Division of Human Nutrition and Health, Wageningen University, Wageningen, the Netherlands.
Division of Human Nutrition and Health, Wageningen University, Wageningen, the Netherlands.
Nutr Metab Cardiovasc Dis. 2021 May 6;31(5):1467-1476. doi: 10.1016/j.numecd.2021.01.012. Epub 2021 Jan 29.
Age-related kidney function decline is accelerated in patients with coronary heart disease (CHD). CHD and chronic kidney disease may share common etiologies. We examined plasma fatty acids (FAs) as novel biomarkers of kidney function decline after myocardial infarction (MI).
The analysis included 2329 Dutch post-MI patients aged 60-80y (Alpha Omega Cohort) most receiving state-of-the-art medications. Plasma FAs (% total FAs) in cholesteryl esters were assessed at baseline (2002-2006), and ∼40 months change in creatinine-cystatin C based glomerular filtration rate was estimated (eGFR, in ml/min per 1.73 m). Beta coefficients for annual eGFR change in relation to plasma linoleic acid (LA; 50.1% of total FAs in CE), omega-3 FAs (EPA + DHA; 1.7%), odd-chain FAs (C15:0 and C17:0; 0.2%), and C14:0 (0.7%) were obtained from linear regression analyses adjusted for age, sex, smoking, and alcohol intake. Mean baseline eGFR ±SD was 78.5 ± 18.7, which declined by 4.7 ± 13.1 during follow-up, or 1.4 ± 3.9 per year. The annual decline in eGFR was less in patients with higher plasma LA (adjusted beta: 0.40 for LA >47 vs ≤ 47%, 95% CI: 0.01; 0.78; p = 0.046). Associations of plasma LA with annual eGFR decline were stronger in 437 patients with diabetes (1.21, 0.24; 2.19) and in 402 patients with CKD (eGFR<60; 0.90, -0.09; 1.89). Weaker, non-significant associations with kidney function decline were observed for the other plasma FAs.
Higher plasma LA may be a good predictor of less kidney function decline after MI, particularly in patients with diabetes. The Alpha Omega Cohort is registered with clinicaltrials.gov, NCT03192410.
冠心病（CHD）患者的肾功能随年龄增长而加速下降。CHD 和慢性肾脏病可能有共同的病因。我们研究了血浆脂肪酸（FAs）作为心肌梗死后（MI）肾功能下降的新型生物标志物。
该分析包括 2329 名年龄在 60-80 岁的荷兰 MI 后患者（Alpha Omega 队列），大多数患者接受了最先进的药物治疗。在基线（2002-2006 年）评估了胆固醇酯中血浆 FA（总 FA 的%），并估算了基于肌酐-胱抑素 C 的肾小球滤过率约 40 个月的变化（eGFR，以 ml/min/1.73 m 表示）。通过线性回归分析获得了与血浆亚油酸（LA；CE 中总 FA 的 50.1%）、ω-3 FA（EPA+DHA；1.7%）、奇数链 FA（C15:0 和 C17:0；0.2%）和 C14:0（0.7%）的年度 eGFR 变化的β系数，这些分析均经过年龄、性别、吸烟和饮酒摄入量的调整。平均基线 eGFR ±SD 为 78.5 ± 18.7，随访期间下降 4.7 ± 13.1，即每年 1.4 ± 3.9。在 LA 水平较高的患者中，eGFR 的年下降幅度较小（LA>47% vs ≤47%的调整后β值：0.40，95%CI：0.01；0.78；p=0.046）。在 437 名糖尿病患者（1.21，0.24；2.19）和 402 名 CKD 患者（eGFR<60；0.90，-0.09；1.89）中，LA 与 eGFR 年下降的相关性更强。与肾功能下降的其他血浆 FA 之间存在较弱的、无统计学意义的关联。
较高的血浆 LA 可能是 MI 后肾功能下降速度较慢的良好预测指标，特别是在糖尿病患者中。Alpha Omega 队列在 clinicaltrials.gov 注册，NCT03192410。
