Boron Intake and decreased risk of mortality in kidney transplant recipients

Daan Kremer; Adrian Post; TransplantLines Investigators; Ulrike Seidel; Patricia Huebbe; Yvonne van der Veen; Dion Groothof; A. W. Gomes Neto; T. J. Knobbe; Kai Lüersen; M. F. Eisenga; Gerjan J. Navis; Gerald Rimbach; Stephan J.L. Bakker

doi:10.1007/s00394-021-02702-0

Boron Intake and decreased risk of mortality in kidney transplant recipients

Daan Kremer^*, Adrian Post, TransplantLines Investigators, Ulrike Seidel, Patricia Huebbe, Yvonne van der Veen, Dion Groothof, A. W. Gomes Neto, T. J. Knobbe, Kai Lüersen, M. F. Eisenga, Gerjan J. Navis, Gerald Rimbach, Stephan J.L. Bakker

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

Purpose:

In a search for potentially modifiable factors to improve long-term outcome among kidney transplant recipients (KTR), we hypothesized that boron exposure is associated with improved long-term outcome in KTR.

Methods:

We determined 24 h urinary boron excretion using inductively coupled plasma mass spectrometry as a measure of boron exposure in 693 stable KTR (57% male, mean age 53y), enrolled in the TransplantLines Food and Nutrition Biobank and Cohort Study. Dietary intake was assessed using validated food-frequency questionnaires.

Results:

Linear regression analyses showed that dietary intake of fruit, wine and nuts were key determinants of boron excretion. In addition, boron excretion was negatively correlated with homocysteine and inflammatory parameters. In total, 73 (32%), 47 (20%) and 30 (13%) KTR died among the lowest, middle and highest tertiles of 24 h urinary boron excretion, respectively (P_log-rank < 0.001). Cox regression analyses showed that high boron excretion was strongly associated with lower risk of mortality, independent of age, sex, estimated glomerular filtration rate and history of cardiovascular disease (HR per doubling: 0.51, 95% CI: 0.40 to 0.66, P < 0.001).

Conclusion:

Boron may be an overlooked target to improve long-term survival among KTR and potentially other patients, likely through pathways other than inflammation or the methionine-homocysteine cycle that were previously suggested. Interventional trials are warranted to confirm the potential of dietary boron supplementation in KTR and other patient populations.

Original language	English
Pages (from-to)	973-984
Number of pages	12
Journal	European Journal of Nutrition
Volume	61
Issue number	2
DOIs	https://doi.org/10.1007/s00394-021-02702-0
Publication status	Published - Mar 2022

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Publisher Copyright:
© 2021, The Author(s).

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Kremer, D., Post, A., TransplantLines Investigators, Seidel, U., Huebbe, P., van der Veen, Y., Groothof, D., Gomes Neto, A. W., Knobbe, T. J., Lüersen, K., Eisenga, M. F., Navis, G. J., Rimbach, G., & Bakker, S. J. L. (2022). Boron Intake and decreased risk of mortality in kidney transplant recipients. European Journal of Nutrition, 61(2), 973-984. https://doi.org/10.1007/s00394-021-02702-0

@article{97fba0c6e8ae412893cd407ad0a2e8d3,

title = "Boron Intake and decreased risk of mortality in kidney transplant recipients",

abstract = "Purpose: In a search for potentially modifiable factors to improve long-term outcome among kidney transplant recipients (KTR), we hypothesized that boron exposure is associated with improved long-term outcome in KTR. Methods: We determined 24 h urinary boron excretion using inductively coupled plasma mass spectrometry as a measure of boron exposure in 693 stable KTR (57% male, mean age 53y), enrolled in the TransplantLines Food and Nutrition Biobank and Cohort Study. Dietary intake was assessed using validated food-frequency questionnaires. Results: Linear regression analyses showed that dietary intake of fruit, wine and nuts were key determinants of boron excretion. In addition, boron excretion was negatively correlated with homocysteine and inflammatory parameters. In total, 73 (32%), 47 (20%) and 30 (13%) KTR died among the lowest, middle and highest tertiles of 24 h urinary boron excretion, respectively (Plog-rank < 0.001). Cox regression analyses showed that high boron excretion was strongly associated with lower risk of mortality, independent of age, sex, estimated glomerular filtration rate and history of cardiovascular disease (HR per doubling: 0.51, 95% CI: 0.40 to 0.66, P < 0.001). Conclusion: Boron may be an overlooked target to improve long-term survival among KTR and potentially other patients, likely through pathways other than inflammation or the methionine-homocysteine cycle that were previously suggested. Interventional trials are warranted to confirm the potential of dietary boron supplementation in KTR and other patient populations.",

author = "Daan Kremer and Adrian Post and {TransplantLines Investigators} and Ulrike Seidel and Patricia Huebbe and {van der Veen}, Yvonne and Dion Groothof and {Gomes Neto}, {A. W.} and Knobbe, {T. J.} and Kai L{\"u}ersen and Eisenga, {M. F.} and Navis, {Gerjan J.} and Gerald Rimbach and Bakker, {Stephan J.L.} and Knobbe, {T. J.} and {Annema-de Jong}, {J. H.} and Berger, {S. P.} and J. Blokzijl and Bodewes, {F. A.J.A.} and {de Boer}, {M. T.} and K. Damman and {De Borst}, {M. H.} and A. Diepstra and Douwes, {R. M.} and Eisenga, {M. F.} and Erasmus, {M. E.} and Gan, {C. T.} and {Gomes Neto}, {A. W.} and H. Grootjans and E. Hak and Heiner-Fokkema, {M. R.} and Hepkema, {B. G.} and F. Klont and Leuvenink, {H. G.D.} and Lexmond, {W. S.} and {de Meijer}, {V. E.} and Niesters, {H. G.M.} and {van Pelt}, {L. J.} and Pol, {R. A.} and Porte, {R. J.} and Ranchor, {A. V.} and Sanders, {J. S.F.} and Schutten, {J. C.} and Siebelink, {M. J.} and Slart, {R. H.J.A.} and Swarte, {J. C.} and {van den Heuvel}, {M. C.} and Verschuuren, {E. A.M.} and Vos, {M. J.}",

note = "Publisher Copyright: {\textcopyright} 2021, The Author(s).",

year = "2022",

month = mar,

doi = "10.1007/s00394-021-02702-0",

language = "English",

volume = "61",

pages = "973--984",

journal = "European Journal of Nutrition",

issn = "1436-6207",

publisher = "D. Steinkopff-Verlag",

number = "2",

}

Kremer, D, Post, A, TransplantLines Investigators, Seidel, U, Huebbe, P, van der Veen, Y, Groothof, D, Gomes Neto, AW, Knobbe, TJ, Lüersen, K, Eisenga, MF, Navis, GJ, Rimbach, G & Bakker, SJL 2022, 'Boron Intake and decreased risk of mortality in kidney transplant recipients', European Journal of Nutrition, vol. 61, no. 2, pp. 973-984. https://doi.org/10.1007/s00394-021-02702-0

TY - JOUR

T1 - Boron Intake and decreased risk of mortality in kidney transplant recipients

AU - Kremer, Daan

AU - Post, Adrian

AU - TransplantLines Investigators

AU - Seidel, Ulrike

AU - Huebbe, Patricia

AU - van der Veen, Yvonne

AU - Groothof, Dion

AU - Gomes Neto, A. W.

AU - Knobbe, T. J.

AU - Lüersen, Kai

AU - Eisenga, M. F.

AU - Navis, Gerjan J.

AU - Rimbach, Gerald

AU - Bakker, Stephan J.L.

AU - Knobbe, T. J.

AU - Annema-de Jong, J. H.

AU - Berger, S. P.

AU - Blokzijl, J.

AU - Bodewes, F. A.J.A.

AU - de Boer, M. T.

AU - Damman, K.

AU - De Borst, M. H.

AU - Diepstra, A.

AU - Douwes, R. M.

AU - Eisenga, M. F.

AU - Erasmus, M. E.

AU - Gan, C. T.

AU - Gomes Neto, A. W.

AU - Grootjans, H.

AU - Hak, E.

AU - Heiner-Fokkema, M. R.

AU - Hepkema, B. G.

AU - Klont, F.

AU - Leuvenink, H. G.D.

AU - Lexmond, W. S.

AU - de Meijer, V. E.

AU - Niesters, H. G.M.

AU - van Pelt, L. J.

AU - Pol, R. A.

AU - Porte, R. J.

AU - Ranchor, A. V.

AU - Sanders, J. S.F.

AU - Schutten, J. C.

AU - Siebelink, M. J.

AU - Slart, R. H.J.A.

AU - Swarte, J. C.

AU - van den Heuvel, M. C.

AU - Verschuuren, E. A.M.

AU - Vos, M. J.

PY - 2022/3

Y1 - 2022/3

N2 - Purpose: In a search for potentially modifiable factors to improve long-term outcome among kidney transplant recipients (KTR), we hypothesized that boron exposure is associated with improved long-term outcome in KTR. Methods: We determined 24 h urinary boron excretion using inductively coupled plasma mass spectrometry as a measure of boron exposure in 693 stable KTR (57% male, mean age 53y), enrolled in the TransplantLines Food and Nutrition Biobank and Cohort Study. Dietary intake was assessed using validated food-frequency questionnaires. Results: Linear regression analyses showed that dietary intake of fruit, wine and nuts were key determinants of boron excretion. In addition, boron excretion was negatively correlated with homocysteine and inflammatory parameters. In total, 73 (32%), 47 (20%) and 30 (13%) KTR died among the lowest, middle and highest tertiles of 24 h urinary boron excretion, respectively (Plog-rank < 0.001). Cox regression analyses showed that high boron excretion was strongly associated with lower risk of mortality, independent of age, sex, estimated glomerular filtration rate and history of cardiovascular disease (HR per doubling: 0.51, 95% CI: 0.40 to 0.66, P < 0.001). Conclusion: Boron may be an overlooked target to improve long-term survival among KTR and potentially other patients, likely through pathways other than inflammation or the methionine-homocysteine cycle that were previously suggested. Interventional trials are warranted to confirm the potential of dietary boron supplementation in KTR and other patient populations.

AB - Purpose: In a search for potentially modifiable factors to improve long-term outcome among kidney transplant recipients (KTR), we hypothesized that boron exposure is associated with improved long-term outcome in KTR. Methods: We determined 24 h urinary boron excretion using inductively coupled plasma mass spectrometry as a measure of boron exposure in 693 stable KTR (57% male, mean age 53y), enrolled in the TransplantLines Food and Nutrition Biobank and Cohort Study. Dietary intake was assessed using validated food-frequency questionnaires. Results: Linear regression analyses showed that dietary intake of fruit, wine and nuts were key determinants of boron excretion. In addition, boron excretion was negatively correlated with homocysteine and inflammatory parameters. In total, 73 (32%), 47 (20%) and 30 (13%) KTR died among the lowest, middle and highest tertiles of 24 h urinary boron excretion, respectively (Plog-rank < 0.001). Cox regression analyses showed that high boron excretion was strongly associated with lower risk of mortality, independent of age, sex, estimated glomerular filtration rate and history of cardiovascular disease (HR per doubling: 0.51, 95% CI: 0.40 to 0.66, P < 0.001). Conclusion: Boron may be an overlooked target to improve long-term survival among KTR and potentially other patients, likely through pathways other than inflammation or the methionine-homocysteine cycle that were previously suggested. Interventional trials are warranted to confirm the potential of dietary boron supplementation in KTR and other patient populations.

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U2 - 10.1007/s00394-021-02702-0

DO - 10.1007/s00394-021-02702-0

M3 - Article

C2 - 34677681

AN - SCOPUS:85117916628

SN - 1436-6207

VL - 61

SP - 973

EP - 984

JO - European Journal of Nutrition

JF - European Journal of Nutrition

IS - 2

ER -

Boron Intake and decreased risk of mortality in kidney transplant recipients

Abstract

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