Omega-3 fatty acid supplementation increases 1,25-dihydroxyvitamin D and fetuin-A levels in dialysis patients.
Vitamin D deficiency, low levels of fetuin-A, and fibroblast growth factor 23 (FGF-23) are related to vascular calcification, which is associated with cardiovascular disease. We hypothesized that omega-3 fatty acid (FA), which has cardioprotective properties, modifies vitamin D status, fetuin-A, and FGF-23 levels in dialysis patients. In a randomized, open-label, controlled study, a total of 47 patients treated with dialysis for at least 1 year were randomized to treatment for 6 months with omega-3 FAs (Omacor, 3 g/d; Pronova, Sandefjord, Norway) or a control group. Levels of fetuin-A and FGF-23 were measured by enzyme-linked immunoassay, 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D were measured by radioimmunoassay. The mean age of the enrolled patients was 57.4 ± 10.4 years, and mean dialysis duration was 46.5 ± 28.1 months. Twenty-seven hemodialysis patients and 16 peritoneal dialysis patients finished this trial. After 6 months, the levels of 1,25-dihydroxyvitamin D and fetuin-A were significantly increased in the group taking the omega-3 FA supplement compared with baseline. Levels of calcium, phosphorous, parathyroid hormone, 25-hydroxyvitamin D, FGF-23, and lipid profiles were not significantly changed in the omega-3 FA-supplemented group after 6 months compared with baseline. The erythrocyte membrane contents of eicosapentaenoic acid and docosahexaenoic acid were significantly increased, and oleic acid content was significantly decreased in the omega-3 FA-supplemented group after 6 months compared with baseline. Regarding vascular calcification and cardiovascular disease, omega-3 FA supplementation may have a clinical benefit caused by activating vitamin D, increasing fetuin-A levels, and modifying erythrocyte membrane FA contents in dialysis patients.
Department of Internal Medicine, Dong-A University, 3Ga-1, Dongdaesin-Dong, Seo-Gu, Busan 602-715, Republic of Korea. anws@dau.ac.kr
Won Suk
WS
An
Su Mi
SM
Lee
Young Ki
YK
Son
Seong Eun
SE
Kim
Ki Hyun
KH
Kim
Jin Yeong
JY
Han
Hae Rahn
HR
Bae
Seo Hee
SH
Rha
Yongsoon
Y
Park
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002118:Calcium / Q000097:blood; D002318:Cardiovascular Diseases / Q000188:drug therapy / Q000503:physiopathology; D004032:Diet; D019587:Dietary Supplements; D004281:Docosahexaenoic Acids / Q000008:administration & dosage; D004338:Drug Combinations; D015118:Eicosapentaenoic Acid / Q000008:administration & dosage; D002149:Energy Intake; D004910:Erythrocyte Membrane / Q000187:drug effects / Q000378:metabolism; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage* / Q000097:blood; D005260:Female; D000089703:Fibroblast Growth Factor-23; D006801:Humans; D008297:Male; D008875:Middle Aged; D019301:Oleic Acid / Q000097:blood; D010281:Parathyroid Hormone / Q000097:blood; D010530:Peritoneal Dialysis; D010758:Phosphorus / Q000097:blood; D011863:Radioimmunoassay; D006435:Renal Dialysis; D061205:Vascular Calcification / Q000188:drug therapy / Q000503:physiopathology; D014807:Vitamin D / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000097:blood; D060749:alpha-2-HS-Glycoprotein / Q000032:analysis*
D004338:Drug Combinations; C000717427:FGF23 protein, human; D015525:Fatty Acids, Omega-3; D010281:Parathyroid Hormone; D060749:alpha-2-HS-Glycoprotein; D014807:Vitamin D; D004281:Docosahexaenoic Acids; D010758:Phosphorus; D019301:Oleic Acid; C097949:1,25-dihydroxyvitamin D; D000089703:Fibroblast Growth Factor-23; C104450:25-hydroxyvitamin D; D015118:Eicosapentaenoic Acid; C405603:Omacor; D002118:Calcium