Sixteen Weeks of High Amylose-Resistant Starch Supplementation Leads to a Reduction in p-Cresyl-Sulphate in Predialysis Patients
Bibliographic record
Abstract
Background: Patients with chronic kidney disease (CKD) have high levels of systemic inflammation and oxidative stress. The current study was designed to determine the effect of 16 weeks of supplementation with high amylose resistant starch (HAM-RS2) on the microbiota and biomarkers indicative of inflammation, oxidative stress, and uremic toxins in stage 3-4 patients with CKD. Methods: This was a double-blind, placebo controlled, parallel arm, randomized controlled trial. Sixty-eight participants were randomized to one of two groups: HAM-RS2 & usual care (RS2) or placebo (cornstarch) & usual care (Con). RS2 was provided as Hi-Maize® 260 RS. For week 1, the dose of supplements was 15 grams/day. The dose was then increased to 33 grams/day for weeks 2-16. Participants attended two baseline (BL) sessions with follow up visits 8 (wk8) and 16 weeks (wk16) later. Fasting blood samples were collected at BL, wk8 and wk16. A stool sample was collected for analysis of microbial composition using 16s RNA sequencing at BL and wk16. The blood samples were analysed for interleukin 6, interleukin 10, tumor necrosis factor alpha, c reactive protein, monocyte chemoattractant protein-1, malondialdehyde, 8-isoprostanes F2a, indoxyl sulphate (IS), and p-cresyl sulphate (PCS). Results: Sixty-five patients completed the study (RS2 = 33, Con =32). RS2 led to a significant increase in the levels of butyrate producing bacteria. RS2 also led to a significant reduction in PCS (mg/dl): (BL,3.75 ± 2.88, wk8 3.34 ± 2.65, wk16 2.88 ± 1.78) χ2(2) = 8.74, p = .02, while the control group did not change (BL 3.01 ± 2.18, wk8 2.62 ± 1.71, wk16 3.13 ± 2.52) χ2(2) = 1.13, p = .57. Post hoc analysis indicated that the change from baseline to 16 weeks for PCS in the RS2 group was significant (p = .02). IS followed a similar pattern but did not reach statistical significance. In addition, RS2 did not lead to any significant changes in inflammatory or oxidative stress markers. Conclusions: Supplementation with RS2 led to a reduction in PCS in our sample of patients with CKD. Since high levels of PCS are associated with increased mortality and progression of CKD, our finding has important clinical implications. Funding: Commercial Support - Ingredion donated the resistant starch and the placebo that was used in this study
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".