title: Lipophilic index, kidney function, and kidney function decline.
abstract: Unhealthy dietary fats are associated with faster kidney function decline. The cell membrane composition of phospholipid fatty acids (FAs) is a determinant of membrane fluidity and rheological properties. These properties, which have been linked to kidney damage, are thought to be reflected by the lipophilic index (LI). We prospectively investigated the associations of LI with kidney function and its decline.
  
  
  
  Observational study from the Prospective Investigation of Vasculature in Uppsala Seniors including 975 men and women with plasma phospholipid FAs composition and cystatin-C estimate glomerular filtration rate (eGFR). Of these, 780 attended re-examination after 5 years, and eGFR changes were assessed. Participants with a 5-year eGFR reduction ≥30% were considered chronic kidney disease (CKD) progressors (n = 198). LI was calculated as the sum of the products of the FA proportions with the respective FAs melting points. Blood rheology/viscosity measurements were performed in a random subsample of 559 subjects at baseline. Increased LI showed a statistically significant but overall weak association with blood, plasma viscosity (both Spearman rho = 0.16, p < 0.01), and erythrocyte deformability (rho = -0.09, p < 0.05). In cross-sectional analyses, LI associated with lower eGFR (regression coefficient 3.00 ml/min/1.73 m21-standard deviation (SD) increment in LI, 95% CI: -4.31, -1.69, p < 0.001). In longitudinal analyses, LI associated with a faster eGFR decline (-2.13 [95% CI -3.58, -0.69] ml/min/1.73 m2, p < 0.01) and with 32% increased odds of CKD progression (adjusted OR 1.32 [95%, CI 1.05-1.65]).
  
  
  
  A high LI was associated with lower kidney function, kidney function decline, and CKD progression.
authors: Divisions of Renal Medicine and Baxter Novum, Karolinska Institutet, Stockholm, Sweden.
authors: H
authors: H
authors: Xu
authors: Department of Medical Sciences, Cardiovascular Epidemiology, Uppsala University, Uppsala, Sweden; School of Health and Social Studies, Dalarna University, Falun, Sweden.
authors: J
authors: J
authors: Ärnlöv
authors: Department of Medical Sciences, Cardiovascular Epidemiology, Uppsala University, Uppsala, Sweden.
authors: B
authors: B
authors: Sandhagen
authors: Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden.
authors: U
authors: U
authors: Risérus
authors: Divisions of Renal Medicine and Baxter Novum, Karolinska Institutet, Stockholm, Sweden.
authors: B
authors: B
authors: Lindholm
authors: Department of Medical Sciences, Cardiovascular Epidemiology, Uppsala University, Uppsala, Sweden.
authors: L
authors: L
authors: Lind
authors: Divisions of Renal Medicine and Baxter Novum, Karolinska Institutet, Stockholm, Sweden; Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden. Electronic address: juan.jesus.carrero@ki.se.
authors: J J
authors: JJ
authors: Carrero
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D001809:Blood Viscosity; D003430:Cross-Sectional Studies; D055316:Cystatin C / Q000097:blood; D004041:Dietary Fats / Q000009:adverse effects* / Q000097:blood; D018450:Disease Progression; D004907:Erythrocyte Deformability; D004912:Erythrocytes / Q000187:drug effects / Q000378:metabolism; D005227:Fatty Acids / Q000009:adverse effects / Q000097:blood; D005260:Female; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D008137:Longitudinal Studies; D008297:Male; D008560:Membrane Fluidity; D015999:Multivariate Analysis; D016017:Odds Ratio; D010743:Phospholipids / Q000009:adverse effects / Q000097:blood; D011446:Prospective Studies; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D012307:Risk Factors; D013548:Sweden; D013997:Time Factors
chemical_list: D015415:Biomarkers; C525030:CST3 protein, human; D055316:Cystatin C; D004041:Dietary Fats; D005227:Fatty Acids; D010743:Phospholipids
keywords: CKD progression; Fatty acids; Fluidity; Kidney function; Kidney function decline; Lipophilic index