Risk factor paradox in wasting diseases.

Risk factor paradox in wasting diseases. Research Abstract Details 

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Risk factor paradox in wasting diseases. Abstract Text:

Kamyar Kalantar-Zadeh,Tamara B Horwich,Antigone Oreopoulos,Csaba P Kovesdy,Houman Younessi,Stefan D Anker,John E Morley,

PURPOSE OF REVIEW: Emerging data indicate that conventional cardiovascular risk factors (e.g. hypercholesterolemia and obesity) are paradoxically associated with better survival in distinct populations with wasting. We identify these populations and review survival paradoxes and common pathophysiologic mechanisms. RECENT FINDINGS: A 'reverse epidemiology' of cardiovascular risk is observed in chronic kidney disease, chronic heart failure, chronic obstructive lung disease, cancer, AIDS and rheumatoid arthritis, and in the elderly. These populations apparently have slowly progressive to full-blown wasting and significantly greater short-term mortality than the general population. The survival paradoxes may result from the time differential between the two competing risk factors [i.e. over-nutrition (long-term killer but short-term protective) versus undernutrition (short-term killer)]. Hemodynamic stability of obesity, protective adipokine profile, endotoxin-lipoprotein interaction, toxin sequestration of fat, antioxidation of muscle, reverse causation, and survival selection may also contribute. SUMMARY: The seemingly counterintuitive risk factor paradox is the hallmark of chronic disease states or conditions associated with wasting disease at the population level. Studying similarities among these populations may help reveal common pathophysiologic mechanisms of wasting disease, leading to a major shift in clinical medicine and public health beyond the conventional Framingham paradigm and to novel therapeutic approaches related to wasting and short-term mortality.

Risk factor paradox in wasting diseases. Publishing Authors By Initials

K Kalantar-Zadeh,TB Horwich,A Oreopoulos,CP Kovesdy,H Younessi,SD Anker,JE Morley,

For similar nutritional and metabolic diseases: metabolic diseases: wasting syndrome research abstracts see: nutritional and metabolic diseases: metabolic diseases: wasting syndrome research

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Risk factor paradox in wasting diseases. Journal Published:

PUBLICATION TYPE: Review

Journal: Current opinion in clinical nutrition and metaboli

VOLUME: 10

Page Numbers: 433-42

Journal Abbreviation:

ISSN: 1363-1950

DAY: 3

MONTH: Jul

YEAR: 2007

Risk factor paradox in wasting diseases. Information

Number of References: 102

LANGUAGE: eng

NlmUniqueID: 9804399

Risk factor paradox in wasting diseases. Keywords Mesh Terms:

KEYWORDS: Wasting Syndrome

MESH TERMS: mortality

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Grant and Affiliation Information for Risk factor paradox in wasting diseases.

AFFILIATION: Harold Simmons Center for Kidney Disease Research and Epidemiology, Los Angeles Biomedical Research Center at Harbor-UCLA, Torrance, California 90509-2910, USA. kamkal@ucla.edu

Country: England

AGENCY: United States NIDDK

GRANT: DK61162

ACRONYM: DK

MEDLINETA: Curr Opin Clin Nutr Metab Care

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