Xu H, Ärnlöv J, Sandhagen B, Risérus U, Lindholm B, Lind L, Carrero J J
Divisions of Renal Medicine and Baxter Novum, Karolinska Institutet, Stockholm, Sweden.
Department of Medical Sciences, Cardiovascular Epidemiology, Uppsala University, Uppsala, Sweden; School of Health and Social Studies, Dalarna University, Falun, Sweden.
Nutr Metab Cardiovasc Dis. 2016 Dec;26(12):1096-1103. doi: 10.1016/j.numecd.2016.09.006. Epub 2016 Sep 16.
Unhealthy dietary fats are associated with faster kidney function decline. The cell membrane composition of phospholipid fatty acids (FAs) is a determinant of membrane fluidity and rheological properties. These properties, which have been linked to kidney damage, are thought to be reflected by the lipophilic index (LI). We prospectively investigated the associations of LI with kidney function and its decline.
Observational study from the Prospective Investigation of Vasculature in Uppsala Seniors including 975 men and women with plasma phospholipid FAs composition and cystatin-C estimate glomerular filtration rate (eGFR). Of these, 780 attended re-examination after 5 years, and eGFR changes were assessed. Participants with a 5-year eGFR reduction ≥30% were considered chronic kidney disease (CKD) progressors (n = 198). LI was calculated as the sum of the products of the FA proportions with the respective FAs melting points. Blood rheology/viscosity measurements were performed in a random subsample of 559 subjects at baseline. Increased LI showed a statistically significant but overall weak association with blood, plasma viscosity (both Spearman rho = 0.16, p < 0.01), and erythrocyte deformability (rho = -0.09, p < 0.05). In cross-sectional analyses, LI associated with lower eGFR (regression coefficient 3.00 ml/min/1.73 m 1-standard deviation (SD) increment in LI, 95% CI: -4.31, -1.69, p < 0.001). In longitudinal analyses, LI associated with a faster eGFR decline (-2.13 [95% CI -3.58, -0.69] ml/min/1.73 m, p < 0.01) and with 32% increased odds of CKD progression (adjusted OR 1.32 [95%, CI 1.05-1.65]).
A high LI was associated with lower kidney function, kidney function decline, and CKD progression.
不健康的膳食脂肪与肾功能衰退加快有关。磷脂脂肪酸（FAs）的细胞膜组成是膜流动性和流变学特性的决定因素。这些特性与肾损伤有关，被认为可通过亲脂性指数（LI）反映出来。我们前瞻性地研究了LI与肾功能及其衰退之间的关联。
来自乌普萨拉老年人血管前瞻性调查的观察性研究，纳入了975名男性和女性，检测了其血浆磷脂脂肪酸组成和胱抑素C估算的肾小球滤过率（eGFR）。其中，780人在5年后接受了复查，并评估了eGFR的变化。5年eGFR降低≥30%的参与者被视为慢性肾脏病（CKD）进展者（n = 198）。LI的计算方法是脂肪酸比例与各自脂肪酸熔点乘积的总和。在基线时对559名受试者的随机子样本进行了血液流变学/粘度测量。LI升高与血液、血浆粘度呈统计学显著但总体较弱的关联（斯皮尔曼相关系数均为0.16，p < 0.01），与红细胞变形性呈负相关（相关系数为 -0.09，p < 0.05）。在横断面分析中，LI与较低的eGFR相关（回归系数为3.00 ml/min/1.73 m²，LI每增加1个标准差（SD），95%可信区间：-4.31，-1.69，p < 0.001）。在纵向分析中，LI与更快的eGFR下降相关（-2.13 [95%可信区间 -3.58，-0.69] ml/min/1.73 m²，p < 0.01），且CKD进展几率增加32%（调整后的比值比为1.32 [95%，可信区间1.05 - 1.65]）。
高LI与较低的肾功能、肾功能衰退和CKD进展相关。
