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ARS Home » Northeast Area » Boston, Massachusetts » Jean Mayer Human Nutrition Research Center On Aging » Research » Publications at this Location » Publication #358033

Research Project: Cardiovascular Nutrition and Health

Location: Jean Mayer Human Nutrition Research Center On Aging

Title: Low linolenic and linoleic acid consumption are associated with chronic kidney disease in patients with type 2 diabetes

Author
item Teixeira Dos Santos, Ana Luiz - Federal University Of Rio Grande Do Sul
item Duarte, Camila Kummel - Federal University Of Rio Grande Do Sul
item Dos Santos, Manoella - Federal University Of Rio Grande Do Sul
item Zoldan, Maira - Federal University Of Rio Grande Do Sul
item De Almeida, Jussara - Federal University Of Rio Grande Do Sul
item Gross, Jorge - Federal University Of Rio Grande Do Sul
item De Azevedo, Mirela - Federal University Of Rio Grande Do Sul
item Lichtenstein, Alice - Jean Mayer Human Nutrition Research Center On Aging At Tufts University
item Zelmanovitz, Themis - Federal University Of Rio Grande Do Sul

Submitted to: PLoS One
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 3/19/2018
Publication Date: 8/9/2018
Citation: Teixeira Dos Santos, A., Duarte, C., Dos Santos, M., Zoldan, M., De Almeida, J.C., Gross, J.L., De Azevedo, M.J., Lichtenstein, A.H., Zelmanovitz, T. 2018. Low linolenic and linoleic acid consumption are associated with chronic kidney disease in patients with type 2 diabetes. PLoS One. 13(8):e0195249. https://doi.org/10.1371/journal.pone.0195249.
DOI: https://doi.org/10.1371/journal.pone.0195249

Interpretive Summary: A cross-sectional study was conducted to assess the association between dietary fat and the presence of diabetic kidney disease in patients with type 2 diabetes. Patients were recruited from the diabetes research clinic at Hospital de Clinicas de Porto Alegre (Rio Grande do Sul, Brazil). Exclusion criteria included body mass index >40 kg/m^2, heart failure, gastroparesis, diabetic diarrhea, dietary counseling by a registered dietitian during the previous 12 months, and inability to collect the weighed food intake data. Dietary fatty acid (saturated, monounsaturated and polyunsaturated) intake was estimated using 3-day weighed diet records. The presence of diabetic kidney disease was defined as urinary albumin excretion >/= 30 mg/24 h or/and glomerular filtration rate <60 ml/min/1.73 m^2. A total of 367 patients were evaluated, of which 41% (n=122) had diabetic kidney disease. Multivariate analysis showed that the intake of linolenic acid was negatively associated with the presence of diabetic kidney disease, after adjusted for gender, smoking, ischemic heart disease, anti-hypertensive medication use, systolic blood pressure, and fasting plasma glucose and HDL cholesterol concentrations. In a separate model, similar results were observed for linoleic acid, adjusting to the same co-variables. The data indicate that lower intake of polyunsaturated fatty acids, especially linolenic and linoleic acids, is associated with the presence of chronic kidney disease in patients with type 2 diabetes.

Technical Abstract: This cross-sectional study aimed to assess the association of the fat content in the diet with the presence of Diabetic Kidney Disease (DKD) in patients with type 2 diabetes. Patients from the Diabetes research clinic at Hospital de Clinicas de Porto Alegre (Rio Grande do Sul, Brazil) were consecutively recruited based on the following exclusion criteria: body mass index >40 kg/m^2, heart failure, gastroparesis, diabetic diarrhea, dietary counseling by a registered dietitian during the previous 12 months, and inability to perform the weighed diet records. The dietary fatty acids (saturated, monounsaturated and polyunsaturated) consumption was estimated by 3-day weighed diet record (WDR). Compliance with the WDR technique was assessed by comparison of protein intake estimated from the 3-day WDR and from the 24-h urinary nitrogen output performed on the third day of the WDR period. The presence of DKD was defined as urinary albumin excretion (UAE) >/= 30 mg / 24 h or/and glomerular filtration rate (eGFR) <60 ml/min/1.73 m^2. Urinary albumin was measured twice and eGFR was estimated by using the CKD-EPI equation. A total of 367 patients were evaluated; of these, 41% (n=122) had DKD. Multivariate analysis showed that the intake of linolenic acid was negatively associated with the presence of DKD (OR 0.60; 95% CI 0.39 - 0.93; P = 0.03), adjusted for gender, smoking, ischemic heart disease, ACE inhibitors and/or angiotensin receptor blocker use, systolic blood pressure, fasting plasma glucose and HDL cholesterol. In a separate model, similar results were observed for linoleic acid, adjusting to the same co-variables (OR 0.92; 95% CI 0.85 - 0.99; p = 0.04). In conclusion, the lower intake of polyunsaturated fatty acids, especially linolenic and linoleic acid, is associated with the presence of chronic kidney disease in patients with type 2 diabetes.