Is body size a biomarker for optimizing dosing of omega-3 polyunsaturated fatty acids in the treatment of patients with IgA nephropathy?
Is body size a biomarker for optimizing dosing of omega-3 polyunsaturated fatty acids in the treatment of patients with IgA nephropathy?
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DOI：
10.2215/cjn.00260106
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发表时间：
2006-09-01
影响因子：
9.8
通讯作者：
Grande, Joseph P.
中科院分区：
文献类型：
--
作者：
Donadio, James V.;Bergstralh, Eric J.;Grande, Joseph P.
北美IgA肾病研究的重新分析表明，omega-3多不饱和脂肪酸(omega-3 PUFA)的疗效取决于身体大小和血浆omega-3/omega-6和二十碳五烯酸(EPA)/花生四烯酸(AA)的比率。这项研究的目的是证实这些断言。回顾了先前报道的一项为期两年的随机临床试验的数据，在该试验中，73名高危IgA肾病患者服用了两种剂量的w-3多不饱和脂肪酸乙酯(Omacor)。Omacor也被用于北美IgA肾病研究。参数包括体重；体重指数(BMI)；血浆磷脂AA、EPA和二十二碳六酸(DHA)水平；血清肌酐和24小时尿蛋白(UP)水平；以及6.4年后发生终末期肾病的时间。在Omacor 4-g剂量组中，血浆EPA、DHA和EPA/AA比值与体重增加和BMI呈显著负相关，而在Omacor 8-g剂量组中无显著相关。相反，在治疗6周时，随着Omacor(EPA+DHA)每千克体重剂量的增加，血脂参数水平也随之增加。在2年试验期间，血浆omega-3 PUFA水平、EPA/AA比率或Omacor每公斤剂量与相互的血肌酐或上坡或ESRD均无显著关联。这项对体重和BMI、血浆omega-3PUFA状态和肾脏结果的事后分析没有发现omega-3PUFA的治疗效果取决于身体大小的剂量。
Re-analysis of the North American IgA Nephropathy Study suggested that efficacy of omega-3 polyunsaturated fatty acids (omega-3 PUFA) was dosage-dependent on the basis of body size and plasma omega-3/omega-6 and eicosapentaenoic acid (EPA)/arachidonic acid (AA) ratios. The objective of this study was to confirm these assertions. Data from a previously reported randomized 2-yr clinical trial in which two dosages of an ethyl ester w-3 PUFA (Omacor) were given to 73 high-risk patients with IgA nephropathy were reviewed. Omacor also was used in the North American IgA Nephropathy Study. Parameters included body weight; body mass index (BMI); plasma phospholipid AA, EPA, and docosahexanoic acid (DHA) levels and serum creatinine and 24-h urine protein (UP) levels during the 2-yr trial; and time to ESRD after 6.4 yr. Plasma phospholipid levels of EPA, DHA, and EPA/AA ratios were significantly inversely correlated with increasing body weight and BMI in the Omacor 4-g dosage group but not in the Omacor 8-g dosage group. Conversely, increasing levels of lipid parameters were observed with increasing dosages of Omacor (EPA+DHA) in grams per kilogram of body weight at 6 wk of treatment. None of the plasma omega-3 PUFA levels, EPA/AA ratios, or Omacor dosage per kilogram was significantly associated with reciprocal serum creatinine or UP slopes during the 2-yr trial or with ESRD. This post hoc analysis of body weight and BMI, plasma omega-3 PUFA status, and renal outcome did not find that treatment efficacy of omega-3 PUFA was dosage dependent on the basis of body size.