Low linolenic and linoleic acid consumption are associated with chronic kidney disease in patients with type 2 diabetes

Aim: This cross-sectional study aimed to assess the association of the fat content in the diet with Diabetic Kidney Disease (DKD) in patients with type 2 diabetes. Methodology: Patients from the Diabetes research clinic at Hospital de Clínicas de Porto Alegre (Brazil) were consecutively recruited. The inclusion criterion was the diagnosis of type 2 diabetes. The exclusion criteria were as follows: body mass index >40 kg/m2, heart failure, gastroparesis, diabetic diarrhea, dietary counseling by a registered dietitian during the previous 12 months, and inability to perform the weighed diet records (WDR). The dietary fatty acids (saturated, monounsaturated and polyunsaturated) consumption was estimated by 3-day WDR. Compliance with the WDR technique was assessed by comparison of protein intake estimated from the 3-day WDR and from the 24-h urinary nitrogen output performed on the third day of the WDR period. The presence of DKD was defined as urinary albumin excretion (UAE) ≥ 30 mg / 24 h or/and glomerular filtration rate (eGFR) <60 ml/min/1.73 m2. Urinary albumin was measured twice and eGFR was estimated by using the CKD-EPI equation. Results: A total of 366 patients were evaluated; of these, 33% (n = 121) had DKD. Multivariate analysis showed that the intake of linolenic acid was negatively associated with DKD (OR = 0.57; 95% CI 0.35–0.93; P = 0.024), adjusted for gender, smoking, cardiovascular disease, ACE inhibitors and/or angiotensin receptor blocker use, systolic blood pressure, fasting plasma glucose and HDL cholesterol. In a separate model, similar results were observed for linoleic acid, adjusting to the same co-variables (OR = 0.95; 95% CI 0.91–0.99; P = 0.006). Conclusion: The lower intake of polyunsaturated fatty acids, especially linolenic and linoleic acid, is associated with chronic kidney disease in patients with type 2 diabetes

A generalised linear model approach to predict the result of research evaluation

Peer review is still used as the main tool for research evaluation, but its costly and time-consuming nature triggers a debate about the necessity to use, alternatively or jointly with it, bibliometric indicators. In this contribution we introduce an approach based on generalised linear models that jointly uses former peer-review and bibliometric indicators to predict the outcome of UK’s Research Excellence Framework (REF) 2014. We use the outcomes of the Research Assessment Exercise (RAE) 2008 as peer-review indicators and the departmental h-indices for the period 2008–2014 as bibliometric indicators. The results show that a joint use of bibliometric and peer-review indicators can be an effective tool to predict the research evaluation made by REF

Low linolenic and linoleic acid consumption are associated with chronic kidney disease in patients with type 2 diabetes

Aim: This cross-sectional study aimed to assess the association of the fat content in the diet with Diabetic Kidney Disease (DKD) in patients with type 2 diabetes. Methodology: Patients from the Diabetes research clinic at Hospital de Clínicas de Porto Alegre (Brazil) were consecutively recruited. The inclusion criterion was the diagnosis of type 2 diabetes. The exclusion criteria were as follows: body mass index >40 kg/m2, heart failure, gastroparesis, diabetic diarrhea, dietary counseling by a registered dietitian during the previous 12 months, and inability to perform the weighed diet records (WDR). The dietary fatty acids (saturated, monounsaturated and polyunsaturated) consumption was estimated by 3-day WDR. Compliance with the WDR technique was assessed by comparison of protein intake estimated from the 3-day WDR and from the 24-h urinary nitrogen output performed on the third day of the WDR period. The presence of DKD was defined as urinary albumin excretion (UAE) ≥ 30 mg / 24 h or/and glomerular filtration rate (eGFR) <60 ml/min/1.73 m2. Urinary albumin was measured twice and eGFR was estimated by using the CKD-EPI equation. Results: A total of 366 patients were evaluated; of these, 33% (n = 121) had DKD. Multivariate analysis showed that the intake of linolenic acid was negatively associated with DKD (OR = 0.57; 95% CI 0.35–0.93; P = 0.024), adjusted for gender, smoking, cardiovascular disease, ACE inhibitors and/or angiotensin receptor blocker use, systolic blood pressure, fasting plasma glucose and HDL cholesterol. In a separate model, similar results were observed for linoleic acid, adjusting to the same co-variables (OR = 0.95; 95% CI 0.91–0.99; P = 0.006). Conclusion: The lower intake of polyunsaturated fatty acids, especially linolenic and linoleic acid, is associated with chronic kidney disease in patients with type 2 diabetes

Logistic regression analysis—dependent variable: the presence of diabetic kidney disease based on the values of albuminuria > 30 mg/day and/or eGFR <60 ml/min/1.73 m².

<p>Logistic regression analysis—dependent variable: the presence of diabetic kidney disease based on the values of albuminuria > 30 mg/day and/or eGFR <60 ml/min/1.73 m².</p

Clinical and laboratory characteristics of patients with type 2 diabetes divided according to the presence or not of diabetic kidney disease.

<p>Clinical and laboratory characteristics of patients with type 2 diabetes divided according to the presence or not of diabetic kidney disease.</p

Renal function status of patients with type 2 diabetes divided according to the presence or not of diabetic kidney disease.

<p>Renal function status of patients with type 2 diabetes divided according to the presence or not of diabetic kidney disease.</p

Diagram of the study design.

<p>Diagram of the study design.</p

Albuminuria values in the tertiles of dietary fatty acids intake.

<p>2A. Tertiles of dietary polyunsaturated fatty acids (% energy). 2B. Tertiles of dietary linoleic acid (% energy). 2C. Tertiles of dietary linolenic acid (% energy). Urinary Albumin Excretion is expressed log-transformed.</p

Dietary polyunsaturated fatty acids content of type 2 diabetic patients according to the degree of albuminuria.

<p>Dietary polyunsaturated fatty acids content of type 2 diabetic patients according to the degree of albuminuria.</p

Individual dietary polyunsaturated fatty acids of patients with type 2 diabetes divided according to the presence or not of diabetic kidney disease.

<p>Individual dietary polyunsaturated fatty acids of patients with type 2 diabetes divided according to the presence or not of diabetic kidney disease.</p