Dietary Oxidative Balance Scores and Biomarkers of Inflammation among Individuals with and without Chronic Kidney Disease

• Type of Material: Article
• Authors: Kristin J. Marks, Rollins School of Public Health; Terryl Hartman, Emory University; Suzanne E. Judd, University of Alabama at Birmingham; Titilayo O. Ilori, University of Arizona; Katharine L. Cheung, University of Vermont; David G. Warnock, University of Alabama at Birmingham; Orlando M. Gutiérrez, University of Alabama at Birmingham; Mark Goodman, Emory University; Mary Cushman, University of Vermont; William McClellan, Emory University
• Language: English
• Date: 2018-05-01
• Publisher: Karger Publishers Open Access
• Publication Version: Final Published Version
• Copyright Statement: © 2018 © 2018 The Author(s) Published by S. Karger AG, Basel.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1159/000490499
• Title of Journal or Parent Work: Nephron Extra
• ISSN: 1664-5529
• Volume: 8
• Issue: 2
• Start Page: 11
• End Page: 23
• Grant/Funding Information: This research project is supported by a cooperative agreement U01 NS041588 from the National Institute of Neurological Disorders and Stroke, National Institutes of Health, Department of Health and Human Services.
• Keywords: Chronic kidney disease; Pro-oxidant; Antioxidant; Inflammatory markers; Oxidative balance
• Research Categories: Health Sciences, Epidemiology; Health Sciences, Public Health

Abstract

Background: Oxidative stress and inflammation are proposed mechanisms of nonspecific kidney injury and progressive kidney failure. Higher dietary oxidative balance scores (OBS) are associated with lower prevalence of chronic kidney disease (CKD). Methods: We investigated the association between OBS and biomarkers of inflammation using data from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study. Nutrient estimates from the Block Food Frequency Questionnaires were used to define tertiles of 11 pro- and antioxidant factors. Points for each OBS component were summed, with a higher score indicating predominance of antioxidant exposures. Multivariable linear regression models were used to estimate the association between OBS and biomarkers of inflammation (interleukin-6 [IL-6], interleukin-8 [IL-8], interleukin-10 [IL-10], fibrinogen, C-reactive protein [CRP], white blood cell count, and cystatin C). An interaction term was included to determine if associations between OBS and inflammatory markers differed between individuals with and without CKD. Results: Of 682 participants, 22.4% had CKD. In adjusted models, OBS was associated with CRP and IL-6. For every 5-unit increase in OBS, the CRP concentration was -15.3% lower (95% CI: -25.6, -3.6). The association of OBS with IL-6 differed by CKD status; for every 5-unit increase in OBS, IL-6 was -10.7% lower (95% CI: -16.3, -4.7) among those without CKD, but there was no association among those with CKD (p = 0.03). Conclusion: This study suggests that a higher OBS is associated with more favorable levels of IL-6 and CRP, and that the association of OBS and IL-6 may be modified by CKD status.