SP410LYCOPENE DIET SUPPLEMENTATION DECREASES OXYSTEROLS AS IMPROVES ANEMIC STATUS DESPITE NO EFFECTS ON INFLAMMATION IN AGING WITH CKD

Abstract

INTRODUCTION AND AIMS: Aging and chronic kidney disease (CKD) are frequently associated with anemia. Partly treatable nutritional deficiencies in addition to a complex and heterogeneous interplay of chronic inflammation, functional iron deficiency and renal impairment have been identified as possible causes of hemoglobin (Hb) fall. Increased activity of reactive oxygen species, leading to oxidative and carbonyl stress, has been revealed in aging related diseases and in chronic kidney insufficiency. The carotenoid lycopene is characterized by strong quenching and free radical scavenging attitude. Evidence from observational studies have supported the hypothesis of its protective role for several chronic degenerative diseases. However the role of this vegetable derived micronutrient against anemia in aged with reduced glomerular filtration rate (GFR) hasn't yet been investigated. Humans are unable to synthesize carotenoids, therefore food intake constitutes the only source. On lipid metabolism lycopene acts as hypocholesterolemic agent, with inhibitory effects on HMG-CoA reductase. It also contrasts in human macrophages the pro-inflammatory cascade induced by cholesterol oxidation products (oxysterols). Renal anaemia with its lack of erythrocytes, effective mobile free radical scavengers, contributes to prooxidants/ antioxidants imbalance. In addition, age-associated risk factors for malnutrition result in anemia related to deficiency of micronutrients and antioxidants. The objective of the study was to evaluate the role of vegetable derived antioxidant diet supplementation against oxidative stress, inflammation and anemia in aging with CKD. METHODS: Ten persons, seven women and three men (age: 90, 3 ± 9,5 years; eGFR: 45 ± 10,4 ml/min/1,73 m2, calculated by Cochroft-Gault equation), had lycopene daily diet supplementation for six weeks. The oxysterols, cholestane-3β, 5a, 6β-triol and 5β - 6β epoxy-cholesterol, C reactive protein (CRP) and total blood white cells (WBC) as parameters of inflammation, Hb values, number of erythrocytes (RBC) and mean corpuscular hemoglobin concentration (MCHC) were assayed before and after 6 weeks of diet supplementation with lycopene (one tablet/day of 100 mg tomato powder containing 10 mg of lycopene). Blood oxysterols were measured by extraction, derivation and gas chromatographic separation. Statistical analysis was performed using “T” Student Test. Values are expressed as mean ± SD. Statistical significance was set at p<0.05 RESULTS: Lycopene induced a statistical reduction of oxysterols (α-triol: 0,40 ± 0,07 μg / L vs 0,32 ± 0, 04 μg / L [p <0.01]; β-epoxy cholesterol: 5,3 ± 1,3 μg / L vs 3,7 ± 0,6 μg / L [p <0.01]), but not in parameters of inflammation (WBC : 7,9 ± 3,9 x 103 vs 7,7 ± 3,8 x 103; CRP: 2 ± 0,9 μg/dl vs 1,7 ± 0,9 μg/dl ). Statistical differences were also revealed in Hb after lycopene diet supplements and in RBC but not in MCHC. Particularly, Hb: 11,5 ± 1,8 gr/dl vs 13,3 ± 1,7 gr/dl [ p< 0.05]; RBC: 3,27 ± 0,96 x 106 vs 4,41 ± 1,14 x 106 [ p< 0.05]; MCHC: 24,2 ± 4,18 pg vs 25,1 ± 4,1 pg [ns]. CONCLUSIONS: The carotenoid lycopene decreased cholesterol oxidation products and increased Hb values in aged with CKD. In depth and longer studies, however, are needed to evaluate the long term benefits of vegetable derived antioxidants on renal and aging related anemia as the protective role against the progressive impairment of renal function.