Dietary Nutrients and Cardiovascular Risk Factors among Renal Transplant Recipients
Abstract
:1. Introduction
2. Material and Methods
2.1. Study Design and Participants
2.2. Patient Characteristics and Laboratory Parameters
2.3. Traditional and Nontraditional CVD Risk Factors
2.4. Dietary Intake
2.5. Statistical Analysis
3. Results
3.1. Characteristics and CVD Risk Factors of RTRs
3.2. The Proportion of RTRs with Adequate Nutrient Intake
3.3. Nutrient Intake Adequacy and Traditional CVD Risk Factors
3.4. Nutrient Intake Adequacy and Nontraditional CVD Risk Factors
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Variables | All Patients Mean ± SD | Patients with CVD Risk Factors n (%) | CVD Risk Factors | ||
---|---|---|---|---|---|
Characteristics | |||||
Age, y | 48.9 | 12.8 | 8 | (7.5) | <65 1,2 |
Gender | 61 | (57.5) | Men 1,2 | ||
Hemodialysis vintage, y | 6.5 | 4.9 | |||
Transplant vintage, y | 8.6 | 5.9 | |||
Hypertension | 94 | (88.6) | |||
Dyslipidemia | 34 | (32.1) | |||
Diabetes mellitus | 23 | (21.7) | |||
Traditional CVD risk factors | |||||
WC, cm | 83.4 | 9.8 | 44 | (41.5) | ≥90 for male; ≥80 for female 3 |
BMI, kg/m2 | 24.0 | 3.7 | 55 | (51.9) | ≥ 24 3 |
TBF, % | 26.3 | 7.4 | 54 | (50.9) | ≥25 for male; ≥30 for female 4 |
SBP, mm Hg | 132.6 | 15.9 | 63 | (59.4) | ≥130 5 |
DBP, mm Hg | 77.5 | 11.8 | 42 | (39.6) | ≥80 5 |
FPG, mg/dL | 126.9 | 24.0 | 94 | (88.7) | ≥126 6 |
HOMA-IR | 2.3 | 4.5 | 53 | (50.0) | ≥1.44 (median) |
TC, mg/dL | 205.4 | 43.6 | 54 | (50.1) | ≥200 7 |
LDL-C, mg/dL | 118.9 | 38.0 | 69 | (65.1) | ≥100 7 |
HDL-C, mg/dL | 52.0 | 17.7 | 41 | (38.7) | <40 for male; <50 for female 7 |
TG, mg/dL | 156.1 | 118.0 | 32 | (30.2) | ≥150 7 |
Nontraditional CVD risk factors | |||||
Hemoglobin, g/dL | 12.6 | 3.8 | 51 | (48.1) | <12 for male; <13 for female 8 |
Serum creatinine, mg/dL | 1.49 | 0.89 | 52 | (49.1) | ≥1.29 (median) |
eGFR, ml/min/1.73 m2 | 55.1 | 20.7 | 33 | (31.1) | ≤45; CKD stage 3b–5 8 |
Corrected calcium, mg/dL | 9.2 | 0.9 | 11 | (10.4) | <8.4 8 |
Serum phosphate, mg/dL | 3.5 | 1.0 | 57 | (53.8) | <3.5 8 |
iPTH, pg/mL | 116.1 | 123.7 | 18 | (17.0) | ≥150 8 |
hs-CRP, mg/dL | 4.43 | 5.86 | 87 | (82.1) | >0.5 9 |
Uric acid, g/dL | 6.3 | 1.3 | 36 | (34.0) | <7.0 10 |
Serum potassium, mg/dL | 4.4 | 0.5 | 12 | (11.4) | ≥5.0 11 |
Numbers of CVR risk factors | 8.3 | 2.7 |
Nutrient | All Patients Mean ± SD | Patients within Normal Ranges n (%) | Recommended Dietary Intake Values | ||
---|---|---|---|---|---|
Calorie density, kcal/kg BW 1 | 30.41 | 7.2 | 29 | (27.4) | ≥35 |
Protein density, g/kg BW 2 | 1.12 | 0.3 | 19 | (18.0) | M ≤ 0.84; F ≤ 0.75 |
Dietary carbohydrates, % 3 | 211.5 | 49.7 | 22 | (20.8) | >50 |
Total dietary fat, % of energy 2 | 39.8 | 5.9 | 23 | (21.7) | <35 |
SFA, % of energy 2 | 8.7 | 3.2 | 44 | (41.5) | ≤8 |
MUFA, % of energy 2 | 12.0 | 4.4 | 101 | (95.3) | ≤20 |
PUFA, % of energy 3 | 12.0 | 5.3 | 41 | (38.7) | ≤10 |
Cholesterol, mg 3 | 249.5 | 125.3 | 43 | (40.6) | <200 |
Fiber, g 2 | 12.7 | 5.3 | 3 | (2.8) | M ≥ 30; F ≥ 25 |
Vitamins | |||||
Vitamin A, μg 4 | 778.4 | 517.3 | 53 | (50.0) | ≥700 |
Vitamin E, mg 1 | 28.8 | 15.2 | 21 | (19.8) | >12 |
Vitamin C, mg 4 | 101.9 | 71.9 | 63 | (59.4) | ≥75 |
Vitamin B1, mg 4 | 1.0 | 0.4 | 33 | (31.1) | M ≥1.2; F ≥ 1.1 |
Vitamin B2, mg 4 | 0.8 | 0.3 | 14 | (13.2) | M ≥1.3; F ≥ 1.1 |
Vitamin B3 (Niacin), mg 4 | 11.6 | 4.3 | 26 | (24.5) | M ≥ 16; F ≥ 14 |
Vitamin B6, mg 4 | 1.2 | 0.5 | 29 | (27.4) | ≤50 year ≥ 1.3; >50 year M ≥ 1.7; F ≥ 1.5 |
Vitamin B12, μg 4 | 2.9 | 2.2 | 50 | (47.2) | ≥2.4 |
Folic acid, μg 4 | 195.9 | 98.9 | 5 | (4.7) | ≥400 |
Minerals | |||||
Sodium, mg 2 | 1020.9 | 655.5 | 10 | (9.4) | ≥2000 |
Potassium, mg 4 | 1822.6 | 619.0 | 40 | (37.7) | ≥1950 |
Calcium, mg 2 | 349.8 | 160.2 | 1 | (0.9) | ≥1000 |
Magnesium, mg 1 | 280.2 | 539.0 | 6 | (6.6) | M ≥ 350; F ≥ 300 |
Phosphorus, mg 4 | 731.6 | 226.2 | 41 | (38.7) | ≥800 |
Iron, mg 4 | 8.4 | 2.8 | 31 | (29.2) | M ≥ 8; F ≥ 15 |
Zinc, mg 4 | 8.1 | 2.8 | 3 | (2.8) | M > 15; F > 12 |
High WC | High BMI | High TBF | High BP | High FPG | HOMA | High TC | High LDL-C | Low HDL-C | High TG | |
---|---|---|---|---|---|---|---|---|---|---|
OR (95% CI) | (95% CI) | (95% CI) | (95% CI) | (95% CI) | (95% CI) | (95% CI) | (95% CI) | (95% CI) | (95% CI) | |
Nutrients | ||||||||||
Energy/kg | 1.05 (0.12–9.30) | 1.29 (0.15–11.19) | 0.73 (0.27–2.00) | 0.05 (0.01–0.81) † | 0.42 (0.04–4.30) | 0.39 (0.04–3.93) | 0.09 (0.01–1.28) | 0.07 (0.00–1.25) | ||
Protein/kg | 1.08 (0.95–1.24) | 1.07 (0.92–1.24) | 0.85 (0.24–3.08) | 1.02 (0.89–1.17) | 1.04 (0.90–1.20) | 1.09 (0.94–1.25) | 0.87 (0.74–1.03) | 0.98 (0.84–1.15) | ||
Carbohydrate | 1.12 (0.96–1.30) | 1.04 (0.91–1.20) | 1.08 (0.93–1.25) | 1.08 (0.93–1.25) | 0.53 (0.17–1.67) | 1.03 (0.89–1.19) | 0.99 (0.86–1.14) | 0.90 (0.77–1.04) | 1.10 (0.93–1.30) | 1.26 (1.01–1.57) † |
Fat | 0.94 (0.75–1.17) | 0.89 (0.71–1.10) | 0.98 (0.79–1.21) | 0.98 (0.78–1.21) | 0.65 (0.21–2.02) | 1.07 (0.85–1.35) | 1.00 (0.81–1.24) | 0.91 (0.73–1.14) | 1.09 (0.86–1.38) | 1.16 (0.89–1.50) |
SFA | 0.95 (0.80–1.13) | 0.94 (0.80–1.12) | 1.04 (0.88–1.23) | 0.98 (0.82–1.16) | 0.42 (0.16–1.10) | 1.15 (0.94–1.41) | 0.93 (0.78–1.12) | 0.87 (0.72–1.05) | 1.13 (0.93–1.36) | 1.11 (0.92–1.34) |
PUFA | 1.00 (1.00–1.01) | 1.00 (1.00–1.01) | 1.00 (1.00–1.01) | 1.00 (0.99–1.01) | 0.93 (0.36–2.41) | 1.00 (0.99–1.00) | 1.00 (1.00–1.01) | 1.00 (1.00–1.01) | 1.00 (0.99–1.01) | 1.01 (1.00–1.02) |
Cholesterol | 1.00 (0.84–1.20) | 1.11 (0.93–1.32) | 1.03 (0.87–1.23) | 1.01 (0.85–1.20) | 1.33 (0.52–3.45) | 1.18 (0.96–1.46) | 1.06 (0.89–1.27) | 0.98 (0.82–1.17) | 1.02 (0.83–1.25) | 0.91 (0.73–1.12) |
Vitamins | ||||||||||
Vitamin A | 1.09 (0.88–1.35) | 1.15 (0.93–1.41) | 1.30 (1.00–1.69) | 1.07 (0.87–1.30) | 1.06 (0.42–2.66) | 1.22 (0.96–1.56) | 0.69 (0.52–0.91) ‡ | 0.89 (0.72–1.1) | 1.17 (0.91–1.51) | 0.98 (0.79–1.22) |
Vitamin C | 0.46 (0.12–1.85) | 0.48 (0.12–1.9) | 0.67 (0.16–2.82) | 1.83 (0.44–7.56) | 0.63 (0.24–1.63) | 2.68 (0.64–11.3) | 1.04 (0.25–4.27) | 0.88 (0.22–3.47) | 0.92 (0.20–4.28) | 2.80 (0.47–16.66) |
Vitamin E | 1.01 (0.99–1.02) | 1.01 (0.99–1.02) | 1.00 (0.99–1.01) | 1.01 (1.00–1.03) | 4.17 (1.04–16.73) | 1.00 (0.99–1.02) | 0.99 (0.98–1.01) | 1.00 (0.99–1.02) | 0.98 (0.96–1.00) † | 0.99 (0.97–1.00) |
Vitamin B1 | 0.11 (0.01–1.03) | 0.37 (0.06–2.44) | 1.05 (0.16–6.87) | 0.64 (0.08–4.93) | 0.97 (0.35–2.72) | 0.67 (0.10–4.44) | 0.77 (0.12–4.83) | 2.25 (0.21–23.95) | 2.25 (0.21–23.95) | 1.20 (0.14–10.25) |
Vitamin B2 | 0.96 (0.81–1.12) | 1.05 (0.89–1.22) | 1.03 (0.88–1.21) | 0.92 (0.24–3.57) | 0.99 (0.84–1.17) | 1.09 (0.92–1.29) | 0.96 (0.80–1.16) | 0.96 (0.80–1.16) | 1.10 (0.90–1.33) | |
Niacin | 2.70 (0.60–12.17) | 1.79 (0.42–7.69) | 1.97 (0.44–8.74) | 1.94 (0.43–8.72) | 0.69 (0.23–2.05) | 1.92 (0.41–9.00) | 0.64 (0.13–3.20) | 0.24 (0.04–1.48) | 0.24 (0.04–1.48) | 7.31 (0.80–66.53) |
Vitamin B6 | 0.90 (0.64–1.25) | 1.06 (0.76–1.47) | 1.15 (0.79–1.67) | 0.88 (0.61–1.28) | 1.00 (0.99–1.01) | 0.75 (0.47–1.18) | 0.90 (0.63–1.28) | 0.75 (0.45–1.25) | 1.13 (0.71–1.79) | 1.73 (0.82–3.66) |
Vitamin B12 | 1.00 (0.99–1.00) | 1.00 (1.00–1.01) | 1.00 (1.00–1.01) | 1.00 (0.99–1.01) | 0.49 (00.19–1.27) | 1.00 (0.99–1.01) | 1.00 (0.99–1.01) | 1.00 (1.00–1.01) | 1.00 (0.99–1.01) | 1.01 (0.99–1.03) |
Minerals | ||||||||||
Sodium | 1.00 (1.00–1.00) | 0.70 (0.15–3.25) | 1.00 (1.00–1.00) | |||||||
Potassium | 1.00 (1.00–1.01) | 1.00 (1.00–1.01) | 1.01 (1.00–1.01) | 1.00 (0.99–1.00) | 0.58 (0.22–1.50) | 1.01 (1.00–1.01) | 1.00 (1.00–1.01) | 1.00 (1.00–1.01) | 1.01 (1.00–1.01) | 1.00 (0.99–1.00) |
Phosphate | 1.03 (0.82–1.29) | 1.08 (0.87–1.35) | 1.07 (0.86–1.34) | 1.08 (0.86–1.35) | 1.74 (0.67–4.54) | 1.11 (0.87–1.42) | 1.14 (0.91–1.44) | 1.02 (0.81–1.28) | 1.21 (0.91–1.60) | 1.07 (0.83–1.37) |
Iron | 1.02 (0.83–1.24) | 1.12 (0.92–1.37) | 1.09 (0.89–1.34) | 1.11 (0.90–1.37) | 1.04 (0.33–3.33) | 0.96 (0.79–1.17) | 1.07 (0.88–1.30) | 1.04 (0.85–1.26) | 1.06 (0.84–1.32) | 1.02 (0.83–1.27) |
Anemia | Low eGFR OR (95% CI) | Low Ca | Low P | High K | High UA | High hs-CRP | High iPTH | |
---|---|---|---|---|---|---|---|---|
OR (95% CI) | OR (95% CI) | OR (95% CI) | OR (95% CI) | OR (95% CI) | OR (95% CI) | OR (95% CI) | ||
Nutrients | ||||||||
Energy/kg | 2.99 (0.26–34.78) | 1.42 (0.17–11.61) | 2.49 (0.27–23.03) | 0.42 (0.04–4.92) | 0.63 (0.04–10.40) | |||
Protein/kg | 0.89 (0.75–1.05) | 1.02 (0.89–1.18) | 0.96 (0.84–1.10) | 1.32 (1.03–1.70) † | ||||
CHO | 1.03 (0.90–1.18) | 0.91 (0.78–1.05) | 0.95 (0.82–1.1) | 0.97 (0.74–1.28) | ||||
Fat | 1.03 (0.82–1.28) | 0.96 (0.77–1.19) | 1.04 (0.83–1.31) | 0.92 (0.73–1.16) | 0.86 (0.57–1.30) | 1.01 (0.78–1.32) | ||
SFA | 1.10 (0.92–1.32) | 0.98 (0.83–1.16) | 1.06 (0.89–1.27) | 1.00 (0.79–1.28) | 0.97 (0.81–1.16) | 1.04 (0.77–1.39) | 1.10 (0.89–1.35) | |
PUFA | 1.00 (1.00–1.01) | 1.00 (0.99–1.01) | 0.99 (0.99–1.00) † | 1.00 (0.99–1.00) | 1.00 (0.99–1.00) | 1.01 (1.00–1.02) | 1.00 (1.00–1.01) | |
Cholesterol | 1.24 (1.00–1.54) | 1.00 (0.84–1.18) | 0.75 (0.50–1.11) | 1.00 (0.83–1.20) | 0.88 (0.73–1.07) | 1.21 (0.86–1.71) | 1.11 (0.87–1.42) | |
Vitamins | ||||||||
Vitamin A | 2.10 (0.45–9.81) | 1.09 (0.89–1.33) | 1.05 (0.70–1.57) | 1.14 (0.93–1.39) | 1.06 (0.86–1.32) | 1.45 (0.97–2.17) | 1.34 (0.92–1.96) | |
Vitamin C | 2.10 (0.45–9.81) | 0.30 (0.07–1.25) | 0.96 (0.09–10.73) | 0.44 (0.11–1.86) | 0.95 (0.18–5.06) | 0.14 (0.00–5.26) | 0.70 (0.11–4.32) | |
Vitamin E | 0.99 (0.98–1.01) | 1.00 (0.99–1.01) | 1.01 (0.99–1.02) | 0.99 (0.97–1.01) | 1.01 (0.99–1.02) | 1.02 (1.00–1.05) | ||
Vitamin B1 | 1.85 (0.24–14.29) | 0.61 (0.25–1.50) | 0.56 (0.09–3.64) | 0.61 (0.02–20.01) | 2.06 (0.19–22.99) | 1.71 (0.03–117.92) | 1.64 (0.11–25.64) | |
Vitamin B2 | 1.23 (1.01–1.50) † | 0.85 (0.25–2.95) | 0.84 (0.70–1.01) | |||||
Niacin | 0.93 (0.19–4.58) | 0.56 (0.21–1.49) | 1.54 (0.33–7.22) | 0.46 (0.08–2.66) | 1.14 (0.09–14.16) | |||
Vitamin B6 | 0.86 (0.61–1.21) | 1.40 (0.83–2.37) | 1.17 (0.83–1.66) | 0.89 (0.60–1.33) | 1.05 (0.70–1.60) | 0.85 (0.38–1.89) | ||
Vitamin B12 | 1.00 (0.99–1.00) | 1.00 (1.00–1.01) | 1.01 (0.99–1.03) | 1.00 (1.00–1.01) | 1.00 (0.99–1.00) | 1.00 (0.99–1.02) | 1.01 (1.00–1.03) | |
Minerals | ||||||||
Sodium | 1.00 (1.00–1.00) | |||||||
Potassium | 1.01 (1.00–1.01) | 1.00 (1.00–1.01) | 1.00 (0.99–1.01) | 1.00 (0.99–1.00) | 1.00 (0.99–1.00) | 1.00 (0.99–1.01) | 1.00 (1.00–1.01) | |
Phosphate | 1.33 (0.98–1.80) | 0.92 (0.74–1.14) | 0.83 (0.62–1.09) | 0.82 (0.58–1.14) | 0.66 (0.46–0.94) † | 0.90 (0.55–1.47) | ||
Iron | 1.34 (1.01–1.80) † | 1.02 (0.84–1.24) | 0.78 (0.59–1.03) | 0.81 (0.64–1.03) |
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Lin, I.-H.; Duong, T.V.; Wong, T.-C.; Nien, S.-W.; Tseng, I.-H.; Chiang, Y.-J.; Wang, H.-H.; Yang, S.-H. Dietary Nutrients and Cardiovascular Risk Factors among Renal Transplant Recipients. Int. J. Environ. Res. Public Health 2021, 18, 8448. https://doi.org/10.3390/ijerph18168448
Lin I-H, Duong TV, Wong T-C, Nien S-W, Tseng I-H, Chiang Y-J, Wang H-H, Yang S-H. Dietary Nutrients and Cardiovascular Risk Factors among Renal Transplant Recipients. International Journal of Environmental Research and Public Health. 2021; 18(16):8448. https://doi.org/10.3390/ijerph18168448
Chicago/Turabian StyleLin, I-Hsin, Tuyen Van Duong, Te-Chih Wong, Shih-Wei Nien, I-Hsin Tseng, Yang-Jen Chiang, Hsu-Han Wang, and Shwu-Huey Yang. 2021. "Dietary Nutrients and Cardiovascular Risk Factors among Renal Transplant Recipients" International Journal of Environmental Research and Public Health 18, no. 16: 8448. https://doi.org/10.3390/ijerph18168448