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

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

doi:10.1136/bmj-2022-072909

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

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

Bloomberg School of Public Health

Research output: Contribution to journal › Article › peer-review

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 m2. In a sensitivity analysis, incident CKD was defined as new onset estimated glomerular filtration rate <60 mL/min/1.73 m2 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, I2=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, I2=0.0%). Plant derived α linolenic acid levels were not associated with incident CKD (1.00, 0.94 to 1.06; P=0.94, I2=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 m2), 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.

Original language	English (US)
Article number	e072909
Journal	BMJ
DOIs	https://doi.org/10.1136/bmj-2022-072909
State	Accepted/In press - 2023

ASJC Scopus subject areas

General Medicine

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10.1136/bmj-2022-072909

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Ong, K. L., Marklund, M., Huang, L., Rye, K. A., Hui, N., Pan, X. F., Rebholz, C. M., Kim, H., Steffen, L. M., Van Westing, A. C., Geleijnse, J. M., Hoogeveen, E. K., Chen, Y. Y., Chien, K. L., Fretts, A. M., Lemaitre, R. N., Imamura, F., Forouhi, N. G., Wareham, N. J., ... Wu, J. H. Y. (Accepted/In press). Association of omega 3 polyunsaturated fatty acids with incident chronic kidney disease: pooled analysis of 19 cohorts. BMJ, Article e072909. https://doi.org/10.1136/bmj-2022-072909

Ong, KL, Marklund, M, Huang, L, Rye, KA, Hui, N, Pan, XF, Rebholz, CM, Kim, H, Steffen, LM, Van Westing, AC, Geleijnse, JM, Hoogeveen, EK, Chen, YY, Chien, KL, Fretts, AM, Lemaitre, RN, Imamura, F, Forouhi, NG, Wareham, NJ, Birukov, A, Jäger, S, Kuxhaus, O, Schulze, MB, De Mello, VD, Tuomilehto, J, Uusitupa, M, Lindström, J, Tintle, N, Harris, WS, Yamasaki, K, Hirakawa, Y, Ninomiya, T, Tanaka, T, Ferrucci, L, Bandinelli, S, Virtanen, JK, Voutilainen, A, Jayasena, T, Thalamuthu, A, Poljak, A, Bustamante, S, Sachdev, PS, Senn, MK, Rich, SS, Tsai, MY, Wood, AC, Laakso, M, Lankinen, M, Yang, X, Sun, L, Li, H, Lin, X, Nowak, C, Ärnlöv, J, Risérus, U, Lind, L, Le Goff, M, Samieri, C, Helmer, C, Qian, F, Micha, R, Tin, A, Köttgen, A, De Boer, IH, Siscovick, DS, Mozaffarian, D & Wu, JHY 2023, 'Association of omega 3 polyunsaturated fatty acids with incident chronic kidney disease: pooled analysis of 19 cohorts', BMJ. https://doi.org/10.1136/bmj-2022-072909

@article{e11a18aa3e5246a0beeff6c20a8f095c,

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

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 m2. In a sensitivity analysis, incident CKD was defined as new onset estimated glomerular filtration rate <60 mL/min/1.73 m2 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, I2=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, I2=0.0%). Plant derived α linolenic acid levels were not associated with incident CKD (1.00, 0.94 to 1.06; P=0.94, I2=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 m2), 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.",

author = "Ong, {Kwok Leung} and Matti Marklund and Liping Huang and Rye, {Kerry Anne} and Nicholas Hui and Pan, {Xiong Fei} and Rebholz, {Casey M.} and Hyunju Kim and Steffen, {Lyn M.} and {Van Westing}, {Anniek C.} and Geleijnse, {Johanna M.} and Hoogeveen, {Ellen K.} and Chen, {Yun Yu} and Chien, {Kuo Liong} and Fretts, {Amanda M.} and Lemaitre, {Rozenn N.} and Fumiaki Imamura and Forouhi, {Nita G.} and Wareham, {Nicholas J.} and Anna Birukov and Susanne J{\"a}ger and Olga Kuxhaus and Schulze, {Matthias B.} and {De Mello}, {Vanessa Derenji} and Jaakko Tuomilehto and Matti Uusitupa and Jaana Lindstr{\"o}m and Nathan Tintle and Harris, {William S.} and Keisuke Yamasaki and Yoichiro Hirakawa and Toshiharu Ninomiya and Toshiko Tanaka and Luigi Ferrucci and Stefania Bandinelli and Virtanen, {Jyrki K.} and Ari Voutilainen and Tharusha Jayasena and Anbupalam Thalamuthu and Anne Poljak and Sonia Bustamante and Sachdev, {Perminder S.} and Senn, {MacKenzie K.} and Rich, {Stephen S.} and Tsai, {Michael Y.} and Wood, {Alexis C.} and Markku Laakso and Maria Lankinen and Xiaowei Yang and Liang Sun and Huaixing Li and Xu Lin and Christoph Nowak and Johan {\"A}rnl{\"o}v and Ulf Ris{\'e}rus and Lars Lind and {Le Goff}, M{\'e}lanie and C{\'e}cilia Samieri and Catherine Helmer and Frank Qian and Renata Micha and Adrienne Tin and Anna K{\"o}ttgen and {De Boer}, {Ian H.} and Siscovick, {David S.} and Dariush Mozaffarian and Wu, {Jason H.Y.}",

note = "Publisher Copyright: {\textcopyright} Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY. No commercial re-use. See rights and permissions. Published by BMJ.",

year = "2023",

doi = "10.1136/bmj-2022-072909",

language = "English (US)",

journal = "BMJ",

issn = "0959-8146",

publisher = "BMJ Publishing Group",

}

TY - JOUR

T1 - Association of omega 3 polyunsaturated fatty acids with incident chronic kidney disease

T2 - pooled analysis of 19 cohorts

AU - Ong, Kwok Leung

AU - Marklund, Matti

AU - Huang, Liping

AU - Rye, Kerry Anne

AU - Hui, Nicholas

AU - Pan, Xiong Fei

AU - Rebholz, Casey M.

AU - Kim, Hyunju

AU - Steffen, Lyn M.

AU - Van Westing, Anniek C.

AU - Geleijnse, Johanna M.

AU - Hoogeveen, Ellen K.

AU - Chen, Yun Yu

AU - Chien, Kuo Liong

AU - Fretts, Amanda M.

AU - Lemaitre, Rozenn N.

AU - Imamura, Fumiaki

AU - Forouhi, Nita G.

AU - Wareham, Nicholas J.

AU - Birukov, Anna

AU - Jäger, Susanne

AU - Kuxhaus, Olga

AU - Schulze, Matthias B.

AU - De Mello, Vanessa Derenji

AU - Tuomilehto, Jaakko

AU - Uusitupa, Matti

AU - Lindström, Jaana

AU - Tintle, Nathan

AU - Harris, William S.

AU - Yamasaki, Keisuke

AU - Hirakawa, Yoichiro

AU - Ninomiya, Toshiharu

AU - Tanaka, Toshiko

AU - Ferrucci, Luigi

AU - Bandinelli, Stefania

AU - Virtanen, Jyrki K.

AU - Voutilainen, Ari

AU - Jayasena, Tharusha

AU - Thalamuthu, Anbupalam

AU - Poljak, Anne

AU - Bustamante, Sonia

AU - Sachdev, Perminder S.

AU - Senn, MacKenzie K.

AU - Rich, Stephen S.

AU - Tsai, Michael Y.

AU - Wood, Alexis C.

AU - Laakso, Markku

AU - Lankinen, Maria

AU - Yang, Xiaowei

AU - Sun, Liang

AU - Li, Huaixing

AU - Lin, Xu

AU - Nowak, Christoph

AU - Ärnlöv, Johan

AU - Risérus, Ulf

AU - Lind, Lars

AU - Le Goff, Mélanie

AU - Samieri, Cécilia

AU - Helmer, Catherine

AU - Qian, Frank

AU - Micha, Renata

AU - Tin, Adrienne

AU - Köttgen, Anna

AU - De Boer, Ian H.

AU - Siscovick, David S.

AU - Mozaffarian, Dariush

AU - Wu, Jason H.Y.

PY - 2023

Y1 - 2023

N2 - 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 m2. In a sensitivity analysis, incident CKD was defined as new onset estimated glomerular filtration rate <60 mL/min/1.73 m2 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, I2=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, I2=0.0%). Plant derived α linolenic acid levels were not associated with incident CKD (1.00, 0.94 to 1.06; P=0.94, I2=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 m2), 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.

AB - 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 m2. In a sensitivity analysis, incident CKD was defined as new onset estimated glomerular filtration rate <60 mL/min/1.73 m2 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, I2=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, I2=0.0%). Plant derived α linolenic acid levels were not associated with incident CKD (1.00, 0.94 to 1.06; P=0.94, I2=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 m2), 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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UR - http://www.scopus.com/inward/citedby.url?scp=85146485567&partnerID=8YFLogxK

U2 - 10.1136/bmj-2022-072909

DO - 10.1136/bmj-2022-072909

M3 - Article

C2 - 36653033

AN - SCOPUS:85146485567

SN - 0959-8146

JO - BMJ

JF - BMJ

M1 - e072909

ER -

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

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