title: Serum fatty acid patterns, insulin sensitivity and the metabolic syndrome in individuals with chronic kidney disease.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  METHODS
  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.
authors.affiliation: Divisions of Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention, and Technology, Karolinska Institutet, Stockholm, Sweden.
authors.forename: X
authors.initials: X
authors.lastname: Huang
authors.forename: P
authors.initials: P
authors.lastname: Sjögren
authors.forename: J
authors.initials: J
authors.lastname: Ärnlöv
authors.forename: T
authors.initials: T
authors.lastname: Cederholm
authors.forename: L
authors.initials: L
authors.lastname: Lind
authors.forename: P
authors.initials: P
authors.lastname: Stenvinkel
authors.forename: B
authors.initials: B
authors.lastname: Lindholm
authors.forename: U
authors.initials: U
authors.lastname: Risérus
authors.forename: J J
authors.initials: JJ
authors.lastname: Carrero
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004041:Dietary Fats / Q000032:analysis*; D005227:Fatty Acids / Q000097:blood*; D005260:Female; D005919:Glomerular Filtration Rate; D015309:Glucose Clamp Technique / Q000379:methods; D006306:Health Surveys; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000209:etiology; D007333:Insulin Resistance; D019787:Linoleic Acid / Q000097:blood*; D008137:Longitudinal Studies; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D008875:Middle Aged; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000150:complications / Q000178:diet therapy / Q000453:epidemiology; D013548:Sweden / Q000453:epidemiology
chemical_list: D004041:Dietary Fats; D005227:Fatty Acids; D019787:Linoleic Acid
keywords: chronic kidney disease; dietary fat; fatty acid composition; insulin resistance; metabolic syndrome