Highly Purified Eicosapentaenoic Acid Improves Decreased Toe-Brachial Index in Japanese Patients with Type 2 Diabetes Mellitus

Abstract

Eicosapentaenoic acid (EPA), which is an important polyunsaturated fatty acid in fish oil, improves blood coagulability and prevents thrombosis. EPA is usually available for treatment of patients with obliterating arteriosclerosis in Japan, but its usefulness for microcirculation in the foot has not been established. We studied the effect of highly purified ethyl eicosapentaenoate on decreased microcirculation in the foot in Japanese patients with type 2 diabetes mellitus. Changes in ankle-brachial index (ABI), toe systolic pressure, and toe-brachial index (TBI) with administration of EPA were evaluated in outpatients. Individual comparison of mean values before and after treatment was performed by using paired Student t test. Both decreased toe systolic pressure and TBI significantly improved with administration of ethyl eicosapentaenoate for 4 weeks in patients who had decreased TBI; decreased TBI was normalized in 24 of 35 big toes (68.6%). In addition, treatment improved decreased ABI; decreased ABI was normalized in 4 of 6 lower limbs (66.7%). This study confirmed that administration of highly purified ethyl eicosapentaenoate improves peripheral microcirculation in diabetic patients with decreased TBI and ABI.