Cancer incidence associations with drinking water arsenic levels and disinfection methods in Maine, USA.

Maine is a largely rural state where nearly half of the population uses drinking water from private wells. Arsenic (As) is present in some Maine groundwater, has been linked to cancer, and a lack of testing and treatment may expose people with private wells to elevated As levels. Disinfection byproducts (DBPs) include known and suspected carcinogens that form when chlorine or chloramines are added to water.

Urine metabolites are associated with glomerular lesions in type 2 diabetes.

Introduction: Little is known about the association of urine metabolites with structural lesions in persons with diabetes.

Objectives: We examined the relationship between 12 urine metabolites and kidney structure in American Indians with type 2 diabetes.

Methods: Data were from a 6-year clinical trial that assessed renoprotective efficacy of losartan, and included a kidney biopsy at the end of the treatment period.

Cytosine methylation predicts renal function decline in American Indians.

Diabetic nephropathy accounts for most of the excess mortality in individuals with diabetes, but the molecular mechanisms by which nephropathy develops are largely unknown. Here we tested cytosine methylation levels at 397,063 genomic CpG sites for association with decline in the estimated glomerular filtration rate (eGFR) over a six year period in 181 diabetic Pima Indians. Methylation levels at 77 sites showed significant association with eGFR decline after correction for multiple comparisons.

Plasma bradykinin and early diabetic nephropathy lesions in type 1 diabetes mellitus.

Objective: To examine the association of bradykinin and related peptides with the development of diabetic nephropathy lesions in 243 participants with type 1 diabetes (T1D) from the Renin-Angiotensin System Study who, at baseline, were normoalbuminuric, normotensive and had normal or increased glomerular filtration rate (GFR).

Design: Plasma concentrations of bradykinin and related peptides were measured at baseline by quantitative mass spectrometry. All participants were randomly assigned at baseline to receive placebo, enalapril or losartan during the 5 years between kidney biopsies.

The Association Between Changes in Insulin Sensitivity and Consumption of Tobacco and Alcohol in Young Adults: Ordinal Logistic Regression Approach.

Context: Reduced insulin sensitivity is one of the traditional risk factors for chronic diseases such as type 2 diabetes. Reduced insulin sensitivity leads to insulin resistance, which in turn can lead to the development of type 2 diabetes. Few studies have examined factors such as blood pressure, tobacco and alcohol consumption that influence changes in insulin sensitivity over time especially among young adults.

Effect of Geography on the Analysis of Coccidioidomycosis-Associated Deaths, United States.

Because coccidioidomycosis death rates vary by region, we reanalyzed coccidioidomycosis-associated mortality in the United States by race/ethnicity, then limited analysis to Arizona and California. Coccidioidomycosis-associated deaths were shown to increase among African-Americans but decrease among Native Americans and Hispanics. Separately, in a Native American cohort, diabetes co-varied with coccidioidomycosis-associated death.

Long-term Effect of Losartan on Kidney Disease in American Indians With Type 2 Diabetes: A Follow-up Analysis of a Randomized Clinical Trial.

Objective: To determine whether early administration of losartan slows progression of diabetic kidney disease over an extended period.

Research Design And Methods: We conducted a 6-year clinical trial in 169 American Indians with type 2 diabetes and urine albumin/creatinine ratio <300 mg/g; 84 participants were randomly assigned to receive losartan and 85 to placebo. Primary outcome was a decline in glomerular filtration rate (GFR; iothalamate) to ≤60 mL/min or to half the baseline value in persons who entered with GFR <120 mL/min.

Relationship of proximal tubular injury to chronic kidney disease as assessed by urinary kidney injury molecule-1 in five cohort studies.

Background: The primary biomarkers used to define CKD are serum creatinine and albuminuria. These biomarkers have directed focus on the filtration and barrier functions of the kidney glomerulus even though albuminuria results from tubule dysfunction as well. Given that proximal tubules make up ∼90% of kidney cortical mass, we evaluated whether a sensitive and specific marker of proximal tubule injury, urinary kidney injury molecule-1 (KIM-1), is elevated in individuals with CKD or with risk factors for CKD.

Cardiovascular autonomic neuropathy associates with nephropathy lesions in American Indians with type 2 diabetes.

Aims: Cardiovascular autonomic neuropathy (CAN) predicts clinical diabetic nephropathy (DN). We investigated the relationship between DN structural lesions and CAN.

Methods: Sixty three Pima Indians with type 2 diabetes underwent kidney biopsies following a 6-year clinical trial testing the renoprotective efficacy of losartan vs.

Metabolic Risk Factors and Type 2 Diabetes Incidence in American Indian Children.

Context: Data are lacking on how metabolic risk factors during childhood affect the long-term risk of type 2 diabetes.

Objectives: Assess four metabolic risk factors as predictors of type 2 diabetes and determine whether the risk differs between younger and older children.

Design: In a prospective cohort study conducted between 1965 and 2007, participants were followed for development of diabetes.

Structural Predictors of Loss of Renal Function in American Indians with Type 2 Diabetes.

Background And Objectives: Diabetes is the leading cause of kidney failure in the United States, but early structural determinants of renal function loss in type 2 diabetes are poorly defined. We examined the association between morphometrically determined renal structural variables and loss of renal function in 111 American Indians with type 2 diabetes who volunteered for a research kidney biopsy at the end of a 6-year clinical trial designed to test the renoprotective efficacy of losartan versus placebo. Participants were subsequently followed in an observational study, in which annual measurements of GFR (iothalamate) initiated during the clinical trial were continued.

Tumor necrosis factor receptors 1 and 2 are associated with early glomerular lesions in type 2 diabetes.

Elevated serum tumor necrosis factor receptor 1 (TNFR1) and 2 (TNFR2) concentrations are strongly associated with increased risk of end-stage renal disease in type 2 diabetes. However, little is known about the early glomerular structural lesions that develop in patients when these markers are elevated. Here, we examined the relationships between TNFRs and glomerular structure in 83 American Indians with type 2 diabetes.

Urinary monocyte chemoattractant protein-1 and hepcidin and early diabetic nephropathy lesions in type 1 diabetes mellitus.

Background: Urinary monocyte chemoattractant protein-1 (MCP-1) and hepcidin are potential biomarkers of renal inflammation. We examined their association with development of diabetic nephropathy (DN) lesions in normotensive normoalbuminuric subjects with type 1 diabetes (T1D) from the Renin-Angiotensin System Study.

Methods: Biomarker concentrations were measured in baseline urine samples from 224 subjects who underwent kidney biopsies at baseline and after 5 years.

Association of urinary KIM-1, L-FABP, NAG and NGAL with incident end-stage renal disease and mortality in American Indians with type 2 diabetes mellitus.

Aims/hypothesis: Kidney injury molecule 1 (KIM-1), liver fatty acid-binding protein (L-FABP), N-acetyl-β-D-glucosaminidase (NAG) and neutrophil gelatinase-associated lipocalin (NGAL) are urinary biomarkers of renal tubular injury. We examined their association with incident end-stage renal disease (ESRD) and all-cause mortality in American Indians with type 2 diabetes.

Methods: Biomarker concentrations were measured in baseline urine samples in 260 Pima Indians who were followed for a median of 14 years.

Effect of losartan on prevention and progression of early diabetic nephropathy in American Indians with type 2 diabetes.

Angiotensin receptor blockers are renoprotective in hypertensive azotemic patients with type 2 diabetes, but their efficacy in early diabetic kidney disease is uncertain. We performed a 6-year randomized clinical trial in 169 American Indians with type 2 diabetes and normoalbuminuria (albumin/creatinine ratio [ACR] <30 mg/g; n = 91) or microalbuminuria (ACR 30-299 mg/g; n = 78) at baseline. The primary outcome was decline in glomerular filtration rate (GFR) to ≤60 mL/min or to half the baseline value in subjects who entered with GFR <120 mL/min.

Assessment of completeness of reporting of oro-facial cleft cases in Arizona using the capture-recapture method.

The Arizona Birth Defects Monitoring Program (ABDMP) is mandated to collect data on several birth defects including oro-facial clefts such as cleft lip with and without cleft palate (CL) and cleft palate without cleft lip (CP). Completeness of reporting and ascertainment validations had never been conducted on the birth defects monitored by the program. Two-source capture-recapture modeling was used to evaluate the completeness of incidence reporting of CL and CP.