Omega-3 polyunsaturated fatty acids in the treatment of cardiovascular autonomic neuropathy in Type 2 diabetes mellitus patients
Victoria Serhiyenko, Alexander Serhiyenko & Ludmila Serhiyenko
Background and aims: The aim of this study was to assess the effects of docosahexaenoic (DHA) and eicosapentaenoic acid (EPA) on the heart rate variability (HRV), some biochemical parameters in patients (pts) with Type 2 diabetes mellitus and cardiovascular aunonomic neuropathy (CAN).
Materials and methods: 39 pts with CAN (54±5 yrs) were allocated in two groups: A (n=26) were receiving capsules of fish oil every day (2.0 g EPA, 2.0 g DHA and 0.1% α-tocopherol acetate), B (n=13) - placebo capsules of olive oil. We investigated the activities of protein-kinase C (PK-C), Na+, K+-ATPase, Ca2+, Mg2+- ATPase in the membranes of RBCs, levels of the 125I-6-ketoprostaglandin F1alpha (6-ketoPGF1alpha), 125I-thromboxane B2 (TXB2) in the blood plasma.
Results: The manifestation of the CAN is accompanied by decrease of the Na+, K+-ATPase, Ca2+, Mg2+-ATPase activities (P<0.001), 6-ketoPGF1alpha, EPA level (P<0.001) with increase of TXB2, PK-C activity, stage of platelets aggregation, QTc interval. After four months of treatment there were a decrease of TXB2 level (141.2±15.4 pg/ml, P<0.001), activity of PK-C (14.46±4.52 pmol 32P/mg protein per 1 min, P<0.001), degree and speed of an aggregate of thrombocytes with simultaneous increase activities of Na+, K+-ATPase (0.1±0.004 mMol Pi/mg protein per 1 hour, P<0.001), Ca2+, Mg2+-ATPase and the level of the 6-ketoPGF1alpha in the group A marked. Also, we observed significant improvement of HRV parameters, decrease of QTc interval (P<0.01).
Conclusion: DHA and EPA at moderate doses may exert antithrombotic effects and may be used for prophylaxis and treatment of patients with Type 2 diabetes mellitus and cardiovascular aunonomic neuropathy.