Effect of Omega-3 Fatty Acid Supplementation on Plasma Fibroblast Growth Factor 23 Levels in Post-Myocardial Infarction Patients with Chronic Kidney Disease: The Alpha Omega Trial

dc.citation.issue11
dc.citation.volume9
dc.contributor.authorde Borst, Martin H.
dc.contributor.authorBaia, Leandro C. [UNIFESP]
dc.contributor.authorHoogeveen, Ellen K.
dc.contributor.authorGiltay, Erik J.
dc.contributor.authorNavis, Gerjan
dc.contributor.authorBakker, Stephan J. L.
dc.contributor.authorGeleijnse, Johanna M.
dc.contributor.authorKromhout, Daan
dc.contributor.authorSoedamah-Muthu, Sabita S.
dc.coverageBasel
dc.date.accessioned2020-09-01T13:21:24Z
dc.date.available2020-09-01T13:21:24Z
dc.date.issued2017
dc.description.abstractFibroblast growth factor 23 (FGF23) is an independent risk factor for cardiovascular mortality in chronic kidney disease. Omega-3 (n-3) fatty acid consumption has been inversely associated with FGF23 levels and with cardiovascular risk. We examined the effect of marine n-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) and plant-derived alpha-linolenic acid (ALA) on plasma FGF23 levels in post-myocardial infarction patients with chronic kidney disease. In the randomized double-blind Alpha Omega Trial, 4837 patients with a history of myocardial infarction aged 60-80 years (81% men) were randomized to one of four trial margarines supplemented with a targeted additional intake of 400 mg/day EPA and DHA, 2 g/day ALA, EPA-DHA plus ALA, or placebo for 41 months. In a subcohort of 336 patients with an eGFR < 60 mL/min/1.73 m(2) (creatinine-cystatin C-based CKD-EPI formula), plasma C-terminal FGF23 was measured by ELISA at baseline and end of follow-up. We used analysis of covariance to examine treatment effects on FGF23 levels adjusted for baseline FGF23. Patients consumed 19.8 g margarine/day on average, providing an additional amount of 236 mg/day EPA with 158 mg/day DHA, 1.99 g/day ALA or both, in the active intervention groups. Over 79% of patients were treated with antihypertensive and antithrombotic medication and statins. At baseline, plasma FGF23 was 150 (128 to 172) RU/mL (mean (95% CI)). After 41 months, overall FGF23 levels had increased significantly (p < 0.0001) to 212 (183 to 241) RU/mL. Relative to the placebo, the treatment effect of EPA-DHA was indifferent, with a mean change in FGF23 (95% CI) of -17 (-97, 62) RU/mL (p = 0.7). Results were similar for ALA (36 (-42, 115) RU/mL) and combined EPA-DHA and ALA (34 (-44, 113) RU/mL). Multivariable adjustment, pooled analyses, and subgroup analyses yielded similar non-significant results. Long-term supplementation with modest quantities of EPA-DHA or ALA does not reduce plasma FGF23 levels when added to cardiovascular medication in post-myocardial patients with chronic kidney disease.en
dc.description.affiliationUniv Groningen, Univ Med Ctr Groningen, Dept Nephrol, Hanzepl 1, NL-9713 GZ Groningen, Netherlands
dc.description.affiliationUniv Fed Sao Paulo, Dept Nephrol, Rua Botucatu 740, BR-04023900 Sao Paulo, SP, Brazil
dc.description.affiliationJeroen Bosch Hosp, Dept Internal Med & Nephrol, Henri Dunantstr 1, NL-5223 GZ Den Bosch, Netherlands
dc.description.affiliationLeiden Univ, Med Ctr, Dept Clin Epidemiol, Albinusdreef 2, NL-2333 ZA Leiden, Netherlands
dc.description.affiliationLeiden Univ, Med Ctr, Dept Psychiat, Albinusdreef 2, NL-2333 ZA Leiden, Netherlands
dc.description.affiliationWageningen Univ & Res, Div Human Nutr, Stippeneng 4, NL-6708 WE Wageningen, Netherlands
dc.description.affiliationUnifespUniv Fed Sao Paulo, Dept Nephrol, Rua Botucatu 740, BR-04023900 Sao Paulo, SP, Brazil
dc.description.sourceWeb of Science
dc.description.sponsorshipNetherlands Heart Foundation]
dc.description.sponsorshipUS National Institutes of Health (NIH/NHLBI)
dc.description.sponsorshipUS National Institutes of Health (ODS)
dc.description.sponsorshipUnilever RD, Vlaardingen
dc.description.sponsorshipRoyal Netherlands Academy of Arts and Sciences (KNAW)
dc.description.sponsorshipRoyal Netherlands Academy of Arts and Sciences
dc.description.sponsorshipDutch Kidney Foundation
dc.description.sponsorshipIDNetherlands Heart Foundation: 2000T401
dc.description.sponsorshipIDUS National Institutes of Health (ODS): R01HL-076200
dc.description.sponsorshipIDDutch Kidney Foundation: PV41
dc.format.extent-
dc.identifierhttp://dx.doi.org/10.3390/nu9111233
dc.identifier.citationNutrients. Basel, v. 9, n. 11, p. -, 2017.
dc.identifier.doi10.3390/nu9111233
dc.identifier.fileWOS000416547200071.pdf
dc.identifier.issn2072-6643
dc.identifier.urihttps://repositorio.unifesp.br/handle/11600/58233
dc.identifier.wosWOS:000416547200071
dc.language.isoeng
dc.publisherMdpi Ag
dc.relation.ispartofNutrients
dc.rightsAcesso aberto
dc.subjectn-3 polyunsaturated fatty acidsen
dc.subjectfibroblast growth factor 23en
dc.subjectmyocardial infarctionen
dc.subjectchronic kidney diseaseen
dc.subjectcardiovascularen
dc.titleEffect of Omega-3 Fatty Acid Supplementation on Plasma Fibroblast Growth Factor 23 Levels in Post-Myocardial Infarction Patients with Chronic Kidney Disease: The Alpha Omega Trialen
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