Association of Serum Adropin Levels with Nutritional Status and Lipid Profile in Patients with Kidney Failure with Replacement Therapy

Objective. This study aimed to determine serum adropin levels and to examine the relationship of serum adropin levels with nutritional status and lipid profile in patients with kidney failure with replacement therapy (KFRT). Methods. The study consisted of 88 subjects, including 30 patients treated with hemodialysis (HD), 29 patients treated with peritoneal dialysis (PD), and 29 patients who had undergone kidney transplantation (TX). The study included assessing anthropometric measurements, handgrip strength, bioelectrical impedance analysis, malnutrition-inflammation score, dietary intake, resting energy expenditure, and biochemical parameters. The patients’ food consumption was recorded for three days. The malnutrition-inflammation score (MIS) was calculated to assess the patients’ nutritional status. Blood samples were collected for serum adropin and other biochemical parameters. Results. Adropin levels were significantly higher in the TX group when compared to the HD group. Patients with low adropin levels had higher MIS, serum ferritin, and lower low-density lipoprotein-cholesterol (LDL-C) and total cholesterol (total-C) levels. Serum adropin levels were negatively correlated with the MIS and positively correlated with total-C, LDL-C, and HDL-C levels. Multiple linear regression analyses showed that the MIS (β=-0.25 p=0.038) and LDL-C level (β=0.29, p=0.007) were associated with serum adropin. Conclusions. Adropin may be considered as a new marker of nutritional status and possibly plays a role in the pathophysiological mechanisms and complications of patients with KFRT

Determınatıon Of The Relatıonshıp Between Dıetary Potentıal Renal Acıd Load, Nutrıtonal Status And Dısease Actıvıty Of Patıents Wıth Rheumatoıd Arthrıtıs And Ankylosıng Spondylıtıs

Bu çalışma, romatoid artrit (RA) ya da ankilozan spondilit (AS) tanısı almış yetişkin bireylerde diyet potansiyel böbrek asit yük değerleri (PRAL) ile hastalık aktiviteleri, ağrı düzeyleri, beslenme durumu, kan biyokimyasal parametreleri ve antropometrik ölçüm değerleri arasındaki ilişkinin belirlenmesi amacıyla yapılmıştır. Çalışma Ocak 2014-Eylül 2015 tarihleri arasında Gazi Üniversitesi Tıp Fakültesi Hastanesi Romatoloji polikliniğinde RA ya da AS tanısı almış ve tanı süresi beş yılı geçmeyen, yaşları 25-65 yıl arasında değişen, 24 ü erkek (%42,3) 33 ü kadın (%57,7) toplam 57 yetişkin birey üzerinde yürütülmüştür. Bireylere yüz yüze görüşme yöntemi ile anket formu uygulanmıştır ve üç günlük besin tüketim kayıtları alınmıştır. Bireylerin hastalık aktivitelerinin belirlenmesi için hekim tarafında RA lı bireylere Hastalık Aktivite Skoru (DAS-28) ve Vizüel Analog Skala (VAS), AS li bireylere ise Ankilozan Spondilit Hastalık Aktivite İndeksi- (BASDAI) uygulanmıştır. Çalışmaya katılan RA lı erkek ve kadın bireylerin yaş ortalaması sırasıyla 44,5&#61617;12,02 yıl ve 48,0&#61617;11,25 yıl dır. Ankilozan spondilitli erkek ve kadın bireylerin yaş ortalaması ise sırasıyla 38,7&#61617;10,27 yıl ve 41,9&#61617;11,96 yıl olarak saptanmıştır. Romatoid artritli ve AS li erkek bireylerin BKİ değerleri sırasıyla 27,6±4,34 kg/m2 ve 27,2±5,41 kg/m2 olarak saptanmıştır. Romatoid artritli ve AS li kadın bireylerin ise BKİ değerleri sırasıyla 30,2±6,44 kg/m2 ve 28,9±4,03 kg/m2 dir. Romatoid artritli erkek bireylerin diyet PRAL değerleri (15,7&#61617;7,34 mEq/gün), kadın bireylerden yüksektir (2,7&#61617;13,40 mEq/gün) (p<0,01). Ankilozan spondilitli erkek bireylerin diyet PRAL değerleri (15,2&#61617;8,55 mEq/gün), kadın bireylerden yüksektir (2,8&#61617;10,56mEq/gün) (p<0,01). Romatoid artritli bireylerin DAS 28 skorları ve AS li bireylerin BASDAI skorları ile diyet PRAL değerleri arasında istatistiksel olarak anlamlı bir ilişki saptanmamıştır (p>0,05). Bireylerin diyetlerinin PRAL değerini en çok artıran grup tahıl grubu iken; en çok azaltan grup ise sebze grubu olmuştur. Çalışmaya katılan RA lı ve AS li bireyler birlikte incelendiğinde posa ve doymuş yağın diyet PRAL düzeyi üzerindeki etkisinin istatistiksel olarak anlamlı olduğu görülmüştür (p<0,05). Sonuç olarak RA li ve AS li bireylerde hastalık aktivitesi ile diyet PRAL değeri arasında anlamlı bir ilişki bulunmamıştır.The aim of this study is to determine the relationship between dietary potential renal acid load (PRAL), and disease activity, pain levels, nutritional status, blood biochemical parameters and anthropometric measurements of adults who were diagnosed with rheumatoid arthritis (RA) or ankylosing spondylitis (AS). The current study was conducted on 57 individuals (between the ages 25 and 65) including 24 male (42,3%) and 33 female (57,7%) diagnosed with RA or AS and whose diagnosis duration is less than 5 years. The study was done between January 2014 and September 2015 at Gazi University, Faculty of Medicine, Division of Rheumatology. Research data was collected by a questionnaire via a face to face interview and 3-days-food consumption record was taken. Disease Activity Score (DAS-28) and Visual Analogue Scale (VAS) were applied to patients with RA and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) was applied to patients with AS by the physicians in order to determine individuals disease activity. The average age of the male and the females with RA were 44,5&#61617;12,02 years and 48,0&#61617;11,25 while in patients with AS were 38,7&#61617;10,27 years and 41,9&#61617;11,96 years respectively. Body mass indexes of the male and female patients with RA were 27,6±4,34 kg/m2 and 30,2±6,44 kg/m2 while in patients with AS were 27,2±5,41 kg/m2 and 28,9±4,03 kg/m2 respectively. Dietary PRAL values of male patients with RA (15,7&#61617;7,34 mEq/day), are higher than female patients (2,7&#61617;13,40 mEq/day) (p<0,01). Dietary PRAL values of male patients with AS (15,2&#61617;8,55 mEq/day) are higher than female patients (2,8&#61617;10,56mEq/day) (p<0,01). No statistically significant correlation was found between DAS 28 scores of individuals with RA, BASDAI scores of individuals with AS, and dietary PRAL values (p>0,05). In the food groups, the grains was found to increase the PRAL value of the diet at most while the vegetables was decreased the value at least. When the individuals with RA and AS in the study were examined together, the effect of dietary fiber and saturated fats on the dietary PRAL level was found to be statistically significant (p<0,05). Regarding dietary habits, it is found that dietary PRAL values of female individuals are lower than male individuals . In conclusion, there was no significiant relationship between disease activity and dietary PRAL in patients with RA and AS