Filipovic Mark G, Reiner Martin F, Rittirsch Saskia, Irincheeva Irina, Aeschbacher Stefanie, Grossmann Kirsten, Risch Martin, Risch Lorenz, Limacher Andreas, Conen David, Beer Juerg H
Institute of Anesthesiology, Cantonal Hospital of Winterthur, Winterthur, Switzerland.
Department of Internal Medicine, Cantonal Hospital of Baden, Baden, Switzerland.
Front Cardiovasc Med. 2021 Apr 27;8:622619. doi: 10.3389/fcvm.2021.622619. eCollection 2021.
Omega-3 fatty acids are associated with a lower risk of cardiovascular disease (CVD) and with beneficial effects on CV risk factors. The albumin-creatinine ratio (ACR) is a risk factor for CVD, all-cause mortality and accelerated glomerular filtration rate (GFR) decline in the general population. We aimed to investigate the association between n-3 PUFAS and ACR in heathy individuals with preserved GFR. The present cross-sectional analysis is part of the GAPP study, a population-based cohort of healthy adults aged 25-41 years. Individuals with known CVD, diabetes, or a BMI >35 kg/m were excluded. eGFR was calculated according to the combined Creatinine/Cystatin C CKD-EPI formula. ACR was obtained from a fasting morning urine sample. The Omega-3 Index (relative amount of EPA and DHA of total fatty acids in %) was obtained from whole blood aliquots. Overall, 2001 participants (median age 37 years IQR 31; 40, 53% female) were included in this analysis. Median Omega-3 Index was 4.59 (IQR 4.06; 5.25) and median eGFR 111 ml/min/1.73 m (IQR 103; 118). Median ACR was 0.14 mg/mmol (IQR 0; 0.43). We found a significant inverse association of the Omega-3 Index with ACR (ratio 0.84, 95%CI 0.73-0.96; p = 0.011) which remained after comprehensive adjustment (ratio 0.86, 95%CI 0.74-1.00; = 0.048). No association of the Omega-3 Index with eGFR was found. The adjusted difference in eGFR per 1-unit increase in Omega3-Index was -0.21 (95%CI -0.76; 0.35; = 0.47). A higher Omega-3 Index was significantly associated with lower ACR in this young and healthy population with preserved eGFR. Omega-3 fatty acids may exhibit cardio- and nephroprotective effects in healthy individuals through modulation of ACR.
欧米伽-3脂肪酸与较低的心血管疾病（CVD）风险相关，并对心血管风险因素具有有益作用。白蛋白-肌酐比值（ACR）是一般人群中CVD、全因死亡率和肾小球滤过率（GFR）加速下降的风险因素。我们旨在研究在GFR正常的健康个体中n-3多不饱和脂肪酸（PUFAS）与ACR之间的关联。本横断面分析是GAPP研究的一部分，GAPP研究是一个基于人群的队列研究，研究对象为年龄在25至41岁的健康成年人。排除已知患有CVD、糖尿病或体重指数（BMI）>35kg/m²的个体。根据肌酐/胱抑素C联合慢性肾脏病流行病学合作（CKD-EPI）公式计算估算肾小球滤过率（eGFR）。ACR取自空腹晨尿样本。欧米伽-3指数（EPA和DHA占总脂肪酸的相对含量，以%表示）取自全血样本。总体而言，本分析纳入了2001名参与者（中位年龄37岁，四分位间距31；40，53%为女性）。中位欧米伽-3指数为4.59（四分位间距4.06；5.25），中位eGFR为111ml/min/1.73m²（四分位间距103；118）。中位ACR为0.14mg/mmol（四分位间距0；0.43）。我们发现欧米伽-3指数与ACR之间存在显著的负相关（比值0.84，9５%置信区间0.73-0.96；p = 0.011），在进行全面调整后该相关性依然存在（比值0.86，9５%置信区间0.74-1.00；p = 0.048）。未发现欧米伽-3指数与eGFR之间存在关联。欧米伽-3指数每增加1个单位，eGFR的调整差异为-0.21（9５%置信区间-0.76；0.35；p = 0.47）。在这个eGFR正常的年轻健康人群中，较高的欧米伽-3指数与较低的ACR显著相关。欧米伽-3脂肪酸可能通过调节ACR对健康个体发挥心脏和肾脏保护作用。
