The relationship between cognitive impairment and fatty acids and carnitine in hemodialysis patients
Bibliographic record
Abstract
The prevalence of cognitive impairment (CI) is high in hemodialysis patients. In this study, the relationship between CI and serum carnitine, plasma omega-3, omega-6 and omega-3/omega-6 fatty acid ratio was evaluated in hemodialysis patients. Sixty two patients [male: 40 (64.5%), mean age 51 ±13 years] were included in this cross-sectional study. Serum total and free-carnitine levels were determined by ELISA. Plasma omega-3 [eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA)] and omega-6 [arachidonic acid (AA), dihomo gamma linoleic acid (DGLA)] levels were measured using LC-ESI-MS/MS. According to the Montreal Cognitive Assessment (MoCA) scores, ≤24 points were considered as CI. MoCA score ≤24 and >24 were determined as Group 1 and Group 2, respectively. Group 1 had significantly higher AA + DGLA/EPA + DHA ratios and lower free-carnitine, DHA and EPA + DHA levels compared to Group 2 (P = 0.008, P = 0.040, P = 0.032, P = 0.032, respectively). Group 1 had a statistically lower education level (P < 0.05). Negative correlation was found between MoCA scores and AA + DGLA/EPA + DHA ratios (rs = −0.284, P = 0.026). Free-carnitine levels were positively correlated with EPA and EPA + DHA levels (rs = 0.278, P = 0.030 and rs = 0.271, P = 0.034, respectively), and negative correlated with AA + DGLA/EPA + DHA ratios (rs = −0.414, P = 0.001). In multivariate logistic regression analysis, MoCA scores was associated with AA + DGLA/EPA + DHA ratio (P = 0.009) and education level (P < 0.001). It was determined that high AA + DGLA/EPA + DHA ratio and low education level could be independent risk factors of the CI. It has been shown that free-carnitine level can have positive effects on plasma EPA + DHA and AA + DGLA distributions. Low omega-3 fatty acid levels may be associated with CI in hemodialysis patients, and low carnitine level may contribute partially to this process. In addition, cognitive education programs may have an effect on preventing CI in hemodialysis patients with low education levels. La prevalencia de deterioro cognitivo (CI) es alta en pacientes en hemodiálisis. En este estudio se evaluó la relación entre el CI y las proporciones de carnitina sérica, ácidos grasos omega-3, omega-6 y omega-3/omega-6 en plasma en pacientes en hemodiálisis. En este estudio transversal se incluyeron 62 pacientes (hombres: 40 [64,5%], edad media 51 ± 13 años). Los niveles séricos de carnitina total y libre se determinaron mediante ELISA. Los niveles plasmáticos de omega-3 (ácido eicosapentaenoico [EPA], ácido docosahexaenoico [DHA]) y omega-6 (ácido araquidónico [AA], ácido dihomo gamma linoleico [DGLA]) se midieron utilizando LC-ESI-MS/MS. Según las puntuaciones de la Evaluación Cognitiva de Montreal (MoCA), ≤24 indican CI. Las puntuaciones MoCA ≤24 y >24 se determinaron como grupo 1 y grupo 2, respectivamente. El grupo 1 tenía proporciones de AA + DGLA/EPA + DHA significativamente más altas y niveles más bajos de carnitina libre, DHA y EPA + DHA en comparación con el grupo 2 (p = 0,008, p = 0,040, p = 0,032 y p = 0,032, respectivamente). El grupo 1 tenía un nivel educativo estadísticamente más bajo (p < 0,05). Se descubrió una correlación negativa entre las puntuaciones de MoCA y las proporciones AA + DGLA/EPA + DHA (rs = −0,284, p = 0,026). Los niveles de carnitina libre se correlacionaron positivamente con los niveles de EPA y EPA + DHA (rs = 0,278, p = 0,030, y rs = 0,271, p = 0,034, respectivamente), y negativamente con las proporciones AA + DGLA/EPA + DHA (rs = −0,414, p = 0,001). En el análisis de regresión logística multivariante las puntuaciones de MoCA se asociaron con las proporciones AA + DGLA/EPA + DHA (p = 0,009) y con el nivel educativo (p < 0,001). Se determinó que una alta relación AA + DGLA/EPA + DHA y un bajo nivel educativo podrían ser factores de riesgo independientes del CI. Se ha demostrado que el nivel de carnitina libre puede tener efectos positivos en las distribuciones plasmáticas de EPA + DHA y AA + DGLA. Los niveles bajos de ácidos grasos omega-3 pueden estar asociados con el CI en pacientes en hemodiálisis, y los niveles bajos de carnitina pueden contribuir parcialmente a este proceso. Además, los programas de educación cognitiva pueden tener un efecto en la prevención del CI en pacientes en hemodiálisis con bajos niveles educativos.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".