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A Prospective Study on Metabolic, Environmental, and Lifestyle Factors Associated with Risk of End-Stage Renal Disease Among Middle-Aged and Elderly Chinese in Singapore.

Record Type:	Electronic resources : Monograph/item
Title/Author:	A Prospective Study on Metabolic, Environmental, and Lifestyle Factors Associated with Risk of End-Stage Renal Disease Among Middle-Aged and Elderly Chinese in Singapore./
Author:	Geng, Tingting.
Description:	1 online resource (195 pages)
Notes:	Source: Dissertations Abstracts International, Volume: 84-04, Section: B.
Contained By:	Dissertations Abstracts International84-04B.
Subject:	Cardiovascular disease. -
Online resource:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=29352788click for full text (PQDT)
ISBN:	9798352684535

A Prospective Study on Metabolic, Environmental, and Lifestyle Factors Associated with Risk of End-Stage Renal Disease Among Middle-Aged and Elderly Chinese in Singapore.
Geng, Tingting.

A Prospective Study on Metabolic, Environmental, and Lifestyle Factors Associated with Risk of End-Stage Renal Disease Among Middle-Aged and Elderly Chinese in Singapore. - 1 online resource (195 pages)

Source: Dissertations Abstracts International, Volume: 84-04, Section: B.

Thesis (Ph.D.)--National University of Singapore (Singapore), 2021.

Includes bibliographical references

End-stage renal disease (ESRD) is a rising but poorly documented public health issue associated with high morbidity and mortality rates. Singapore has ranked fifth in incidence, and fourth in prevalence of ESRD worldwide. Despite diabetes and hypertension are well-established risk factors of ESRD, the vast majority of metabolic, environmental and lifestyle factors are not well investigated, especially among the Asian populations.Smoking, obesity and physical inactive have been consistently reported to be risk factors of ESRD across different populations; however, other factors including alcohol drinking, dietary patterns, sleep and air pollutions in relation to risk of ESRD have not been comprehensively studied in Asian populations. The overall aim of this project was to investigate the associations between metabolic (different blood pressure indices), environmental (incense smoke) and lifestyle factors (alcohol intake, sleep duration and dietary patterns) and the risk of ESRD in a prospective population-based cohort in Singapore.In this thesis, several important findings have been discovered. First, we found that compared with other blood pressure indices, pulse pressure had the strongest association with ESRD. Further, our study for the first time provided epidemiological evidence of indoor air pollution (incense use) as an emerging risk factor of ESRD.For lifestyle factors, our data showed extreme sleep durations (≤5 hours or ≥9 hours) were risk factors of ESRD; the long sleep duration related ESRD risk was more mediated through baseline comorbidities including diabetes, hypertension and cardiovascular disease compared with the short sleep duration. In addition, our results showed that adherence to healthful dietary patterns namely the Alternate Healthy Eating Index-2010, the Dietary Approaches to Stop Hypertension, and the alternate Mediterranean diet was inversely associated with the risk of ESRD in a dose-dependent manner. Moreover, we found BMI significantly modify the association between these dietary patterns and ESRD risk; the association was stronger among those obese people. We observed low dose alcohol intake was associated with a lower risk of ESRD. In addition, the relationship between alcohol intake and ESRD was modified by pre-existing diabetes. Among the individuals without diabetes, compared with the non-drinkers, low dose intake of alcohol was associated with a lower risk of ESRD whereas daily drinking was not associated with ESRD. In contrast, among those with diabetes, low-dose drinking was not associated with ESRD whereas daily drinking was associated with a substantially higher risk of ESRD.In conclusion, the findings of these studies contribute to the knowledge on the metabolic, environmental, and lifestyle risk factors and ESRD risk in Asian populations. These findings also contribute towards the scientific basis for the development of the life course interventions on ESRD prevention.

Electronic reproduction.
Ann Arbor, Mich. :
ProQuest,
2023

Mode of access: World Wide Web

ISBN: 9798352684535Subjects--Topical Terms:

3564561
Cardiovascular disease.
Index Terms--Genre/Form:

542853
Electronic books.

A Prospective Study on Metabolic, Environmental, and Lifestyle Factors Associated with Risk of End-Stage Renal Disease Among Middle-Aged and Elderly Chinese in Singapore.
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245 1 2 $a A Prospective Study on Metabolic, Environmental, and Lifestyle Factors Associated with Risk of End-Stage Renal Disease Among Middle-Aged and Elderly Chinese in Singapore.
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500 $a Source: Dissertations Abstracts International, Volume: 84-04, Section: B.
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502 $a Thesis (Ph.D.)--National University of Singapore (Singapore), 2021.
504 $a Includes bibliographical references
520 $a End-stage renal disease (ESRD) is a rising but poorly documented public health issue associated with high morbidity and mortality rates. Singapore has ranked fifth in incidence, and fourth in prevalence of ESRD worldwide. Despite diabetes and hypertension are well-established risk factors of ESRD, the vast majority of metabolic, environmental and lifestyle factors are not well investigated, especially among the Asian populations.Smoking, obesity and physical inactive have been consistently reported to be risk factors of ESRD across different populations; however, other factors including alcohol drinking, dietary patterns, sleep and air pollutions in relation to risk of ESRD have not been comprehensively studied in Asian populations. The overall aim of this project was to investigate the associations between metabolic (different blood pressure indices), environmental (incense smoke) and lifestyle factors (alcohol intake, sleep duration and dietary patterns) and the risk of ESRD in a prospective population-based cohort in Singapore.In this thesis, several important findings have been discovered. First, we found that compared with other blood pressure indices, pulse pressure had the strongest association with ESRD. Further, our study for the first time provided epidemiological evidence of indoor air pollution (incense use) as an emerging risk factor of ESRD.For lifestyle factors, our data showed extreme sleep durations (≤5 hours or ≥9 hours) were risk factors of ESRD; the long sleep duration related ESRD risk was more mediated through baseline comorbidities including diabetes, hypertension and cardiovascular disease compared with the short sleep duration. In addition, our results showed that adherence to healthful dietary patterns namely the Alternate Healthy Eating Index-2010, the Dietary Approaches to Stop Hypertension, and the alternate Mediterranean diet was inversely associated with the risk of ESRD in a dose-dependent manner. Moreover, we found BMI significantly modify the association between these dietary patterns and ESRD risk; the association was stronger among those obese people. We observed low dose alcohol intake was associated with a lower risk of ESRD. In addition, the relationship between alcohol intake and ESRD was modified by pre-existing diabetes. Among the individuals without diabetes, compared with the non-drinkers, low dose intake of alcohol was associated with a lower risk of ESRD whereas daily drinking was not associated with ESRD. In contrast, among those with diabetes, low-dose drinking was not associated with ESRD whereas daily drinking was associated with a substantially higher risk of ESRD.In conclusion, the findings of these studies contribute to the knowledge on the metabolic, environmental, and lifestyle risk factors and ESRD risk in Asian populations. These findings also contribute towards the scientific basis for the development of the life course interventions on ESRD prevention.
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