Table 2.
Association of seafood n-3 PUFA biomarkers with primary outcome of incident CKD
| n-3 PUFA biomarker (No of studies; participants with incident CKD)* | Model† | Per interquintile range | Highest fifth v lowest fifth | |||
|---|---|---|---|---|---|---|
| Relative risk (95% CI) | I2 (%) | Relative risk (95% CI) | I2 (%) | |||
| EPA (19; 4940) | 1 | 0.94 (0.89 to 1.00) | 0.0 | 0.92 (0.84 to 1.00) | 0.0 | |
| 2 | 0.94 (0.88 to 0.99) | 0.0 | 0.91 (0.83 to 0.99) | 7.0 | ||
| DPA (16; 4350) | 1 | 0.94 (0.88 to 1.00) | 0.0 | 0.89 (0.81 to 0.98) | 0.0 | |
| 2 | 0.94 (0.80 to 1.01) | 0.0 | 0.90 (0.82 to 0.99) | 0.0 | ||
| DHA (19; 4944) | 1 | 0.93 (0.87 to 1.00) | 27.0 | 0.89 (0.81 to 0.97) | 0.0 | |
| 2 | 0.93 (0.87 to 0.99) | 30.1 | 0.89 (0.81 to 0.97) | 8.4 | ||
| EPA+DPA+DHA‡ (19; 4939) | 1 | 0.92 (0.86 to 0.98) | 9.9 | 0.87 (0.80 to 0.96) | 0.0 | |
| 2 | 0.91 (0.85 to 0.97) | 17.2 | 0.88 (0.80 to 0.96) | 0.0 | ||
| ALA (19; 4940) | 1 | 1.00 (0.94 to 1.06) | 5.8 | 0.98 (0.89 to 1.07) | 0.0 | |
| 2 | 0.99 (0.93 to 1.05) | 0.0 | 0.97 (0.88 to 1.06) | 0.0 | ||
Effect estimates were pooled using inverse variance weighted meta-analysis.
ALA=α linolenic acid; CKD=chronic kidney disease; DHA=docosahexaenoic acid; DPA=docosapentaenoic acid; EPA=eicosapentaenoic acid; n-3 PUFA=omega 3 polyunsaturated fatty acid.
Small difference in number of participants with incident CKD was due to missing measurement for specific n-3 PUFA fatty acids in some cohorts.
Model 1 adjusted for age, sex, race, clinical centre or field site, education, occupation, body mass index, smoking, alcohol intake, physical activity, prevalent coronary heart disease, and use of lipid lowering drugs, when applicable. Model 2 adjusted for all covariates in model 1 and also adjusted for prevalent diabetes mellitus, urine albumin-creatinine ratio, systolic blood pressure, use of angiotensin converting enzyme inhibitors or angiotensin receptor blockers, and use of other antihypertensive drugs.
DPA was not available in three of the cohorts (CCCC—Chin-Shan Community Cardiovascular Cohort, InCHIANTI—Invecchiare in Chianti Study, and ULSAM—Uppsala Longitudinal Study of Adult Men), therefore the sum in these cohorts was calculated as EPA+DHA.