Abstract
The current study was carried out to assess the effects of omega-3 fatty acid and alpha-tocopherol co-supplementation on malnutrition-inflammation score (MIS), biomarkers of inflammation and oxidative stress in chronic hemodialysis (HD) patients. In a randomized double-blind placebo-controlled clinical trial, 120 patients with chronic HDwere included. Patients were randomly allocated into four groups to receive: (1) 1250mg/day omega-3 fatty acid containing 600mg EPA and 300mg DHA+alpha-tocopherol placebo (n=30); (2) 400IU/day alpha-tocopherol+omega-3 fatty acids placebo (n=30); (3) 1250mg omega-3 fatty acids/day+400IU/day alpha-tocopherol (n=30); and (4) omega-3 fatty acids placebo+alpha-tocopherol placebo (n=30) for 12weeks. After 12weeks of intervention, all three groups of alpha-tocopherol only, individual omega-3 fatty acids, and combined omega-3 fatty acids and alpha-tocopherol experienced a significant improvements in MIS compared with the placebo group; however, improvements were much greater in the individual omega-3 fats (-1.4±1.4) and combined omega-3 fats and alpha-tocopherol (-1.1±2.3) groups compared with alpha-tocopherol group alone (-0.5±1.7, P=0.004). Furthermore, both individual and combined intervention with omega-3 fats and alpha-tocopherol led to a significant increase in plasma nitric oxide (NO) (combined group: +17.6±29.3; alpha-tocopherol: +43.1±36.3; omega-3 fats: +31.0±40.0; and placebo: -0.5±18.5µmol/L, respectively, P<0.001) and total antioxidant capacity (TAC) (+64.9±113.6, +53.0±144.6, +57.6±157.8 and -69.9±215.1mmol/L, respectively, P=0.004) levels. Overall, omega-3 fatty acids and alpha-tocopherol co-supplementation for 12weeks among HD patients improved MIS, plasma NO and TAC levels. Future studies with longer duration of the intervention are needed to confirm the validity of our findings. CLINICAL REGISTRATION: www.irct.ir as IRCT201410245623N28.
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