Urinary Excretion of <i>N</i><sup>1</sup>-Methylnicotinamide and <i>N</i><sup>1</sup>-Methyl-2-Pyridone-5-Carboxamide and Mortality in Kidney Transplant Recipients
It is unclear whether niacin nutritional status is a target for improvement of long-term outcome after renal transplantation. The 24-h urinary excretion of <i>N</i><sup>1</sup>-methylnicotinamide (<i>N</i><sup>1</sup>-MN), as a biomarker of niacin stat...
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doaj-c14863542bb343e2add2d4072a8e7c0e2020-11-25T03:23:37ZengMDPI AGNutrients2072-66432020-07-01122059205910.3390/nu12072059Urinary Excretion of <i>N</i><sup>1</sup>-Methylnicotinamide and <i>N</i><sup>1</sup>-Methyl-2-Pyridone-5-Carboxamide and Mortality in Kidney Transplant RecipientsCarolien P.J. Deen0Anna van der Veen1António W. Gomes-Neto2Johanna M. Geleijnse3Karin J. Borgonjen-van den Berg4M. Rebecca Heiner-Fokkema5Ido P. Kema6Stephan J.L. Bakker7Department of Internal Medicine, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The NetherlandsDepartment of Laboratory Medicine, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The NetherlandsDepartment of Internal Medicine, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The NetherlandsDivision of Human Nutrition and Health, Wageningen University, 6708 PB Wageningen, The NetherlandsDivision of Human Nutrition and Health, Wageningen University, 6708 PB Wageningen, The NetherlandsDepartment of Laboratory Medicine, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The NetherlandsDepartment of Laboratory Medicine, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The NetherlandsDepartment of Internal Medicine, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The NetherlandsIt is unclear whether niacin nutritional status is a target for improvement of long-term outcome after renal transplantation. The 24-h urinary excretion of <i>N</i><sup>1</sup>-methylnicotinamide (<i>N</i><sup>1</sup>-MN), as a biomarker of niacin status, has previously been shown to be negatively associated with premature mortality in kidney transplant recipients (KTR). However, recent evidence implies higher enzymatic conversion of <i>N</i><sup>1</sup>-MN to <i>N</i><sup>1</sup>-methyl-2-pyridone-5-carboxamide (2Py) in KTR, therefore the need exists for interpretation of both <i>N</i><sup>1</sup>-MN and 2Py excretion for niacin status assessment. We assessed niacin status by means of the 24-h urinary excretion of the sum of <i>N</i><sup>1</sup>-MN and 2Py (<i>N</i><sup>1</sup>-MN + 2Py), and its associations with risk of premature mortality in KTR. <i>N</i><sup>1</sup>-MN + 2Py excretion was measured in a longitudinal cohort of 660 KTR with LS-MS/MS. Prospective associations of <i>N</i><sup>1</sup>-MN + 2Py excretion were investigated with Cox regression analyses. Median <i>N</i><sup>1</sup>-MN + 2Py excretion was 198.3 (155.9–269.4) µmol/day. During follow-up of 5.4 (4.7–6.1) years, 143 KTR died, of whom 40 due to an infectious disease. <i>N</i><sup>1</sup>-MN + 2Py excretion was negatively associated with risk of all-cause mortality (HR 0.61; 95% CI 0.47–0.79; <i>p</i> < 0.001), and infectious mortality specifically (HR 0.47; 95% CI 0.29–0.75; <i>p</i> = 0.002), independent of potential confounders. Secondary analyses showed effect modification of hs-CRP on the negative prospective association of <i>N</i><sup>1</sup>-MN + 2Py excretion, and sensitivity analyses showed negative and independent associations of <i>N</i><sup>1</sup>-MN and 2Py excretion with risk of all-cause mortality separately. These findings add further evidence to niacin status as a target for nutritional strategies for improvement of long-term outcome in KTR.https://www.mdpi.com/2072-6643/12/7/2059<i>N</i><sup>1</sup>-methylnicotinamide<i>N</i><sup>1</sup>-methyl-2-pyridone-5-carboxamideurinary excretionniacin statusrenal transplantationmortality |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Carolien P.J. Deen Anna van der Veen António W. Gomes-Neto Johanna M. Geleijnse Karin J. Borgonjen-van den Berg M. Rebecca Heiner-Fokkema Ido P. Kema Stephan J.L. Bakker |
spellingShingle |
Carolien P.J. Deen Anna van der Veen António W. Gomes-Neto Johanna M. Geleijnse Karin J. Borgonjen-van den Berg M. Rebecca Heiner-Fokkema Ido P. Kema Stephan J.L. Bakker Urinary Excretion of <i>N</i><sup>1</sup>-Methylnicotinamide and <i>N</i><sup>1</sup>-Methyl-2-Pyridone-5-Carboxamide and Mortality in Kidney Transplant Recipients Nutrients <i>N</i><sup>1</sup>-methylnicotinamide <i>N</i><sup>1</sup>-methyl-2-pyridone-5-carboxamide urinary excretion niacin status renal transplantation mortality |
author_facet |
Carolien P.J. Deen Anna van der Veen António W. Gomes-Neto Johanna M. Geleijnse Karin J. Borgonjen-van den Berg M. Rebecca Heiner-Fokkema Ido P. Kema Stephan J.L. Bakker |
author_sort |
Carolien P.J. Deen |
title |
Urinary Excretion of <i>N</i><sup>1</sup>-Methylnicotinamide and <i>N</i><sup>1</sup>-Methyl-2-Pyridone-5-Carboxamide and Mortality in Kidney Transplant Recipients |
title_short |
Urinary Excretion of <i>N</i><sup>1</sup>-Methylnicotinamide and <i>N</i><sup>1</sup>-Methyl-2-Pyridone-5-Carboxamide and Mortality in Kidney Transplant Recipients |
title_full |
Urinary Excretion of <i>N</i><sup>1</sup>-Methylnicotinamide and <i>N</i><sup>1</sup>-Methyl-2-Pyridone-5-Carboxamide and Mortality in Kidney Transplant Recipients |
title_fullStr |
Urinary Excretion of <i>N</i><sup>1</sup>-Methylnicotinamide and <i>N</i><sup>1</sup>-Methyl-2-Pyridone-5-Carboxamide and Mortality in Kidney Transplant Recipients |
title_full_unstemmed |
Urinary Excretion of <i>N</i><sup>1</sup>-Methylnicotinamide and <i>N</i><sup>1</sup>-Methyl-2-Pyridone-5-Carboxamide and Mortality in Kidney Transplant Recipients |
title_sort |
urinary excretion of <i>n</i><sup>1</sup>-methylnicotinamide and <i>n</i><sup>1</sup>-methyl-2-pyridone-5-carboxamide and mortality in kidney transplant recipients |
publisher |
MDPI AG |
series |
Nutrients |
issn |
2072-6643 |
publishDate |
2020-07-01 |
description |
It is unclear whether niacin nutritional status is a target for improvement of long-term outcome after renal transplantation. The 24-h urinary excretion of <i>N</i><sup>1</sup>-methylnicotinamide (<i>N</i><sup>1</sup>-MN), as a biomarker of niacin status, has previously been shown to be negatively associated with premature mortality in kidney transplant recipients (KTR). However, recent evidence implies higher enzymatic conversion of <i>N</i><sup>1</sup>-MN to <i>N</i><sup>1</sup>-methyl-2-pyridone-5-carboxamide (2Py) in KTR, therefore the need exists for interpretation of both <i>N</i><sup>1</sup>-MN and 2Py excretion for niacin status assessment. We assessed niacin status by means of the 24-h urinary excretion of the sum of <i>N</i><sup>1</sup>-MN and 2Py (<i>N</i><sup>1</sup>-MN + 2Py), and its associations with risk of premature mortality in KTR. <i>N</i><sup>1</sup>-MN + 2Py excretion was measured in a longitudinal cohort of 660 KTR with LS-MS/MS. Prospective associations of <i>N</i><sup>1</sup>-MN + 2Py excretion were investigated with Cox regression analyses. Median <i>N</i><sup>1</sup>-MN + 2Py excretion was 198.3 (155.9–269.4) µmol/day. During follow-up of 5.4 (4.7–6.1) years, 143 KTR died, of whom 40 due to an infectious disease. <i>N</i><sup>1</sup>-MN + 2Py excretion was negatively associated with risk of all-cause mortality (HR 0.61; 95% CI 0.47–0.79; <i>p</i> < 0.001), and infectious mortality specifically (HR 0.47; 95% CI 0.29–0.75; <i>p</i> = 0.002), independent of potential confounders. Secondary analyses showed effect modification of hs-CRP on the negative prospective association of <i>N</i><sup>1</sup>-MN + 2Py excretion, and sensitivity analyses showed negative and independent associations of <i>N</i><sup>1</sup>-MN and 2Py excretion with risk of all-cause mortality separately. These findings add further evidence to niacin status as a target for nutritional strategies for improvement of long-term outcome in KTR. |
topic |
<i>N</i><sup>1</sup>-methylnicotinamide <i>N</i><sup>1</sup>-methyl-2-pyridone-5-carboxamide urinary excretion niacin status renal transplantation mortality |
url |
https://www.mdpi.com/2072-6643/12/7/2059 |
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