Serum fatty acid patterns, insulin sensitivity and the metabolic syndrome in individuals with chronic kidney disease

Authors

  • X. Huang,

    1. Divisions of Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention, and Technology, Karolinska Institutet, Stockholm, Sweden
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  • P. Sjögren,

    1. Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden
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  • J. Ärnlöv,

    1. Department of Public Health and Caring Sciences, Section of Geriatrics, Uppsala University, Uppsala, Sweden
    2. School of Health and Social Studies, Dalarna University, Falun, Sweden
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  • T. Cederholm,

    1. Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden
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  • L. Lind,

    1. Department of Medical Sciences, Acute and Internal Medicine, Uppsala University, Uppsala, Sweden
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  • P. Stenvinkel,

    1. Divisions of Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention, and Technology, Karolinska Institutet, Stockholm, Sweden
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  • B. Lindholm,

    1. Divisions of Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention, and Technology, Karolinska Institutet, Stockholm, Sweden
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  • U. Risérus,

    1. Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden
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  • J. J. Carrero

    Corresponding author
    1. Divisions of Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention, and Technology, Karolinska Institutet, Stockholm, Sweden
    2. Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
    • Correspondence: Juan Jesús Carrero, Divisions of Renal Medicine and Baxter Novum, Karolinska University Hospital at Huddinge K56, Karolinska Institutet, SE-14186 Stockholm, Sweden.

      (fax: +46-8-58583925; e-mail: juan.jesus.carrero@ki.se).

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Abstract

Objectives

The causes of the multiple metabolic disorders of individuals with chronic kidney disease (CKD) are not fully known. We investigated the relationships between dietary fat quality, the metabolic syndrome (MetS), insulin sensitivity and inflammation in individuals with CKD.

Subjects

Two population-based surveys were conducted in elderly Swedish individuals (aged 70 years) with serum cystatin C-estimated glomerular filtration rate <60 mL min−1/1.73 m2: the Uppsala Longitudinal Study of Adult Men (ULSAM) and the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) surveys. The present population comprised 274 men and 187 subjects (63% women) from the ULSAM and PIVUS cohorts, respectively.

Design

Factor analyses of serum fatty acids were used to evaluate dietary fat quality. Insulin sensitivity was measured by homeostasis model assessment of insulin resistance (IR) and, in ULSAM, also by euglycaemic clamp.

Results

Factor analyses generated two fatty acid patterns of (i) low linoleic acid (LA)/high saturated fatty acid (SFA) or (ii) high n-3 polyunsaturated fatty acid (n-3 PUFA) levels. In both surveys, the low LA/high SFA pattern increased the odds of having MetS [adjusted odds ratio 0.60 [95% confidence interval (CI) 0.44–0.81] and 0.45 (95% CI 0.30–0.67) per SD decrease in factor score in the ULSAM and PIVUS surveys, respectively] and was directly associated with both IR and C-reactive protein. The n-3 PUFA pattern was not consistently associated with these risk factors.

Conclusions

A serum fatty acid pattern reflecting low LA and high SFA was strongly associated with MetS, IR and inflammation in two independent surveys of elderly individuals with CKD. At present, there are no specific dietary guidelines for individuals with CKD; however, these findings indirectly support current recommendations to replace SFAs with PUFAs from vegetable oils.

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