Lauretani Fulvio, Semba Richard D, Bandinelli Stefania, Miller Edgar R, Ruggiero Carmelinda, Cherubini Antonio, Guralnik Jack M, Ferrucci Luigi
Tuscany Regional Agency, Florence, Italy.
Clin Chem. 2008 Mar;54(3):475-81. doi: 10.1373/clinchem.2007.095521. Epub 2008 Jan 17.
Recent studies suggest an association between polyunsaturated fatty acids (PUFAs) and the development of chronic kidney disease. The aim of this study was to examine the relationship between PUFAs and renal function in older adults.
We performed a cross-sectional and prospective analysis of 931 adults, > or = 65 years old, enrolled in the InCHIANTI study, a population-based cohort in Tuscany, Italy. Plasma PUFAs were measured at enrollment, and creatinine clearance was estimated by the Cockcroft-Gault equation at baseline and after 3-year follow-up.
At enrollment, participants with higher creatinine clearance had higher concentrations of HDL cholesterol, total plasma PUFAs, plasma n-3 fatty acid (FA), and plasma n-6 FA and lower triglycerides. From enrollment to the 3-year follow-up visit, creatinine clearance declined by 7.8 (12.2) mL/min (P <0.0001). Baseline total plasma PUFAs, n-3 FA, n-6 FA, and linoleic, linolenic, and arachidonic acids were strong independent predictors of less steep decline in creatinine clearance from baseline to follow-up (P <0.0001, after adjusting for baseline creatinine clearance). After adjusting for baseline creatinine, baseline total plasma PUFAs, n-3 FA, and linoleic, linolenic, and arachidonic acids were negatively associated with creatinine at 3-year follow-up. Participants with higher plasma PUFAs at enrollment had a lower risk of developing renal insufficiency, defined by a creatinine clearance <60 mL/min, during 3-year follow-up.
High PUFA concentrations, both n-3 FA and n-6 FA, may attenuate the age-associated decline in renal function among older community-dwelling women and men.
近期研究表明多不饱和脂肪酸(PUFAs)与慢性肾脏病的发生之间存在关联。本研究旨在探讨老年人中PUFAs与肾功能之间的关系。
我们对931名年龄≥65岁的成年人进行了横断面和前瞻性分析,这些成年人参与了InCHIANTI研究,该研究是意大利托斯卡纳地区一项基于人群的队列研究。在入组时测量血浆PUFAs,并在基线和3年随访后通过Cockcroft-Gault方程估算肌酐清除率。
入组时,肌酐清除率较高的参与者具有较高的高密度脂蛋白胆固醇、血浆总PUFAs、血浆n-3脂肪酸(FA)和血浆n-6 FA浓度以及较低的甘油三酯水平。从入组到3年随访时,肌酐清除率下降了7.8(12.2)mL/分钟(P<0.0001)。基线血浆总PUFAs、n-3 FA、n-6 FA以及亚油酸、亚麻酸和花生四烯酸是从基线到随访期间肌酐清除率下降较缓的强有力独立预测因素(在调整基线肌酐清除率后,P<0.0001)。在调整基线肌酐后,基线血浆总PUFAs、n-3 FA以及亚油酸、亚麻酸和花生四烯酸在3年随访时与肌酐呈负相关。入组时血浆PUFAs较高的参与者在3年随访期间发生肾功能不全(定义为肌酐清除率<60 mL/分钟)的风险较低。
高浓度的PUFAs,包括n-3 FA和n-6 FA,可能会减轻社区居住的老年女性和男性中与年龄相关的肾功能下降。