title: Serum n-3 and n-6 polyunsaturated fatty acid profile as an independent predictor of cardiovascular events in hemodialysis patients.
abstract: BACKGROUND
  Unlike the n-6 polyunsaturated fatty acid (PUFA) arachidonic acid (AA), n-3-PUFAs such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) appear to have beneficial effects on inflammation, thrombosis, and cardiovascular disease (CVD). We examined possible alterations in serum PUFA profiles in patients on maintenance hemodialysis therapy and its association with CVD risk.
  
  
  METHODS
  An observational study including cross-sectional and longitudinal analyses.
  
  
  METHODS
  Single-center study of 517 maintenance hemodialysis patients in an urban area in Japan.
  
  
  METHODS
  Serum EPA, DHA, and AA concentrations and EPA:AA, DHA:AA, and (EPA+DHA):AA ratios.
  
  
  RESULTS
  CVD events, including ischemic heart disease, stroke, peripheral artery disease, pulmonary edema, and valve disease.
  
  
  RESULTS
  Hemodialysis patients showed lower (EPA+DHA):AA, EPA:AA, and DHA:AA ratios than 122 controls similar in age and sex. During follow-up, 190 CVD events were recorded. (EPA+DHA):AA ratio was not associated significantly with CVD in unadjusted analysis, but was associated significantly and inversely with CVD in Cox models adjusted for age and other confounding variables, with HRs in the range of 1.71-1.99 in the lowest versus highest quartile of (EPA+DHA):AA ratios. Similarly, EPA:AA and DHA:AA ratios showed inverse associations with CVD, whereas serum EPA, DHA, and AA concentrations were not predictive of CVD.
  
  
  CONCLUSIONS
  No information for dietary intake, use of dietary supplements, or cell membrane PUFA content.
  
  
  CONCLUSIONS
  In hemodialysis patients, serum PUFA profile is unfavorably altered, and the low n-3-PUFA:AA ratios are independent predictors of CVD.
authors.affiliation: Department of Geriatrics and Vascular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan. t-shoji@med.osaka-cu.ac.jp
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Shoji
authors.forename: Ryusuke
authors.initials: R
authors.lastname: Kakiya
authors.forename: Tomoshige
authors.initials: T
authors.lastname: Hayashi
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Tsujimoto
authors.forename: Mika
authors.initials: M
authors.lastname: Sonoda
authors.forename: Hideaki
authors.initials: H
authors.lastname: Shima
authors.forename: Katsuhito
authors.initials: K
authors.lastname: Mori
authors.forename: Shinya
authors.initials: S
authors.lastname: Fukumoto
authors.forename: Hideki
authors.initials: H
authors.lastname: Tahara
authors.forename: Atushi
authors.initials: A
authors.lastname: Shioi
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Tabata
authors.forename: Masanori
authors.initials: M
authors.lastname: Emoto
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Nishizawa
authors.forename: Masaaki
authors.initials: M
authors.lastname: Inaba
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000097:blood* / Q000175:diagnosis*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D015525:Fatty Acids, Omega-3 / Q000097:blood*; D043371:Fatty Acids, Omega-6 / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D006435:Renal Dialysis / Q000009:adverse effects*
chemical_list: D015415:Biomarkers; D015525:Fatty Acids, Omega-3; D043371:Fatty Acids, Omega-6
keywords: arachidonic acid (AA); cardiovascular disease; docosahexaenoic acid (DHA); eicosapentaenoic acid (EPA); hemodialysis; n-3-polyunsaturated fatty acid (PUFA)