Association of omega 3 polyunsaturated fatty acids with incident chronic kidney disease: pooled analysis of 19 cohorts - Bordeaux Population Health Access content directly
Journal Articles BMJ Year : 2023

Association of omega 3 polyunsaturated fatty acids with incident chronic kidney disease: pooled analysis of 19 cohorts

Kwok Leung Ong
  • Function : Author
Matti Marklund
  • Function : Author
Liping Huang
  • Function : Author
Kerry-Anne Rye
  • Function : Author
Nicholas Hui
  • Function : Author
Xiong-Fei Pan
  • Function : Author
Casey M. Rebholz
  • Function : Author
Hyunju Kim
  • Function : Author
Lyn M. Steffen
  • Function : Author
Anniek C. van Westing
  • Function : Author
Johanna M. Geleijnse
  • Function : Author
Ellen K. Hoogeveen
  • Function : Author
Yun-Yu Chen
  • Function : Author
Kuo-Liong Chien
  • Function : Author
Amanda M. Fretts
  • Function : Author
Rozenn N. Lemaitre
  • Function : Author
Fumiaki Imamura
  • Function : Author
Nita G. Forouhi
  • Function : Author
Nicholas J. Wareham
  • Function : Author
Anna Birukov
  • Function : Author
Susanne Jager
  • Function : Author
Olga Kuxhaus
  • Function : Author
Matthias B. Schulze
  • Function : Author
Vanessa Derenji de Mello
  • Function : Author
Jaakko Tuomilehto
  • Function : Author
Matti Uusitupa
  • Function : Author
Jaana Lindstrom
  • Function : Author
Nathan Tintle
  • Function : Author
William S. Harris
  • Function : Author
Keisuke Yamasaki
  • Function : Author
Yoichiro Hirakawa
  • Function : Author
Toshiharu Ninomiya
  • Function : Author
Toshiko Tanaka
  • Function : Author
Luigi Ferrucci
  • Function : Author
Stefania Bandinelli
  • Function : Author
Jyrki K. Virtanen
  • Function : Author
Ari Voutilainen
  • Function : Author
Tharusha Jayasena
  • Function : Author
Anbupalam Thalamuthu
  • Function : Author
Anne Poljak
  • Function : Author
Sonia Bustamante
  • Function : Author
Perminder S. Sachdev
  • Function : Author
Mackenzie K. Senn
  • Function : Author
Stephen S. Rich
  • Function : Author
Michael Y. Tsai
  • Function : Author
Alexis C. Wood
  • Function : Author
Markku Laakso
  • Function : Author
Maria Lankinen
  • Function : Author
Xiaowei Yang
  • Function : Author
Liang Sun
  • Function : Author
Huaixing Li
  • Function : Author
Xu Lin
  • Function : Author
Christoph Nowak
  • Function : Author
Johan Arnlov
  • Function : Author
Ulf Riserus
  • Function : Author
Lars Lind
  • Function : Author
Frank Qian
  • Function : Author
Renata Micha
  • Function : Author
Adrienne Tin
  • Function : Author
Anna Kottgen
  • Function : Author
Ian H. de Boer
  • Function : Author
David S. Siscovick
  • Function : Author
Dariush Mozaffarian
  • Function : Author
Jason Hy Wu
  • Function : Author

Abstract

OBJECTIVE: To assess the prospective associations of circulating levels of omega 3 polyunsaturated fatty acid (n-3 PUFA) biomarkers (including plant derived α linolenic acid and seafood derived eicosapentaenoic acid, docosapentaenoic acid, and docosahexaenoic acid) with incident chronic kidney disease (CKD). DESIGN: Pooled analysis. DATA SOURCES: A consortium of 19 studies from 12 countries identified up to May 2020. STUDY SELECTION: Prospective studies with measured n-3 PUFA biomarker data and incident CKD based on estimated glomerular filtration rate. DATA EXTRACTION AND SYNTHESIS: Each participating cohort conducted de novo analysis with prespecified and consistent exposures, outcomes, covariates, and models. The results were pooled across cohorts using inverse variance weighted meta-analysis. MAIN OUTCOME MEASURES: Primary outcome of incident CKD was defined as new onset estimated glomerular filtration rate <60 mL/min/1.73 m(2). In a sensitivity analysis, incident CKD was defined as new onset estimated glomerular filtration rate <60 mL/min/1.73 m(2) and <75% of baseline rate. RESULTS: 25 570 participants were included in the primary outcome analysis and 4944 (19.3%) developed incident CKD during follow-up (weighted median 11.3 years). In multivariable adjusted models, higher levels of total seafood n-3 PUFAs were associated with a lower incident CKD risk (relative risk per interquintile range 0.92, 95% confidence interval 0.86 to 0.98; P=0.009, I(2)=9.9%). In categorical analyses, participants with total seafood n-3 PUFA level in the highest fifth had 13% lower risk of incident CKD compared with those in the lowest fifth (0.87, 0.80 to 0.96; P=0.005, I(2)=0.0%). Plant derived α linolenic acid levels were not associated with incident CKD (1.00, 0.94 to 1.06; P=0.94, I(2)=5.8%). Similar results were obtained in the sensitivity analysis. The association appeared consistent across subgroups by age (≥60 v <60 years), estimated glomerular filtration rate (60-89 v ≥90 mL/min/1.73 m(2)), hypertension, diabetes, and coronary heart disease at baseline. CONCLUSIONS: Higher seafood derived n-3 PUFA levels were associated with lower risk of incident CKD, although this association was not found for plant derived n-3 PUFAs. These results support a favourable role for seafood derived n-3 PUFAs in preventing CKD.
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hal-04102401 , version 1 (22-05-2023)

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Kwok Leung Ong, Matti Marklund, Liping Huang, Kerry-Anne Rye, Nicholas Hui, et al.. Association of omega 3 polyunsaturated fatty acids with incident chronic kidney disease: pooled analysis of 19 cohorts. BMJ, 2023, 380, ⟨10.1136/bmj-2022-072909⟩. ⟨hal-04102401⟩

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