Background: N-3 polyunsaturated fatty acids (PUFA), such as α linolenic acid (ALA), eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), have been shown to modify several key risk factors for cardiovascular disease, although n-6 PUFA arachidonic acid (AA) has important roles in inflammation. However, it is not clear whether the apparent protection of n-3 PUFA against cardiovascular disease has been found in diabetic patients.
Methods: To clarify the effects of PUFA, firstly we calculated fasting serum PUFA, LDL-cholesterol, HDL cholesterol and triglyceride (TG) levels three times in type 2 diabetic patients. Those patients had been never treated with EPA drugs. Next we have followed the patients, focusing on newly onset of acute coronary syndrome, which have been undergoing elective coronary intervention for three years. Then, we divided diabetic patients into two groups in which acute coronary syndrome (ACS, PCI-group, n=42) was observed or not (DM-group, n=44), whereas 36 normal glucose tolerance subjects (Nor-group) were studied as control. Finally, we analyzed EPA/AA ratio and absolute EPA, AA levels among three groups. These values were analyzed using an ANOVA model.
Results: EPA/AA ratio in PCI-group (0.37) were significantly lower than in DM (0.47, P<0.05) and in Nor-group (0.52, P<0.01), although absolute AA ratio in PCI-group (207.2 mol%) was statistically higher than in DM (173.9, P<0.05) and in Nor-group (162.3, P<0.01). Moreover, absolute EPA levels were statistically lower in PCI-group compared to DM and Nor-group (P<0.05, P<0.05), whereas the average levels of LDL, HDL-cholesterol and HbA1c were not significantly changed among three groups.
Conclusion: A negative correlation was noted between the event of coronary artery disease and both EPA/AA ratio and absolute EPA values in diabetic patients. In addition, constantly high AA levels in PCI-group may contribute the incidence of acute coronary syndrome. We also suggest that both EPA/AA ratio and absolute EPA levels constitute an independent risk factor for coronary atherosclerosis.
Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.
Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.
05 - 09 May 2012
European Society of Endocrinology