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肾移植患者血清多不饱和脂肪酸紊乱

Disorders of Serum Polyunsaturated Fatty Acids in Renal Transplant Patients.

作者信息

Sikorska-Wisniewska Malgorzata, Mika Adriana, Sledzinski Tomasz, Czaplinska Monika, Malgorzewicz Sylwia, Debska-Slizien Alicja, Chmielewski Michal

机构信息

Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdansk, Gdansk, Poland.

Department of Environmental Analysis, University of Gdansk, Gdansk, Poland; Department of Pharmaceutical Biochemistry, Medical University of Gdansk, Gdansk, Poland.

出版信息

Transplant Proc. 2020 Oct;52(8):2324-2330. doi: 10.1016/j.transproceed.2020.01.106. Epub 2020 Apr 23.

Abstract

BACKGROUND

Disturbances in polyunsaturated fatty acids (PUFA) could predispose renal transplant (RTx) patients to cardiovascular risk. The purpose of this study was to evaluate serum content of ω-3 and ω-6 PUFA in RTx subjects, in comparison to nontransplanted chronic kidney disease (CKD) patients in predialysis stages and to healthy controls. In the second part of the study, PUFA were analyzed in subcutaneous adipose tissue of CKD subjects at the time of kidney transplantation.

METHODS

The first part of the study was conducted in a cohort (n = 134) of 3 groups: patients after renal transplantation (RTx group, n = 24), patients with CKD in stages 2-5, not on dialysis (CKD-ND group, n = 67), and controls without CKD (control group, n = 43). The fatty acids (FA) assessed by gas chromatography-mass spectrometry (GC-MS) were alpha-linolenic acid (ALA), eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), linoleic acid (LA), and arachidonic acid (AA). Diet was assessed by food frequency questionnaire FFQ-6. In the second part of the study, the same FA were evaluated in samples of adipose tissue taken during the kidney transplantation procedure and compared with FA of controls from the adipose tissue collected during hernia surgeries.

RESULTS

The first part of the study showed that RTx patients presented significantly lower serum content of all the examined PUFA, in comparison to the CKD-ND group and controls. For instance, EPA in RTx equaled 0.65 ± 0.32%, in CKD-ND 0.82 ± 0.43%, and in controls 1.06 ± 0.68% (P = .005). No significant correlations were found between serum PUFA and diet in RTx patients. The second part of the study revealed no significant difference in the adipose tissue PUFA between CKD patients at the time of kidney transplantation and controls.

CONCLUSIONS

RTx patients present with low serum content of potentially beneficial PUFA. This finding does not seem to be solely due to an altered diet. Observed disorders might result from immunosuppressive drugs or other, yet undetermined, causes.

摘要

背景

多不饱和脂肪酸(PUFA)紊乱可能使肾移植(RTx)患者易患心血管疾病。本研究旨在评估RTx受试者血清中ω-3和ω-6多不饱和脂肪酸的含量,并与未透析的慢性肾脏病(CKD)患者及健康对照进行比较。在研究的第二部分,对CKD受试者肾移植时皮下脂肪组织中的多不饱和脂肪酸进行了分析。

方法

研究的第一部分在一个队列(n = 134)中进行,分为3组:肾移植后患者(RTx组,n = 24)、2 - 5期未透析的CKD患者(CKD - ND组,n = 67)和无CKD的对照组(对照组,n = 43)。通过气相色谱 - 质谱联用(GC - MS)评估的脂肪酸(FA)有α-亚麻酸(ALA)、二十碳五烯酸(EPA)、二十二碳六烯酸(DHA)、亚油酸(LA)和花生四烯酸(AA)。通过食物频率问卷FFQ - 6评估饮食情况。在研究的第二部分,对肾移植手术期间采集的脂肪组织样本中的相同脂肪酸进行评估,并与疝气手术期间采集的对照脂肪组织中的脂肪酸进行比较。

结果

研究的第一部分表明,与CKD - ND组和对照组相比,RTx患者所有检测的多不饱和脂肪酸血清含量显著降低。例如,RTx组中EPA含量为0.65±0.32%,CKD - ND组为0.82±0.43%,对照组为1.06±0.68%(P = 0.005)。RTx患者血清多不饱和脂肪酸与饮食之间未发现显著相关性。研究的第二部分显示,肾移植时CKD患者与对照组的脂肪组织多不饱和脂肪酸无显著差异。

结论

RTx患者血清中潜在有益的多不饱和脂肪酸含量较低。这一发现似乎并非仅由饮食改变所致。观察到的紊乱可能是由免疫抑制药物或其他尚未确定的原因引起的。

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