Sikorska-Wisniewska Malgorzata, Mika Adriana, Sledzinski Tomasz, Chmielewski Michal
Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdansk, 80-210 Gdansk, Poland.
Department of Pharmaceutical Biochemistry, Faculty of Pharmacy, Medical University of Gdansk, 80-210 Gdansk, Poland.
J Clin Med. 2022 Aug 28;11(17):5051. doi: 10.3390/jcm11175051.
Background: Cardiovascular mortality in dialysis population remains very high. Saturated fatty acids (SFA) contribute to atherosclerosis and to cardiovascular risk. Aim: The aim of this study was to evaluate the relationship between mortality in dialysis patients and the serum SFA content. Methods: Survival of 54 patients on dialysis was assessed. A total of 21 SFA from patients’ sera were measured by gas chromatography-mass spectrometry (GC-MS). Diet was assessed by food frequency questionnaire FFQ-6. The SFA content is presented as fatty acid proportion (%). Results: During the observation time (median 66 months) 22 patients died. There was a significant relationship between elevated SFA (above SFA mean) and mortality (log-rank 3.13; p = 0.0017). Moreover, patients who ingested foods rich in SFA, according to FFQ-6, had a higher mortality risk (log-rank 2.24; p = 0.03). The hazard ratio for mortality associated with increased SFA content equalled 4.47 (1.63−12.26). Addition of age and inflammation (hsCRP > 5 mg/L) into the Cox model did not modify this relationship. However, SFA content turned out to be significantly higher in patients with diabetes mellitus and cardiovascular disease, as compared to patients free from these co-morbidities. Their addition to the model attenuated the relationship between SFA and mortality, making it statistically insignificant. Conclusion: The serum content of SFA turned out to be a strong predictor of mortality in dialysis patients. However, given the significant associations between SFA, DM, and CVD, interventional studies with controlled SFA intake are needed to evaluate the causal links between SFA, co-morbidities and survival.
透析人群的心血管死亡率仍然很高。饱和脂肪酸（SFA）会导致动脉粥样硬化和心血管风险。目的：本研究旨在评估透析患者死亡率与血清SFA含量之间的关系。方法：评估54例透析患者的生存率。通过气相色谱 - 质谱联用仪（GC-MS）测定患者血清中总共21种SFA。通过食物频率问卷FFQ-6评估饮食情况。SFA含量以脂肪酸比例（%）表示。结果：在观察期（中位数66个月）内，22例患者死亡。SFA升高（高于SFA均值）与死亡率之间存在显著关系（对数秩检验3.13；p = 0.0017）。此外，根据FFQ-6，摄入富含SFA食物的患者死亡风险更高（对数秩检验2.24；p = 0.03）。与SFA含量增加相关的死亡风险比为4.47（1.63 - 12.26）。将年龄和炎症（高敏C反应蛋白> 5 mg/L）纳入Cox模型并未改变这种关系。然而，与无这些合并症的患者相比，糖尿病和心血管疾病患者的SFA含量明显更高。将它们纳入模型后减弱了SFA与死亡率之间的关系，使其在统计学上无显著意义。结论：血清SFA含量是透析患者死亡率的有力预测指标。然而，鉴于SFA、糖尿病和心血管疾病之间存在显著关联，需要进行控制SFA摄入量的干预研究，以评估SFA、合并症与生存率之间的因果关系。
