Effects of N-3 PUFAs Supplementation on Insulin Resistance and Inflammatory Biomarkers in Hemodialysis Patients

Figures & data

Table 1 The baseline characteristics of study participants and responsiveness to fish oil supplementation after eight weeks

Variable	Before supplementation	After supplementation	Significance
Age (years)	54.5 ± 12
Gender (male/female)	20/15 (54.3%/ 45.7%)
Hemodialysis duration (months)	48 (24–82)
Body mass index (kg/m^2)	22.17 ± 2.99	22.31 ± 2.86	0.93
Waist (cm)	86.47 ± 9.90	85.65 ± 8.40	0.86
Triglycerides (mmol/L)	2.30 ± 0.68	2.19 ± 0. 88	0.21
Total cholesterol (mmol/L)	5.31 ± 1.13	4.90 ± 1.02	0.84
HDL cholesterol (mmol/L)	0.91 ± 0.14	1.14 ± 0.17	0.08
Glucose (mmol/L)	5.31 ± 0.90	4.94 ± 0.79	0.51
Insulin (mU/L)	35.25 (26.90–59.20)	17.6 (14.40–27.90)	0.001
IR HOMA	8.67 (6.01–15.30)	3.55 (2.77–6.97)	0.001
hs-CRP (mg/L)	24.6 (19.7–30.5)	3.7 (1.4–10.9)	0.001
TNFalpha (pg/ml)	2.08 (0.99–2.82)	0.45 (0.23–0.71)	0.01
IL-6 (pg/ml)	1.60 (1.16–8.04)	0.30 (0.17–0.78)	0.001
Iron (μg/L)	13.15 (6.9–17.9)	20.6 (9.9–27.0)	0.23
Ferritin (μg/L)	462.0 (262.0–807.2)	310.9 (164.5–382.8)	0.01

Values are mean ± SD or median (interquartile range).

*Independent sample t test or †Kruskal-Wallis test for skewed variables.

Table 2 Erythrocyte phospholipid fatty acids composition before and after eight weeks of fish oil supplementation in HD patients

Fatty acid (% of total)	Before supplementation	After supplementation	Significance
14:0	1.18 ± 0.48	0.56 ± 0.32	0.007
15:0	0.58 (0.35–0.62)	0.21 (0.10–0.42)	0.001
16:0	29.93 ± 3.52	28.30 ± 3.70	0.04
18:0	13.58 ± 2.03	12.28 ± 3.85	0.002
16:1 (n-7)	0.78 ± 0.36	1.06 ± 0.75	0.001
18:1 (n-9)	23.96 ± 2.76	23.90 ± 3.55	0.07
18:2 (n-6)	12.17 (9.98–13.16)	15.80 (13.80–17.70)	0.02
18:3 (n-3)	0.18 ± 0.13	0.30 ± 0.18	0.01
18:3 (n-6)	0.10 (0.0–0.17)	0.19 (0.13–0.28)	0.01
20:3 (n-6)	1.91 ± 0.54	2.58 ± 1.10	0.03
20:4 (n-6)	7.44 ± 1.14	8.18 ± 2.70	0.001
20:5 (n-3)	0.21 (0.04–0.34)	0.30 (0.18–0.60)	0.009
22:4 (n-6)	0.45 ± 0.10	0.35 ± 0.17	0.02
22:5 (n-3)	0.63 ± 0.42	0.64 ± 0.51	0.19
22:6 (n-3)	1.97 ± 0.69 (1.91[1.56–2.27])	2.53 ± 0.81(2.44[2.0–3.0])	0.37 (p = 0.002)
PUFA (n-6)	20.28 ± 3.15	24.65 ± 3.58	0.29
PUFA (n-3)	3.07 ± 0.81	4.00 ± 0.97	0.23
PUFA (n-6): (n-3)	7.15 ± 2.580	6.52 ± 1.87	0.31
MUFA	24.74 ± 2.76	24.96 ± 3.38	0.07
SFA	45.33 ± 3.14	41.47 ± 4.45	0.01
SFA:n-3 PUFA	15.21 ± 4.51	10.79 ± 3.11	0.04

Values are mean ± SD or median (interquartile range). Abbreviations: PUFA = polyunsaturated fatty acids, MUFA = mono-unsaturated fatty acids, SFA = saturated fatty acids.

*Independent sample t test or †Kruskal-Wallis test for skewed variables.

Table 3 Multiple linear regression analysis equations in HD patients (IR HOMA and fatty acids) before fish oil supplementation

Variable	Beta	Significance
EPA	–0.487	0.03
AA	0.322	0.13

Adjusted R² = 0.34.

Table 4 Multiple linear regression analysis equations in HD patients (IR HOMA and fatty acids) after fish oil supplementation

Variable	Beta	Significance
Δ n-6 PUFA/ n-3 PUFA	0.675	0.002
Δ AA	0.301	0.10
Δ iron	0.150	0.32

Adjusted R² = 0.40.

Table 5 Multiple linear regression analysis equations in HD patients (TNF alpha and fatty acids) after fish oil supplementation

Variable	Beta	Significance
Δ n-6 PUFA/ n-3 PUFA	0.331	0.03
Δ MUFA	0.263	0.16

Adjusted R² = 0.18.