Health-Associated Nutrition and Exercise Behaviors in Relation to Metabolic Risk Factors Stratified by Body Mass Index

Serum Nutritional Biomarkers and All-Cause and Cause-Specific Mortality in U.S. Adults with Metabolic Syndrome: The Results from National Health and Nutrition Examination Survey 2001-2006

BACKGROUND

There is limited research on the associations between serum nutritional biomarkers and mortality risk in patients with metabolic syndrome (MetS). Existing studies merely investigated the single-biomarker effect. Thus, this study aimed to investigate the combined effect of nutritional biomarker mixtures and mortality risk using the Bayesian kernel machine regression (BKMR) model in patients with MetS.

METHODS

We included the MetS patients, defined according to the 2018 Guideline on the Management of Blood Cholesterol from the National Health and Nutrition Examination Survey (NHANES) 2001-2006. A total of 20 serum nutritional biomarkers were measured and evaluated in this study. The Cox proportional hazard model and restricted cubic spline models were used to evaluate the individual linear and non-linear association of 20 nutritional biomarkers with mortality risk. Bayesian kernel machine regression (BKMR) was used to assess the associations between mixture of nutritional biomarkers and mortality risk.

RESULTS

A total of 1455 MetS patients had a median age of 50 years (range: 20-85). During a median of 17.1-year follow-up, 453 (24.72%) died: 146 (7.20%) caused by CVD and 87 (5.26%) by cancer. Non-linear and linear analyses indicated that, in total, eight individual biomarkers (α-carotene, β-carotene, bicarbonate, lutein/zeaxanthin, lycopene, potassium, protein, and vitamin A) were significantly associated with all-cause mortality (all p-values < 0.05). Results from BKMR showed an association between the low levels of the mixture of nutritional biomarkers and high risk of all-cause mortality with the estimated effects ranging from 0.04 to 0.14 (referent: medians). α-Carotene (PIP = 0.971) and potassium (PIP = 0.796) were the primary contributors to the combined effect of the biomarker mixture. The nutritional mixture levels were found to be negatively associated with the risk of cardiovascular disease (CVD) mortality and positively associated with the risk of cancer mortality. After it was stratified by nutrients, the mixture of vitamins showed a negative association with all-cause and CVD mortality, whereas the mixture of mineral-related biomarkers was positively associated with all-cause and cancer mortality.

CONCLUSION

Our findings support the evidence that nutritional status was associated with long-term health outcomes in MetS patients. It is necessary for MetS patients to be concerned with certain nutritional status (i.e., vitamins and mineral elements).

Physical Activity versus Sclerostin and Interleukin 6 Concentration in Patients Receiving Renal Replacement Therapy by Hemodialysis

Introduction

Chronic kidney disease and renal replacement therapy are associated with reduced motor activity, which may result in the presence of mineral bone disorders and an increase in inflammation markers. The aim of the study was to assess the relationship between the performance of daily physical activity, expressed in the number of steps performed by patients undergoing hemodialysis and the concentration of selected biochemical parameters (SCL, IL-6).

Patients and Methods

The study group (B) involved 33 patients aged 59.8 ± 9.8 years from the dialysis station at the Department of Nephrology, Transplantology and Internal Medicine PUM. In group B, interventions considering an increase in physical activity expressed in the number of steps were introduced. Group C consisted of 30 people aged 54.9 (9.37), with GFR over 60 mL/min/1.73m. Physical activity was measured with pedometers. Anthropometric and biochemical parameters were assessed at baseline, after the third and sixth month of the study. Descriptive statistics, intergroup comparisons using Mann–Whitney U test and Spearman correlation analysis were performed. The level of significance was set at p≤0.005.

Results

A relationship between IL-6 concentration and the number of steps in group B after three months of intervention was demonstrated. In group C, the concentration of SCL and IL-6 decreased with the increase in the number of steps taken. Only in group C the waist circumference decreased with the increase of the number of steps performed.

Conclusion

Patients receiving renal replacement therapy by hemodialysis showed significantly lower physical activity compared to people without kidney disease. Performing bigger number of steps can lower interleukin 6 levels in hemodialysis patients.