title: Ratio of dietary ω-3 and ω-6 fatty acids-independent determinants of muscle mass-in hemodialysis patients with diabetes.
abstract: OBJECTIVE
  ω-3 and ω-6 polyunsaturated fatty acids (PUFAs) are essential nutrients in the human diet and possibly affect muscle mass. We evaluated the association between the dietary ratios of ω-3 and ω-6 PUFAs and muscle mass, indicated as skeletal muscle mass (SMM) and appendicular skeletal muscle mass (ASM), in patients with diabetes undergoing hemodialysis (HD).
  
  
  METHODS
  In this cross-sectional study, data on 69 patients with diabetes who underwent standard HD therapy were analyzed. For estimating muscle mass, anthropometric and bioelectrical impedance analyses were conducted following dialysis. In addition, routine laboratory and 3-d dietary data were obtained. The adequate intake (AI) cut-off for ω-3 PUFAs was 1.6 g/d and 1.1 g/d for male and female patients, respectively.
  
  
  RESULTS
  The average age of the participants was 63.0 ± 10.4 y. The mean ratios of ω-3/ω-6 PUFA intake, ω-6/ω-3 PUFA intake, SMM, and ASM of the patients were 0.13 ± 0.07, 9.4 ± 6.4, 24.6 ± 5.4 kg, and 18.3 ± 4.6 kg, respectively. Patients who had AI of ω-3 PUFAs had significantly higher SMM and ASM than did their counterparts. Linear and stepwise multivariable adjustment analyses revealed that insulin resistance and the ω-6/ω-3 PUFA ratio were the independent deleterious determinants of ASM normalized to height in HD patients.
  
  
  CONCLUSIONS
  Patients with AI of ω-3 PUFAs had total-body SMM and ASM that were more appropriate. A higher dietary ratio of ω-6/ω-3 PUFAs was associated with reduced muscle mass in HD patients.
authors.affiliation: School of Nutrition and Health Sciences, Taipei Medical University, Taipei, Taiwan, Republic of China.
authors.forename: Te-Chih
authors.initials: TC
authors.lastname: Wong
authors.affiliation: School of Nutrition and Health Sciences, Taipei Medical University, Taipei, Taiwan, Republic of China.
authors.forename: Yu-Tong
authors.initials: YT
authors.lastname: Chen
authors.affiliation: School of Nutrition and Health Sciences, Taipei Medical University, Taipei, Taiwan, Republic of China.
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, Republic of China.
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, Republic of China.
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, Republic of China.
authors.forename: Tso-Hsiao
authors.initials: TH
authors.lastname: Chen
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan, Republic of China.
authors.forename: Yung-Ho
authors.initials: YH
authors.lastname: Hsu
authors.affiliation: School of Nutrition and Health Sciences, Taipei Medical University, Taipei, Taiwan, Republic of China; Nutrition Research Center, Taipei Medical University Hospital, Taipei, Taiwan, Republic of China. Electronic address: Sherry@tmu.edu.tw.
authors.forename: Shwu-Huey
authors.initials: SH
authors.lastname: Yang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001823:Body Composition; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000097:blood* / Q000628:therapy*; D017097:Electric Impedance; D015525:Fatty Acids, Omega-3 / Q000097:blood*; D043371:Fatty Acids, Omega-6 / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal; D006435:Renal Dialysis
chemical_list: D015525:Fatty Acids, Omega-3; D043371:Fatty Acids, Omega-6
keywords: Appendicular skeletal muscle mass; Diabetes; Hemodialysis; Polyunsaturated fatty acids; Skeletal muscle mass