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Fatty Acid Composition of Serum Lipid Fractions in Type 2 Diabetic Patients With Microalbuminuria

Endocrine Division, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil

OBJECTIVE—To determine the fatty acid composition of serum phospholipid, triglyceride, and cholesterol ester fractions and to analyze the lipid profile of microalbuminuric type 2 diabetic patients.

RESEARCH DESIGN AND METHODS—A case-control study was conducted with 72 patients: 37 were normoalbuminuric (urinary albumin excretion rate [UAER] <20 µg/min), and 35 were microalbuminuric (UAER 20–200 µg/min). After 4 weeks of a standardized diet, the fatty acid composition of phospholipid, triglyceride, and cholesterol ester fractions was determined by gas chromatography. Total cholesterol and triglycerides were measured by enzymatic-colorimetric methods; cholesterol HDL by double precipitation with heparin, MnCl₂, and dextran sulfate; and apolipoprotein B by immunoturbidimetry.

RESULTS—Microalbuminuric patients showed a lower proportion of polyunsaturated fatty acids (24.8 ± 11.0%), especially of the n-6 family (21.7 ± 10.5%), in triglyceride fraction than normoalbuminuric patients (34.1 ± 11.3%, P = 0.001 and 31.4 ± 11.5%, P < 0.001, respectively). Patients with microalbuminuria also presented higher levels of saturated fatty acids in triglyceride fraction (43.4 ± 18.0% vs. 34.7 ± 13.1%, P = 0.022). In the logistic regression analysis, only the proportion of polyunsaturated fatty acids in triglyceride fraction remained significantly associated with microalbuminuria (odds ratio [OR] 0.92, 95% CI 0.85–0.98, P = 0.019). Total cholesterol, HDL cholesterol, triglyceride, and apolipoprotein B levels were similar in normo- and microalbuminuric patients.

CONCLUSION—Microalbuminuria in type 2 diabetic patients is associated with low polyunsaturated fatty acid contents in serum triglyceride fraction. This association may represent a risk factor for cardiovascular disease and may contribute to the progression of renal disease.

Abbreviations: FAPB2, fatty acid-binding protein type 2 • MUFA, monounsaturated fatty acids • OR, odds ratio • PUFA, polyunsaturated fatty acids • SFA, saturated fatty acids • UAER, urinary albumin excretion rate

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