Department of System Medicine, Nephrology and Hypertension Unit, "Tor Vergata" University Hospital, Viale Oxford 81, 00133 Rome, Italy.
Lipids Health Dis. 2014 Mar 21;13:54. doi: 10.1186/1476-511X-13-54.
Dyslipidemia and abnormal phospholipid metabolism are frequent in uremic patients and increase their risk of cardiovascular disease (CVD): ω-3 polyunsaturated fatty acids (PUFAs) may reduce this risk in the general population. In this study we compared the plasma and erythrocyte cell membrane composition of PUFAs in a group of Caucasian hemodialysis (HD) patients and in a control group of healthy subjects and evaluated the erythrocyte/cell membrane fatty acid ratio as a marker of the dietary intake of phospholipids. The relationship between ω-3 and ω-6 fatty acids and the possible differences in PUFAs concentrations were also investigated.
After obtaining a fully informed consent, a total of ninety-nine HD patients and 160 non uremic control subjects from "Tor Vergata" University Hospital were enrolled into the study. None of them took antioxidant drugs or dietary supplements for at least 90 days prior to the observation. Blood samples were analysed by gas-chromatographic coupled to a mass spectrometric detector.The daily intake of total calories, proteins, lipids and carbohydrates is significantly lower in HD patients than in controls (p < 0.001). Most plasma and erythrocyte PUFA were also reduced significantly in HD patients (p < 0.001).
Our results suggest that many classes of PUFAs are lacking in HD patients, due to the removal of nutrients during the dialysis and to persistent malnutrition. A dietary treatment addressed to increase plasma ω-3 PUFAs and to optimize ω-6/ω-3 ratio may exert a protective action and reduce the risk of CVD in HD patient.
脂代谢紊乱和磷脂代谢异常在尿毒症患者中较为常见，增加了其心血管疾病（CVD）的风险：ω-3 多不饱和脂肪酸（PUFA）可能会降低普通人群的这种风险。在这项研究中，我们比较了一组白种人血液透析（HD）患者和一组健康对照组的血浆和红细胞细胞膜中 PUFAs 的组成，并评估了红细胞/细胞膜脂肪酸比值作为磷脂膳食摄入量的标志物。我们还研究了 ω-3 和 ω-6 脂肪酸之间的关系以及 PUFAs 浓度的可能差异。
在获得完全知情同意后，共有 99 名 HD 患者和 160 名非尿毒症对照组患者来自“Tor Vergata”大学医院参与了这项研究。在观察之前的至少 90 天内，他们都没有服用抗氧化药物或膳食补充剂。通过气相色谱-质谱联用仪分析血液样本。HD 患者的每日总热量、蛋白质、脂肪和碳水化合物摄入量明显低于对照组（p<0.001）。大多数血浆和红细胞 PUFAs 在 HD 患者中也显著降低（p<0.001）。
我们的研究结果表明，由于透析过程中营养素的流失和持续的营养不良，HD 患者缺乏多种类 PUFAs。增加血浆 ω-3 PUFAs 和优化 ω-6/ω-3 比值的饮食治疗可能会发挥保护作用，降低 HD 患者 CVD 的风险。
