The Relationship Between Myostatin, Inflammatory Markers, and Sarcopenia in Patients With Chronic Kidney Disease.

OBJECTIVE: To determine the prevalence of sarcopenia in patients with chronic kidney disease (CKD), investigate the relationship of the serum myostatin level with sarcopenia and inflammatory markers. METHODS: The study was conducted with four patient groups: renal transplantation (TX), stage 3-5 non-dialysis-dependent CKD (NDD-CKD), hemodialysis (HD), and peritoneal dialysis (PD). Laboratory parameters, serum myostatin, C-reactive protein, and interleukin-6 levels were studied. Body composition was estimated using a multifrequency bioimpedance analysis. Handgrip strength (HGS) was evaluated with a handgrip dynamometer. The HGS and appendicular skeletal muscle index measurements were used to determine sarcopenia presence. RESULTS: The study included 130 patients (72 [55%] male patients). The patient distribution in groups was as follows: 37 in HD, 28 in PD, 37 in renal TX, and 28 in NDD-CKD. The highest level of myostatin was measured in the HD group, and the lowest in the TX group (P < .001). The HGS measurement in the PD group was significantly lower than that in the TX group (P = .025). The myostatin was negatively correlated with HGS, albumin, estimated glomerular filtration rate, and Kt/Vurea. However, myostatin had no correlation with inflammatory markers or appendicular skeletal muscle index. Sarcopenia was present in 37 (29%) patients: 15 (40%) in the HD group, nine (32%) in NDD-CKD, seven (25%) in PD, and six (16%) in TX. When the patients with and without sarcopenia were compared, only myostatin was higher in the former (P = .045). As a result of multivariate analysis, myostatin was the only independent factor which predicts sarcopenia (odds ratio: 1.002, 95% confidence interval: 1.001-1.005, P = .048). CONCLUSION: To prevent devastating events associated with sarcopenia in patients with CKD, renal transplantation seems to be the best treatment solution. For the early recognition of sarcopenia, the measurement of the serum myostatin level may be a promising diagnostic approach.

A Comparison of the Indirect Calorimetry and Different Energy Equations for the Determination of Resting Energy Expenditure of Patients With Renal Transplantation.

OBJECTIVE: We aimed to evaluate the agreement between the resting energy expenditure (REE) obtained by indirect calorimetry and eight prediction equations in adult patients with renal transplantation and a newly developed REE prediction equation for use in patients with renal transplantation in the clinic. METHODS: A total of 51 patients (30 males and 21 females) were involved in the study. The REE was measured by indirect calorimetry and compared with the previous prediction equations. The agreement was assessed by the interclass correlation coefficient and by Bland-Altman plot analysis. RESULTS: No significant difference was found in terms of age and body mass index between the genders. Differences between the predicted and measured REEs were maximum in the Bernstein equation (-478 kcal) and minimum in the Cunningham equation (-69 kcal). It was found that underprediction values varied from 27.5% (chronic kidney disease equation) to 98.0% (Bernstein equation). The highest overprediction value was found in the Schofield equation (17.7%). The Cunningham equation and the new equation had the lowest root mean square error (265 kcal/day). In this study, fat-free mass (FFM) was found to be the most significant variable in multiple regression analysis (r2: 0.55). The new specific equation based on FFM was generated as 424.2 + 24.7∗FFM (kg). Besides that, it was found that the new equation and Cunningham equation were distributed randomly according to Bland-Altman analysis. A supplementary new equation based on available anthropometric measurements was developed as -1996.8 + 19.1∗height (cm) + 7.2∗body weight (kg). CONCLUSION: This study showed that most of the predictive equations significantly underestimated REE. In patients with renal transplantation, if the REE is not measurable by indirect calorimetry, the use of the proposed equations will be more accurate.

A nutritional approach to microbiota in Parkinson's disease.

Parkinson's disease (PD) is a neurodegenerative disease characterized by motor impairment and the accumulation of alpha-synucleinopathy (α-syn), which can affect different levels of the brain-gut axis. There is a two-way communication between the gastrointestinal tract, and brain that includes the gut microbiota. This bidirectional communication between the gut microbiota and the brain includes many pathways, such as immune mechanisms, the vagus nerve, and microbial neurometabolite production. The common cause of constipation in PD is thought to be the accumulation of α-syn proteins in the enteric nervous system. Recent studies have focused on changes in microbial metabolites and gut microbiota dysbiosis. Microbiota dysbiosis is associated with increased intestinal permeability, intestinal inflammation, and neuroinflammation. Many factors, such as unbalanced nutrition, antibiotic use, age, and infection, result in alteration of microbial metabolites, triggering α-syn accumulation in the intestinal mucosa cells. Increased evidence indicates that the amount, type, and balance of dietary macronutrients (carbohydrates, proteins, and fats); high consumption of vegetables, fruits, and omega-3 fatty acids; and healthy diet patterns such as the Mediterranean diet may have a great protective impact on PD. This review focuses on the potential benefits of prebiotics, probiotics, and synbiotics to regulate microbiota dysbiosis along with the effect of diet on the gut microbiota in PD.

Association of Adipokines and Insulin, Which Have a Role in Obesity, with Colorectal Cancer.

Obesity-related diseases are an important part of public health; and obesity is related with colorectal cancer. Adipocyte hypertrophy and visceral adipose tissue accumulation can cause adipocitis-related diseases and pathogenic adipocyte formation. Adipose tissue has a very important and active role in immune response formation. Cytokines/adipokines, which are secreted from adipose tissue, have an active role in communication between adipocytes and macrophages. Thus, visceral adipocyte is related with low-grade chronic systemic inflammation. Adipocytes have an important role in colorectal cancer pathogenesis because of proinflammatory cytokines, growth factors, and hormones secretion. Most highlighted cytokines are adiponectin, resistin, and ghrelin. Also, insulin resistance, glucose intolerance, increased plasma insulin levels, body mass index, insulin-like growth factor (IGF-1), glucose, and serum free fatty acids levels are considered to be related with colorectal cancer pathogenesis. Thus, in this review, we focus on the role of adipokines and insulin in colorectal cancer.

Association of Mediterranean diet and anthropometric measures with quality of life in coronary artery disease patients / Asociación de la dieta mediterránea y las medidas antropométricas con la calidad de vida en pacientes con enfermedad arterial coronaria

Introduction: the Mediterranean diet (MD) and ideal body weight are associated with a reduction in the risk of chronic diseases, but their association with health-related quality of life (HRQL) is not clear. Objective: the aim of this study was to assess the association between adherence to MD and the HRQL and anthropometric measurements in coronary artery disease patients. Methods: this cross-sectional study was carried out in 55 women and 84 men who were diagnosed with coronary artery disease by a physician. Anthropometric indices were measured, MD adherence was evaluated with a 14-item questionnaire and the 36-Item Short Form Health Survey (SF-36) was used for HRQL. Results: mean age in males was 63.0 ± 9.7 years and mean age in females was 63.1 ± 10.1 years. Prevalence of overweight and obesity was 53.5% and 40.5%, respectively, in men and 14.5% and 83.6%, respectively, in women. Adherence to the MD was assessed and the median values were found statistically higher in male patients (p < 0.05). A significant positive correlation was found between MD and all physical component summary (PCS, its subscale) and most mental component summary (MCS) (except emotional role, social health subscale) (p < 0.05). Inverse significant associations were found between BMI, waist circumference, waist/height ratio, percent of body fat and both PCS and MCS (including most subscales). Conclusion: adoption of healthy dietary habits (adherence to the Mediterranean diet) by the participants and optimal anthropometric measurements may be considered as a possible contributor to HRQL

Introducción: la dieta mediterránea (DM) y el peso corporal ideal se asocian con una reducción en el riesgo de enfermedades crónicas, pero su asociación con la calidad de vida relacionada con la salud (CVRS) no está clara. Objetivo: el objetivo de este estudio fue evaluar la asociación entre la adherencia a la DM y la CVRS y las mediciones antropométricas en pacientes con enfermedad arterial coronaria. Métodos: este estudio transversal se llevó a cabo en 55 mujeres y 84 hombres que fueron diagnosticados con enfermedad de las arterias coronarias por un médico. Se midieron los índices antropométricos, se evaluó la adherencia a la DM con un cuestionario de 14 ítems y se utilizó el cuestionario de salud SF-36 para la CVRS. Resultados: la edad media de los hombres fue de 63,0 ± 9,7 y la edad media de las mujeres fue de 63,1 ± 10,1. La prevalencia de sobrepeso y obesidad fue del 53,5% y 40,5%, respectivamente, en hombres y del 14,5% y 83,6%, respectivamente, en mujeres. Se evaluó la adherencia a la DM y los valores de la mediana fueron estadísticamente más altos en los pacientes varones (p < 0,05). Se encontró una correlación positiva significativa (p < 0,05) entre la DM y el resumen general del componente físico (PCS, subescala) y la mayor parte del resumen del componente mental (MCS), excepto el subpeso emocional y la subescala de salud social. Hubo una correlación negativa entre el IMC, la circunferencia de la cintura, la relación cintura/estatura, el porcentaje de grasa corporal y PCS y MCS (incluida la mayoría de las subescalas). Conclusión: la adopción de hábitos alimentarios saludables (adherencia a la dieta mediterránea) por parte de los participantes y las mediciones antropométricas óptimas pueden considerarse como un posible contribuyente a la CVRS