Advertisement

Testing the dogma that total phospholipid fatty acid composition of blood plays a role in kidney stone pathogenesis, using a high–low risk human model: results from a pilot study

  • Allen L. Rodgers
  • Dalielah Jappie-Mahomed
  • Paul J. van Jaarsveld
Original Paper
  • 56 Downloads

Abstract

Previous studies have suggested that ω-3 and ω-6 polyunsaturated fatty acid (PUFA) composition in plasma and red blood cell (RBC) total phospholipids plays a role in urolithiasis. Our aim was to test the robustness of this dogma by retrospectively comparing baseline profiles of these parameters in subjects from high- and low-stone-risk groups. The documented difference in stone occurrence in white (relatively common) (W) and black (rare) (B) subjects prompted us to select these groups as the high–low risk model for the study. Blood and urine samples were obtained from ten subjects in each group and were analysed for PUFAs and stone risk factors, respectively. Concentrations of linoleic acid (LA), eicosadienoic acid (EDA) and arachidonic acid (AA) in plasma and or/RBC total phospholipids were significantly higher in B. Differences in other PUFA profiles were also observed. There was no inter-group difference in AA/LA ratios. Urinary oxalate was significantly higher while urinary phosphate was significantly lower in B. We speculate that elevated AA in B might arise because of a possibly enhanced elongation of LA to EDA, as well as an enhanced ∆-8-desaturation of EDA to dihomo-gamma-linolenic acid (DGLA), which is the immediate precursor of AA. Alternatively, we speculate that the ∆-5-desaturation step of DGLA to AA might be more highly activated in this group. Irrespective of the mechanism, our observed inter-group differences in phospholipid PUFA composition are in conflict with previously published dogma which relates PUFA characteristics to high- and low-stone risk.

Keywords

Arachidonic acid Inter-race comparisons Kidney stone risk factors Phospholipid fatty acid composition Polyunsaturated fatty acids Urolithiasis 

Abbreviations

AA

Arachidonic acid

DGLA

Dihomo-gamma-linolenic acid

DHA

Docosahexaenoic acid

DPA

Docosapentaenoic acid

EDA

Eicosadienoic acid

EPA

Eicosapentaenoic acid

FA

Fatty acid

GLA

Gamma (γ) linolenic acid

LA

Linoleic acid

MUFA

Monounsaturated fatty acid

PUFA

Polyunsaturated fatty acid

PGE2

Prostaglandin E2

PGE3

Prostaglandin E3

RSS

Relative supersaturation

SFA

Saturated fatty acid

TPL

Total phospholipid

TRI

Tiselius Risk Index

Notes

Acknowledgements

The financial support of the South African Medical Research Council, the South African National Research Foundation and the University of Cape Town is gratefully acknowledged. The authors would like to extend their appreciation to Johanna van Wyk of the NCDRU of the SAMRC for her invaluable laboratory assistance analyzing plasma and RBC total phospholipid fatty acids.

Compliance with ethical standards

Conflict of interest

The authors declare that they do not have any conflicts of interest. The authors also wish to declare that the data in Table 1 were collected as part of a 30-day study in which intra-group effects of the ingestion of a fatty acid supplement on total phospholipid FA composition were investigated. These data have been published in a paper in which intra-group comparisons were made of the effects from day 0 to day 30 [14]. No inter-group baseline comparisons, as those described in the present paper, were made in the published paper.

Research involving human participants and/or animals

The study was approved by the Human Research Ethics Committee of the University of Cape Town (HRE REF: 366/2011). All procedures were performed in accordance with the ethical standards of the University of Cape Town and with the 1964 Declaration of Helsinki and its later amendments.

Informed consent

A signed informed consent declaration was obtained from all individual participants in the study.

References

  1. 1.
    Baggio B, Gambaro G, Zambon S, Marchini F, Bassi A, Manzato E (1996) Anomalous phospholipid n-6 polyunsaturated fatty acid composition in idiopathic calcium nephrolithiasis. J Am Soc Nephrol 7(4):613–620Google Scholar
  2. 2.
    Baggio B, Budakovic A, Nassuato MA, Vezzoli G, Manzato E, Luisetto G, Zaninotto M (2000) Plasma phospholipid arachidonic acid content and calcium metabolism in idiopathic calcium nephroloithiasis. Kidney Int 58:1278–1284CrossRefGoogle Scholar
  3. 3.
    Buck AC, Davies R, Harrison T (1991) The protective role of eicosapantaenoic acid (EPA) in the pathogenesis of nephrolithiasis. J Urol 146:188–194CrossRefGoogle Scholar
  4. 4.
    Buck AC, Lote CJ, Sampson WF (1983) The influence of renal prostaglandins on urinary calcium excretion in idiopathic urolithiasis. J Urol 129(2):421–426CrossRefGoogle Scholar
  5. 5.
    Baggio B, Gambaro G (1993) Abnormal arachidonic acid content of membrane phospholipids—the unifying hypothesis for the genesis of hypercalciuria and hyperoxaluria in idiopathic calcium nephrolithiasis. Nephrol Dial Transplant 14(3):553–555CrossRefGoogle Scholar
  6. 6.
    Baggio B, Gambaro G, Marchini F, Cicerello E, Borsatti A (1984) Raised transmembrane oxalate flux in red blood cells in idiopathic calcium oxalate nephrolithiasis. Lancet 324(8393):12–13CrossRefGoogle Scholar
  7. 7.
    Naya Y, Ito H, Masai M, Yamaguchi K (2002) Association of dietary fatty acids with urinary oxalate excretion in calcium oxalate stone-formers in their fourth decade. BJU Int 89(9):842–846CrossRefGoogle Scholar
  8. 8.
    Taylor EN, Stampfer MJ, Curhan GC (2005) Fatty acid intake and incident nephrolithiasis. Am J Kidney Dis 45:267–274CrossRefGoogle Scholar
  9. 9.
    Siener R, Jansen B, Watzer B, Hesse A (2011) Effect of n-3 fatty acid supplementation on urinary risk factors for calcium oxalate stone formation. J Urol 185:719–724CrossRefGoogle Scholar
  10. 10.
    Buck AC, Smellie WS, Jenkins A, Meddings R, James A, Horrobin D (1994) The treatment of idiopathic recurrent urolithiasis with fish oil and evening primrose oil—a double-blind study. In: Ryall R et al (eds) Urolithiasis 2. Plenum Press, New York, pp 575–580CrossRefGoogle Scholar
  11. 11.
    Rothwell PJ, Green R, Blacklock NJ, Kavanagh JP (1993) Does fish oil benefit stone formers? J Urol 150:1391–1394CrossRefGoogle Scholar
  12. 12.
    Messa P, Londero D, Massarino F, Paganin L, Mioni G, Zattoni F, Cannella G (2000) Abnormal arachidonic acid content of red blood cell membranes and main lithogenic factors in stone formers. Nephrol Dial Transplant 15:1388–1393CrossRefGoogle Scholar
  13. 13.
    Whalley NA, Moraes MF, Shar TG, Pretorius SS, Meyers AM (1998) Lithogenic risk factors in the urine of black and white controls. Br J Urol 82(6):785–790CrossRefGoogle Scholar
  14. 14.
    Rodgers A, Jappie-Mahomed, van Jaarsveld PJ (2017) Different effects of γ-linolenic acid (GLA) supplementation on plasma and red blood cell phospholipid fatty acid composition and calcium oxalate kidney stone risk factors in healthy subjects from two race groups with different risk profiles pose questions about the GLA-arachidonic acid-oxaluria metabolic pathway: pilot study. Urolithiasis.  https://doi.org/10.1007/s00240-017-0989-7 Google Scholar
  15. 15.
    Wolmarans P, Humpreys J, Sayed N (2002) Foodfinder™ 2. Nutritional Intervention Unit, South African Medical Research Council, Cape TownGoogle Scholar
  16. 16.
    Folch J, Lees M, Sloane-Stanley GH (1957) A simple method for the isolation and purification of total lipids from animal tissues. J Biol Chem 226:497–509Google Scholar
  17. 17.
    Hon G, Hassan M, van Rensburg SJ, Abel S, Marais DW, van Jaarsveld P, Smuts C, Henning F, Erasmus R, Matsha T (2009) Immune cell membrane fatty acids and inflammatory marker, C-reactive protein, in patients with multiple sclerosis. Br J Nutr 102:1334–1340CrossRefGoogle Scholar
  18. 18.
    Van Jaarsveld PJ, Smuts CM, Tichelaar HY, Kruger M, Benadé AJ (2000) Effect of palm oil on plasma lipoprotein concentrations and plasma low-density lipoprotein composition in non-human primates. Int J Food Sci Nutr 51(Suppl):S21–S30CrossRefGoogle Scholar
  19. 19.
    Allie-Hamdulay S, Rodgers A (2005) Prophylactic and therapeutic properties of a sodium citrate preparation in the management of calcium oxalate urolithiasis: randomized, placebo-controlled trial. Urol Res 33:116–124CrossRefGoogle Scholar
  20. 20.
    Tiselius HG (1982) An improved method for the routine biochemical evaluation of patients with recurrent calcium oxalate stone disease. Clin Chim Acta 122:409–418CrossRefGoogle Scholar
  21. 21.
    Werness PG, Brown CM, Smith LH, Finlayson B (1985) Equil 2: a basic computer program for the calculation of urinary saturation. J Urol 134:1242–1244CrossRefGoogle Scholar
  22. 22.
    Park WJ, Kothapalli KS, Lawrence P, Tyburczy C, Brenna JT (2009) An alternate pathway to long chain polyunsaturates: the FADS2 gene product ∆8-desaturates 20:2n-6 and 20:3n-3. J Lipid Res 50:1195–1202CrossRefGoogle Scholar
  23. 23.
    Brenna JT, Kothapalli KS, Park WJ (2010) Alternative transcripts of fatty acid desaturase (FADS) genes. Prostaglandins Leukot Essent Fatty Acids 82:281–285CrossRefGoogle Scholar
  24. 24.
    Nouvenne A, Meschi T, Guerra A, Allegri F, Prati B, Borghi L (2008) Dietary treatment of nephrolithiasis. Clin Cases Miner Bone Metab 5:135–141Google Scholar
  25. 25.
    Curhan GC (1993) A prospective study of dietary calcium and other nutrients and the risk of symptomatic kidney stones. N Engl J Med 328:833–838CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of ChemistryUniversity of Cape TownCape TownSouth Africa
  2. 2.Non-Communicable Diseases Research Unit (NCDRU)South African Medical Research CouncilCape TownSouth Africa
  3. 3.Division of Medical Physiology, Faculty of Medicine and Health SciencesStellenbosch UniversityTygerbergSouth Africa

Personalised recommendations