The association between docosanoic acid and the risks of occurrence and mortality of chronic kidney disease

Objective This study aims to investigate the association between docosanoic acid (DA) in human circulation and the risk of occurrence and mortality of chronic kidney disease (CKD).

This is a cross-sectional study including individuals in NHANES 2011-2014. RCS were used to fit the dose-effect curve between DA levels and CKD risk in the general population, and mortality in CKD patients. Multiple logistic and Cox regressions were used to analyze the association of DA with CKD occurrence and mortality risks respectively.

A total of 2,366 participants were included in this study, including 1,958 (82.8%) individuals without CKD and 408 (17.2%) CKD individuals. The RCS results showed a linear association between DA and the risk of CKD in individuals. Per standard deviation (per-SD) increase in DA, the risk of CKD in the general population decreased by 18% (OR = 0.82; 95% CI, 0.70 - 0.96; P = 0.02). In addition, the RCS results showed a linear association between DA and the risk of cardiovascular and all-cause mortality in CKD. Multivariate Cox regression analysis showed that per-SD increase in DA, the risk of cardiovascular mortality in CKD patients decreased by 44% (HR = 0.56; 95% CI, 0.35 - 0.90; P = 0.02) and all-cause mortality decreased by 27% (HR = 0.73; 95% CI, 0.59 - 0.89; P = 0.002).

Higher serum DA in populations means lower CKD risk. Moreover, for CKD patients, as DA levels increase, the risk of cardiovascular and all-cause mortality decreases. Competing Interest Statement The authors have declared no competing interest. Funding Statement The Science and technology fund of Chengdu Medical College (CYZYB22-02). The research fund of Sichuan Medical and Health Care Promotion institute (KY2022QN0309). The Sichuan Provincial Medical Association Youth Innovation Project (Q23021). The Sichuan Province Science and Technology Project (No. 2023NSFSC1529). Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: NCHS Ethics Review Board (ERB)Approval* I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes