Association between the metabolic profile of serum fatty acids and diabetic nephropathy: a study conducted in northeastern China

Yazhuo Liu; Yingying Li; Hui Shen; Yike Li; Yanbing Xu; Mi Zhou; Xinghai Xia; Binyin Shi

doi:10.1177/20420188221118750

Association between the metabolic profile of serum fatty acids and diabetic nephropathy: a study conducted in northeastern China

Ther Adv Endocrinol Metab. 2022 Sep 16:13:20420188221118750. doi: 10.1177/20420188221118750. eCollection 2022.

Authors

Yazhuo Liu¹, Yingying Li², Hui Shen², Yike Li², Yanbing Xu², Mi Zhou³, Xinghai Xia³, Binyin Shi⁴

Affiliations

¹ Department of Endocrinology, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China.
² Department of Clinical Nutrition and Metabolism, Dalian University Affiliated Zhongshan Hospital, Dalian, China.
³ Department of Ophthalmology, Penn State Hershey Medical Center, Hershey, PA, USA.
⁴ Department of Endocrinology, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an 710000, China.

Abstract

Background and purpose: With the progressive increase in the prevalence of type 2 diabetes mellitus (T2DM), diabetic nephropathy (DN) - one of the most common chronic microvascular complications - has evolved into a significant cause of death worldwide among end-stage renal disease patients. Academic researchers have for decades focused on the development of DN and recently found that free fatty acids (FFAs) constituted an independent risk factor for vascular complications in T2DM patients. It is therefore critical to determine whether the metabolic profile of FFAs is related to DN.

Methods: This study comprised 611 research subjects in Dalian, a city in northeast China: 52 DN patients, 115 T2DM patients, and 444 healthy controls. We determined 15 forms of serum FFAs, including arachidonic acid (AA, C20:4), docosahexaenoic acid (DHA, C22:6), erucic acid (C22:1), nervonic acid (NA, C24:1), estimated total omega-3s, total omega-6s, the omega-3/omega-6 ratio, and total FFA content by liquid chromatography-mass spectrometry (LC-MS).

Results: The levels of NA (mean = 45.27, range = 0.84-76.57) and DHA (mean = 324.58, range = 205.38-450.03) in DN patients were slightly lower than those in T2DM patients or healthy controls. The serum omega-3 polyunsaturated fatty acid (PUFA) DHA (C22:6) was significantly negatively correlated with microalbuminuria (MAU), the albumin/creatinine ratio (ACR), body mass index (BMI), fasting plasma glucose (FPG), and glycosylated hemoglobin (HbA1c). The serum monounsaturated fatty acid (MUFA) NA (C24:1) was significantly negatively correlated with BMI, FPG, and HbA1c. After adjustment of variables, multiple logistic regression analysis revealed significant odds ratios (ORs) [with confidence intervals (CIs)] for DHA (0.991, 0.985-0.997; p = 0.002) and NA (0.978, 0.958-0.999; p = 0.037).

Conclusion: In this study, we ascertained that the contents of NA and DHA in patients with DN were relatively low, and that DHA was negatively correlated with MAU and the ACR. However, large-scale, population-based studies focusing on the role of NA and DHA in the pathogenesis of DN are still required in the future.

Keywords: diabetic nephropathy; docosahexaenoic acid; nervonic acid; polyunsaturated fatty acid; type 2 diabetes mellitus.