n-3 Polyunsaturated fatty acids supplementation in peripheral artery disease: the OMEGA-PAD trial

Grenon, S. Marlene; Owens, Christopher D.; Alley, Hugh; Chong, Karen; Yen, Priscilla; Harris, William S.; Hughes‐Fulford, Millie; Conte, Michael S.

doi:10.1177/1358863x13503695

Cited by 27 publications

(29 citation statements)

References 99 publications

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“…9 We previously demonstrated that the O3I was inversely associated with inflammatory status in patients with PAD. 10 Our data also demonstrate that supplementation with n -3 PUFA leads to decreased adhesion of monocytes to the endothelial monolayer in vitro . 11 …”

Section: Introductionsupporting

confidence: 64%

“…10 The investigator-initiated protocol was approved by the Committee on Human Research at the University of California, San Francisco (UCSF) and all patients provided informed consent. Patients referred to the outpatient vascular surgery clinic of the San Francisco Veterans Affairs Medical Center (SF VAMC) for evaluation of PAD were screened for the study.…”

Section: Methodsmentioning

confidence: 99%

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Clinical correlates of red blood cell omega-3 fatty acid content in male veterans with peripheral arterial disease

Nosova

Chong

Alley

et al. 2014

Journal of Vascular Surgery

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Objectives Despite available medical therapies, patients with peripheral arterial disease (PAD) remain at high risk for cardiovascular events. n-3 polyunsaturated fatty acids (PUFA), derived from marine sources, have been shown to improve cardiovascular mortality. The omega-3 index (O3I), a proportion of the n-3 PUFA eicosapentaenoic acid and docosahexaenoic acid in the red blood cell membrane, correlates with cardiovascular risk. Previous investigations have found that n-3 PUFA supplementation, fish consumption, older age and smoking history affect the O3I in different patient populations, though similar correlations have never been explored in PAD. We hypothesized that in our PAD cohort, blood content of omega-3 fatty acids would directly and positively correlate with a history of fish oil supplementation and older age, and inversely correlate with a smoking history and obesity Methods This cross-sectional study included 111 patients, who had an ankle-brachial index of <0.9 associated with claudication symptoms. We used linear regression to determine the association between clinical factors and the O3I. Results The mean age of the cohort was 69 ± 8 years, 37% had diabetes mellitus (hemoglobin A1c: 7 ± 1%), and 94% reported current or a history of smoking. The mean O3I was 5 ± 2%. In multivariate linear regression analysis, O3I was associated with older age, increasing BMI, and a history of smoking and fish oil intake. Conclusions This is the first report of the relation between blood content of omega-3 fatty acids and clinical factors in a PAD population. In patients with PAD, older age, elevated BMI, and prior fish oil supplementation predicted a higher O3I. A history of smoking correlated with a lower O3I. These results demonstrate that the O3I is a reliable measure of dietary n-3 PUFAs intake and that clinical factors related to the O3I in PAD are similar to those observed in other populations.

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Section: Introductionsupporting

confidence: 64%

Section: Methodsmentioning

confidence: 99%

Clinical correlates of red blood cell omega-3 fatty acid content in male veterans with peripheral arterial disease

Nosova

Chong

Alley

et al. 2014

Journal of Vascular Surgery

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“…32 Importantly, studies have shown that increasing n-3 PUFA intake, especially EPA and DHA (the most biologically active in terms of inflammation resolution), can help balance high n-6/n3 ratios. 32,33 Thus, when indicated, EPA and DHA supplementation may help reduce the chronic inflammation associated with CVLUs.…”

Section: Discussionmentioning

confidence: 99%

Nutritional profile of older adults with chronic venous leg ulcers: A pilot study

McDaniel¹,

Kemmner²,

Rusnak³

2015

Geriatric Nursing

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The purpose of this cross-sectional descriptive pilot study was to describe daily intake of select nutrients important for efficient wound healing and general health in a sample of older adults (64.25 ± 9.49 years of age) with chronic venous leg ulcers (CVLUs; N = 12), compared to recommended dietary allowances (RDA). Anthropometric data were also collected. Compared to RDA, participants on average consumed lower vitamin C (60.03 ± 49.73 mg/d) and higher sodium (3197.07 ± 1455.04 mg/d), sugar (181.21 ± 115.45 g/d), and saturated fat (33.75 ± 1.06 g/d). They also demonstrated a relatively high plasma n-6/n-3 polyunsaturated fatty acid ratio, a biomarker of inflammation (11.25 ± 1.99). The mean body mass index indicated extreme obesity (41.48 ± 11.47). A multidisciplinary treatment approach that includes routine dietary assessments followed by tailored dietary interventions may improve wound healing and long-term health outcomes in this population.

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“…We included baseline data from patients enrolled into the OMEGA-PAD trial (NCT01310270) and the OMEGA-PAD Cohort. 13 Subjects were enrolled if they had at least one of the following inclusion criteria: intermittent claudication associated with an ankle-brachial index (ABI) < 0.9, toe pressures < 70 mm Hg, or imaging confirming >50% stenosis in the lower extremity arteries. Intermittent claudication was diagnosed based on fatigue, discomfort, or pain that occurs in specific limb muscle groups during effort due to exercise-induced ischemia.…”

Section: Methodsmentioning

confidence: 99%

Relationship between kidney disease and endothelial function in peripheral artery disease

Chong

Owens

Park

et al. 2014

Journal of Vascular Surgery

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Objective We have previously shown that peripheral artery disease (PAD) is associated with marked impairment of endothelial function (EF). Given that poor EF is associated with functional status of PAD patients as well as increased morbidity and mortality in patients undergoing vascular procedures, determining factors associated with poor EF in a PAD cohort is important. We hypothesized that decreased kidney function is associated with impaired endothelial function (EF) in patients with PAD. Methods This was a cross-sectional study of PAD patients presenting to a vascular surgery outpatient clinic at the San Francisco Veterans Affairs Medical Center including patients enrolled into the OMEGA-PAD I trial (NCT01310270) and the OMEGA-PAD Cohort. Brachial artery flow-mediated vasodilation (FMD) was performed to assess EF. Kidney function was characterized by eGFR using the abbreviated Modification of Diet in Renal Disease formula. Linear regression was performed to assess the relationship between EF and kidney function in claudicants. Results 97 patients with intermittent claudication participated in this study. Mean age was 69 ± 8 years, 97% were male, and 77% were Caucasian. Comorbidities included hypertension (91%), dyslipidemia (87%), coronary artery disease (42%) and diabetes mellitus (38%). Mean ABI was 0.73 ± 0.14 and mean FMD was 7.0% ± 3.8, indicating impaired EF. Linear regression showed an association between kidney function and EF (by 10 ml/min/1.73m2, β: 0.12; CI: 0.05, 0.20; P = .001). After multivariable regression adjusting for age, race, log TNF-α, hypertension, dyslipidemia, and diabetes, eGFR remained significantly associated with EF (P = .033). Conclusions In patients with PAD, decreased kidney function is associated with endothelial dysfunction. Further longitudinal studies are needed to better understand the impact of kidney function on PAD progression and the role of endothelial dysfunction in this process.

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n-3 Polyunsaturated fatty acids supplementation in peripheral artery disease: the OMEGA-PAD trial

Cited by 27 publications

References 99 publications

Clinical correlates of red blood cell omega-3 fatty acid content in male veterans with peripheral arterial disease

Clinical correlates of red blood cell omega-3 fatty acid content in male veterans with peripheral arterial disease

Nutritional profile of older adults with chronic venous leg ulcers: A pilot study

Relationship between kidney disease and endothelial function in peripheral artery disease

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