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The effects of n-3 long-chain polyunsaturated fatty acid supplementation on biomarkers of kidney injury in adults with diabetes: results of the GO-FISH trial.
Diabetes Care 2013; 36(6):1462-9DC

Abstract

OBJECTIVE

Long-chain n-3 polyunsaturated fatty acid (n-3 PUFA) supplements may have renoprotective effects in patients with diabetes, but previous trials have been inconsistent. We performed a randomized controlled trial of n-3 PUFA supplementation on urine albumin excretion and markers of kidney injury in adults with type 2 diabetes. RESEARCH DESIGN AND

METHODS

We conducted a randomized, placebo-controlled, two-period crossover trial to test the effects of 4 g/day of n-3 PUFA supplementation on markers of glomerular filtration and kidney injury in adults with adult-onset diabetes and greater than or equal to trace amounts of proteinuria. Each period lasted 6 weeks and was separated by a 2-week washout. The main outcome was urine albumin excretion and, secondarily, markers of kidney injury (kidney injury molecule-1, N-acetyl β-d-glucosaminidase [NAG], neutrophil gelatinase-associated lipocalin [NGAL], and liver fatty acid-binding protein [LFABP]), serum markers of kidney function (cystatin C, β2-microglobulin, and creatinine), and estimated glomerular filtration rate (eGFR).

RESULTS

Of the 31 participants, 29 finished both periods. A total of 55% were male, and 61% were African American; mean age was 67 years. At baseline, mean BMI was 31.6 kg/m(2), median eGFR was 76.9 mL/min/1.73 m(2), and median 24-h urine albumin excretion was 161 mg/day. Compared with placebo, n-3 PUFA had nonsignificant effects on urine albumin excretion (-7.2%; 95% CI -20.6 to 8.5; P = 0.35) and significant effects on urine NGAL excretion (-16% [-29.1 to -0.5%]; P = 0.04). There was no effect on serum markers of kidney function or eGFR. In subgroup analyses, there were significant decreases in 24-h urinary excretion of albumin, NGAL, LFABP, and NAG among participants taking medications that block the renin-angiotensin-aldosterone system (RAAS).

CONCLUSIONS

These results suggest a potential effect of n-3 PUFA supplementation on markers of kidney injury in patients with diabetes and early evidence of kidney disease. In the context of prior studies, these results provide a strong rationale for long-term trials of n-3 PUFA on chronic kidney disease progression.

Authors+Show Affiliations

Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. ermiller@jhmi.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23275364

Citation

Miller, Edgar R., et al. "The Effects of N-3 Long-chain Polyunsaturated Fatty Acid Supplementation On Biomarkers of Kidney Injury in Adults With Diabetes: Results of the GO-FISH Trial." Diabetes Care, vol. 36, no. 6, 2013, pp. 1462-9.
Miller ER, Juraschek SP, Anderson CA, et al. The effects of n-3 long-chain polyunsaturated fatty acid supplementation on biomarkers of kidney injury in adults with diabetes: results of the GO-FISH trial. Diabetes Care. 2013;36(6):1462-9.
Miller, E. R., Juraschek, S. P., Anderson, C. A., Guallar, E., Henoch-Ryugo, K., Charleston, J., ... Appel, L. J. (2013). The effects of n-3 long-chain polyunsaturated fatty acid supplementation on biomarkers of kidney injury in adults with diabetes: results of the GO-FISH trial. Diabetes Care, 36(6), pp. 1462-9. doi:10.2337/dc12-1940.
Miller ER, et al. The Effects of N-3 Long-chain Polyunsaturated Fatty Acid Supplementation On Biomarkers of Kidney Injury in Adults With Diabetes: Results of the GO-FISH Trial. Diabetes Care. 2013;36(6):1462-9. PubMed PMID: 23275364.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The effects of n-3 long-chain polyunsaturated fatty acid supplementation on biomarkers of kidney injury in adults with diabetes: results of the GO-FISH trial. AU - Miller,Edgar R,3rd AU - Juraschek,Stephen P, AU - Anderson,Cheryl A, AU - Guallar,Eliseo, AU - Henoch-Ryugo,Karen, AU - Charleston,Jeanne, AU - Turban,Sharon, AU - Bennett,Michael R, AU - Appel,Lawrence J, Y1 - 2012/12/28/ PY - 2013/1/1/entrez PY - 2013/1/1/pubmed PY - 2013/12/27/medline SP - 1462 EP - 9 JF - Diabetes care JO - Diabetes Care VL - 36 IS - 6 N2 - OBJECTIVE Long-chain n-3 polyunsaturated fatty acid (n-3 PUFA) supplements may have renoprotective effects in patients with diabetes, but previous trials have been inconsistent. We performed a randomized controlled trial of n-3 PUFA supplementation on urine albumin excretion and markers of kidney injury in adults with type 2 diabetes. RESEARCH DESIGN AND METHODS We conducted a randomized, placebo-controlled, two-period crossover trial to test the effects of 4 g/day of n-3 PUFA supplementation on markers of glomerular filtration and kidney injury in adults with adult-onset diabetes and greater than or equal to trace amounts of proteinuria. Each period lasted 6 weeks and was separated by a 2-week washout. The main outcome was urine albumin excretion and, secondarily, markers of kidney injury (kidney injury molecule-1, N-acetyl β-d-glucosaminidase [NAG], neutrophil gelatinase-associated lipocalin [NGAL], and liver fatty acid-binding protein [LFABP]), serum markers of kidney function (cystatin C, β2-microglobulin, and creatinine), and estimated glomerular filtration rate (eGFR). RESULTS Of the 31 participants, 29 finished both periods. A total of 55% were male, and 61% were African American; mean age was 67 years. At baseline, mean BMI was 31.6 kg/m(2), median eGFR was 76.9 mL/min/1.73 m(2), and median 24-h urine albumin excretion was 161 mg/day. Compared with placebo, n-3 PUFA had nonsignificant effects on urine albumin excretion (-7.2%; 95% CI -20.6 to 8.5; P = 0.35) and significant effects on urine NGAL excretion (-16% [-29.1 to -0.5%]; P = 0.04). There was no effect on serum markers of kidney function or eGFR. In subgroup analyses, there were significant decreases in 24-h urinary excretion of albumin, NGAL, LFABP, and NAG among participants taking medications that block the renin-angiotensin-aldosterone system (RAAS). CONCLUSIONS These results suggest a potential effect of n-3 PUFA supplementation on markers of kidney injury in patients with diabetes and early evidence of kidney disease. In the context of prior studies, these results provide a strong rationale for long-term trials of n-3 PUFA on chronic kidney disease progression. SN - 1935-5548 UR - https://www.unboundmedicine.com/medline/citation/23275364/The_effects_of_n_3_long_chain_polyunsaturated_fatty_acid_supplementation_on_biomarkers_of_kidney_injury_in_adults_with_diabetes:_results_of_the_GO_FISH_trial_ L2 - http://care.diabetesjournals.org/cgi/pmidlookup?view=long&pmid=23275364 DB - PRIME DP - Unbound Medicine ER -