Anoop Shankar

University of Washington

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Charumathi Sabanayagam

Duke-NUS Medical School

Tien Yin Wong

National University of Singapore

Ronald Klein

University of Chicago

Srinivas Teppala

Griffith University

Alan Ducatman

West Virginia University

Seang‐Mei Saw

National University of Singapore

Barbara E.K. Klein

University of Wisconsin–Madison

Jie Xiao

Chinese Academy of Medical Sciences & Peking Union Medical College

E. Shyong Tai

National University of Singapore

Paul Muntner

University of Alabama at Birmingham

Cooperative Institutions

University of Washington

Institute for Health Metrics and Evaluation

National University of Singapore

University of Sydney

West Virginia University

Johns Hopkins University

University of Wisconsin–Madison

National University Health System

Singapore Eye Research Institute

Heidelberg University

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Global Cardiovascular and Renal Outcomes of Reduced GFR

Journal of the American Society of Nephrology (2017)

Bernadette Thomas Kunihiro Matsushita Kalkidan Hassen Abate Ziyad Al‐Aly Johan Ärnlöv

The burden of premature death and health loss from ESRD is well described. Less is known regarding the burden of cardiovascular disease attributable to reduced GFR. We estimated the prevalence of reduced GFR categories 3, 4, and 5 (not on RRT) for 188 countries at six time points from 1990 to 2013. Relative risks of cardiovascular outcomes by three categories of reduced GFR were calculated by pooled random effects meta-analysis. Results are presented as deaths for outcomes of cardiovascular disease and ESRD and as disability-adjusted life years for outcomes of cardiovascular disease, GFR categories 3, 4, and 5, and ESRD. In 2013, reduced GFR was associated with 4% of deaths worldwide, or 2.2 million deaths (95% uncertainty interval [95% UI], 2.0 to 2.4 million). More than half of these attributable deaths were cardiovascular deaths (1.2 million; 95% UI, 1.1 to 1.4 million), whereas 0.96 million (95% UI, 0.81 to 1.0 million) were ESRD-related deaths. Compared with metabolic risk factors, reduced GFR ranked below high systolic BP, high body mass index, and high fasting plasma glucose, and similarly with high total cholesterol as a risk factor for disability-adjusted life years in both developed and developing world regions. In conclusion, by 2013, cardiovascular deaths attributed to reduced GFR outnumbered ESRD deaths throughout the world. Studies are needed to evaluate the benefit of early detection of CKD and treatment to decrease these deaths.

10.1681/asn.2016050562

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Citations (171)

Effect of provider volume on resource utilization for surgical procedures of the knee

Knee Surgery Sports Traumatology Arthroscopy (2004)

Nitin B. Jain Ricardo Pietrobon Ulrich Güller Anoop Shankar Ajit S. Ahluwalia

10.1007/s00167-004-0516-6

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Citations (26)

BMI and Retinal Vascular Caliber in Children

Obesity (2007)

Ning Cheung Seang‐Mei Saw Amirul Islam Sophie Rogers Anoop Shankar

In adult populations, changes in retinal vascular caliber have been linked with obesity and metabolic syndrome. We examined the association of BMI and weight with retinal vascular caliber in children.This was a school-based, cross-sectional study of 768 children, 7 to 9 years old, randomly sampled from the Singapore Cohort Study of the Risk Factors for Myopia. Participants had digital retinal photographs. Retinal vascular caliber was measured using a computer-based program and combined to provide average calibers of arterioles and venules in that eye. Weight and height were measured using standardized protocol. These data were used to calculate BMI.In this population, the mean retinal arteriolar and venular calibers were 156.40 microm [95% confidence interval (CI), 155.44 to 157.36] and 225.43 microm (95% CI, 224.10 to 226.74) respectively. After controlling for age, gender, race, parental monthly income, axial length, birth weight, and birth length, each 3.1 kg/m2 (standard deviation) increase in BMI was associated with a 2.55-microm (95% CI, 1.21 to 3.89; p < 0.001) larger retinal venular caliber. In multivariable analysis, greater weight was also significantly associated with larger retinal venular caliber. BMI and weight were not associated with retinal arteriolar caliber. Height was not significantly associated with retinal arteriolar or venular caliber.Greater BMI and weight are associated with larger retinal venular caliber in healthy children.

Caliber

10.1038/oby.2007.576

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Citations (94)

The association between active smoking, smokeless tobacco, second-hand smoke exposure and insufficient sleep

Sleep Medicine (2010)

Charumathi Sabanayagam Anoop Shankar

Odds

Sleep

Rest (music)

10.1016/j.sleep.2010.09.002

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Citations (130)

The association between circulating white blood cell count, triglyceride level and cardiovascular and all-cause mortality: Population-based cohort study

Atherosclerosis (2006)

Anoop Shankar Paul Mitchell Elena Rochtchina Jie Jin Wang

Quartile

White blood cell

Risk of mortality

10.1016/j.atherosclerosis.2006.04.029

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Citations (53)

Urinary Bisphenol A and Hypertension in a Multiethnic Sample of US Adults

Journal of Environmental and Public Health (2012)

Anoop Shankar Srinivas Teppala

Background . Bisphenol A (BPA) is a common chemical used in the manufacture of polycarbonate plastics and epoxy resins, with >93% of US adults having detectable BPA levels in urine. Recent animal studies have suggested that BPA exposure may have a role in several mechanisms involved in the development of hypertension, including weight gain, insulin resistance, thyroid dysfunction, endothelial dysfunction, and oxidative stress. However, no previous human study has examined the association between markers of BPA exposure and hypertension. Methods . We examined urinary BPA levels in 1380 subjects from the National Health and Nutritional Examination Survey 2003-2004. Main outcome-of-interest was hypertension, defined as blood pressure-reducing medication use and/or blood pressures >140/90 mm of Hg (n=580). Results . We observed a positive association between increasing levels of urinary BPA and hypertension independent of confounding factors such as age, gender, race/ethnicity, smoking, body mass index (BMI), diabetes mellitus and total serum cholesterol levels. Compared to tertile 1 (referent), the multivariate-adjusted odds ratio (95% confidence interval) of hypertension associated with tertile 3 was 1.50 (1.12−2.00); P -trend = 0.007. The association was consistently present in subgroup analyses by race/ethnicity, smoking status, BMI, and diabetes mellitus. Conclusions . Urinary BPA levels are associated with hypertension, independent of traditional risk factors.

10.1155/2012/481641

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Citations (152)

A cross-sectional analysis of type II diabetes in a community with exposure to perfluorooctanoic acid (PFOA)

Environmental Research (2009)

Jessica R. MacNeil N. Kyle Steenland Anoop Shankar Alan Ducatman

Perfluorooctanoic acid

Decile

Cross-sectional study

Impaired fasting glucose

10.1016/j.envres.2009.08.002

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Citations (92)

Socioeconomic status and microalbuminuria in an Asian population

Elements (2020)

Charumathi Sabanayagam Anoop Shankar Seang‐Mei Saw Su Chi Lim E. Shyong Tai

BACKGROUND In studies from developed Western countries, lower socioeconomic status (SES) has been reported to be associated with kidney diseases. However, this hypothesis has not been examined in populations from newly industrialized Asian countries. We evaluated the association between SES and micro/macroalbuminuria in a population-based sample in Singapore. METHODS We examined 920 participants of Malay ethnicity aged 40-80 years (49.6% female). SES was defined through education, income and housing type of participants. The main outcome of interest was the presence of micro/macroalbuminuria defined as a urinary albumin-to-creatinine ratio (ACR) >or=17 mg/g for men and >or=25 mg/g for women. RESULTS Lower categories of SES were associated with micro/macroalbuminuria; compared to the higher categories of SES, the odds ratio (95% confidence interval) of micro/macroalbuminuria was 1.76 (1.23-2.52) for primary/lower education, 1.64 (1.16-2.31) for income <1000 Singapore dollars (SGD)/retired status, 1.44 (1.01-2.06) for small/medium housing type and 2.37 (1.56-3.60) for the coexistence of all three low SES factors (primary/ below education, income <1000 SGD/retired status and small/medium housing type) compared to

Microalbuminuria

Malay

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Citations (0)

The relationship between albuminuria and hypercholesterolemia.

PubMed (2004)

Anoop Shankar Ronald Klein Scott E Moss Ronald Klein Tien Yin Wong

Albuminuria

Microalbuminuria

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Citations (28)

The Relationship Between Surgeon and Hospital Volume and Outcomes for Shoulder Arthroplasty

Journal of Bone and Joint Surgery (2004)

Nitin B. Jain Ricardo Pietrobon Shawn Hocker Ulrich Güller Anoop Shankar

Background: As far as we know, no previous study has determined the relationship between volume and outcomes for shoulder arthroplasty. We hypothesized that surgeons and hospitals with higher caseloads of total shoulder arthroplasties and hemiarthroplasties have better outcomes as measured by decreased mortality rate, shorter length of stay in the hospital, reduced postoperative complications, and routine disposition of patients on discharge. Methods: Data on patients undergoing shoulder arthroplasty were extracted from the Nationwide Inpatient Sample databases for the years 1988 through 2000. Logistic regression with generalized estimating equations and multiple linear regression models were used to estimate the adjusted association between surgeon and hospital volume and outcomes for total shoulder arthroplasty and hemiarthroplasty after adjusting for comorbidity, age, race, household income, and sex. Results: The mortality rates for patients who had a total shoulder arthroplasty performed by surgeons who did fewer than two procedures per year (0.36%) or who did between two and fewer than four procedures per year (0.32%) were higher than those for patients who had a total shoulder arthroplasty performed by surgeons who did four procedures or more per year (0.20%). The risk-adjusted rate of postoperative complications after hemiarthroplasty was significantly higher for patients managed by surgeons who performed fewer than two procedures per year (1.68%) than for those managed by surgeons with a volume of five procedures or more per year (0.97%). The possibility of postoperative complications when total shoulder arthroplasty was performed in hospitals with a volume of fewer than five procedures (1.44%) or in those with a volume of five to ten procedures per year (1.45%) was significantly higher than that in hospitals where ten procedures or more were performed every year (0.64%). The mean lengths of stay in the hospital after total shoulder arthroplasty and hemiarthroplasty were significantly longer when the operations were performed by surgeons who did fewer than two procedures per year or when they were done in hospitals with a volume of fewer than five procedures per year or with a volume of five to fewer than ten procedures per year than when they were done in hospitals or by surgeons in the highest volume category (p < 0.001). Conclusions: Patients who have a total shoulder arthroplasty or hemiarthroplasty performed by a high-volume surgeon or in a high-volume hospital are more likely to have a better outcome. Level of Evidence: Therapeutic study, Level III-2 (retrospective cohort study). See Instructions to Authors for a complete description of levels of evidence.

10.2106/00004623-200403000-00006

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Citations (265)