Vitamin C Depletion and All-Cause Mortality in Renal Transplant Recipients

Camilo G. Sotomayor; Michele F. Eisenga; Antonio W. Gomes Neto; Akin Ozyilmaz; Rijk O.B. Gans; Wilhelmina H.A. de Jong; Dorien M. Zelle; Stefan P. Berger; Carlo A. J.M. Gaillard; Gerjan J. Navis; Stephan J.L. Bakker

Vitamin C Depletion and All-Cause Mortality in Renal Transplant Recipients

2017

Vitamin C may reduce inflammation and is inversely associated with mortality in the general population. We investigated the association of plasma vitamin C with all-cause mortality in renal transplant recipients (RTR): and whether this association would be mediated by inflammatory biomarkers. Vitamin C, high sensitive C-reactive protein (hs-CRP), soluble intercellular cell adhesion molecule 1 (sICAM-1), and soluble vascular cell adhesion molecule 1 (sVCAM-1) were measured in a cohort of 598 RTR. Cox regression analyses were used to analyze the association between vitamin C depletion (≤28 µmol/L: 22% of RTR) and mortality. Mediation analyses were performed according to Preacher and Hayes’s procedure. At a median follow-up of 7.0 (6.2–7.5) years, 131 (21%) patients died. Vitamin C depletion was univariately associated with almost two-fold higher risk of mortality (Hazard ratio (HR) 1.95: 95% confidence interval (95%CI) 1.35–2.81, p &lt: 0.001). This association remained independent of potential confounders (HR 1.74: 95%CI 1.18–2.57, p = 0.005). Hs-CRP, sICAM-1, sVCAM-1 and a composite score of inflammatory biomarkers mediated 16, 17, 15, and 32% of the association, respectively. Vitamin C depletion is frequent and independently associated with almost two-fold higher risk of mortality in RTR. It may be hypothesized that the beneficial effect of vitamin C at least partly occurs through decreasing inflammation.

显示更多 [+]