title: Ratio of Dietary n-6/n-3 Polyunsaturated Fatty Acids Independently Related to Muscle Mass Decline in Hemodialysis Patients.
abstract: BACKGROUND
  n-3 polyunsaturated fatty acids (PUFAs) might be useful nutritional strategy for treating patients with sarcopenia. We evaluated the effect of the intake of dietary n-3 PUFAs on the skeletal muscle mass (SMM), appendicular skeletal muscle mass (ASM), and its determinants in patients receiving standard hemodialysis (HD) treatment for the management of end stage renal disease.
  
  
  METHODS
  In this cross-sectional study, data of 111 HD patients were analyzed. Anthropometric and bioelectrical impedance measurements used to estimate the muscle mass were performed the day of dialysis immediately after the dialysis session. Routine laboratory and 3-day dietary data were also collected. The cutoff value of adequate intake (AI) for both n-3 PUFAs and alpha-linolenic acid (ALA) was 1.6 g/day and 1.1 g/day for men and women, respectively.
  
  
  RESULTS
  The mean age, mean dietary n-3 PUFAs intake, ALA intake, ratio of n-6/n-3 PUFAs intake, SMM, and ASM of patients were 61.4 ± 10.4 years, 2.0 ± 1.3 g/day, 1.5 ± 1.0 g/day, 9.5 ± 6.7 g/day, 23.9 ± 5.5 kg, and 17.5 ± 4.5 kg, respectively. A higher SMM and ASM significantly observed in patients who achieved an AI of n-3 PUFAs. Similar trends appeared to be observed among those patients who achieved the AI of ALA, but the difference was not significantly, except for ASM (P = 0.047). No relevant differences in demographics, laboratory and nutritional parameters were observed, regardless of whether the patients achieved an AI of n-3 PUFAs. Multivariate analysis showed that the BMI and equilibrated Kt/V were independent determinants of the muscle mass. Moreover, the ratio of n-6/n-3 PUFAs was an independent risk determinant of reduced ASM in HD patients.
  
  
  CONCLUSIONS
  Patients with an AI of n-3 PUFAs had better total-body SMM and ASM. A higher dietary ratio of n-6/n-3 PUFAs seemed to be associated with a reduced muscle mass in HD patients.
authors.affiliation: School of Nutrition and Health Sciences, Taipei Medical University, Taipei, Taiwan, R.O.C.
authors.forename: Te-Chih
authors.initials: TC
authors.lastname: Wong
authors.affiliation: School of Nutrition and Health Sciences, Taipei Medical University, Taipei, Taiwan, R.O.C.
authors.forename: Yu-Tong
authors.initials: YT
authors.lastname: Chen
authors.affiliation: School of Nutrition and Health Sciences, Taipei Medical University, Taipei, Taiwan, R.O.C.
authors.forename: Pei-Yu
authors.initials: PY
authors.lastname: Wu
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan, R.O.C.
authors.forename: Tzen-Wen
authors.initials: TW
authors.lastname: Chen
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan, R.O.C.
authors.forename: Hsi-Hsien
authors.initials: HH
authors.lastname: Chen
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan, R.O.C.
authors.forename: Tso-Hsiao
authors.initials: TH
authors.lastname: Chen
authors.affiliation: School of Nutrition and Health Sciences, Taipei Medical University, Taipei, Taiwan, R.O.C; Nutrition Research Center, Taipei Medical University Hospital, Taipei, Taiwan, R.O.C.
authors.forename: Shwu-Huey
authors.initials: SH
authors.lastname: Yang
mesh_terms: D000368:Aged; D019587:Dietary Supplements; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000150:complications* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D055948:Sarcopenia / Q000150:complications / Q000188:drug therapy*
chemical_list: D015525:Fatty Acids, Omega-3