低血浆海洋 N-3 多不饱和脂肪酸与维持性血液透析患者心血管事件风险增加有关。

IF 3.4 3区医学 Q2 NUTRITION & DIETETICS

Journal of Renal Nutrition Pub Date : 2025-07-01 DOI:10.1053/j.jrn.2025.02.001

Caroline Liboriussen MD , Louis Nygaard MD , Jens Dam Jensen MD, PhD , Erik Berg Schmidt MD, DMSc , Rie Io Glerup MD, PhD , My Hanna Sofia Svensson MD, PhD

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引用次数: 0

摘要

目的：探讨血液透析（HD）患者血浆n-3多不饱和脂肪酸（n-3 PUFAs）、二十碳五烯酸（EPA）和二十二碳六烯酸（DHA）与心血管（CV）事件和全因死亡率的关系。方法：前瞻性多中心队列研究，随访5年。主要结局是心血管事件，次要结局是全因死亡率和心血管事件的各个组成部分。血浆EPA和DHA的总和以海洋n-3 PUFAs的重量百分比（wt%）表示。根据血浆n-3 PUFA水平将种群分为三类：低三类为6.52 wt%。结果：共纳入336例患者。中位随访时间为5.05（5.02-5.07）年。一般来说，较低的分值与较高的心血管事件风险相关。未经调整，中位数与心血管事件风险降低36%相关[HR 0.64 (95% CI 0.43-0.96)]，中位数与心血管事件风险降低34%相关[HR 0.66 (95% CI 0.44-0.98)]。在调整混杂因素后，中位数与较低的心血管事件风险[HR 0.60 (95% CI 0.40-0.92)]、外周动脉疾病（PAD） [HR 0.44 (95% CI 0.22-0.88)]和全因死亡率[HR 0.61 (95% CI 0.42-0.86)]相关。限制三次样条显示，低于中位数5.7%的患者的CV风险更高，表明存在潜在的阈值效应。结论：低血浆海洋n-3 PUFA水平与HD患者心血管事件、PAD和全因死亡率升高相关。

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Low Plasma Marine N-3 Polyunsaturated Fatty Acids are Associated With Increased Risk of Cardiovascular Events in Patients Treated With Maintenance Hemodialysis

Objective

This study investigated the association between the plasma marine n-3 polyunsaturated fatty acids (n-3 PUFAs) eicosapentaenoic acid and docosahexaenoic acid and cardiovascular (CV) events and all-cause mortality in patients treated with hemodialysis.

Methods

Prospective multicenter cohort study with 5 years of follow-up. Primary outcome was CV events and secondary outcomes were all-cause mortality and each component of CV events. The sum of plasma eicosapentaenoic acid and docosahexaenoic acid was expressed as marine n-3 PUFAs in weight percentage (wt%). The population was divided into tertiles according to plasma n-3 PUFA levels: lower tertile <5.06 wt%, middle tertile 5.06-6.52 wt%, and upper tertile >6.52 wt%.

Results

In total, 336 patients were included. Median follow-up was 5.05 (5.02-5.07) years. Generally, the lower tertile was associated with a higher risk of CV events. Unadjusted, the middle tertile was associated with a 36% lower risk of CV events [hazard ratio (HR) 0.64 (95% confidence interval (CI) 0.43-0.96)], and the upper tertile was associated with a 34% lower risk of CV events [HR 0.66 (95% CI 0.44-0.98)]. After adjusting for confounders, the middle tertile was associated with a lower risk of CV events [HR 0.60 (95% CI 0.40-0.92)], peripheral arterial disease [HR 0.44 (95% CI 0.22-0.88)], and all-cause mortality [HR 0.61 (95% CI 0.42-0.86)]. A restricted cubic spline showed that the CV risk was higher in patients with levels below the median of 5.7 wt%, indicating a potential threshold effect.

Conclusion

Low plasma marine n-3 PUFA levels were associated with a higher risk of CV events, peripheral arterial disease, and all-cause mortality in patients treated with hemodialysis.

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来源期刊

Journal of Renal Nutrition 医学-泌尿学与肾脏学

CiteScore

5.70

自引率

12.50%

发文量

146

审稿时长

6.7 weeks

期刊介绍： The Journal of Renal Nutrition is devoted exclusively to renal nutrition science and renal dietetics. Its content is appropriate for nutritionists, physicians and researchers working in nephrology. Each issue contains a state-of-the-art review, original research, articles on the clinical management and education of patients, a current literature review, and nutritional analysis of food products that have clinical relevance.