Abstract
Diabetic nephropathy is the leading cause of end-stage renal disease and is associated with an increased risk of cardiovascular events. Dietary omega-3 fatty acid (FA) has cardioprotective effect and is associated with a slower deterioration of albumin excretion in patients with diabetic nephropathy. In this study, we evaluated the effect of omega-3 FA on proteinuria in diabetic nephropathy patients who are controlling blood pressure (BP) with angiotensin converting enzyme inhibitor (ACEi) or angiotensin II receptor blocker (ARB). In addition, we identified changes in erythrocyte membrane FA contents. A total of 19 patients who were treated with ACEi or ARB for at least 6 months were treated for 12 weeks with omega-3 FA (Omacor, 3 g/day) or a control treatment (olive oil, 3 g/day). Proteinuria levels were unchanged after 12 weeks compared with baseline values in both groups. The erythrocyte membrane contents of omega-3 FA and eicosapentaenoic acid (EPA) were significantly increased, and oleic acid, arachidonic acid : EPA ratio, and omega-6 : omega-3 FA ratio were significantly decreased after 12 weeks compared with the baseline values in the omega-3 FA group. Although omega-3 FA did not appear to alter proteinuria, erythrocyte membrane FA contents, including oleic acid, were altered by omega-3 FA supplementation.
Highlights
Diabetic nephropathy is the leading cause of end-stage renal disease (ESRD), and the incidence of diabetic nephropathy has been increasing rapidly [1]
We found that omega-3 fatty acid (FA) supplementation decreased the erythrocyte membrane oleic acid content in patients with diabetic nephropathy and overt proteinuria
They identified that the erythrocyte levels of oleic acid and the omega-6 : omega3 ratio were positively associated with diabetes risk and that erythrocyte levels of omega-3 FA were negatively associated with diabetes risk
Summary
Diabetic nephropathy is the leading cause of end-stage renal disease (ESRD), and the incidence of diabetic nephropathy has been increasing rapidly [1]. Dietary omega-3 fatty acid (FA) is associated with a slower deterioration of albumin excretion in patients with diabetic nephropathy and in model diabetic rats [4,5,6]. It is not clear whether omega-3 FA has an additional effect on decreasing proteinuria in patients treated with ACEi or ARB. There are no reports regarding changes of the FA contents of the erythrocyte membrane, including oleic acid, caused by omega-3 FA supplementation in diabetic nephropathy patients with overt proteinuria. We hypothesized that omega-3 FA supplementation may decrease proteinuria in patients with BP controlled by ACEi or ARB. We evaluated the status of erythrocyte membrane FA contents and the effect of omega-3 FA on erythrocyte membrane FA contents, including oleic acid, in diabetic nephropathy patients with overt proteinuria
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