Dietary total antioxidant capacity, cardiovascular risk, and anthropometric obesity indices in hemodialysis patients
A case-control study
Palabras clave:
Anthropometry, Antioxidant, Cardiovascular risk, Hemodialysis, PatientsResumen
Objective
Oxidative stress is triggered by malnutrition and antioxidant losses due to dialysis in hemodialysis patients and thus, oxidative stress increases the risk of mortality in patients with cardiovascular disease and obesity. The study aims to determine differences in cardiovascular risk scores and obesity indices between hemodialysis and control groups and to examine the relationship between the tertiles of dietary total antioxidant capacity with cardiovascular risk, and obesity in hemodialysis and control groups.
Methods
This is a cross-sectional case-control study involving hemodialysis patients (n=46) and healthy individuals (n=46). Participants’ general characteristics were obtained via a questionnaire, and the Framingham Risk Score was calculated. The dietary total antioxidant capacity was calculated using two methods based on a seven-day food record. Obesity indices, such as Basal Metabolism Index and Body Shape Index, were calculated using anthropometric measurements.
Results
The mean age of the participants was 51.1±10.4 years. In the hemodialysis group, obesity indices including body weight, Basal Metabolism Index, waist circumference, fat mass index, and fat-free mass index were lower, while Framingham Risk Score values were higher than the control group (p<0.05). Energy-adjusted dietary total antioksidant capacity values were lower in hemodialysis group, and most patients were in the low tertiles of Trolox equivalent antioxidant capacity, total radical-trapping antioxidant parameter, ferric reducing-antioxidant power and vitamin C equivalent antioxidant capacity (p<0.05).
Conclusion
Providing hemodialysis patients with a healthy diet can increase the dietary total antioxidant capacity, and potentially reduce cardiovascular risk, and obesity indices.
Citas
Modaresi A, Nafar M, Sahraei Z. Oxidative stress in chronic kidney disease. Iran J Kidney Dis. 2015;9(3):165-79.
Soleymanian T, Ranjbar A, Alipour M, Ganji MR, Najafi I. Impact of Kidney Transplantation on Biomarkers of Oxidative Stress and Inflammation. Iran J Kidney Dis [Internet]. 2015 [cited 2024 Jan 8];9(5):400-5. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26338165
Liakopoulos V, Roumeliotis S, Gorny X, Dounousi E, Mertens PR. Oxidative Stress in Hemodialysis Patients: A Review of the Literature. Oxid Med Cell Longev. 2017;2017:3081856. https://doi.org/10.1155/2017/3081856
Bouayed J, Bohn T. Exogenous antioxidants – Double-edged swords in cellular redox state: Health beneficial effects at physiologic doses versus deleterious effects at high doses. Oxid Med Cell Longev. 2010;3(4):22837. https://doi.org/10.4161/oxim.3.4.12858
Puchau B, Zulet MÁ, Echávarri AG, Hermsdorff HHM, Martínez JA. Dietary total antioxidant capacity: A novel indicator of diet quality in healthy young adults. J Am Coll Nutr. 2009;28(6):648-56. https://doi.or g/10.1080/07315724.2009.10719797
Wang Y, Yang M, Lee SG, Davis CG, Koo SI, Chun OK. Dietary Total Antioxidant Capacity Is Associated with Diet and Plasma Antioxidant Status in Healthy Young Adults. J Acad Nutr Diet. 2012;112(10): P162635. https://doi.org/10.1016/j.jand.2012.06.007
Wang Y, Yang M, Lee SG, Davis CG, Kenny A, Koo SI, et al. Plasma total antioxidant capacity is associated with dietary intake and plasma level of antioxidants in postmenopausal women. J Nutr Biochem. 2012;23(12): 1725-31. https://doi.org/10.1016/j.jnutbio.2011.12.004
Cozzolino M, Mangano M, Stucchi A, Ciceri P, Conte F, Galassi A. Cardiovascular disease in dialysis patients. Nephrol Dial Transplant. 2018;33:28-34. https://doi.org/10.1093/ndt/gfy174
Akil L, Anwar Ahmad H. Relationships between obesity and cardiovascular diseases in four southern states and Colorado. J Health Care Poor Underserved. 2011;22:61-72. https://doi.org/10.1353/hpu.2011.0166
Kutluay-Merdol T. Toplu Beslenme Yapılan Kurumlar İçin Standart Yemek Tarifeleri. 3rd ed. Ankara: Hatiboğlu Basım ve Yayın San. Tic. LTD. ŞTİ.; 2003.
Rakıcıoğlu N, Tek AN, Ayaz A, Pekcan G. Photograph Catalog of Food and Dishes: Portion Sizes and Amounts. 3rd ed. Ankara: Ata Ofset Pub.; 2012.
Haytowitz DB, Bhagwat SA, Prior RL, Wu X, Gebhardt SE, Holden JM. 2007. Oxygen Radical Absorbance Capacity (ORAC) of Selected Food – 2007 [Internet]. Maryland: USDA; 2007 [cited 2024 Jan 28]. Available from: https://www.govinfo.gov/content/pkg/GOVPUB-A77-PURL-LPS106748/pdf/GOVPUB-A77-PURLLPS106748.pdf
Floegel A, Kim DO, Chung SJ, Song WO, Fernandez ML, Bruno RS, et al. Development and validation of an algorithm to establish a total antioxidant capacity database of the US diet. Int J Food Sci Nutr. 2010;61(6): 600-23. https://doi.org/10.3109/09637481003670816
Haytowitz DB, Bhagwat SA. USDA Database for the Oxygen Radical Absorbance Capacity (ORAC) of Selected Foods, Release 2 [Internet]. Maryland: USDA; 2010. [cited 2024 Jan 28]. Available from: https:// www.ars.usda.gov/research/publications/publication/?seqNo115=251105
Wang H, Cao G, Prior RL. Total antioxidant capacity of fruits. J Agric Food Chem. 1996;44(3):701-5 https:// doi.org/10.1021/jf950579y
Wu X, Beecher GR, Holden JM, Haytowitz DB, Gebhardt SE, Prior RL. Lipophilic and hydrophilic antioxidant capacities of common foods in the United States. J Agric Food Chem. 2004;52(12):4026-37. https://doi. org/10.1021/jf049696w
Wu X, Gu L, Holden J, Haytowitz DB, Gebhardt SE, Beecher G, et al. Development of a database for total antioxidant capacity in foods: A preliminary study. J Food Compos Anal. 2004;17(3-4):407-22. https://doi. org/10.1016/j.jfca.2004.03.001
Pellegrini N, Serafini M, Colombi B, Del Rio D, Salvatore S, Bianchi M, et al. Total antioxidant capacity of plant foods, beverages and oils consumed in Italy assessed by three different in vitro assays. J Nutr. 2003;133(9):2812-19. https://doi.org/10.1093/jn/133.9.2812
Pellegrini N, Serafini M, Salvatore S, Del Rio D, Bianchi M, Brighenti F. Total antioxidant capacity of spices, dried fruits, nuts, pulses, cereals and sweets consumed in Italy assessed by three different in vitro assays. Mol Nutr Food Res. 2006;50(11):1030-8. https://doi.org/10.1002/mnfr.200600067
Halvorsen BL, Carlsen MH, Phillips KM, Bøhn SK, Holte K, Jacobs DR, et al. Content of redox-active compounds (ie, antioxidants) in foods consumed in the United States. Am J Clin Nutr. 2006;84(1):95-135. https://doi.org/10.1093/ajcn/84.1.95
Christakoudi S, Tsilidis KK, Muller DC, Freisling H, Weiderpass E, Overvad K, et al. A Body Shape Index (ABSI) achieves better mortality risk stratification than alternative indices of abdominal obesity: results from a large European cohort. Sci Rep. 2020;10(1):14541. https://doi.org/10.1038/s41598-020-71302-5
Krakauer NY, Krakauer JC. A new body shape index predicts mortality hazard independently of body mass index. Plos One. 2012;7(7):e39504. https://doi.org/10.1371/journal.pone.0039504
Ashwell M, Hsieh SD. Six reasons why the waist-to-height ratio is a rapid and effective global indicator for health risks of obesity and how its use could simplify the international public health message on obesity. Int J Food Sci Nutr. 2005;56(5):303-7. https://doi.org/10.1080/09637480500195066
Lukaski HC, Siders WA. Validity and accuracy of regional bioelectrical impedance devices to determine whole-body fatness. Nutrition. 2003;19(10):851-7. https://doi.org/10.1016/s0899-9007(03)00166-7
Lu Y, Shu H, Zheng Y, Li C, Liu M, Chen Z, et al. Comparison of fat-free mass index and fat mass index in Chinese adults. Eur J Clin Nutr. 2012;66(9):1004-7. https://doi.org/10.1038/ejcn.2012.86
Dullaart RPF, De Vries R, Sluiter WJ, Voorbij HAM. High plasma C-reactive protein (CRP) is related to low paraoxonase-I (PON-I) activity independently of high leptin and low adiponectin in type 2 diabetes mellitus. Clin Endocrinol (Oxf). 2009;70(2):221-6. https://doi.org/10.1111/j.1365-2265.2008.03306.x
Razminia M, Trivedi A, Molnar J, Elbzour M, Guerrero M, Salem Y, et al. Validation of a new formula for mean arterial pressure calculation: The new formula is superior to the standard formula. Catheter Cardiovasc Interv. 2004;63(4):419-25. https://doi.org/10.1002/ccd.20217
Wilson PWF, D’Agostino RB, Levy D, Belanger AM, Silbershatz H, Kannel WB. Prediction of coronary heart disease using risk factor categories. Circulation. 1998;97(18):1837-47. https://doi.org/10.1161/01.CIR.97.18.1837
Kültürsay H. Methods of risk estimation for cardiovascular disease. Archives Turkish Soc Cardiol. 2011;39(4):613. https://doi.org/10.5543/tkda.2011.kultursay
IBM Corp. Released 2013. IBM SPSS Statistics for Windows, Version 22.0 [software]. Armonk, NY: IBM Corp; 2013.
Abshirini M, Siassi F, Koohdani F, Qorbani M, Mozaffari H, Aslani Z, et al. Dietary total antioxidant capacity is inversely associated with depression, anxiety and some oxidative stress biomarkers in postmenopausal women: a cross-sectional study. Ann Gen Psychiatry. 2019;18(1). https://doi.org/10.1186/s12991-019-0225-7
Ural A, Kılıç İ. Bilimsel Araştırma Süreci ve SPSS ile Veri Analizi. Ankara: Detay Yayıncılık; 2011.
Hayran M, Hayran M. Sağlık araştırmaları için temel istatistik. Ankara: Omega Araştırma Organizasyon Eğit. Danış. Ltd. Şti.; 2011.
Süleymanlar G, Ateş K, Seyahi N. Türkiye’de nefroloji, diyaliz ve transplantasyon. Türk Nefroloji Derneği Yayınları; 2019.
Ama Moor VJ, Nansseu JRN, Azingni DBT, Kaze FF. Assessment of the 10-year risk of cardiovascular disease among a group of patients on maintenance hemodialysis: A cross-sectional study from Cameroon. JRSM Cardiovasc Dis. 2017;6. https://doi.org/10.1177/2048004017705273
Andrade IS, Cunha CM, Brito BP, França FCO, Oliveira LPM. Malnutrition and cardiovascular risk in haemodialysis patients with chronic kidney disease. Rev Nutr. 2019;32:e190050. https://doi.org/10.1590/16789865201932e190050
Cedeño Mora S, Goicoechea M, Torres E, Verdalles Ú, Pérez de José A, Verde E, et al. Cardiovascular risk prediction in chronic kidney disease patients. Nefrologia. 2017;37(3):293-300. https://doi.org/10.1016/j. nefroe.2017.03.005
Ahmadmehrabi S, Tang WHW. Hemodialysis-induced cardiovascular disease. Semin Dial. 2018;31(3):258-7. https://doi.org/10.1111/sdi.12694
Kotur-Stevuljevic J, Simic-Ogrizovic S, Dopsaj V, Stefanovic A, Vujovic A, Ivanic-Corlomanovic T, et al. A hazardous link between malnutrition, inflammation and oxidative stress in renal patients. Clin Biochem. 2012;45(15):1202-5. https://doi.org/10.1016/j.clinbiochem.2012.04.021
Rapa SF, Di Iorio BR, Campiglia P, Heidland A, Marzocco S. Inflammation and Oxidative Stress in Chronic Kidney Disease-Potential Therapeutic Role of Minerals, Vitamins and Plant-Derived Metabolites. Int J Mol Sci. 2019;21(1):263. https://doi.org/10.3390/ijms21010263
Roach LA, Lambert K, Holt JL, Meyer BJ. Diet quality in patients with end-stage kidney disease undergoing dialysis. J Ren Care. 2017;43(4):226-34. https://doi.org/10.1111/jorc.12215
Sabatino A, Piotti G, Cosola C, Gandolfini I, Kooman JP, Fiaccadori E. Dietary protein and nutritional supplements in conventional hemodialysis. Semin Dial. 2018;31(6):583-91. https://doi.org/10.1111/sdi.12730
Wang Y, Chun O, Song W. Plasma and Dietary Antioxidant Status as Cardiovascular Disease Risk Factors: A Review of Human Studies. Nutrients [Internet]. 2013 [cited 2024 Jan 8];5(8):2969-3004. Available from: http://www.mdpi.com/2072-6643/5/8/2969
