Abstract

Background: Recent epidemiological studies indicate that high exposure to very long chain saturated fatty acids (VL-SFA), present in peanuts and canola oil, is associated with positive health effects. Despite successful transplantation, health of renal transplant recipients (RTR) remains fragile, resulting in high risk of premature mortality. We hypothesized that high circulation concentrations of VL-SFA in RTR are associated with low risk of premature mortality in RTR. Methods: We included 680 stable RTR with a functioning graft >1 year. Plasma behenic acid (C22:0) and lignoceric acid (C24:0) were measured by Agilent gas chromatography with flame ionization detector. Dietary data were collected using a Food Frequency Questionnaire. Correlations between dietary intake and C22:0 and C24:0 were analyzed by Spearman’s Rho. Cox regression was used to analyze the association of VLSFA on mortality and to estimate mortality risk across tertiles of VL-SFA concentrations. Results: Age was 53±13 years, 57% were male and eGFR 52±20 ml/min/1.73m2. Plasma concentrations of C22:0 and C24:0 were 73.7±17.7 and 62.5±16.3 nmol/L, respectively. C22:0 and C24:0 concentrations were correlated with intake of peanuts (r=0.13; P=0.001 and R=0.16, P<0.001, resp.) and peanutbutter (r=0.11, P=0.008 and R=0.11, P=0.005, resp.). During median follow-up of 5.4 years, 146 (22%) RTR died. Plasma C22:0 and C24:0 were inversely associated with mortality, independent of potential confounders, including age, sex and eGFR (HR 0.84 [95%CI 0.76-0.93], P=0.001 and HR 0.82 [95%CI 0.74-0.92], P=0.001, reps.). Moreover, RTR in the 3rd tertile of plasma C22:0 and C24:0 had significantly better survival compared to RTR in the 1st tertile (Table1). Conclusions: Plasma VL-SFA is inversely associated with mortality in RTR. Increasing intake of foods containing VL-SFA, such as peanuts, may improve patient survival in RTR.