Nutritional Status, Selected Nutrients Intake and Their Relationship with the Concentration of Ghrelin and Adiponectin in Patients with Diabetic Nephropathy.

Anna Jeznach-Steinhagen,Aleksandra Rymarz,Iwona Boniecka,Stanisław Niemczyk,Weronika Michalska,Dorota Szostak-Węgierek

doi:10.3390/nu13124416

Anna Jeznach-Steinhagen, Aleksandra Rymarz + Show 4 more

Open Access

https://doi.org/10.3390/nu13124416

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Abstract

Background: Overnutrition is one of the risk factors of chronic kidney disease (CKD). The factors related to both obesity and CKD are adiponectin and ghrelin. The aim of the study was to assess if there is a link of nutritional status and selected nutrients intake with adiponectin and ghrelin in patients with diabetic nephropathy (DN). Methods: The study involved 55 patients diagnosed with DN in the pre-dialysis period (two groups: GFR < 30 and >30 mL/min/1.73 m2). In all participants standard blood tests, total ghrelin and total adiponectin plasma concentrations and anthropometric measurements (BMI, WHR- waist–hip ratio, body composition analysis) were performed. The evaluation of energy and nutrient intakes was made using the three-day food record method. Results: Excessive body weight was found in 92.80% patients. The average daily energy intake was 1979.67 kcal/day (14.45% protein energy, 28.86% fat, and carbohydrates 56.89%). In the group with eGFR < 30 mL/min/1.73 m2 the analysis showed a negative relationship between ghrelin and WHR value, and the creatine and albumin concentrations. There was a positive correlation between ghrelin concentration and the consumption of carbohydrates and sucrose. In the group of patients with eGFR > 30 mL/min/1.73 m2, a positive correlation was found between the concentration of ghrelin and the consumption of vegetable protein, carbohydrates, and glucose. Conclusions: The study confirms the high prevalence of obesity in patients with DN-Excessive supply of protein was found in the patients’ diets, which may contribute to the deterioration of the course of the disease and its prognosis. In patients with eGFR < 30 there was a negative correlation between ghrelin concentration and nutritional status, and in patents with eGFR > 30 between ghrelin concentration and some nutrients intake.

Highlights

In 2017, there were 697.5 million cases of chronic kidney disease (CKD)
Abdominal obesity based on waist circumference and waist–hip ratio (WHR) was shown in 89.09% of participants (87.50% of men and 95.65% of women) and in 92.73% (96.88% of men and 86.96% of women) respectively
This study confirms a high prevalence of excess body weight in patients with diabetic nephropathy may complicate the treatment of chronic kidney disease, accelerate the progress and aggravate the course of CKD [1,2,3,24,27,28,30, 31,33,34,35,36,37,38,39,40,41,42,43]

Summary

Introduction

In 2017, there were 697.5 million cases of CKD (chronic kidney disease). The prevalence of CKD is higher than that of diabetes, osteoarthritis, chronic obstructive pulmonary disease (COPD), asthma, or depressive disorders. The prevalence of CKD was estimated as 9.1% in the world’s population, with CKD Stages 1–2 accounting for 5.0%, Stage 3 for 3.9%, Stage 4 for 0.16%, Stage 5 for 0.07%, dialysis patients for 0.041%, and those after kidney transplantation for 0.011%. Since 1990 the global all-age prevalence of CKD increased by 29.3%. In 2017, 1.2 million people died from CKD. It is predicted that in 2040 this number may increase to 4.0 million [1]

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