Abstract
Although abnormalities in the fatty acid composition of serum and red cell membrane phospholipids of patients with type 2 diabetes are well-documented, lacking are studies of this issue in prediabetic individuals. For this cross-sectional study, we recruited 180 subjects (30-80 years), 56 of whom were normal with regard to glucose control (HbA1c, <5.7%), 61 who had prediabetes (HbA1c, 5.7%-6.4%) and 59 who had type 2 diabetes (HbA1c, >6.5%). Serum phospholipids were isolated and analyzed for fatty acids. Most importantly, the fatty acid compositions of the controls and prediabetic subjects were not different for 19 fatty acids. However, the fatty acid profile of the phospholipids of the patients with diabetes differed from the other two groups; the 14 to 18-carbon saturated fatty acids were decreased by 12%-26% whereas the unsaturated fatty acids 16:1n-7, 18:1n-9, 18:2n-6, 20:3n-6 and 20:4n-6 were increased by 45%-64%. Of note, the docosahexaenoic acid (DHA) status of individuals in all three study groups was remarkably low compared with international values, as indicated by DHA proportions in the 1.62%-2.07% range, and there were no differences between groups. The mean melting point of the phospholipid fatty acids of the diabetic patients (32.2°C) was significantly lower (p < 0.001) than that of the prediabetic subjects (38.1°C) and the controls (39.9°C) which were not different from each other. These observations indicate that the fatty acid changes associated with type 2 diabetes follow the onset of the disease as opposed to being a causative factor of poor glucose control and insulin insensitivity.
Highlights
The incidence of type 2 diabetes mellitus has increased markedly over the past several decades in most regions of the world, but nowhere has this increase been greater than among populations living in the US Southwest [1], especially American Indians
A total of 176 subjects were enrolled in the study: 56 subjects were in the control group; 61 in the prediabetes group and 59 in the type 2 diabetes group
Borkman and colleagues [13] reported that the proportion of 20- and 22-carbon fatty acids in skeletal-muscle phospholipids was inversely correlated with hyperinsulinemia and insulin resistance
Summary
The incidence of type 2 diabetes mellitus has increased markedly over the past several decades in most regions of the world, but nowhere has this increase been greater than among populations living in the US Southwest [1], especially American Indians. There is growing interest in the metabolic changes that occur in prediabetes which is the intermediate condition between normal glucose homeostasis and the hyperglycemia of type 2 diabetes [2]. The main characteristics of prediabetes are elevated fasting blood glucose and impaired glucose tolerance which is strong risk factor for type 2 diabetes. Prediabetes has a strong association with the metabolic syndrome and is presumed to be a risk factor for heart disease and mortality [3]. It is important to identify prediabetes so that measures such as modest weight loss, increased physical activity and dietary changes can be taken to reduce the risk of developing type 2 diabetes. Alterations in the fatty acid composition of serum and membrane phospholipids have been reported in individuals with type 2 diabetes
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