Ristic-Medic Danijela, Takic Marija, Pokimica Biljana, Terzic Brankica, Kojadinovic Milica, Lepic Toplica, Radjen Slavica, Vucic Vesna
Group for Nutritional Biochemistry and Dietology, Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, National Institute of Republic of Serbia, University of Belgrade, 11129 Belgrade, Serbia.
Group for Nutrition and Metabolism, Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, National Institute of Republic of Serbia, University of Belgrade, 11129 Belgrade, Serbia.
J Clin Med. 2024 Sep 20;13(18):5593. doi: 10.3390/jcm13185593.
Numerous risk factors associated with development of cardiovascular disease (CVD) have been unfavorably altered in patients with chronic kidney disease (CKD). Low omega-3 polyunsaturated fatty acid (PUFA) intake and vitamin D deficiency are potential cardiometabolic risk factors in patients with CKD. The aim of this study was to evaluate dietary intake and status of omega-3 PUFA and vitamin D in pre-dialysis and hemodialysis patients and to examine the association of dietary α-linolenic acid (ALA) and fish consumption with blood pressure and carotid intima-media thickness (C-IMT), representing a non-invasive marker of atherosclerosis in CKD patients. All 77 selected patients (36 pre-dialysis, 41 on hemodialysis) underwent standardized clinical, nutritional, and laboratory assessments. Repeated 24 h recalls were performed to assess dietary intake. The fatty acid profile was determined by gas-liquid chromatography. Inadequate vitamin D intake and vitamin D status were found in 95% of patients. PUFA profiles did not differ between hemodialysis and pre-dialysis participants. Dietary intake of ALA was negatively correlated with systolic blood pressure (SBP) ( = 0.013), C-IMT ( = 0.002), serum CRP ( = 0.044), iPTH ( = 0.01), and 25(OH)D3 ( = 0.006). ALA intake of more than 0.23 g daily was linked with lower SBP ( = 0.001), serum 25(OH)D3 ( = 0.004), and C-IMT ( = 0.002). This study contributes to a better understanding of the relationship between dietary ALA intake and C-IMT in CKD. The results of this study could emphasize the significant role of the high prevalence of vitamin D deficiency and inadequate omega-3 PUFA intake and status regarding CVD health in CKD patients.
慢性肾脏病(CKD)患者中,许多与心血管疾病(CVD)发生相关的危险因素已发生不利改变。ω-3多不饱和脂肪酸(PUFA)摄入不足和维生素D缺乏是CKD患者潜在的心脏代谢危险因素。本研究的目的是评估透析前和血液透析患者的ω-3 PUFA和维生素D的饮食摄入量及状态,并研究饮食中α-亚麻酸(ALA)和鱼类消费与血压及颈动脉内膜中层厚度(C-IMT)之间的关联,C-IMT是CKD患者动脉粥样硬化的一种非侵入性标志物。所有77名入选患者(36名透析前患者,41名血液透析患者)均接受了标准化的临床、营养和实验室评估。通过重复进行24小时回忆法来评估饮食摄入量。采用气液色谱法测定脂肪酸谱。95%的患者存在维生素D摄入不足和维生素D状态不佳的情况。血液透析患者和透析前参与者的PUFA谱无差异。饮食中ALA的摄入量与收缩压(SBP)(r = 0.013)、C-IMT(r = 0.002)、血清CRP(r = 0.044)、iPTH(r = 0.01)和25(OH)D3(r = 0.006)呈负相关。每日ALA摄入量超过0.23克与较低的SBP(r = 0.001)、血清25(OH)D3(r = 0.004)和C-IMT(r = 0.002)相关。本研究有助于更好地理解CKD患者饮食中ALA摄入量与C-IMT之间的关系。本研究结果可能凸显了维生素D缺乏的高患病率以及ω-3 PUFA摄入不足和状态不佳在CKD患者心血管疾病健康方面的重要作用。