The effects of n-3 long-chain polyunsaturated fatty acid supplementation on biomarkers of kidney injury in adults with diabetes: results of the GO-FISH trial.
The effects of n-3 long-chain polyunsaturated fatty acid supplementation on biomarkers of kidney injury in adults with diabetes: results of the GO-FISH trial.
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DOI：
10.2337/dc12-1940
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发表时间：
2013-06
期刊：
影响因子：
16.2
通讯作者：
Appel LJ
中科院分区：
文献类型：
--
作者：
Miller ER 3rd;Juraschek SP;Anderson CA;Guallar E;Henoch-Ryugo K;Charleston J;Turban S;Bennett MR;Appel LJ
长链n-3多不饱和脂肪酸(n-3 PUFA)补充剂可能对糖尿病患者具有肾脏保护作用，但之前的试验一直不一致。我们进行了一项补充n-3多不饱和脂肪酸对成年2型糖尿病患者尿白蛋白排泄和肾脏损伤标志物影响的随机对照试验。我们进行了一项随机、安慰剂对照、两个周期的交叉试验，以测试每天补充4g n-3PUFA对成年糖尿病患者肾小球滤过和肾脏损伤标志物的影响，这些患者的蛋白尿量大于或等于微量。每期持续6周，间隔2周。主要结果是尿白蛋白排泄，其次是肾脏损伤标志物(肾损伤分子-1，N-乙酰-β-d-氨基葡萄糖苷酶、中性粒细胞明胶酶相关脂蛋白和肝脏脂肪酸结合蛋白)、血清肾功能标志物(胱抑素C、β-2-微球蛋白和肌酐)，以及估计肾小球滤过率。在31名参与者中，29人完成了这两个阶段。共有55%是男性，61%是非裔美国人；平均年龄为67岁。基线时，平均BMI为31.6 kg/m2，EGFR中位数为76.9mL/min/1.73m2，24小时尿白蛋白排泄量中位数为161 mg/d。与安慰剂相比，n-3多不饱和脂肪酸对尿白蛋白排泄无显著影响(−7.2%；95%CI−20.6~8.5；P=0.35)，对尿白蛋白排泄有显著影响(−16%[−29.1~−0.5%]；P=0.04)。对肾功能和EGFR的血清标志物无影响。在亚组分析中，在服用阻断肾素-血管紧张素-醛固酮系统(RAAS)的药物的参与者中，24小时尿白蛋白、NGAL、LFABP和NAG的排泄显著减少。这些结果表明，补充n-3多不饱和脂肪酸对糖尿病患者和肾脏疾病早期证据的肾脏损伤标志物具有潜在的影响。在先前研究的背景下，这些结果为n-3多不饱和脂肪酸在慢性肾脏疾病进展方面的长期试验提供了强有力的理由。
Long-chain n-3 polyunsaturated fatty acid (n-3 PUFA) supplements may have renoprotective effects in patients with diabetes, but previous trials have been inconsistent. We performed a randomized controlled trial of n-3 PUFA supplementation on urine albumin excretion and markers of kidney injury in adults with type 2 diabetes. We conducted a randomized, placebo-controlled, two-period crossover trial to test the effects of 4 g/day of n-3 PUFA supplementation on markers of glomerular filtration and kidney injury in adults with adult-onset diabetes and greater than or equal to trace amounts of proteinuria. Each period lasted 6 weeks and was separated by a 2-week washout. The main outcome was urine albumin excretion and, secondarily, markers of kidney injury (kidney injury molecule-1, N-acetyl β-d-glucosaminidase [NAG], neutrophil gelatinase-associated lipocalin [NGAL], and liver fatty acid–binding protein [LFABP]), serum markers of kidney function (cystatin C, β2-microglobulin, and creatinine), and estimated glomerular filtration rate (eGFR). Of the 31 participants, 29 finished both periods. A total of 55% were male, and 61% were African American; mean age was 67 years. At baseline, mean BMI was 31.6 kg/m2, median eGFR was 76.9 mL/min/1.73 m2, and median 24-h urine albumin excretion was 161 mg/day. Compared with placebo, n-3 PUFA had nonsignificant effects on urine albumin excretion (−7.2%; 95% CI −20.6 to 8.5; P = 0.35) and significant effects on urine NGAL excretion (−16% [−29.1 to −0.5%]; P = 0.04). There was no effect on serum markers of kidney function or eGFR. In subgroup analyses, there were significant decreases in 24-h urinary excretion of albumin, NGAL, LFABP, and NAG among participants taking medications that block the renin-angiotensin-aldosterone system (RAAS). These results suggest a potential effect of n-3 PUFA supplementation on markers of kidney injury in patients with diabetes and early evidence of kidney disease. In the context of prior studies, these results provide a strong rationale for long-term trials of n-3 PUFA on chronic kidney disease progression.
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影响因子：
7.1
作者：
Miller, Edgar R., III;Juraschek, Stephen P.;Guallar, Eliseo
通讯作者：
Guallar, Eliseo
影响因子：
7.5
作者：
HAINES, AP;SANDERS, TAB;WALLACE, PG
通讯作者：
WALLACE, PG
影响因子：
1.9
作者：
HAMAZAKI, T;TAKAZAKURA, E;YANO, S
通讯作者：
YANO, S
影响因子：
4.9
作者：
Mori, Trevor A.;Burke, Valerie;Watts, Gerald F.
通讯作者：
Watts, Gerald F.
DOI：
10.1016/j.plefa.2009.05.018
发表时间：
2009-07-01
影响因子：
3
作者：
Metherel, A. H.;Armstrong, J. M.;Stark, K. D.
通讯作者：
Stark, K. D.