [HR] = 0.99, 95% confidence interval [CI] = 0.92-1.06). No associations were found with PCa risk and individual measurements of TG, HDL, BP, or WC. However, an inverse association was observed with elevated HbA1c (≥42 mmol/mol) (HR = 0.89, 95% CI = 0.79-0.98). Consistent inverse associations were observed between HbA1c and risk of PCa. Mediation analysis revealed TT, CRP, and IGF-1 as potential mediating factors for this association contributing 10.2%, 7.1%, and 7.9% to the total effect, respectively. Overall MetS had no association with PCa risk. However, a consistent inverse association with PCa risk was found for HbA1c. This association may be explained in part through hormonal and inflammatory pathways.