Meat intake and risk of mortality and graft failure in kidney transplant recipients

Author:

Said M Yusof1ORCID,Rodriguez-Niño Angelica12,Post Adrian1ORCID,Schutten Joelle C1,Kieneker Lyanne M1ORCID,Gomes-Neto Antonio W1,van Londen Marco1ORCID,Osté Maryse Cj1,Borgonjen-van den Berg Karin J3,Nolte Ilja M4ORCID,van den Berg Else1,de Blaauw Pim5,van der Krogt Jennifer5,Heiner-Fokkema M Rebecca5,Navis Gerjan16,Yard Benito A2,Bakker Stephan Jl16

Affiliation:

1. Department of Internal Medicine, Division of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands

2. Vth Department of Medicine (Nephrology/Endocrinology/Rheumatology), University Medical Center Mannheim, University of Heidelberg, Mannheim, Germany

3. Department of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands

4. Department of Epidemiology, University of Groningen, Groningen, The Netherlands

5. Department of Laboratory Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands

6. Groningen Kidney Center, Groningen, The Netherlands

Abstract

ABSTRACT Background It is unknown whether meat intake is beneficial for long-term patient and graft survival in kidney transplant recipients (KTR). Objectives We first investigated the association of the previously described meat intake biomarkers 1-methylhistidine and 3-methylhistidine with intake of white and red meat as estimated from a validated food frequency questionnaire (FFQ). Second, we investigated the association of the meat intake biomarkers with long-term outcomes in KTR. Methods We measured 24-h urinary excretion of 1-methylhistidine and 3-methylhistidine by validated assays in a cohort of 678 clinically stable KTR. Cross-sectional associations were assessed by linear regression. We used Cox regression analyses to prospectively study associations of log2-transformed biomarkers with mortality and graft failure. Results Urinary 1-methylhistidine and 3-methylhistidine excretion values were median: 282; interquartile range (IQR): 132–598 µmol/24 h and median: 231; IQR: 175–306 µmol/24 h, respectively. Urinary 1-methylhistidine was associated with white meat intake [standardized β (st β): 0.20; 95% CI: 0.12, 0.28; P < 0.001], whereas urinary 3-methylhistidine was associated with red meat intake (st β: 0.30; 95% CI: 0.23, 0.38; P < 0.001). During median follow-up for 5.4 (IQR: 4.9–6.1) y, 145 (21%) died and 83 (12%) developed graft failure. Urinary 3-methylhistidine was inversely associated with mortality independently of potential confounders (HR per doubling: 0.55; 95% CI: 0.42, 0.72; P < 0.001). Both urinary 1-methylhistidine and urinary 3-methylhistidine were inversely associated with graft failure independent of potential confounders (HR per doubling: 0.84; 95% CI: 0.73, 0.96; P = 0.01; and 0.59; 95% CI: 0.41, 0.85; P = 0.004, respectively). Conclusions High urinary 3-methylhistidine, reflecting higher red meat intake, is independently associated with lower risk of mortality. High urinary concentrations of both 1- and 3-methylhistidine, of which the former reflects higher white meat intake, are independently associated with lower risk of graft failure in KTR. Future intervention studies are warranted to study the effect of high meat intake on mortality and graft failure in KTR, using these biomarkers.

Funder

Top Institute Food and Nutrition of the Netherlands

Publisher

Oxford University Press (OUP)

Subject

Nutrition and Dietetics,Medicine (miscellaneous)

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