Tags

Type your tag names separated by a space and hit enter

Altered Serum n-6 Polyunsaturated Fatty Acid Profile and Risks of Mortality and Cardiovascular Events in a Cohort of Hemodialysis Patients.
J Ren Nutr. 2018 01; 28(1):54-63.JR

Abstract

OBJECTIVE

Alterations in the balance between serum n-3 and n-6 polyunsaturated fatty acids (PUFAs) is predictive of cardiovascular events among hemodialysis patients, although little is known about the serum ratio of n-6 arachidonic acid (AA) to n-6 dihomo-γ-linoleic acid (DGLA) in renal failure. We hypothesized that AA/DGLA ratio is altered in hemodialysis patients resulting in poor clinical outcomes.

METHODS

This was a single center cohort study in an urban area in Japan with cross-sectional analyses. Subjects were 517 hemodialysis patients and 122 control subjects. The main exposure was serum AA/DGLA ratio, and the main outcome measures were all-cause mortality and cardiovascular events during 5 years.

RESULTS

The hemodialysis patients showed a higher median (interquartile range) AA/DGLA ratio than the control subjects (6.46 [5.22-7.81] versus 4.56 [3.74-6.34], P < .001). In a Cox proportional hazard model adjusted for age, sex, dialysis duration, diabetic nephropathy, prior cardiovascular disease, and the ratio of serum n-3 polyunsaturated fatty acids (eicosapentaenoic acid plus docosahexaenoic acid) to AA, the higher quartiles of AA/DGLA ratio were associated with higher risk for all-cause mortality with hazard ratios (95% confidence interval) of 1.50 (0.84-2.76) for quartile 2, 2.10 (1.18-3.86) for quartile 3, and 2.02 (1.10-3.78) for quartile 4 compared with quartile 1. AA/DGLA ratio showed a similar association with the risk of cardiovascular events.

CONCLUSIONS

AA/DGLA ratio was elevated in patients with end-stage renal disease requiring hemodialysis, and a high AA/DGLA ratio was an independent predictor of poor clinical outcomes in this population.

Links

Publisher Full Text (DOI)

Authors+Show Affiliations

Kuwamura Y
Department of Metabolism, Endocrinology and Molecular Medicine, Graduate School of Medicine, Osaka City University, Osaka, Japan.
Shoji T
Department of Vascular Medicine, Graduate School of Medicine, Osaka City University, Osaka, Japan; Vascular Science Center for Translational Research, Graduate School of Medicine, Osaka City University, Osaka, Japan. Electronic address: t-shoji@med.osaka-cu.ac.jp.
Okute Y
Department of Metabolism, Endocrinology and Molecular Medicine, Graduate School of Medicine, Osaka City University, Osaka, Japan.
Yamazaki Y
Department of Metabolism, Endocrinology and Molecular Medicine, Graduate School of Medicine, Osaka City University, Osaka, Japan.
Motoyama K
Department of Metabolism, Endocrinology and Molecular Medicine, Graduate School of Medicine, Osaka City University, Osaka, Japan.
Morioka T
Department of Metabolism, Endocrinology and Molecular Medicine, Graduate School of Medicine, Osaka City University, Osaka, Japan.
Mori K
Department of Nephrology, Graduate School of Medicine, Osaka City University, Osaka, Japan.
Fukumoto S
Department of Premier Preventive Medicine, Graduate School of Medicine, Osaka City University, Osaka, Japan.
Tsujimoto Y
Division of Internal Medicine, Dialysis Center, Inoue Hospital, Suita, Osaka, Japan.
Shioi A
Department of Vascular Medicine, Graduate School of Medicine, Osaka City University, Osaka, Japan; Vascular Science Center for Translational Research, Graduate School of Medicine, Osaka City University, Osaka, Japan.
Emoto M
Department of Metabolism, Endocrinology and Molecular Medicine, Graduate School of Medicine, Osaka City University, Osaka, Japan.
Inaba M
Department of Metabolism, Endocrinology and Molecular Medicine, Graduate School of Medicine, Osaka City University, Osaka, Japan; Vascular Science Center for Translational Research, Graduate School of Medicine, Osaka City University, Osaka, Japan.

MeSH

AgedArachidonic AcidCardiovascular DiseasesCholesterolCross-Sectional StudiesDelta-5 Fatty Acid DesaturaseDocosahexaenoic AcidsEicosapentaenoic AcidFatty Acid DesaturasesFatty Acids, Omega-6FemaleFollow-Up StudiesHumansJapanKidney Failure, ChronicMaleMiddle AgedProportional Hazards ModelsProspective StudiesRenal DialysisRisk FactorsSerum AlbuminTreatment Outcome

Pub Type(s)

Journal Article
Observational Study

Language

eng

PubMed ID

29089279

Citation

Kuwamura, Yukinobu, et al. "Altered Serum N-6 Polyunsaturated Fatty Acid Profile and Risks of Mortality and Cardiovascular Events in a Cohort of Hemodialysis Patients." Journal of Renal Nutrition : the Official Journal of the Council On Renal Nutrition of the National Kidney Foundation, vol. 28, no. 1, 2018, pp. 54-63.
Kuwamura Y, Shoji T, Okute Y, et al. Altered Serum n-6 Polyunsaturated Fatty Acid Profile and Risks of Mortality and Cardiovascular Events in a Cohort of Hemodialysis Patients. J Ren Nutr. 2018;28(1):54-63.
Kuwamura, Y., Shoji, T., Okute, Y., Yamazaki, Y., Motoyama, K., Morioka, T., Mori, K., Fukumoto, S., Tsujimoto, Y., Shioi, A., Emoto, M., & Inaba, M. (2018). Altered Serum n-6 Polyunsaturated Fatty Acid Profile and Risks of Mortality and Cardiovascular Events in a Cohort of Hemodialysis Patients. Journal of Renal Nutrition : the Official Journal of the Council On Renal Nutrition of the National Kidney Foundation, 28(1), 54-63. https://doi.org/10.1053/j.jrn.2017.07.001
Kuwamura Y, et al. Altered Serum N-6 Polyunsaturated Fatty Acid Profile and Risks of Mortality and Cardiovascular Events in a Cohort of Hemodialysis Patients. J Ren Nutr. 2018;28(1):54-63. PubMed PMID: 29089279.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Altered Serum n-6 Polyunsaturated Fatty Acid Profile and Risks of Mortality and Cardiovascular Events in a Cohort of Hemodialysis Patients. AU - Kuwamura,Yukinobu, AU - Shoji,Tetsuo, AU - Okute,Yujiro, AU - Yamazaki,Yuko, AU - Motoyama,Koka, AU - Morioka,Tomoaki, AU - Mori,Katsuhito, AU - Fukumoto,Shinya, AU - Tsujimoto,Yoshihiro, AU - Shioi,Atsushi, AU - Emoto,Masanori, AU - Inaba,Masaaki, Y1 - 2017/10/28/ PY - 2017/05/07/received PY - 2017/07/12/revised PY - 2017/07/12/accepted PY - 2017/11/2/pubmed PY - 2018/8/7/medline PY - 2017/11/2/entrez SP - 54 EP - 63 JF - Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation JO - J Ren Nutr VL - 28 IS - 1 N2 - OBJECTIVE: Alterations in the balance between serum n-3 and n-6 polyunsaturated fatty acids (PUFAs) is predictive of cardiovascular events among hemodialysis patients, although little is known about the serum ratio of n-6 arachidonic acid (AA) to n-6 dihomo-γ-linoleic acid (DGLA) in renal failure. We hypothesized that AA/DGLA ratio is altered in hemodialysis patients resulting in poor clinical outcomes. METHODS: This was a single center cohort study in an urban area in Japan with cross-sectional analyses. Subjects were 517 hemodialysis patients and 122 control subjects. The main exposure was serum AA/DGLA ratio, and the main outcome measures were all-cause mortality and cardiovascular events during 5 years. RESULTS: The hemodialysis patients showed a higher median (interquartile range) AA/DGLA ratio than the control subjects (6.46 [5.22-7.81] versus 4.56 [3.74-6.34], P < .001). In a Cox proportional hazard model adjusted for age, sex, dialysis duration, diabetic nephropathy, prior cardiovascular disease, and the ratio of serum n-3 polyunsaturated fatty acids (eicosapentaenoic acid plus docosahexaenoic acid) to AA, the higher quartiles of AA/DGLA ratio were associated with higher risk for all-cause mortality with hazard ratios (95% confidence interval) of 1.50 (0.84-2.76) for quartile 2, 2.10 (1.18-3.86) for quartile 3, and 2.02 (1.10-3.78) for quartile 4 compared with quartile 1. AA/DGLA ratio showed a similar association with the risk of cardiovascular events. CONCLUSIONS: AA/DGLA ratio was elevated in patients with end-stage renal disease requiring hemodialysis, and a high AA/DGLA ratio was an independent predictor of poor clinical outcomes in this population. SN - 1532-8503 UR - https://www.unboundmedicine.com/medline/citation/29089279/Altered_Serum_n_6_Polyunsaturated_Fatty_Acid_Profile_and_Risks_of_Mortality_and_Cardiovascular_Events_in_a_Cohort_of_Hemodialysis_Patients_ DB - PRIME DP - Unbound Medicine ER -
Grapherence [↓5]

Related Citations

More