HbA1c Levels Affect Serum Phospholipids, Inflammation in T2D, CVD

Investigators sought to determine the association between serum phospholipid fatty acid composition, low-grade inflammation, and glycemic control in patients with T2D.

In patients with type 2 diabetes (T2D) and atherosclerotic cardiovascular disease, worse glycemic control is associated with unfavorable serum phospholipid ratios and greater systemic inflammation, according to results published in Cardiovascular Diabetology.

The study included 74 patients with T2D and documented atherosclerotic cardiovascular disease (ASCVD; 74 with coronary artery disease, 26 with peripheral arterial disease). The researchers estimated baseline glycated hemoglobin (HbA1c) with turbidimetric inhibition immunoassay. Patients were then grouped into individuals with HbA1c <7.0% (n=38) and individuals with HbA1c ≥7.0% (n=36). The researchers used gas chromatography to measure patients’ serum phosolipid fatty acids.

Patients with HbA1c <7.0% and patients with HbA1c ≥7.0% had similar composition of saturated and monounsaturated fatty acids in serum phospholipids. Compared with patients with HbA1c <7.0%, patients with HbA1c ≥7.0% had higher concentrations of linoleic acid and higher n‐6/n‐3 polyunsaturated fatty acid (PUFA) ratios as well as lower levels of eicosapentaenoic acid (EPA), total n‐3 PUFAs, and the EPA/arachidonic acid ratio.

The researchers found that linoleic acid (correlation coefficient [r]=0.25; =.03) and n‐6/n‐3 PUFA ratio (r=0.28; =.02) were positively correlated with HbA1c. In addition, they found that n‐6/n‐3 PUFA ratio, high-sensitivity C-reactive protein, and diabetes duration were independent predictors of worse glycemic control in patients with T2D and ASCVD.

“These results confirm the beneficial effect of long-chain n-3 PUFAs in T2D and support current recommendations for regular fish consumption,” the researchers wrote.

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Poreba M, Rostoff P, Siniarski A, et al. Relationship between polyunsaturated fatty acid composition in serum phospholipids, systemic low-grade inflammation, and glycemic control in patients with type 2 diabetes and atherosclerotic cardiovascular disease. Cardiovasc Diabetol. (2018)17:29.