Serum n-3 and n-6 polyunsaturated fatty acid profile as an independent predictor of cardiovascular events in hemodialysis patients.

Abstract

BACKGROUND:

Unlike the n-6 polyunsaturated fatty acid (PUFA) arachidonic acid (AA), n-3-PUFAs such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) appear to have beneficial effects on inflammation, thrombosis, and cardiovascular disease (CVD). We examined possible alterations in serum PUFA profiles in patients on maintenance hemodialysis therapy and its association with CVD risk.

STUDY DESIGN:

An observational study including cross-sectional and longitudinal analyses.

SETTING & PARTICIPANTS:

Single-center study of 517 maintenance hemodialysis patients in an urban area in Japan.

PREDICTORS:

Serum EPA, DHA, and AA concentrations and EPA:AA, DHA:AA, and (EPA+DHA):AA ratios.

OUTCOMES:

CVD events, including ischemic heart disease, stroke, peripheral artery disease, pulmonary edema, and valve disease.

RESULTS:

Hemodialysis patients showed lower (EPA+DHA):AA, EPA:AA, and DHA:AA ratios than 122 controls similar in age and sex. During follow-up, 190 CVD events were recorded. (EPA+DHA):AA ratio was not associated significantly with CVD in unadjusted analysis, but was associated significantly and inversely with CVD in Cox models adjusted for age and other confounding variables, with HRs in the range of 1.71-1.99 in the lowest versus highest quartile of (EPA+DHA):AA ratios. Similarly, EPA:AA and DHA:AA ratios showed inverse associations with CVD, whereas serum EPA, DHA, and AA concentrations were not predictive of CVD.

LIMITATIONS:

No information for dietary intake, use of dietary supplements, or cell membrane PUFA content.

CONCLUSIONS:

In hemodialysis patients, serum PUFA profile is unfavorably altered, and the low n-3-PUFA:AA ratios are independent predictors of CVD.

• Authors: Tetsuo Shoji, Ryusuke Kakiya, Tomoshige Hayashi, Yoshihiro Tsujimoto, Mika Sonoda, Hideaki Shima, Katsuhito Mori, Shinya Fukumoto, Hideki Tahara, Atushi Shioi, Tsutomu Tabata, Masanori Emoto, Yoshiki Nishizawa, Masaaki Inaba
• Journal: American journal of kidney diseases : the official journal of the National Kidney Foundation (Am J Kidney Dis) Vol. 62 Issue 3 Pg. 568-76 (Sep 2013) ISSN: 1523-6838 [Electronic] United States
• PMID: 23602192 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2013 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Chemical References

• Biomarkers
• Fatty Acids, Omega-3
• Fatty Acids, Omega-6

Topics

• Aged
• Biomarkers (blood)
• Cardiovascular Diseases (blood, diagnosis)
• Cohort Studies
• Cross-Sectional Studies
• Fatty Acids, Omega-3 (blood)
• Fatty Acids, Omega-6 (blood)
• Female
• Follow-Up Studies
• Humans
• Longitudinal Studies
• Male
• Middle Aged
• Predictive Value of Tests
• Renal Dialysis (adverse effects)