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Effects of omega-3 fatty acid plus alpha-tocopherol supplementation on malnutrition–inflammation score, biomarkers of inflammation and oxidative stress in chronic hemodialysis patients

  • Nephrology - Original Paper
  • Published:
International Urology and Nephrology Aims and scope Submit manuscript

30 April 2020 Concerns have been raised about integrity of the clinical trial reported in 10.1007/s11255-016-1399-4. There is an ongoing investigation by the Iranian National Committee for Ethics in Biomedical Researches. Further editorial action will be taken as appropriate once the investigation into the concerns is complete and all parties have been given an opportunity to respond in full.

Abstract

Objective

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.

Methods

In a randomized double-blind placebo-controlled clinical trial, 120 patients with chronic HD were included. Patients were randomly allocated into four groups to receive: (1) 1250 mg/day omega-3 fatty acid containing 600 mg EPA and 300 mg DHA + alpha-tocopherol placebo (n = 30); (2) 400 IU/day alpha-tocopherol + omega-3 fatty acids placebo (n = 30); (3) 1250 mg omega-3 fatty acids/day + 400 IU/day alpha-tocopherol (n = 30); and (4) omega-3 fatty acids placebo + alpha-tocopherol placebo (n = 30) for 12 weeks.

Results

After 12 weeks 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 ± 18.5 µmol/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 ± 215.1 mmol/L, respectively, P = 0.004) levels.

Conclusion

Overall, omega-3 fatty acids and alpha-tocopherol co-supplementation for 12 weeks 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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Change history

  • 30 April 2020

    Concerns have been raised about integrity of the clinical trial reported in 10.1007/s11255-016-1399-4. There is an ongoing investigation by the Iranian National Committee for Ethics in Biomedical Researches. Further editorial action will be taken as appropriate once the investigation into the concerns is complete and all parties have been given an opportunity to respond in full.

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Acknowledgment

The present study was supported by a grant from the Vice-chancellor for Research, KUMS, and Iran.

Author contributions

ZA and AE contributed in conception, data collection and manuscript drafting. AS, HSh, NM and MB contributed in conception, data collection and manuscript drafting.

Author information

Authors and Affiliations

  1. Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran

    Zatollah Asemi, Hossein Shakeri & Navid Mazroii

  2. Department of Internal Medicine, Kashan University of Medical Sciences, Kashan, Iran

    Alireza Soleimani

  3. Food Security Research Center, Isfahan University of Medical Sciences, PO Box 81745-151, Isfahan, Iran

    Ahmad Esmaillzadeh

  4. Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran

    Ahmad Esmaillzadeh

  5. Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran

    Ahmad Esmaillzadeh

Authors
  1. Zatollah Asemi
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  2. Alireza Soleimani
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  3. Hossein Shakeri
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  4. Navid Mazroii
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  5. Ahmad Esmaillzadeh
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Correspondence to Ahmad Esmaillzadeh.

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Asemi, Z., Soleimani, A., Shakeri, H. et al. Effects of omega-3 fatty acid plus alpha-tocopherol supplementation on malnutrition–inflammation score, biomarkers of inflammation and oxidative stress in chronic hemodialysis patients. Int Urol Nephrol 48, 1887–1895 (2016). https://doi.org/10.1007/s11255-016-1399-4

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  • DOI: https://doi.org/10.1007/s11255-016-1399-4

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