Is there relationship between epicardial fat and cardiovascular parameters in incident kidney transplant patients? A post-hoc analysis.

BACKGROUND: Epicardial fat (EF) has been related to increased cardiovascular risk in chronic kidney disease patients. Kidney transplantation is associated with weight gain, especially within the first 12 months. Recently an association between EF and left ventricular mass (LVM) has been suggested in kidney transplant (KTX) recipients. OBJECTIVE: Evaluate the EF in KTX recipients and its association with cardiovascular parameters in a 12-month follow-up study. METHODS: EF volume was determined using thoracic computed tomography. The EF progressor group (EF gain) was defined by any increment in EF after 12 months. LVM and LVM index were calculated by echocardiography. RESULTS: Ninety-eight incident KTX patients [57% men, 41.2 ± 10.1 years, mean dialysis time prior to transplant of 24 (11-60) months] were analyzed. At baseline and after 12 months, EF was 318.6 (275.2-392.6) ml and 329.5 (271.7-384.8) ml, respectively (p = 0.03). When compared to patients who EF decreased (n = 33), those with EF gain (n = 65) had a greater increase of body mass index, abdominal circumference and blood glucose. These patients also had a lower reduction of LVM index. However in the multivariate analysis, there was no difference in LVM index change between groups (interaction p = 0.565), even after adjustment for hypertension, glucose and coronary calcium score (interaction p = 0.538). CONCLUSION: The impact of EF gain on ventricular mass after KTX could not be definitely confirmed. Further prospective studies in a large sample of KTX patients should be considered to address a possible causal relationship between EF gain and cardiac hypertrophy in this population.

Cowpea protein reduces LDL-cholesterol and apolipoprotein B concentrations, but does not improve biomarkers of inflammation or endothelial dysfunction in adults with moderate hypercholesterolemia.

INTRODUCTION: The risks of cardiovascular diseases, the leading cause of death in the world, can be reduced by diet. Cowpea protein has been shown to significantly reduce total cholesterol, LDL-cholesterol, and liver steatosis in hamsters. OBJECTIVE: The objective of this proof-of-concept study was to verify whether the consumption of cowpea protein improves lipid profile and biomarkers of inflammation and endothelial dysfunction in adults with moderate hypercholesterolemia. METHODS: In a randomized, double-blind, crossover design, 38 hypercholesterolemic subjects (LDL-cholesterol = 182.5 ± 2.7 mg/dL) consumed 25 g/day of cowpea protein isolate or 25 g/day of casein (control group) for 6 weeks each, separated by a 4-week washout interval. Fasting blood samples were collected at baseline and at the end of each diet period. Lipids (total cholesterol, LDL-cholesterol, triglycerides, HDL-cholesterol) were determined by enzymatic methods, apolipoproteins (apoA-I and apoB) by standardized immunoassays, inflammatory biomarkers (C-reactive protein) by turbidimetry, and biomarkers of endothelial dysfunction (intercellular adhesion molecule 1 and vascular cell adhesion molecule 1) by enzyme-linked immunosorbent assays. RESULTS AND DISCUSSION: Consumption of cowpea protein significantly reduced total cholesterol ( 12 %), LDL cholesterol ( 18.9 %), non HDL-cholesterol ( 16 %) and apoB ( 14 %), and increased HDL cholesterol (+2.7 %). No significant differences between treatment groups were observed for any of the serum inflammatory or endothelial dysfunction biomarkers. CONCLUSION: The present findings demonstrated the favorable effect of cowpea protein consumption on proatherogenic serum lipids and apoB in subjects with moderate hypercholesterolemia, similar to what was observed in a previous studies on animals.

Introducción: Los riesgos de las enfermedades cardiovasculares, la principal causa de muerte en el mundo, pueden ser reducidos con la dieta. Proteína caupí en hámsters redujo el colesterol total, LDL-colesterol, así como la esteatosis hepática de manera significativa. Objetivo: Este estudio de prueba de concepto fue verificar si el consumo de proteína de frijol mejora el perfil de lípidos y actúa sobre los biomarcadores de inflamación y disfunción endotelial en pacientes con hipercolesterolemia moderada. Métodos: En un diseño aleatorio doble ciego cruzado, 38 sujetos con hipercolesterolemia (colesterol-LDL = 182,5 ± 2,7 mg/dL) consumieron 25 g / día de aislado de proteína de frijol o 25 g / día de caseína (grupo control) durante seis semanas cada uno, y un intervalo de lavado de cuatro semanas Se recogieron muestras de sangre en ayunas al comienzo y al final de cada período de dieta. Los lípidos (colesterol total, LDL-colesterol, triglicéridos, HDL-colesterol) se determinaron por métodos enzimáticos, apolipoproteínas (apoA-I y apoB) por inmunoensayos normalizados, biomarcadores de inflamación (proteína C reactiva) por turbidimetría y los biomarcadores de disfunción endotelial (molecule-1 de adhesión intercelular y de molécula-1 de adhesión celular vascular) por técnicas de ensayo de inmunoabsorción ligados a enzimas. Resultados y discusión: El consumo de proteínas caupí redujo significativamente el colesterol total (12%), el colesterol LDL (18,9%), colesterol no HDL (16%), apoB (14%), y aumentó el colesterol HDL (2,7%). No se observaron diferencias significativas relacionadas con el grupo de tratamiento para cualquiera de los biomarcadores inflamatorios y de disfunción endotelial. Conclusión: Los presentes hallazgos demostraron el efecto favorable del consumo de proteína caupí en lípidos séricos pro-aterogénicas y apoB en sujetos con hipercolesterolemia moderada, de manera similar a lo observado en un trabajo previo con los animales.