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Metabolic, inflammatory and oxidative stress markers in the nitric oxide variation of hemodialysis subjects

Andreza De Paula Santos Epifânio, Karla Pereira Balbino, Monica De Paula Jorge, Sonia Machado Rocha Ribeiro, Jerusa Maria Oliveira, Leandro Licursi Oliveira, Helen Hermana Miranda Hermsdorff

Introduction: Oxidative stress markers such as nitric oxide (NO) have been investigated in hemodialysis (HD).Objective: Evaluate the association of NO variation with adiposity indicators, metabolic, inflammatory and oxidative stress markers in individuals to HD.Methods: Cross-sectional study with 85 subjects on HD treatment (≥ 18 years). The clinical-nutritional status was evaluated through subjective global assessment modified (SGAm), anthropometric measurements and body composition. Dietary intake was evaluated using a food frequency questionnaire. Metabolic markers were obtained from medical records. Inflammatory markers (IL-6 and IL-10) and oxidative stress, (TACs), (SOD), (GST), (MDA) and NO were determined using standardized protocols. Results: Those individuals with a high concentration of NO (> 4.32 μmol/L) had lower values for SGAm score (p = 0.012) and higher iron values (p = 0.050), Fe saturation (p = 0.037) and triacylglycerol (p = 0.003). The same subjects still had lower consumption of copper (p = 0.026), manganese (p = 0.035), vitamin E (p = 0.050), ω3 (p = 0.021) and ω6 (p = 0.020). In a multiple regression model, concentrations of ferritin, triacylglycerol, IL6 and SOD contributed to a 54.8% increase in NO concentrations, whereas triacylglycerol and SOD concentrations were independent factors for NO variation (p < 0.001). Conclusions: The clinical and nutritional status as well as intake of nutrients with antioxidant properties (Cu, Zn, Mn, vitamin C and ω3) appears to modulate the variation of NO in this population.

Palabras Clave: Reactive nitrogen species (RNS); Inflammation; Superoxide dismutase; Food Intake; Terminal Renal Disease.

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