Plasma fatty acids and kidney function decline in post-myocardial infarction patients of the Alpha Omega Cohort
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Published on: September 22, 2020
Anniek C van Westing1, Marion R Eckl1, Leanne K Küpers1
1Division of Human Nutrition and Health, Wageningen University, Wageningen, the Netherlands.
Insights
Higher plasma linoleic acid (LA) levels may predict slower kidney function decline after myocardial infarction (MI). This protective effect is particularly notable in patients with diabetes and chronic kidney disease (CKD).
Area of Science:
- Cardiovascular Medicine
- Nephrology
- Nutritional Science
Background:
- Age-related decline in kidney function is often accelerated in patients with coronary heart disease (CHD).
- Shared underlying etiologies may link CHD and chronic kidney disease (CKD).
- Plasma fatty acids (FAs) are being investigated as potential biomarkers for kidney function changes post-myocardial infarction (MI).
Purpose of the Study:
- To investigate the association between plasma fatty acid profiles and kidney function decline following myocardial infarction (MI).
- To identify specific fatty acids that may serve as predictive biomarkers for renal function changes in post-MI patients.
Main Methods:
- Analysis of 2329 Dutch patients (aged 60-80) from the Alpha Omega Cohort post-MI.
- Assessment of plasma fatty acids (FAs) in cholesteryl esters at baseline (2002-2006).
- Estimation of annual change in estimated glomerular filtration rate (eGFR) over approximately 40 months using creatinine-cystatin C.
Main Results:
- Higher plasma linoleic acid (LA) levels were associated with a slower annual decline in eGFR (adjusted beta: 0.40, p=0.046).
- This association was more pronounced in patients with diabetes (adjusted beta: 1.21) and pre-existing CKD (adjusted beta: 0.90).
- Other plasma FAs, including omega-3 FAs, odd-chain FAs, and C14:0, showed weaker or non-significant associations with eGFR decline.
Conclusions:
- Elevated plasma linoleic acid (LA) may serve as a beneficial biomarker, indicating reduced kidney function decline after myocardial infarction (MI).
- The protective association of LA with kidney function is particularly significant in post-MI patients who also have diabetes or CKD.
- Further research into FAs as biomarkers for renal health in cardiovascular disease patients is warranted.
Background And Aims:
Age-related kidney function decline is accelerated in patients with coronary heart disease (CHD). CHD and chronic kidney disease may share common etiologies. We examined plasma fatty acids (FAs) as novel biomarkers of kidney function decline after myocardial infarction (MI).
Methods And Results:
The analysis included 2329 Dutch post-MI patients aged 60-80y (Alpha Omega Cohort) most receiving state-of-the-art medications. Plasma FAs (% total FAs) in cholesteryl esters were assessed at baseline (2002-2006), and ∼40 months change in creatinine-cystatin C based glomerular filtration rate was estimated (eGFR, in ml/min per 1.73 m2). Beta coefficients for annual eGFR change in relation to plasma linoleic acid (LA; 50.1% of total FAs in CE), omega-3 FAs (EPA + DHA; 1.7%), odd-chain FAs (C15:0 and C17:0; 0.2%), and C14:0 (0.7%) were obtained from linear regression analyses adjusted for age, sex, smoking, and alcohol intake. Mean baseline eGFR ±SD was 78.5 ± 18.7, which declined by 4.7 ± 13.1 during follow-up, or 1.4 ± 3.9 per year. The annual decline in eGFR was less in patients with higher plasma LA (adjusted beta: 0.40 for LA >47 vs ≤ 47%, 95% CI: 0.01; 0.78; p = 0.046). Associations of plasma LA with annual eGFR decline were stronger in 437 patients with diabetes (1.21, 0.24; 2.19) and in 402 patients with CKD (eGFR<60; 0.90, -0.09; 1.89). Weaker, non-significant associations with kidney function decline were observed for the other plasma FAs.
Conclusion:
Higher plasma LA may be a good predictor of less kidney function decline after MI, particularly in patients with diabetes. The Alpha Omega Cohort is registered with clinicaltrials.gov, NCT03192410.
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