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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

OBJECTIVE: 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 i...

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Autores principales: Miller, Edgar R., Juraschek, Stephen P., Anderson, Cheryl A., Guallar, Eliseo, Henoch-Ryugo, Karen, Charleston, Jeanne, Turban, Sharon, Bennett, Michael R., Appel, Lawrence J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: American Diabetes Association 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3661851/
https://www.ncbi.nlm.nih.gov/pubmed/23275364
http://dx.doi.org/10.2337/dc12-1940
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author Miller, Edgar R.
Juraschek, Stephen P.
Anderson, Cheryl A.
Guallar, Eliseo
Henoch-Ryugo, Karen
Charleston, Jeanne
Turban, Sharon
Bennett, Michael R.
Appel, Lawrence J.
author_facet Miller, Edgar R.
Juraschek, Stephen P.
Anderson, Cheryl A.
Guallar, Eliseo
Henoch-Ryugo, Karen
Charleston, Jeanne
Turban, Sharon
Bennett, Michael R.
Appel, Lawrence J.
author_sort Miller, Edgar R.
collection PubMed
description OBJECTIVE: 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. RESEARCH DESIGN AND METHODS: 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, β(2)-microglobulin, and creatinine), and estimated glomerular filtration rate (eGFR). RESULTS: 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/m(2), median eGFR was 76.9 mL/min/1.73 m(2), 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). CONCLUSIONS: 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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spelling pubmed-36618512014-06-01 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 Miller, Edgar R. Juraschek, Stephen P. Anderson, Cheryl A. Guallar, Eliseo Henoch-Ryugo, Karen Charleston, Jeanne Turban, Sharon Bennett, Michael R. Appel, Lawrence J. Diabetes Care Original Research OBJECTIVE: 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. RESEARCH DESIGN AND METHODS: 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, β(2)-microglobulin, and creatinine), and estimated glomerular filtration rate (eGFR). RESULTS: 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/m(2), median eGFR was 76.9 mL/min/1.73 m(2), 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). CONCLUSIONS: 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. American Diabetes Association 2013-06 2013-05-15 /pmc/articles/PMC3661851/ /pubmed/23275364 http://dx.doi.org/10.2337/dc12-1940 Text en © 2013 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.
spellingShingle Original Research
Miller, Edgar R.
Juraschek, Stephen P.
Anderson, Cheryl A.
Guallar, Eliseo
Henoch-Ryugo, Karen
Charleston, Jeanne
Turban, Sharon
Bennett, Michael R.
Appel, Lawrence J.
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
title 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
title_full 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
title_fullStr 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
title_full_unstemmed 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
title_short 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
title_sort 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
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3661851/
https://www.ncbi.nlm.nih.gov/pubmed/23275364
http://dx.doi.org/10.2337/dc12-1940
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