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Moloudpour B, Jam SA, Darbandi M, Janati A, Gholizadeh M, Najafi F, Pasdar Y. Association Between Plant-based Diet and Kidney Function in Adults. J Ren Nutr 2024; 34:125-132. [PMID: 37769752 DOI: 10.1053/j.jrn.2023.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 08/16/2023] [Accepted: 09/10/2023] [Indexed: 10/03/2023] Open
Abstract
OBJECTIVE A plant-based diet has both antioxidant and anti-inflammatory properties. Therefore, it is hypothesized that adherence to a plant-based diet may have a positive effect on kidney function. The study aimed to determine the association between the plant-based diet index (PDI) and chronic kidney disease (CKD). METHODS This cross-sectional analysis used information from the Ravansar noncommunicable diseases cohort study, which included 9,746 participants between the ages of 35 and 65. By measuring the estimation glomerular filtration rate (eGFR) with the modification of diet in the renal disease equation, CKD was determined. Using a food frequency questionnaire, the PDI was computed based on food intake. To determine odds ratios (ORs), multivariable logistic regression models were utilized. RESULTS 1,058 (10.86%) participants had CKD (eGFR<60 mL/min/1.73 m2), and the mean PDI was 54.22 ± 6.68. The mean eGFR in the group with a high PDI score was significantly higher than the group with a low PDI score (fourth quartile: 79.20 ± 0.36 vs. first quartile: 72.95 ± 0.31, P < .001). Adherence to a plant-based diet was more prevalent in those with a higher socioeconomic status (P < .001). After adjusting for potential confounders, the odds of CKD in the third and fourth quartiles of PDI were 25% (OR: 0.75; 95% confidence interval: 0.62-0.91) and 39% (OR: 0.61; 95% confidence interval: 0.48-0.78, P trend<.001) lower than the first quartile, respectively. CONCLUSIONS The findings of this study suggest that having a plant-based diet may prevent the prevalent CDK. However, further studies with a cohort design are recommended.
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Affiliation(s)
- Behrooz Moloudpour
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Samira Arbabi Jam
- Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mitra Darbandi
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ali Janati
- Scientific and Educational Center of Iran Health Management, School of Management and Medical Information, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Masoumeh Gholizadeh
- Scientific and Educational Center of Iran Health Management, School of Management and Medical Information, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Farid Najafi
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran; Cardiovascular Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| | - Yahya Pasdar
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran; Cardiovascular Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Doaei S, Gholami S, Rastgoo S, Gholamalizadeh M, Bourbour F, Bagheri SE, Samipoor F, Akbari ME, Shadnoush M, Ghorat F, Mosavi Jarrahi SA, Ashouri Mirsadeghi N, Hajipour A, Joola P, Moslem A, Goodarzi MO. The effect of omega-3 fatty acid supplementation on clinical and biochemical parameters of critically ill patients with COVID-19: a randomized clinical trial. J Transl Med 2021; 19:128. [PMID: 33781275 PMCID: PMC8006115 DOI: 10.1186/s12967-021-02795-5] [Citation(s) in RCA: 100] [Impact Index Per Article: 33.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 03/18/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Omega-3 polyunsaturated fatty acids (n3-PUFAs) may exert beneficial effects on the immune system of patients with viral infections. This paper aimed to examine the effect of n3-PUFA supplementation on inflammatory and biochemical markers in critically ill patients with COVID-19. METHODS A double-blind, randomized clinical trial study was conducted on 128 critically ill patients infected with COVID-19 who were randomly assigned to the intervention (fortified formula with n3-PUFA) (n = 42) and control (n = 86) groups. Data on 1 month survival rate, blood glucose, sodium (Na), potassium (K), blood urea nitrogen (BUN), creatinine (Cr), albumin, hematocrit (HCT), calcium (Ca), phosphorus (P), mean arterial pressure (MAP), O2 saturation (O2sat), arterial pH, partial pressure of oxygen (PO2), partial pressure of carbon dioxide (PCO2), bicarbonate (HCO3), base excess (Be), white blood cells (WBCs), Glasgow Coma Scale (GCS), hemoglobin (Hb), platelet (Plt), and the partial thromboplastin time (PTT) were collected at baseline and after 14 days of the intervention. RESULTS The intervention group had significantly higher 1-month survival rate and higher levels of arterial pH, HCO3, and Be and lower levels of BUN, Cr, and K compared with the control group after intervention (all P < 0.05). There were no significant differences between blood glucose, Na, HCT, Ca, P, MAP, O2sat, PO2, PCO2, WBCs, GCS, Hb, Plt, PTT, and albumin between two groups. CONCLUSION Omega-3 supplementation improved the levels of several parameters of respiratory and renal function in critically ill patients with COVID-19. Further clinical studies are warranted. Trial registry Name of the registry: This study was registered in the Iranian Registry of Clinical Trials (IRCT); Trial registration number: IRCT20151226025699N3; Date of registration: 2020.5.20; URL of trial registry record: https://en.irct.ir/trial/48213.
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Affiliation(s)
- Saeid Doaei
- Research Center of Health and Environment, School of Health, Guilan University of Medical Sciences, Rasht, Iran.,Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Somayeh Gholami
- Razi Hospital, Guilan University of Medical Sciences, Rasht, Iran
| | - Samira Rastgoo
- National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Gholamalizadeh
- Student Research Committee, Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Bourbour
- National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Forough Samipoor
- Razi Hospital, Guilan University of Medical Sciences, Rasht, Iran
| | | | - Mahdi Shadnoush
- Department of Clinical Nutrition, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereshteh Ghorat
- Traditional and Complementary Medicine Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | | | - Narjes Ashouri Mirsadeghi
- National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Azadeh Hajipour
- School of Health, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Parvin Joola
- Department of Non-Communicable Disease, Deputy of Health Services, Dezful University of Medical Sciences, Dezful, Iran
| | - Alireza Moslem
- Iranian Research Center on Healthy Aging, Sabzevar University of Medical Sciences, Sabzevar, Iran.
| | - Mark O Goodarzi
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
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Ma E, Ohira T, Yasumura S, Nakano H, Eguchi E, Miyazaki M, Hosoya M, Sakai A, Takahashi A, Ohira H, Kazama J, Shimabukuro M, Yabe H, Maeda M, Ohto H, Kamiya K. Dietary Patterns and Progression of Impaired Kidney Function in Japanese Adults: A Longitudinal Analysis for the Fukushima Health Management Survey, 2011-2015. Nutrients 2021; 13:nu13010168. [PMID: 33430501 PMCID: PMC7827845 DOI: 10.3390/nu13010168] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 12/31/2020] [Accepted: 01/05/2021] [Indexed: 02/07/2023] Open
Abstract
To investigate associations between dietary patterns and the risk of impaired kidney function, we analyzed data from 14,732 participants (40–89 years) who completed the baseline diet questionnaire of The Fukushima Health Management Survey in 2011. The incidence of chronic kidney disease (CKD) (estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 or proteinuria (≥1+ by dipstick test)) and annual changes in eGFR were assessed from 2012 to 2015. Three major dietary patterns were identified. The adjusted cumulative incidence ratio of the highest vs. lowest tertile of a vegetable diet scores was 0.90 (95% confidence interval (CI): 0.82, 1.00) for eGFR < 60 mL/min/1.73 m2, 0.68 (95% CI: 0.52, 0.90) for proteinuria, and 0.88 (95% CI: 0.80, 0.97) for CKD (P for trend = 0.031, 0.007, and 0.005, respectively). The incident risk of CKD in the highest tertile of juice diet scores was 18% higher than the lowest tertile. The odds ratio of the highest vs. lowest tertile of vegetable diet scores was 0.85 (95% CI: 0.75, 0.98) in the rapidly decreasing eGFR group (P for trend = 0.009). We did not observe significant associations for the meat dietary pattern. A Japanese vegetable diet could reduce the risk of developing impaired kidney function and CKD.
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Affiliation(s)
- Enbo Ma
- Health Promotion Centre, Fukushima Medical University, Fukushima 960-1295, Japan; (T.O.); (M.M.); (M.H.)
- Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan; (H.N.); (E.E.)
- Radiation Medical Science Centre for Fukushima Health Management Survey, Fukushima Medical University, Fukushima 960-1295, Japan; (S.Y.); (A.S.); (A.T.); (J.K.); (M.S.); (H.Y.); (M.M.); (H.O.); (K.K.)
- Correspondence: ; Tel.: +81-24-547-1788; Fax: +81-24-547-1789
| | - Tetsuya Ohira
- Health Promotion Centre, Fukushima Medical University, Fukushima 960-1295, Japan; (T.O.); (M.M.); (M.H.)
- Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan; (H.N.); (E.E.)
- Radiation Medical Science Centre for Fukushima Health Management Survey, Fukushima Medical University, Fukushima 960-1295, Japan; (S.Y.); (A.S.); (A.T.); (J.K.); (M.S.); (H.Y.); (M.M.); (H.O.); (K.K.)
| | - Seiji Yasumura
- Radiation Medical Science Centre for Fukushima Health Management Survey, Fukushima Medical University, Fukushima 960-1295, Japan; (S.Y.); (A.S.); (A.T.); (J.K.); (M.S.); (H.Y.); (M.M.); (H.O.); (K.K.)
- Department of Public Health, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
| | - Hironori Nakano
- Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan; (H.N.); (E.E.)
- Radiation Medical Science Centre for Fukushima Health Management Survey, Fukushima Medical University, Fukushima 960-1295, Japan; (S.Y.); (A.S.); (A.T.); (J.K.); (M.S.); (H.Y.); (M.M.); (H.O.); (K.K.)
| | - Eri Eguchi
- Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan; (H.N.); (E.E.)
- Radiation Medical Science Centre for Fukushima Health Management Survey, Fukushima Medical University, Fukushima 960-1295, Japan; (S.Y.); (A.S.); (A.T.); (J.K.); (M.S.); (H.Y.); (M.M.); (H.O.); (K.K.)
| | - Makoto Miyazaki
- Health Promotion Centre, Fukushima Medical University, Fukushima 960-1295, Japan; (T.O.); (M.M.); (M.H.)
- Radiation Medical Science Centre for Fukushima Health Management Survey, Fukushima Medical University, Fukushima 960-1295, Japan; (S.Y.); (A.S.); (A.T.); (J.K.); (M.S.); (H.Y.); (M.M.); (H.O.); (K.K.)
| | - Mitsuaki Hosoya
- Health Promotion Centre, Fukushima Medical University, Fukushima 960-1295, Japan; (T.O.); (M.M.); (M.H.)
- Radiation Medical Science Centre for Fukushima Health Management Survey, Fukushima Medical University, Fukushima 960-1295, Japan; (S.Y.); (A.S.); (A.T.); (J.K.); (M.S.); (H.Y.); (M.M.); (H.O.); (K.K.)
- Department of Paediatrician, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
| | - Akira Sakai
- Radiation Medical Science Centre for Fukushima Health Management Survey, Fukushima Medical University, Fukushima 960-1295, Japan; (S.Y.); (A.S.); (A.T.); (J.K.); (M.S.); (H.Y.); (M.M.); (H.O.); (K.K.)
- Department of Radiation Life Sciences, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
| | - Atsushi Takahashi
- Radiation Medical Science Centre for Fukushima Health Management Survey, Fukushima Medical University, Fukushima 960-1295, Japan; (S.Y.); (A.S.); (A.T.); (J.K.); (M.S.); (H.Y.); (M.M.); (H.O.); (K.K.)
- Department of Gastroenterology, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan;
| | - Hiromasa Ohira
- Department of Gastroenterology, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan;
| | - Junichiro Kazama
- Radiation Medical Science Centre for Fukushima Health Management Survey, Fukushima Medical University, Fukushima 960-1295, Japan; (S.Y.); (A.S.); (A.T.); (J.K.); (M.S.); (H.Y.); (M.M.); (H.O.); (K.K.)
- Department of Nephrology and Hypertension, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
| | - Michio Shimabukuro
- Radiation Medical Science Centre for Fukushima Health Management Survey, Fukushima Medical University, Fukushima 960-1295, Japan; (S.Y.); (A.S.); (A.T.); (J.K.); (M.S.); (H.Y.); (M.M.); (H.O.); (K.K.)
- Department of Diabetes, Endocrinology, and Metabolism, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
| | - Hirooki Yabe
- Radiation Medical Science Centre for Fukushima Health Management Survey, Fukushima Medical University, Fukushima 960-1295, Japan; (S.Y.); (A.S.); (A.T.); (J.K.); (M.S.); (H.Y.); (M.M.); (H.O.); (K.K.)
- Department of Neuropsychiatry, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
| | - Masaharu Maeda
- Radiation Medical Science Centre for Fukushima Health Management Survey, Fukushima Medical University, Fukushima 960-1295, Japan; (S.Y.); (A.S.); (A.T.); (J.K.); (M.S.); (H.Y.); (M.M.); (H.O.); (K.K.)
- Department of Disaster Psychiatry, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
| | - Hitoshi Ohto
- Radiation Medical Science Centre for Fukushima Health Management Survey, Fukushima Medical University, Fukushima 960-1295, Japan; (S.Y.); (A.S.); (A.T.); (J.K.); (M.S.); (H.Y.); (M.M.); (H.O.); (K.K.)
| | - Kenji Kamiya
- Radiation Medical Science Centre for Fukushima Health Management Survey, Fukushima Medical University, Fukushima 960-1295, Japan; (S.Y.); (A.S.); (A.T.); (J.K.); (M.S.); (H.Y.); (M.M.); (H.O.); (K.K.)
- Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima 734-8553, Japan
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Zhang C, Ge C, Wang J, Sun D. Effects of fish oil during hemodialysis on nutritional status and quality of life: a randomized double-blinded trial. Food Nutr Res 2020; 64:4450. [PMID: 32821255 PMCID: PMC7413645 DOI: 10.29219/fnr.v64.4450] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 03/20/2020] [Accepted: 05/19/2020] [Indexed: 11/20/2022] Open
Abstract
Background Supplementation of fish oil has been shown to exert beneficial effects in patients undergoing hemodialysis. The aim of this study was to investigate the efficacy of fish oil in improving the quality of life of these patients through a randomized, double-blinded clinical trial. Methods Among the 103 patients enrolled in the study, a total of 74 patients were randomized to receive fish oil (intervention group) or placebo (n=37 per group). Patients received identical soft-gel capsules, with each capsule containing either 1000 mg fish oil or placebo for 4 months. Personnel responsible for data collection and analyses were blinded to the grouping. Results The reduction of protein-energy wasting (PEW) in the intervention group was significantly more prominent compared to the placebo group (P=0.023). The intervention group demonstrated significant increase in midarm circumference, arm muscle circumference, and triceps skinfold thickness after fish oil intake. The intervention group also exhibited significant differences from the placebo group in creatinine, uric acid, and serum calcium levels. Significant improvement was seen regarding the physical role and energy/figure in the intervention group. Conclusions Our study demonstrated that fish oil intake in patient undergoing hemodialysis can significantly reduce PEW, and improve physical and biochemical parameters and quality of life, which could provide guidance to clinical management of these patients.
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Affiliation(s)
- Chi Zhang
- Department of Nephrology, Xuzhou Medical University, Jiangsu, China.,Department of Nephrology, The Affiliated Suqian Hospital of Xuzhou Medical University, Jiangsu, China
| | - Chang Ge
- Department of Otorhinolaryngology-Head and Neck Surgery, The Affiliated Suqian Hospital of Xuzhou Medical University, Jiangsu, China
| | - Junsheng Wang
- Department of Nephrology, The Affiliated Suqian Hospital of Xuzhou Medical University, Jiangsu, China
| | - Dong Sun
- Department of Nephrology, Xuzhou Medical University, Jiangsu, China.,Department of Internal Medicine and Diagnostics, Xuzhou Medical University, Jiangsu, China
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Campos JR, Severino P, Ferreira CS, Zielinska A, Santini A, Souto SB, Souto EB. Linseed Essential Oil - Source of Lipids as Active Ingredients for Pharmaceuticals and Nutraceuticals. Curr Med Chem 2019; 26:4537-4558. [PMID: 30378485 DOI: 10.2174/0929867325666181031105603] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 07/19/2018] [Accepted: 07/22/2018] [Indexed: 12/24/2022]
Abstract
Linseed - also known as flaxseed - is known for its beneficial effects on animal health attributed to its composition. Linseed comprises linoleic and α-linolenic fatty acids, various dietary fibers and lignans, which are beneficial to health because they reduce the risk of cardiovascular diseases, as well as cancer, decreasing the levels of cholesterol and relaxing the smooth muscle cells in arteries increasing the blood flow. Essential fatty acids from flax participate in several metabolic processes of the cell, not only as structuring components of the cell membrane but also as storage lipids. Flax, being considered a functional food, can be consumed in a variety of ways, including seeds, oil or flour, contributing to basic nutrition. Several formulations containing flax are available on the market in the form of e.g. capsules and microencapsulated powders having potential as nutraceuticals. This paper revises the different lipid classes found in flaxseeds and their genomics. It also discusses the beneficial effects of flax and flaxseed oil and their biological advantages as ingredients in pharmaceuticals and in nutraceuticals products.
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Affiliation(s)
- Joana R Campos
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Coimbra (FFUC), Polo das Ciencias da Saude, Azinhaga de Santa Comba, 3000-548 Coimbra, Portugal
| | - Patricia Severino
- Biotechnology Industrial Program, Laboratory of Nanotechnology and Nanomedicine (LNMed), University of Tiradentes, Av. Murilo Dantas, 300, 49010-390 Aracaju, Sergipe, Brazil.,Institute of Technology and Research (ITP), Av. Murilo Dantas, 300, 49010-390 Aracaju, Sergipe, Brazil
| | - Classius S Ferreira
- Institute of Environmental, Chemical and Pharmaceutical Sciences, Federal University of Sao Paulo, Diadema, Brazil
| | - Aleksandra Zielinska
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Coimbra (FFUC), Polo das Ciencias da Saude, Azinhaga de Santa Comba, 3000-548 Coimbra, Portugal
| | - Antonello Santini
- Department of Pharmacy, Universita degli Studi di Napoli Federico II, Italy
| | - Selma B Souto
- Department of Endocrinology, Braga Hospital, Sete Fontes, 4710-243 Sao Victor Braga, Portugal
| | - Eliana B Souto
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Coimbra (FFUC), Polo das Ciencias da Saude, Azinhaga de Santa Comba, 3000-548 Coimbra, Portugal.,CEB - Centre of Biological Engineering, University of Minho, Campus de Gualtar 4710-057 Braga, Portugal
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Shamseldeen AM, Ali Eshra M, Ahmed Rashed L, Fathy Amer M, Elham Fares A, Samir Kamar S. Omega-3 attenuates high fat diet-induced kidney injury of female rats and renal programming of their offsprings. Arch Physiol Biochem 2019; 125:367-377. [PMID: 29741967 DOI: 10.1080/13813455.2018.1471511] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Context: Maternal diet composition could influence fetal organogenesis. Objective: We investigated effects of high fat diet (HFD) intake alone or combined with omega 3 during pregnancy, lactation and early days of weaning on nephrogenesis of pups and maternal renal function and morphology. Material and methods: Mothers and their pups included in each group were supplied with the same diet composition. Rats were divided into group I, II and III supplied with chow of either 10 kcal%, 45 kcal% or 45 kcal% from fat together with omega-3 respectively. Results: Group II showed increased serum urea and creatinine, renal TNF-α, IL1β. Structural injury was observed in mothers and their pups as Bowman's capsule and tubular dilatation and increased expression of PCNA that were decreased following omega-3 supplementation added to down regulation of Wnt4, Pax2 gene and podocin expression. Discussion and conclusion: Omega-3 supplementation improves lipid nephrotoxicity observed in mothers and their pups.
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Affiliation(s)
| | - Mohammed Ali Eshra
- a Department of Physiology Faculty of Medicine, Cairo University , Cairo , Egypt
| | - Laila Ahmed Rashed
- b Department of Biochemistry Faculty of Medicine, Cairo University , Cairo , Egypt
| | - Marwa Fathy Amer
- b Department of Biochemistry Faculty of Medicine, Cairo University , Cairo , Egypt
| | - Amal Elham Fares
- c Department of Medical Histology Faculty of Medicine, Cairo University , Cairo , Egypt
| | - Samaa Samir Kamar
- c Department of Medical Histology Faculty of Medicine, Cairo University , Cairo , Egypt
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Foroughinia F, Mirjalili M, Mirzaei E, Oboodi A. Omega-3 Supplementation in the Prevention of Contrast Induced Nephropathy in Patients Undergoing Elective Percutaneous Coronary Intervention: A Randomized Placebo-Controlled Trial. Adv Pharm Bull 2019; 9:307-313. [PMID: 31380258 PMCID: PMC6664110 DOI: 10.15171/apb.2019.036] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 03/02/2019] [Accepted: 04/14/2019] [Indexed: 12/15/2022] Open
Abstract
Purpose: Contrast-induced nephropathy (CIN) is the third cause of hospital-acquired renal failure and is associated with significant morbidity and mortality. Several studies have revealed the protective role of omega-3 in prevention and treatment of some kidney injuries. This study was conducted to examine the effect of omega-3 supplementation on the markers of renal function and to evaluate its potential in the prevention of CIN in patients undergoing elective percutaneous coronary intervention (PCI). Methods: In this double-blind, randomized clinical trial, 85 eligible patients scheduled for PCI was randomly divided into omega-3 (a single 3750 mg dose of omega-3 as well as routine hydration therapy within 12 hours before PCI) or control (placebo plus routine hydration therapy) groups. Serum creatinine (SCr) and cystatin C levels were measured at baseline and 24 hours after PCI. Results: Our results indicated that post- PCI cystatin C levels were significantly decreased in the omega-3 group compared to the control group (P < 0.001). Although less upward manner was seen in the level of 24-hour creatinine in the omega-3 group, it did not reach the significance level (P = 0.008). Conclusion: The positive effect of omega-3 on cystatin C levels showed that it may have a protective role in the prevention of CIN in post-PCI patients with normal kidney function. However, to better assess this effect, it is highly recommended to design future studies with higher doses and longer duration of therapy with omega-3 plus long-term follow up.
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Affiliation(s)
- Farzaneh Foroughinia
- Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,Clinical Pharmacy Department, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Ehsan Mirzaei
- Clinical Pharmacy Department, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Alireza Oboodi
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
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Abstract
Hyperuricemia is recognized as a lifestyle-related disease and the prevalence is increasing in many parts of the world. Excessive intake of purines increases serum uric acid concentration and is thought to be one factor causative of hyperuricemia. Therefore, it is thought that prevention of hyperuricemia by dietary control may be very important. This is an article of our basic research regarding the role of dietary fiber in the suppression of hyperuricemia induced by dietary purines in rats; in addition, clinical research suggesting the possibility that dietary fiber intake has a beneficial effect on the prevention or suppression of hyperuricemia in humans is discussed. Our own studies reveal that the test dietary fiber significantly suppresses the elevation of serum uric acid concentration induced by dietary RNA (12.3-46.2%), adenosine-5'-monophosphate (9.5-23.2%), adenosine (10.7-20.4%), or adenine (16.3-38.9%) and suppresses experimental hyperuricemia in rats. The mechanism is presumed to be mediated by suppression of the digestion and/or absorption of dietary purines by dietary fiber. In clinical studies, intake of dietary fiber decreases serum uric acid concentrations. Reports of recent epidemiological studies indicate that higher levels of hyperuricemia increase the prevalence of its comorbidities (e.g., chronic kidney disease, obesity, hypertension, diabetes, and cardiovascular disease) and dietary fiber intake is associated with significantly lower risk for hyperuricemia and its comorbidities. We wish to emphasize the importance of recognizing the validity of increased dietary fiber intake as a preventive or suppressive method for hyperuricemia and its comorbidities.
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Affiliation(s)
- Takashi Koguchi
- 1Department of Human Education, Kokugakuin Tochigi Junior College, 608 Hirai-cho, Tochigi-Shi, Tochigi 328-8588, Japan
| | - Tadahiro Tadokoro
- 2Department of Administrative Nutrition, Faculty of Health and Nutrition, Tokyo Seiei College, 1-4-6, Nishishinkoiwa, Katsushika-ku, Tokyo 124-8530, Japan
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Pluta A, Stróżecki P, Kęsy J, Lis K, Sulikowska B, Odrowąż-Sypniewska G, Manitius J. Beneficial Effects of 6-Month Supplementation with Omega-3 Acids on Selected Inflammatory Markers in Patients with Chronic Kidney Disease Stages 1-3. Biomed Res Int 2017; 2017:1680985. [PMID: 29349065 DOI: 10.1155/2017/1680985] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Accepted: 10/15/2017] [Indexed: 12/13/2022]
Abstract
Introduction Chronic kidney disease (CKD) is accompanied by inflammation. The aim of this study was to evaluate the effect of 6-month supplementation with omega-3 acids on selected markers of inflammation in patients with CKD stages 1–3. Methods Six-month supplementation with omega-3 acids (2 g/day) was administered to 87 CKD patients and to 27 healthy individuals. At baseline and after follow-up, blood was taken for C-reactive protein (CRP) and monocyte chemotactic protein-1 (MCP-1) concentration and white blood cell (WBC) count. Serum concentration of omega-3 acids—eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and alpha-linolenic acid (ALA)—was determined using gas chromatography. And 24-hour urinary collection was performed to measure MCP-1 excretion. Results After six-month omega-3 supplementation, ALA concentration increased in CKD patients and in the reference group, while EPA and DHA did not change. At follow-up, a significant decrease in urinary MCP-1 excretion in CKD (p = 0.0012) and in the reference group (p = 0.001) was found. CRP, serum MCP-1, and WBC did not change significantly. The estimated glomerular filtration rate (eGFR) did not change significantly in the CKD group. Conclusions The reduction of urinary MCP-1 excretion in the absence of MCP-1 serum concentration may suggest a beneficial effect of omega-3 supplementation on tubular MCP-1 production. Trial Registration This study was registered in ClinicalTrials.gov (identifier: NCT02147002).
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10
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Jiang M, Zhang H, Zhai L, Ye B, Cheng Y, Zhai C. ALA/LA ameliorates glucose toxicity on HK-2 cells by attenuating oxidative stress and apoptosis through the ROS/p38/TGF-β 1 pathway. Lipids Health Dis 2017; 16:216. [PMID: 29145851 PMCID: PMC5691398 DOI: 10.1186/s12944-017-0611-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Accepted: 11/06/2017] [Indexed: 12/27/2022] Open
Abstract
Background Growing evidence indicates that oxidative stress (OS) plays a pivotal role in Diabetic nephropathy (DN). In a previous study we demonstrated that ALA/LA protected HK-2 cells against high glucose-induced cytotoxicity. So we aimed to establish the glucose injury model of HK-2 cells and investigate the beneficial effects of ALA/LA on high glucose-induced excessive production of TGF-β1 and the possible mechanisms mediating the effects. Methods The expression of OS markers in high glucose-induced HK-2 cells treated with ALA/LA., including the antioxidant enzymes and reactive oxygen species (ROS) production, as well as the apoptosis rate were assayed by ELISA and flow cytometry. The p38/transforming growth factor β1 (TGF-β1) signal pathway were measured by real-time RT-PCR and western blot. Results The modeling condition of glucose toxicity on HK-2 cells was at the glucose concentration of 40.9 mM. ALA/LA can significantly increase the activities of antioxidant enzymes and decrease ROS production stimulated by high glucose. The study also found that ALA/LA caused a decrease in the apoptosis rate and TGF-β1 level of HK-2 cells under high glucose stress through the ROS/p38 pathway. Conclusions ALA/LA exerts protective effects in vitro through inhibition of ROS generation, down regulation of the activation of the p38MAPK pathway and the expression of TGF-β1 in HK-2 cells.
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Affiliation(s)
- Mingxia Jiang
- School of Public Health, Southeast University, Nanjing, 210009, China.,Jinling Hospital, Nanjing, 210002, China
| | - Haifen Zhang
- School of Public Health, Southeast University, Nanjing, 210009, China.,School of Tourism and Culinary Science, Yangzhou University, Yangzhou, 225127, China
| | - Lijie Zhai
- Department of Neurological Surgery, Northwestern University - Feinberg School of Medicine, Chicago, IL, 60612, USA
| | - Bianliang Ye
- School of Public Health, Southeast University, Nanjing, 210009, China
| | - Yin Cheng
- School of Public Health, Southeast University, Nanjing, 210009, China
| | - Chengkai Zhai
- School of Public Health, Southeast University, Nanjing, 210009, China.
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11
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Abstract
Chronic kidney disease (CKD) is associated with high risk for cardiovascular disease (CVD). This association is multifactorial, but CKD is often associated with dyslipidemia, which likely contributes. Patients with CKD have dyslipidemia even at early stages of renal dysfunction and dyslipidemia tends to progress with deterioration of kidney function. The dyslipidemia in CKD is largely due to increased triglyceride levels, decreased HDL-C and varying levels of LDL-C. Current management of CKD may also affect lipid levels. Robust clinical trials demonstrate that statins are safe and efficacious in both lipid lowering and prevention of CVD events in pre-end stage CKD and post-transplant. However, there is no evidence of improved CVD outcomes with statin use in dialysis patients. This review will focus on mechanisms underlying dyslipidemia in CKD and clinical trial evidence for lipid lowering therapy in patients with CKD.
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Affiliation(s)
- Matthew R Hager
- Department of Internal Medicine University of Kentucky, Lexington, KY, USA
| | - Archana D Narla
- Division of Endocrinology and Molecular Medicine, University of Kentucky, Lexington, KY, USA
| | - Lisa R Tannock
- Division of Endocrinology and Molecular Medicine, University of Kentucky, Lexington, KY, USA.
- Department of Veterans Affairs, Lexington, KY, USA.
- University of Kentucky, 900 S. Limestone, Room 553 CTW, Lexington, KY, 40536-0200, USA.
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12
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Gopinath B, Harris DC, Flood VM, Burlutsky G, Mitchell P. Associations between dairy food consumption and chronic kidney disease in older adults. Sci Rep 2016; 6:39532. [PMID: 27996057 PMCID: PMC5171808 DOI: 10.1038/srep39532] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Accepted: 11/23/2016] [Indexed: 12/27/2022] Open
Abstract
We aimed to assess the association between dairy product consumption and calcium intake with the prevalence and 10-year incidence of chronic kidney disease (CKD). 1185 participants aged ≥50 years at baseline were examined between 1992–4 and 2002–4. Dietary data were collected using a food frequency questionnaire, and servings of dairy food consumption were calculated. Baseline biochemistry including serum creatinine was measured. CKD was defined as Modification of Diet in Renal Disease Study estimated glomerular filtration rate <60 mL·min−1.1.73 m−2. Cross-sectional analysis showed that older adults in the highest quintile compared to the lowest quintile (reference group) of low/reduced fat dairy food consumption had reduced odds of CKD, multivariable-adjusted odds ratio, OR, 0.64 (95% confidence intervals, CI, 0.43–0.96). Increasing total intake of dietary calcium was associated with reduced odds of CKD (P-trend = 0.02); comparing highest versus lowest quintile: OR 0.62 (95% CI 0.42–0.92). Participants in the second versus first quintile of low/reduced fat dairy food consumption at baseline had 49% reduced risk of CKD 10 years later, OR 0.51 (95% CI 0.29–0.89). Higher consumption of low/reduced fat dairy foods was independently associated with lower risk of CKD. Additional population-based studies are warranted to confirm these findings.
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Affiliation(s)
- Bamini Gopinath
- Centre for Vision Research, The Westmead Institute for Medical Research, University of Sydney, NSW, Australia
| | - David C Harris
- Centre for Transplantation and Renal Research, The Westmead Institute for Medical Research, University of Sydney, NSW, Australia
| | - Victoria M Flood
- Faculty of Health Sciences, University of Sydney and St Vincent's Hospital, Australia
| | - George Burlutsky
- Centre for Vision Research, The Westmead Institute for Medical Research, University of Sydney, NSW, Australia
| | - Paul Mitchell
- Centre for Vision Research, The Westmead Institute for Medical Research, University of Sydney, NSW, Australia
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13
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Xu H, Ärnlöv J, Sandhagen B, Risérus U, Lindholm B, Lind L, Carrero JJ. Lipophilic index, kidney function, and kidney function decline. Nutr Metab Cardiovasc Dis 2016; 26:1096-1103. [PMID: 27773469 DOI: 10.1016/j.numecd.2016.09.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Revised: 08/17/2016] [Accepted: 09/04/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND AND AIMS Unhealthy dietary fats are associated with faster kidney function decline. The cell membrane composition of phospholipid fatty acids (FAs) is a determinant of membrane fluidity and rheological properties. These properties, which have been linked to kidney damage, are thought to be reflected by the lipophilic index (LI). We prospectively investigated the associations of LI with kidney function and its decline. METHODS AND RESULTS Observational study from the Prospective Investigation of Vasculature in Uppsala Seniors including 975 men and women with plasma phospholipid FAs composition and cystatin-C estimate glomerular filtration rate (eGFR). Of these, 780 attended re-examination after 5 years, and eGFR changes were assessed. Participants with a 5-year eGFR reduction ≥30% were considered chronic kidney disease (CKD) progressors (n = 198). LI was calculated as the sum of the products of the FA proportions with the respective FAs melting points. Blood rheology/viscosity measurements were performed in a random subsample of 559 subjects at baseline. Increased LI showed a statistically significant but overall weak association with blood, plasma viscosity (both Spearman rho = 0.16, p < 0.01), and erythrocyte deformability (rho = -0.09, p < 0.05). In cross-sectional analyses, LI associated with lower eGFR (regression coefficient 3.00 ml/min/1.73 m2 1-standard deviation (SD) increment in LI, 95% CI: -4.31, -1.69, p < 0.001). In longitudinal analyses, LI associated with a faster eGFR decline (-2.13 [95% CI -3.58, -0.69] ml/min/1.73 m2, p < 0.01) and with 32% increased odds of CKD progression (adjusted OR 1.32 [95%, CI 1.05-1.65]). CONCLUSIONS A high LI was associated with lower kidney function, kidney function decline, and CKD progression.
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Affiliation(s)
- H Xu
- Divisions of Renal Medicine and Baxter Novum, Karolinska Institutet, Stockholm, Sweden
| | - J Ärnlöv
- Department of Medical Sciences, Cardiovascular Epidemiology, Uppsala University, Uppsala, Sweden; School of Health and Social Studies, Dalarna University, Falun, Sweden
| | - B Sandhagen
- Department of Medical Sciences, Cardiovascular Epidemiology, Uppsala University, Uppsala, Sweden
| | - U Risérus
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden
| | - B Lindholm
- Divisions of Renal Medicine and Baxter Novum, Karolinska Institutet, Stockholm, Sweden
| | - L Lind
- Department of Medical Sciences, Cardiovascular Epidemiology, Uppsala University, Uppsala, Sweden
| | - J J Carrero
- Divisions of Renal Medicine and Baxter Novum, Karolinska Institutet, Stockholm, Sweden; Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden.
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14
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de Assis AM, Rech A, Longoni A, da Silva Morrone M, de Bittencourt Pasquali MA, Perry ML, Souza DO, Moreira JC. Dietary n-3 polyunsaturated fatty acids revert renal responses induced by a combination of 2 protocols that increase the amounts of advanced glycation end product in rats. Nutr Res 2015; 35:512-22. [DOI: 10.1016/j.nutres.2015.04.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Revised: 04/07/2015] [Accepted: 04/17/2015] [Indexed: 01/02/2023]
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15
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Lee SM, Chung SH, Park Y, Park MK, Son YK, Kim SE, An WS. Effect of Omega-3 Fatty Acid on the Fatty Acid Content of the Erythrocyte Membrane and Proteinuria in Patients with Diabetic Nephropathy. Int J Endocrinol 2015; 2015:208121. [PMID: 26089878 PMCID: PMC4452183 DOI: 10.1155/2015/208121] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Accepted: 10/21/2014] [Indexed: 01/13/2023] Open
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.
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Affiliation(s)
- Su Mi Lee
- Department of Internal Medicine, Dong-A University, 3Ga-1, Dongdaesin-Dong, Seo-Gu, Busan 602-715, Republic of Korea
| | - Seuk Hee Chung
- Department of Internal Medicine, Ulsan Central Hospital, Ulsan 680-739, Republic of Korea
| | - Yongjin Park
- Department of Family Medicine, Dong-A University, Busan 602-715, Republic of Korea
| | - Mi Kyoung Park
- Department of Internal Medicine, Dong-A University, 3Ga-1, Dongdaesin-Dong, Seo-Gu, Busan 602-715, Republic of Korea
| | - Young Ki Son
- Department of Internal Medicine, Dong-A University, 3Ga-1, Dongdaesin-Dong, Seo-Gu, Busan 602-715, Republic of Korea
| | - Seong Eun Kim
- Department of Internal Medicine, Dong-A University, 3Ga-1, Dongdaesin-Dong, Seo-Gu, Busan 602-715, Republic of Korea
| | - Won Suk An
- Department of Internal Medicine, Dong-A University, 3Ga-1, Dongdaesin-Dong, Seo-Gu, Busan 602-715, Republic of Korea
- Institute of Medical Science, Dong-A University College of Medicine, Busan 602-714, Republic of Korea
- *Won Suk An:
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16
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Han W, Zhao H, Jiao B, Liu F. EPA and DHA increased PPARγ expression and deceased integrin-linked kinase and integrin β1 expression in rat glomerular mesangial cells treated with lipopolysaccharide. Biosci Trends 2014; 8:120-5. [PMID: 24815389 DOI: 10.5582/bst.8.120] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Fish oil containing n-3 polyunsaturated fatty acids (n-3 PUFAs) including eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) is known to prevent the progression of nephropathy and retard the progression of kidney disease. This study sought to investigate the underlying mechanisms of EPA and DHA in terms of peroxisome proliferator-activated receptor γ (PPARγ), integrin-linked kinase (ILK), and integrin β1 expression in glomerular mesangial cells (GMCs) because of their critical roles in the development and progression of nephropathy. Lipopolysaccharide (LPS) significantly reduced the expression of PPARγand increased the expression of ILK at the mRNA level and at the protein level in GMCs as indicated by real-time PCR and Western blotting. In addition, LPS increased integrin β1 expression in GMCs at the mRNA level. Treatment with EPA and DHA significantly increased the expression of PPARγ and decreased the expression of ILK and integrin β1 in GMCs. These data suggest that the renoprotective effects of EPA and DHA may be related to their potential to increase the expression of PPARγ and decrease the expression of ILK and integrin β1.
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Affiliation(s)
- Wenchao Han
- Department of Pediatrics, the Second Affiliated Hospital of Shandong University
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17
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Goyal A, Sharma V, Upadhyay N, Gill S, Sihag M. Flax and flaxseed oil: an ancient medicine & modern functional food. J Food Sci Technol 2014; 51:1633-53. [PMID: 25190822 PMCID: PMC4152533 DOI: 10.1007/s13197-013-1247-9] [Citation(s) in RCA: 295] [Impact Index Per Article: 29.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Revised: 12/11/2013] [Accepted: 12/26/2013] [Indexed: 02/05/2023]
Abstract
Flaxseed is emerging as an important functional food ingredient because of its rich contents of α-linolenic acid (ALA, omega-3 fatty acid), lignans, and fiber. Flaxseed oil, fibers and flax lignans have potential health benefits such as in reduction of cardiovascular disease, atherosclerosis, diabetes, cancer, arthritis, osteoporosis, autoimmune and neurological disorders. Flax protein helps in the prevention and treatment of heart disease and in supporting the immune system. As a functional food ingredient, flax or flaxseed oil has been incorporated into baked foods, juices, milk and dairy products, muffins, dry pasta products, macaroni and meat products. The present review focuses on the evidences of the potential health benefits of flaxseed through human and animals' recent studies and commercial use in various food products.
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Affiliation(s)
- Ankit Goyal
- />Dairy Chemistry Division, National Dairy Research Institute, Karnal, Haryana India 132001
| | - Vivek Sharma
- />Dairy Chemistry Division, National Dairy Research Institute, Karnal, Haryana India 132001
| | - Neelam Upadhyay
- />Dairy Chemistry Division, National Dairy Research Institute, Karnal, Haryana India 132001
| | - Sandeep Gill
- />BITS Pilani, Hyderabad Campus Shameerpet Mandal Rangareddy District, Hyderabad, Andhra Pradesh India 500078
| | - Manvesh Sihag
- />Dairy Chemistry Division, National Dairy Research Institute, Karnal, Haryana India 132001
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18
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Castro-González I, Maafs-Rodríguez AG, Pérez-Gil Romo F. Effect of six different cooking techniques in the nutritional composition of two fish species previously selected as optimal for renal patient's diet. J Food Sci Technol 2015; 52:4196-205. [PMID: 26139884 DOI: 10.1007/s13197-014-1474-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Revised: 06/13/2014] [Accepted: 07/02/2014] [Indexed: 10/25/2022]
Abstract
Benefits of fish consumption are widely known, but there is little information about nutrient values of raw and cooked fish. The aim was to study the impact that six cooking techniques have on the nutritional composition of two fish species with low content of adverse nutrients in renal diet. Raw and steamed, foiled with aluminum, foiled with banana leaf, gas oven-baked, microwave oven-coked and fried lightly samples were chemically analyzed to determine their protein, phosphorus and lipid content. Crevalle jack: all methods increased lipid and protein content and fatty acids (FA) varied in all cooking methods. Phosphorus decreased in the steamed and microwave oven-cooked samples. Red drum: foiled and fried lightly increased lipid content compared to the raw sample. FA concentration changed in all cooking methods. Protein increased with every technique and phosphorus decreased in the steamed and gas oven-baked samples. Renal patients should preferably consume crevalle jack steamed or microwave oven-cooked and red drum steamed or gas oven-baked.
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19
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Lin Y, Ginsberg G, Lin J, Sonawane B. Mercury exposure and omega-3 fatty acid intake in relation to renal function in the US population. Int J Hyg Environ Health 2014; 217:465-72. [DOI: 10.1016/j.ijheh.2013.09.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2013] [Revised: 09/13/2013] [Accepted: 09/16/2013] [Indexed: 11/19/2022]
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20
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Galan A, Carletti B, Morgaz J, Granados M, Mesa I, Navarrete R, Lombardo R, Martínez C, Martín-Suárez E. Comparative study of select biochemical markers in cerebrospinal fluid of healthy dogs before and after treatment with nutraceuticals. Vet Clin Pathol 2014; 43:72-7. [DOI: 10.1111/vcp.12109] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
- A. Galan
- Animal Medicine and Surgery Department; University of Córdoba; Córdoba Spain
- Teaching Hospital Francisco Santisteban; University of Córdoba; Córdoba Spain
| | - B.E. Carletti
- Animal Medicine and Surgery Department; University of Córdoba; Córdoba Spain
- Teaching Hospital Francisco Santisteban; University of Córdoba; Córdoba Spain
| | - J. Morgaz
- Animal Medicine and Surgery Department; University of Córdoba; Córdoba Spain
- Teaching Hospital Francisco Santisteban; University of Córdoba; Córdoba Spain
| | - M.M. Granados
- Animal Medicine and Surgery Department; University of Córdoba; Córdoba Spain
- Teaching Hospital Francisco Santisteban; University of Córdoba; Córdoba Spain
| | - I. Mesa
- Animal Medicine and Surgery Department; University of Córdoba; Córdoba Spain
| | - R. Navarrete
- Animal Medicine and Surgery Department; University of Córdoba; Córdoba Spain
- Teaching Hospital Francisco Santisteban; University of Córdoba; Córdoba Spain
| | - R. Lombardo
- Veterinary Sciences Department; University of Milan; Milan Italy
| | - C.M. Martínez
- Animal Medicine and Surgery Department; University of Córdoba; Córdoba Spain
- Teaching Hospital Francisco Santisteban; University of Córdoba; Córdoba Spain
| | - E.M. Martín-Suárez
- Animal Medicine and Surgery Department; University of Córdoba; Córdoba Spain
- Teaching Hospital Francisco Santisteban; University of Córdoba; Córdoba Spain
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Tayebi Khosroshahi H, Mousavi Toomatari SE, Akhavan Salamat S, Davar Moin G, Najafi Khosroshahi S. Effectiveness of omega-3 supplement on lipid profile and lipid peroxidation in kidney allograft recipients. Nephrourol Mon 2013; 5:822-6. [PMID: 24282793 PMCID: PMC3830909 DOI: 10.5812/numonthly.9384] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2012] [Revised: 12/30/2012] [Accepted: 02/05/2013] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Omega-3 fatty acids carry major roles in mediating inflammation, immune response, lipid peroxidation and lipoprotein metabolism. Diversity of health benefits have been attributed to dietary supplementation with omega-3 fatty acids in transplant and nontransplant settings. Several studies in renal transplantation have suggested that supplementation with omega-3 fatty acids may lead to significant clinical benefits. However, the extents of these benefits are variable and published data had not coincided with positive findings. OBJECTIVES The aim of this study was to evaluate the effectiveness of omega-3 supplementation on the lipid profile and lipid peroxidation in patients underwent kidney transplant. PATIENTS AND METHODS Thirty cases had been selected with stable allograft function following at least six months of transplantation. The serum levels of lipids including triglyceride, low density lipoprotein (LDL), high density lipoprotein (HDL), very low density lipoprotein (VLDL), total cholesterol and indices of lipid peroxidation (malondialdehyde and APO a1) were measured by biochemical techniques at the baseline. Two months following prescription of oral omega-3 (3 g/day), the biochemical measurements were repeated and the differences were analyzed. RESULTS Of thirty patients, 12 were male and 18 were female with the mean age of 45.3 ± 13.0 (18-65) years. At the baseline, the serum levels of MDA and APO B were 3.5 ± 1.3 and 148.3 ± 20.4 ng/dL respectively. At the end of two months following intervention, they were 3.2 ± 1.2 and 145.7 ± 19.0 ng/dL, respectively (P > 0.05). Correspondingly, at the baseline the serum levels of triglyceride, LDL, VLDL and total cholesterol were 171.1 ± 58.7, 106.9 ± 31.8, 42.2 ± 4.0, 145.7 ± 33.2 and 181.2 ± 35.1 mg/dL and after intervention they were 162.4 ± 82.5, 99.4 ± 35.1, 44.6 ± 6.3, 140.3 ± 33.1 and 170.9 ± 38.3 mg/dL, respectively (P > 0.05). There was no significant difference between the males and females in this instance. CONCLUSIONS Our results seem to indicate that oral omega-3 may promote the lipid profile and indices of lipid peroxidation in patients following kidney transplantation however extents of these effects are not significant.
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Affiliation(s)
- Hamid Tayebi Khosroshahi
- Chronic Kidney Disease Research Center, Imam Reza Hospital, Tabriz University of Medical Sciences, Tabriz, IR Iran
- Corresponding author: Hamid Tayebi Khosroshahi, Chronic Kidney Disease Research Center, Imam Reza Hospital, Tabriz University of Medical Sciences, Tabriz, IR Iran. Tel: +98-4113344339, Fax: +98-4113373969, E-mail:
| | - Seyed Ehsan Mousavi Toomatari
- Chronic Kidney Disease Research Center, Imam Reza Hospital, Tabriz University of Medical Sciences, Tabriz, IR Iran
- Students’ Research Committee, Tabriz University of Medical Sciences, Tabriz, IR Iran
| | - Sara Akhavan Salamat
- Chronic Kidney Disease Research Center, Imam Reza Hospital, Tabriz University of Medical Sciences, Tabriz, IR Iran
| | - Giti Davar Moin
- Chronic Kidney Disease Research Center, Imam Reza Hospital, Tabriz University of Medical Sciences, Tabriz, IR Iran
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Calvani R, Miccheli A, Landi F, Bossola M, Cesari M, Leeuwenburgh C, Sieber CC, Bernabei R, Marzetti E. Current nutritional recommendations and novel dietary strategies to manage sarcopenia. J Frailty Aging 2013; 2:38-53. [PMID: 26082911 PMCID: PMC4465574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Sarcopenia, the loss of skeletal muscle mass and function that occurs with aging, is associated with increased risk for several adverse health outcomes, including frailty, disability, falls, loss of independent living, and mortality. At present, no pharmacological treatment exists that is able to definitely halt the progression of sarcopenia. Likewise, no pharmacological remedies are yet available to prevent the onset of age-related muscle wasting. In this scenario, the combination of nutritional interventions and physical exercise appears to be the most effective strategy presently available for the management of sarcopenia. The purposes of this review are to summarize the current knowledge on the role of nutrition as a countermeasure for sarcopenia, illustrate the mechanisms of action of relevant dietary agents on the aging muscle, and introduce novel nutritional strategies that may help preserve muscle mass and function into old age. Issues related to the identification of the optimal timing of nutritional interventions in the context of primary and secondary prevention are also discussed. Finally, the prospect of elaborating personalized dietary and physical exercise recommendations through the implementation of integrated, high-throughput analytic approaches is illustrated.
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Affiliation(s)
- Riccardo Calvani
- Italian National Research Council (CNR), Institute of Crystallography, Bari 70126, Italy
| | - Alfredo Miccheli
- Department of Chemistry, Sapienza University of Rome, Rome 00185, Italy
| | - Francesco Landi
- Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of the Sacred Heart School of Medicine, Teaching Hospital “Agostino Gemelli”, Rome 00168, Italy
| | - Maurizio Bossola
- Department of Surgery, Catholic University of the Sacred Heart School of Medicine, Teaching Hospital “Agostino Gemelli”, Rome 00168, Italy
| | - Matteo Cesari
- Institut du Vieillissement, Gérontopôle and INSERM Unit 1027, Université de Toulouse, Toulouse 31000, France
| | - Christiaan Leeuwenburgh
- Department of Aging and Geriatric Research, Institute on Aging, University of Florida, Gainesville, FL 32610, USA
| | - Cornel C. Sieber
- Institute for Biomedicine of Aging, Friedrich Alexander University Erlangen-Nürnberg, Nürnberg, 90419, Germany
| | - Roberto Bernabei
- Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of the Sacred Heart School of Medicine, Teaching Hospital “Agostino Gemelli”, Rome 00168, Italy
| | - Emanuele Marzetti
- Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of the Sacred Heart School of Medicine, Teaching Hospital “Agostino Gemelli”, Rome 00168, Italy
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Kang HT, Lee J, Linton JA, Park BJ, Lee YJ. Trends in the prevalence of chronic kidney disease in Korean adults: the Korean National Health and Nutrition Examination Survey from 1998 to 2009. Nephrol Dial Transplant 2012; 28:927-36. [DOI: 10.1093/ndt/gfs535] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
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Chrysohoou C, Pitsavos C, Panagiotakos D, Skoumas J, Lazaros G, Oikonomou E, Galiatsatos N, Striggou M, Xynogala M, Stefanadis C. Long-term fish intake preserves kidney function in elderly individuals: the Ikaria study. J Ren Nutr 2012; 23:e75-82. [PMID: 23131572 DOI: 10.1053/j.jrn.2012.09.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2012] [Revised: 07/19/2012] [Accepted: 09/10/2012] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVES The aim of this work was to evaluate the correlation between the amount of weekly fish intake and kidney function as measured by creatinine clearance (CCr) rate among elderly inhabitants of Ikaria Island, a place that has been related to an increased rate of longevity. METHODS From June to October of 2009, 673 males and females, aged 65-100 years and long-term residents of Ikaria Island were enrolled. Of those, 328 (75 ± 7 years) were males and 339 (75 ± 6 years) were females. Nutritional habits, including fish intake, were evaluated using a validated, semi-frequent food questionnaire and the MedDietScore. Urea and creatinine were measured, and CCr rate was estimated by the Cockcroft-Gault formula. RESULTS Eighty-four percent of participants reported fish consumption of more than 150 g/week; 35% had moderate to severe CCr (<60 mL). Crude analysis revealed that CCr rate was positively associated with fish intake (b ± SE per 100 g/day: 24 ± 9, P = .007); multiple linear regression analysis confirmed the previous finding (b ± SE per 100 g/day: 11 ± 2, P = .001) after adjusting for overall dietary habits through the MedDietScore and other potential confounders. Fish intake was positively associated with CCr. Furthermore, multi-adjusted logistic regression analysis showed that fish consumption of 100 g/day increased the likelihood by 121% of having a CCr greater than 60 mL (95% confidence interval 10%-343%). CONCLUSIONS Long-term fish consumption was independently associated with improved kidney function among elderly individuals, a finding that extends the current knowledge regarding the benefits of fish intake on human health.
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Affiliation(s)
- Christina Chrysohoou
- First Cardiology Clinic, Hippokration Hospital, Medical School, University of Athens, Athens, Greece.
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Castro-González I, Maafs-Rodríguez A, Silencio-Barrita J, Galindo-Gómez C, Pérez-Gil F. Evaluation of the possible inclusion of certain fish species in chronic kidney disease diets based on their adverse and beneficial nutrient ratios. Int J Food Sci Nutr 2012; 64:82-8. [DOI: 10.3109/09637486.2012.700921] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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26
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Kang HT, Kim JK, Kim JY, Linton JA, Yoon JH, Koh SB. Independent association of TG/HDL-C with urinary albumin excretion in normotensive subjects in a rural Korean population. Clin Chim Acta 2011; 413:319-24. [PMID: 22037512 DOI: 10.1016/j.cca.2011.10.021] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2011] [Revised: 10/12/2011] [Accepted: 10/12/2011] [Indexed: 10/16/2022]
Abstract
BACKGROUND The ratio of triglycerides (TG, mg/dl) to high-density lipoprotein cholesterol (HDL-C, mg/dl) is a reliable indicator of insulin resistance and atherosclerotic diseases in some ethnic groups. This study is performed to examine the association between TG/HDL-C and albuminuria. METHODS This cross-sectional study included 9094 adult subjects (4091 men, 5003 women) who were enrolled in the Korean Genomic Rural Cohort (KGRC) and aged 40 years or more. Albuminuria was defined as a urine albumin/creatinine ratio ≥ 30 mg/g. Participants were categorized into TG/HDL-C quartile. RESULTS Compared to the lowest TG/HDL-C quartile (<1.94 in men, <1.71 in women), the odds ratios (ORs) for albuminuria in participants who were categorized in the highest TG/HDL-C quartile (≥ 4.98 in men, ≥ 4.20 in women) were 1.30 (95% CI: 0.97-1.75) and 1.36 (1.03-1.79) in men and women, respectively, when adjusted for blood pressure and other covariates. In normotensive men and women, the ORs for albuminuria in the highest TG/HDL-C quartile were 1.58 (1.04-2.39) and 1.68 (1.15-2.45), respectively, even after fully adjusted. In contrast, TG/HDL-C was not associated with albuminuria in hypertensive subjects. CONCLUSIONS TG/HDL-C was independently associated with increased prevalence of albuminuria in normotensive rural Korean subjects aged 40 years or more in KGRC.
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Affiliation(s)
- Hee-Taik Kang
- Department of Family Medicine, Gangnam Severance Hospital, College of Medicine, Yonsei University, Seoul, South Korea
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Maaløe T, Schmidt EB, Svensson M, Aardestrup IV, Christensen JH. The effect of n-3 polyunsaturated fatty acids on leukotriene B₄ and leukotriene B₅ production from stimulated neutrophil granulocytes in patients with chronic kidney disease. Prostaglandins Leukot Essent Fatty Acids 2011; 85:37-41. [PMID: 21530211 DOI: 10.1016/j.plefa.2011.04.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2010] [Revised: 04/04/2011] [Accepted: 04/06/2011] [Indexed: 11/26/2022]
Abstract
The proinflammatory leukotriene B₄ (LTB₄) may be of importance in the progression of chronic kidney disease (CKD). We investigated whether n-3 polyunsaturated fatty acids (PUFA) decrease LTB₄ and increase the formation of the less inflammatory leukotriene B₅ (LTB₅) in patients with CKD. Fifty-six patients with CKD stage 2-5 were randomised to 2.4 g n-3 PUFA or olive oil for 8 weeks. Compared to controls, n-3 PUFA significantly decreased release of LTB₄ (p<0.001) and 5-hydroxyeicosatetraenoic acid (5-HETE) (p<0.01) and significantly increased release of LTB₅ (p<0.001) and 5-hydroxyeicosapentaenoic acid (5-HEPE) (p<0.001) from stimulated neutrophil granulocytes. Kidney function evaluated by creatinine clearance and proteinuria did not improve. In conclusion, n-3 PUFA supplementation for 8 weeks in patients with CKD stage 2-5 significantly decreased LTB₄ and 5-HETE and significantly increased LTB₅ and 5-HEPE. No effect was seen on kidney function.
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Affiliation(s)
- T Maaløe
- Department of Nephrology, Center for Cardiovascular Research Aalborg Hospital, Aarhus University Hospital, Aalborg, Denmark
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Gopinath B, Harris DC, Flood VM, Burlutsky G, Brand-Miller J, Mitchell P. Carbohydrate nutrition is associated with the 5-year incidence of chronic kidney disease. J Nutr 2011; 141:433-9. [PMID: 21228263 DOI: 10.3945/jn.110.134304] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
It has been shown that dietary glycemic index (GI) and fiber could have a role in the development of chronic diseases; however, the link between carbohydrate nutrition and development of chronic kidney disease (CKD) is unclear. We aimed to determine whether cross-sectional and longitudinal associations exist between carbohydrate nutrition (mean dietary GI, dietary intakes of carbohydrate, sugar, starch, and fiber) and CKD. Data included 2600 Blue Mountains Eye Study (1997-1999) participants aged ≥50 y. Baseline biochemistry including serum creatinine was measured. Moderate CKD was defined as estimated glomerular filtration rate (eGFR) < 60 mL·min(-1)·1.73 m(-2). Dietary data were collected in a semiquantitative FFQ. Cross-sectionally, participants in the 4th quartile of mean dietary GI intake compared with those in the first quartile (reference) had a 55% increased likelihood of having eGFR < 60 mL·min(-1)·1.73 m(-2) [multivariable-adjusted OR = 1.55 (95% CI = 1.07-2.26); P-trend = 0.01]. After multivariable adjustment, participants in the 4th quartile of dietary cereal fiber intake compared with those in the first quartile (reference) had a 50% reduced risk of incident moderate CKD (P-trend = 0.03). Higher baseline consumption of energy-dense, nutrient-poor sources of carbohydrate (e.g. cookies) yielded a 3-fold higher risk of incident CKD (P-trend = 0.01). In summary, we observed a novel link between high cereal fiber intake and reduced incidence of moderate CKD and this was supported by the cross-sectional association with dietary GI. Conversely, our data suggest that higher intake of energy-dense, nutrient-poor sources of carbohydrate, potentially through acute hyperglycemia, could impair renal function.
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Affiliation(s)
- Bamini Gopinath
- Centre for Vision Research, Department of Ophthalmology, Westmead Millennium Institute, Sydney, NSW, Australia
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Gopinath B, Harris DC, Flood VM, Burlutsky G, Mitchell P. Consumption of long-chain n-3 PUFA, α-linolenic acid and fish is associated with the prevalence of chronic kidney disease. Br J Nutr 2011; 105:1361-8. [PMID: 21255476 DOI: 10.1017/S0007114510005040] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Due to the anti-inflammatory properties of PUFA, it has been suggested that they may protect against kidney damage in adults. However, relatively few epidemiological studies have examined this hypothesis in human subjects. We investigated the association between dietary intakes of PUFA (n-3, n-6 and α-linolenic acid), fish and the prevalence of chronic kidney disease (CKD). A total of 2600 Blue Mountains Eye Study (1997-9) participants aged ≥ 50 years were analysed. Dietary data were collected using a semi-quantitative FFQ, and PUFA and fish intakes were calculated. Baseline biochemistry including serum creatinine was measured. Moderate CKD was defined as an estimated glomerular filtration rate of < 60 ml/min per 1·73 m2. Participants in the highest quartile of long-chain n-3 PUFA intake had a significantly reduced likelihood of having CKD compared with those in the lowest quartile of intake (multivariable-adjusted OR 0·69, 95 % CI 0·49, 0·99). α-Linolenic acid intake was positively associated with CKD (OR, per standard deviation increase in α-linolenic acid, 1·18, 95 % CI 1·05, 1·32). Total n-3 PUFA or total n-6 PUFA were not significantly associated with CKD. The highest compared with the lowest quartile of fish consumption was associated with a reduced likelihood of CKD (OR 0·68, 95 % CI 0·48, 0·97; P for trend = 0·02). The present study shows that an increased dietary intake of long-chain n-3 PUFA and fish reduces the prevalence of CKD. Hence, a diet rich in n-3 PUFA and fish could have a role in maintaining healthy kidney function, in addition to roles of these nutrients in the prevention and modulation of other diseases.
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Elshamaa MF, Sabry SM, Elghoroury EA, El-Saaid GS, Kandil D. Serum Lipid Profile and Plasma Fatty Acids Levels in Hemodialysis Pediatric Patients-Possible Deficiency of Essential Fatty Acids. ACTA ACUST UNITED AC 2010. [DOI: 10.1007/s00596-010-0188-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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