Low Serum 3-Methylhistidine Levels Are Associated With First Hospitalization in Kidney Transplantation Recipients

Abstract

Background: Low protein intake and increased muscle breakdown are associated with increased mortality risk in patients with kidney transplantation (KT). 3-methylhistidine (3-MH), a nonproteinogenic amino acid residue, is an index of muscle breakdown. the present study investigated the association between serum 3-MH levels and subsequent first hospitalization events in patients with KT.

Methods: A total of 64 KT patients were enrolled and 43 first hospitalization events occurred. Fasting blood samples were obtained and serum 3-MH level was performed with high-performance liquid chromatography and mass spectrometry. Associations between serum 3-MH levels and first hospitalization over a 5-year follow-up period were examined.

Results: Compared with patients without hospitalization, the 64 patients with KT revealed higher diabetes (P = .012) and hypertension (P = .006) prevalence, higher body fat mass (P = .012) and systolic blood pressure (P = .002), higher serum blood urea nitrogen (BUN) levels (P = .003), and lower serum 3-MH levels (P = .001). Statistical analysis revealed that serum 3-MH (95% confidence interval [CI]: 0.902-0.986, P = .010) and serum BUN (95% CI: 1.003-1.040, P = .022) levels were independently associated with first hospitalization events in patients with KT. Kaplan-Meier analysis showed a greater cumulative incidence of first hospitalization events in the patients with lower 3-MH levels (≤5.91 ng/mL) than that in those with higher 3-MH levels (P = .014; log-rank test).

Conclusions: Low serum 3-MH levels are associated with increased first hospitalization risk in KT recipients.