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Serum n-3 and n-6 polyunsaturated fatty acid profile as an independent predictor of cardiovascular events in hemodialysis patients.
Am J Kidney Dis. 2013 Sep; 62(3):568-76.AJ

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+Show Affiliations

Department of Geriatrics and Vascular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan. t-shoji@med.osaka-cu.ac.jpNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo 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
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23602192

Citation

Shoji, Tetsuo, et al. "Serum N-3 and N-6 Polyunsaturated Fatty Acid Profile as an Independent Predictor of Cardiovascular Events in Hemodialysis Patients." American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation, vol. 62, no. 3, 2013, pp. 568-76.
Shoji T, Kakiya R, Hayashi T, et al. Serum n-3 and n-6 polyunsaturated fatty acid profile as an independent predictor of cardiovascular events in hemodialysis patients. Am J Kidney Dis. 2013;62(3):568-76.
Shoji, T., Kakiya, R., Hayashi, T., Tsujimoto, Y., Sonoda, M., Shima, H., Mori, K., Fukumoto, S., Tahara, H., Shioi, A., Tabata, T., Emoto, M., Nishizawa, Y., & Inaba, M. (2013). Serum n-3 and n-6 polyunsaturated fatty acid profile as an independent predictor of cardiovascular events in hemodialysis patients. American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation, 62(3), 568-76. https://doi.org/10.1053/j.ajkd.2013.02.362
Shoji T, et al. Serum N-3 and N-6 Polyunsaturated Fatty Acid Profile as an Independent Predictor of Cardiovascular Events in Hemodialysis Patients. Am J Kidney Dis. 2013;62(3):568-76. PubMed PMID: 23602192.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Serum n-3 and n-6 polyunsaturated fatty acid profile as an independent predictor of cardiovascular events in hemodialysis patients. AU - Shoji,Tetsuo, AU - Kakiya,Ryusuke, AU - Hayashi,Tomoshige, AU - Tsujimoto,Yoshihiro, AU - Sonoda,Mika, AU - Shima,Hideaki, AU - Mori,Katsuhito, AU - Fukumoto,Shinya, AU - Tahara,Hideki, AU - Shioi,Atushi, AU - Tabata,Tsutomu, AU - Emoto,Masanori, AU - Nishizawa,Yoshiki, AU - Inaba,Masaaki, Y1 - 2013/04/17/ PY - 2012/09/04/received PY - 2013/02/05/accepted PY - 2013/4/23/entrez PY - 2013/4/23/pubmed PY - 2013/11/20/medline KW - arachidonic acid (AA) KW - cardiovascular disease KW - docosahexaenoic acid (DHA) KW - eicosapentaenoic acid (EPA) KW - hemodialysis KW - n-3-polyunsaturated fatty acid (PUFA) SP - 568 EP - 76 JF - American journal of kidney diseases : the official journal of the National Kidney Foundation JO - Am. J. Kidney Dis. VL - 62 IS - 3 N2 - 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. SN - 1523-6838 UR - https://www.unboundmedicine.com/medline/citation/23602192/Serum_n_3_and_n_6_polyunsaturated_fatty_acid_profile_as_an_independent_predictor_of_cardiovascular_events_in_hemodialysis_patients_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0272-6386(13)00573-8 DB - PRIME DP - Unbound Medicine ER -