Lin Ya-Ling, Wang Chia-Liang, Chiang Tsay-I
Department of Nursing, Tajen University, Pingtung, Taiwan.
Department of Nephrology, Kuang-Tien General Hospital, Taichung, Taiwan.
Front Nephrol. 2024 Jul 30;4:1365809. doi: 10.3389/fneph.2024.1365809. eCollection 2024.
The objective of this study is to investigate the effects of oral supplementation with eicosapentaenoic acid (EPA) on circulating inflammatory factors, cardiometabolic parameters, skin moisturization, and the consequent symptoms of pruritus and depression in maintenance hemodialysis patients.
A total of 60 maintenance hemodialysis patients with severe pruritus symptoms completed this randomized, placebo-controlled study. Subjects of treatment group (n = 30) were instructed to consume 1000 mg fish oil (>900 mg EPA) and subjects of placebo group (n = 30) were instructed to consume 1000 mg soybean oil twice daily for 3 months. 5-D pruritus scoring, the Beck Depression Inventory (BDI) scale, skin moisture, serum creatinine, inflammatory factors, and cardiometabolic parameters were examined at baseline, and at the first, second, and third month post-supplementation.
A significantly decreased pruritus level was observed in the treatment group, whereas an opposite result was observed in the placebo group. Increased skin moisture levels on both the face and arms were observed in the treatment group, but not in the placebo group. Supplementation of EPA significantly decreased serum CRP and IL-6 levels. Significant decreases in total cholesterol (CHO), and triglycerides (TG) levels were observed; however, a decrease in high-density lipoprotein (HDL) level was observed in the treatment group. There was no change in plasma creatinine (CR) observed in both groups. A significantly decreased BDI score was observed, whereas the opposite result was observed in the placebo group. A correlational study showed that the severity of pruritus was significantly associated with skin moisture and serum CRP. The severity of pruritus was also positively correlated with the BDI score.
Supplementation of EPA may provide multiple benefits including alleviating pruritus symptoms, addressing skin dryness, and mitigating depression in maintenance hemodialysis patients.
本研究的目的是调查口服补充二十碳五烯酸（EPA）对维持性血液透析患者循环炎症因子、心脏代谢参数、皮肤保湿以及由此产生的瘙痒和抑郁症状的影响。
共有60例有严重瘙痒症状的维持性血液透析患者完成了这项随机、安慰剂对照研究。治疗组（n = 30）的受试者被指示每天服用1000毫克鱼油（>900毫克EPA），安慰剂组（n = 30）的受试者被指示每天服用1000毫克大豆油，持续3个月。在基线时以及补充后的第一个、第二个和第三个月检查5-D瘙痒评分、贝克抑郁量表（BDI）、皮肤水分、血清肌酐、炎症因子和心脏代谢参数。
治疗组瘙痒水平显著降低，而安慰剂组则出现相反结果。治疗组面部和手臂的皮肤水分水平均有所增加，而安慰剂组未出现此情况。补充EPA显著降低了血清CRP和IL-6水平。总胆固醇（CHO）和甘油三酯（TG）水平显著降低；然而，治疗组的高密度脂蛋白（HDL）水平有所下降。两组的血浆肌酐（CR）均未发生变化。观察到BDI评分显著降低，而安慰剂组则出现相反结果。一项相关性研究表明，瘙痒的严重程度与皮肤水分和血清CRP显著相关。瘙痒的严重程度也与BDI评分呈正相关。
补充EPA可能带来多种益处，包括减轻维持性血液透析患者的瘙痒症状、解决皮肤干燥问题以及缓解抑郁。
