Department of Nephrology and Dialysis, University Hospital of Split, Spinčićeva 1, 21 000 Split, Croatia.
Department of Internal Medicine, University of Split School of Medicine, Šoltanska 2, 21 000 Split, Croatia.
Int J Environ Res Public Health. 2022 Sep 4;19(17):11060. doi: 10.3390/ijerph191711060.
There is limited evidence on the associations between dietary patterns, body composition, and nonclassical predictors of worse outcomes such as advanced glycation end products (AGE) in kidney transplant recipients (KTRs). The aim of this cross-sectional study was to determine the level of AGE-determined cardiovascular (CV) risk in Dalmatian KTRs and possible associations between AGE, adherence to the Mediterranean diet (MeDi), and nutritional status. Eighty-five (85) KTRs were enrolled in this study. For each study participant, data were collected on the level of AGE, as measured by skin autofluorescence (SAF), Mediterranean Diet Serving Score (MDSS), body mass composition, anthropometric parameters, and clinical and laboratory parameters. Only 11.76% of the participants were adherent to the MeDi. Sixty-nine percent (69%) of KTRs had severe CV risk based on AGE, while 31% of KTRs had mild to moderate CV risk. The results of the LASSO regression analysis showed that age, dialysis type, dialysis vintage, presence of CV and chronic kidney disease, C- reactive protein level, urate level, percentage of muscle mass, and adherence to recommendations for nuts, meat, and sweets were identified as positive predictors of AGE. The negative predictors for AGE were calcium, phosphate, cereal adherence according to the MeDi, and trunk fat mass. These results demonstrate extremely low adherence to the MeDi and high AGE levels related CV risk in Dalmatian KTRs. Lifestyle interventions in terms of CV risk management and adherence to the MeDi of KTRs should be taken into consideration when taking care of this patient population.
在饮食模式、身体成分和非经典预后指标（如晚期糖基化终产物 [AGE]）与肾移植受者（KTR）不良预后之间的关联方面，证据有限。本横断面研究的目的是确定达尔马提亚 KTR 中由 AGE 确定的心血管（CV）风险水平，以及 AGE、对地中海饮食（MeDi）的依从性和营养状况之间的可能关联。本研究纳入了 85 名 KTR。对于每个研究参与者，收集了由皮肤自发荧光（SAF）测量的 AGE 水平、地中海饮食服务评分（MDSS）、身体成分、人体测量参数以及临床和实验室参数的数据。只有 11.76%的参与者遵循 MeDi。69%的 KTR 根据 AGE 存在严重的 CV 风险，而 31%的 KTR 存在轻度至中度 CV 风险。LASSO 回归分析的结果表明，年龄、透析类型、透析年限、CV 和慢性肾脏病的存在、C 反应蛋白水平、尿酸水平、肌肉质量百分比以及坚果、肉类和甜食推荐的依从性被确定为 AGE 的阳性预测因子。AGE 的负预测因子是钙、磷、根据 MeDi 对谷物的依从性和躯干脂肪量。这些结果表明，达尔马提亚 KTR 对 MeDi 的依从性极低，与 CV 风险相关的 AGE 水平极高。在照顾此类患者人群时，应考虑对 KTR 进行 CV 风险管理和遵循 MeDi 的生活方式干预。
