Background and aims: The aim of this study was to assess the effect of docosahexaenoic (DHA) and eicosapentaenoic acid (EPA) on the heart rate variability (HRV), dynamics of such biochemical parameters in patients (pts) with Type 2 DM and cardiovascular aunonomic neuropathy (CAN).
Materials and methods: Forty-nine pts with CAN (54±5 years) were allocated in two groups. Pts of group A (n=17) were receiving capsules of fish oil every day (Epadol: 2.0 g EPA, 2.0 g DHA and 0.1% α-tocopherol acetate); B (n=14) capsules of olive oil. The duration of the study was 3 months. We investigated the protein-kinase C (PK-C), Na+, K+-ATPase, Ca2+, Mg2+- ATPase activities, RBCs membranes fatty acids composition, 125I-6-ketoprostaglandin F1α (6-ketoPGF1α) and 125I-thromboxane B2 (TXB2) levels in the blood plasma, platelet aggregation parameters.
Results: It has been discovered that manifestation of the CAN is accompanied by decrease of the Na+, K+-ATPase, Ca2+, Mg2+-ATPase activities (P<0.001), 6-ketoPGF1α, EPA level, EPA/arachidonic acid ratio with simultaneously increase of TXB2 level, PK-C activity, QTc interval parameters. Analysis of aggregatory curves shows that platelets in Type 2 DM with CAN began to aggregate earlier and the speed (0.75±0.02 U/min, P<0.001), stage of aggregation (27.78±1.15 MU/min, P<0.01) increase. After 3 months of treatment there was a decrease of TXB2 level (P<0.001), activity of PK-C (12.37±4.11 pmol 32P/mg protein per 1 min, P<0.001), degree and speed of an aggregate of thrombocytes with simultaneous increase of EPA, 6-ketoPGF1α levels, EPA/arachidonic acid ratio, Na+, K+-ATPase, Ca2+, Mg2+-ATPase activities in the group A were marked. Also, we observed significant improvement of cardiovascular autonomic tests, HRV parameters, decrease of QTc interval (P<0.01).
Conclusions: DHA and EPA may exert cardioprotective, antithrombic effects and may be used for effective treatment of diabetic CAN.