Nonesterified Fatty Acids and Kidney Function Decline in Older Adults: Findings From the Cardiovascular Health Study.
Nonesterified Fatty Acids and Kidney Function Decline in Older Adults: Findings From the Cardiovascular Health Study.
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DOI：
10.1053/j.ajkd.2020.11.030
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发表时间：
2021-08
期刊：
影响因子：
--
通讯作者：
Mukamal KJ
中科院分区：
文献类型：
--
作者：
Walther CP;Ix JH;Biggs ML;Kizer JR;Navaneethan SD;Djoussé L;Mukamal KJ
循环非酯化脂肪酸（NEFA）占循环脂质的一小部分，但却是代谢的重要能量来源。过多的循环NEFA可能导致许多组织（包括肾脏）的脂毒性。我们调查了社区老年人总循环NEFA浓度与肾脏预后之间的关系。前瞻性队列研究。心血管健康研究中4，698例年龄≥65岁的受试者，他们在1992-1993年接受了总空腹血清NEFA浓度测量。一个时间点的空腹血清NEFA浓度。三个主要结果：估计肾小球滤过率（eGFR）下降≥30%; eGFR下降≥30%或肾衰竭伴替代治疗（KFRT）的复合终点; eGFR变化。这些结果在4年和13年期间进行了评估。对二分结局采用逻辑回归，对连续结局采用混合效应模型，对基线协变量进行序贯调整。在随访期间，采用了损耗加权的逆概率来解释信息损耗。血清NEFA浓度与肾脏预后无独立相关性。在未校正和部分校正的分析中，血清NEFA浓度的最高四分位数（与最低四分位数相比）与4年时eGFR下降≥30%的风险较高和eGFR下降速度较快相关。在校正合并症、血脂水平、胰岛素敏感性、药物和生命体征后，没有明显的相关性：比值比1.33（95%CI 0.83-2.13）;估计的肾小球滤过率每年变化，Q4 vs Q1：-0.15 ml/min/1.73 m2/年（95%CI-0.36至0.06）。单次NEFA测量，未测量葡萄糖负荷后NEFA浓度或单个NEFA种类，未测量基线尿白蛋白。在社区老年人队列中，单一的空腹血清NEFA浓度与长期不良肾脏结局无关。循环非酯化脂肪酸（也称为游离脂肪酸）是血液中的一种物质，来自食物和身体的新陈代谢，是肾脏和其他器官的重要能量来源。但是，如果它们的含量过高，可能会对器官造成伤害。我们研究了高水平是否与长期肾功能恶化有关。在调整了其他影响肾功能的因素（例如糖尿病和动脉疾病）后，我们没有发现高水平与肾功能恶化有关。这可能是因为某些类型的非酯化脂肪酸可能对肾脏有害，而其他脂肪酸可能具有保护作用。
Circulating non-esterified fatty acids (NEFAs) make up a small portion of circulating lipids but are a metabolically important energy source. Excessive circulating NEFAs may contribute to lipotoxicity in many tissues, including the kidneys. We investigated the relationship between total circulating NEFA concentration and kidney outcomes in older, community-dwelling adults. Prospective cohort study. 4,698 participants ≥65 years of age in the Cardiovascular Health Study who underwent total fasting serum NEFA concentration measurements in 1992-1993. Fasting serum NEFA concentration at one timepoint. Three primary outcomes: estimated glomerular filtration rate (eGFR) decline of ≥30%; the composite of eGFR decline ≥30% or kidney failure with replacement therapy (KFRT); and change in eGFR. These outcomes were assessed over 4- and 13-year periods. Logistic regression for the dichotomous outcomes and mixed effects models for the continuous outcome, with sequential adjustment for baseline covariates. Inverse probability of attrition weighting was implemented to account for informative attrition during the follow-up periods. Serum NEFA concentrations were not independently associated with kidney outcomes. In unadjusted and partially adjusted analyses, the highest quartile of serum NEFA concentration (compared to lowest) was associated with a higher risk of ≥30% eGFR decline at 4 years and faster rate of decline of eGFR. No associations were evident after adjustment for comorbidities, lipid levels, insulin sensitivity, medications, and vital signs: odds ratio 1.33 (95%CI 0.83-2.13); estimated glomerular filtration rate change per year, Q4 vs Q1: −0.15 ml/min/1.73m2/year (95%CI −0.36 to 0.06). Single NEFA measurements, no measurements of post-glucose load NEFA concentrations or individual NEFA species, no measurement of baseline urine albumin. A single fasting serum NEFA concentration was not independently associated with long-term adverse kidney outcomes in a cohort of older community-living adults. Circulating non-esterified fatty acids (also called free fatty acids) are a substance in the blood that comes from food and from the body’s metabolism, and are an important energy source for the kidneys and other organs. However, they might cause injury to organs if their levels are too high. We investigated whether high levels were associated with worse kidney function over the long term. We did not find that high levels were associated with worse kidney function, after other things that affect kidney function (for example diabetes and arterial disease) were adjusted for. This may be because certain types of non-esterified fatty acids may be harmful to the kidneys, while others may be protective.
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DOI：
10.1161/circheartfailure.113.000521
发表时间：
2013-09-01
期刊：
Circulation. Heart failure
影响因子：
--
作者：
Djoussé L;Benkeser D;Arnold A;Kizer JR;Zieman SJ;Lemaitre RN;Tracy RP;Gottdiener JS;Mozaffarian D;Siscovick DS;Mukamal KJ;Ix JH
通讯作者：
Ix JH
DOI：
10.1056/nejmoa1114248
发表时间：
2012-07-05
期刊：
The New England journal of medicine
影响因子：
--
作者：
Inker LA;Schmid CH;Tighiouart H;Eckfeldt JH;Feldman HI;Greene T;Kusek JW;Manzi J;Van Lente F;Zhang YL;Coresh J;Levey AS;CKD-EPI Investigators
通讯作者：
CKD-EPI Investigators
影响因子：
4.8
作者：
Lindsey, Charles;Sheather, Simon
通讯作者：
Sheather, Simon
影响因子：
6.8
作者：
AKAIKE, H
通讯作者：
AKAIKE, H
影响因子：
1.7
作者：
Brodeur, Mathieu R.;Bouvet, Celine;Moreau, Pierre
通讯作者：
Moreau, Pierre