title: Reverse association of omega-3/omega-6 polyunsaturated fatty acids ratios with carotid atherosclerosis in patients on hemodialysis.
abstract: Omega-3 (n-3) polyunsaturated fatty acids (PUFAs) are widely recognized to have beneficial effects against cardiovascular disease. We investigated the association of n-3 PUFAs levels with carotid atherosclerosis in patients on hemodialysis (HD), who are at high risk for cardiovascular events.
  
  
  
  Carotid ultra-sound was performed in a total of 461 patients on HD (male 67%, age 67 ± 12years, diabetes rate 46%). Intima-media thickness (IMT) and the plaque score (PS) in carotid arteries were measured. Carotid atherosclerosis was defined as IMT >1.2 mm and/or PS > 5.0. The levels of n-6 PUFAs [dihomo-gamma-linolenic acid (DHLA) and arachidonic acid (AA)] and n-3 PUFAs [eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)] were also measured prior to carotid ultra-sound.
  
  
  
  Carotid atherosclerosis was observed in 94 patients (20.4%). Individual PUFAs levels were comparable between patients with and without carotid atherosclerosis. However, the ratio of EPA/AA and that of n-3/n-6 PUFAs were significantly lower in patients with carotid atherosclerosis compared to those without (median 0.36 vs. 0.41, p = 0.031 and 0.85 vs. 0.93, p = 0.041, respectively]. After adjustment for other confounders, the ratio of EPA/AA (OR 0.30, 95% CI 0.12-0.70, p = 0.0055) and the ratio of n-3/n-6 PUFAs (OR 0.45, 95% CI 0.25-0.80, p = 0.0066) showed an independent reverse association with carotid atherosclerosis. In addition, the area under receiver-operating characteristic curves for carotid atherosclerosis was significantly greater in an established risk model with EPA/AA and n-3/n-6 ratios than in the established risk model alone.
  
  
  
  These data suggest that low ratios of both EPA/AA ratio and n-3/n-6 PUFAs were closely associated with carotid atherosclerosis in patients on HD.
authors.affiliation: Cardiolovascular Center, Nagoya Kyoritsu Hospital, Nagoya, Japan.
authors.forename: Norio
authors.initials: N
authors.lastname: Umemoto
authors.affiliation: Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan. Electronic address: hkishii@med.nagoya-u.ac.jp.
authors.forename: Hideki
authors.initials: H
authors.lastname: Ishii
authors.affiliation: Cardiolovascular Center, Nagoya Kyoritsu Hospital, Nagoya, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Kamoi
authors.affiliation: Cardiolovascular Center, Nagoya Kyoritsu Hospital, Nagoya, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Aoyama
authors.affiliation: Cardiolovascular Center, Nagoya Kyoritsu Hospital, Nagoya, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Sakakibara
authors.affiliation: Division of Medical Statistics, Fujita Health University, Toyoake, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Takahashi
authors.affiliation: Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Akihito
authors.initials: A
authors.lastname: Tanaka
authors.affiliation: Department of Nephrology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Yoshinari
authors.initials: Y
authors.lastname: Yasuda
authors.affiliation: Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Susumu
authors.initials: S
authors.lastname: Suzuki
authors.affiliation: Department of Internal Medicine, School of Dentistry Aichi-Gakuin University, Nagoya, Japan.
authors.forename: Tatsuaki
authors.initials: T
authors.lastname: Matsubara
authors.affiliation: Cardiolovascular Center, Nagoya Kyoritsu Hospital, Nagoya, Japan.
authors.forename: Toyoaki
authors.initials: T
authors.lastname: Murohara
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000097:blood; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D002340:Carotid Artery Diseases / Q000097:blood*; D059168:Carotid Intima-Media Thickness; D004281:Docosahexaenoic Acids / Q000097:blood; D015118:Eicosapentaenoic Acid / Q000097:blood; D015525:Fatty Acids, Omega-3 / Q000097:blood*; D043371:Fatty Acids, Omega-6 / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D006435:Renal Dialysis; D012307:Risk Factors
chemical_list: D015525:Fatty Acids, Omega-3; D043371:Fatty Acids, Omega-6; D004281:Docosahexaenoic Acids; D015118:Eicosapentaenoic Acid
keywords: Atherosclerosis; Hemodialysis; Polyunsaturated fatty acids