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6 . 2015

Effects of omega-3 polyunsaturated fatty acids on the state of insulin resistance, the content of some pro- and antiinflammatory factors in patients with type 2 diabetes mellitus and cardiovascular autonomic neuropathy

Abstract

We have investigated the influence of the long-chain ω-3 polyunsaturated fatty acids (ω-3 PUFA) administration on the insulin resistance parameters, levels of high sensitivity C-reactive protein (hsCRP), some pro- and anti-inflammatory cytokines in patients with type 2 diabetes mellitus (T2 DM) and cardiovascular autonomic neuropathy (CAN). The study involved 12 patients with T2 DM without verified cardiovascular diseases (CVD), 36 patients with T2 DM and functional stage of CAN, of median age 50–59 years, disease duration 1–6 years and HbA1c levels – 7.1±0.6%. 15 healthy subjects were control group. Screening for CAN, that included five standard cardiovascular tests, was performed.

The levels of blood glucose, HbA1c, immunoreactive insulin (IRI), hsCRP, tumor necrosis factor α (TNFα), interleukin (IL)-6, IL-8 and IL-10 were measured. The index of insulin resistance (HOMA-IR) and TNFα/IL-10 ratio were calculated. Patients with T2 DM and CAN were divided into 2 groups: patients of the 1st group (group of comparison, n=15) received standard glucose-lowering therapy; patients of the 2nd group (n=21) received one capsule/day of the ω-3 PUFA (90% ethyl ester of PUFA (1000 mg), in particular eicosapentaenoic – 460 mg, docosahexaenoic acid – 380 mg and 4 mg α-tocopherol acetate) in addition to the standard therapy. The duration of the study was 3 months. Obtained results showed, that development of CAN in patients with T2 DM is accompanied by increase of the IRI (26.6±1.73 mcIU/ml, p<0.001 – compared to the control; p1<0.001 – compared to T2 DM patients without CVD); hsCRP (2.77±0.24 mg/l, p<0.001, p1<0,001); TNFα (5.75±0.24 pg/ml, p<0.001, p1<0.001); IL-6 (5.88±0.38 pg/ml, p<0.001, p1<0.001); IL-8 (6.65±0.3 pg/ml, p<0.001, p1>0.05); IL-10 (15.86±1.4 pg/ml, p<0.05, p1>0.05) levels; TNFα/IL-10 (44.2±3.57%, p<0.01, p1<0.05) and HOMA-IR. After 3 months of treatment no statistically significant changes (p>0.05) of investigated parameters, in particular levels of IRI (-6.8±2.0%); hsCRP (-7.2±1.63%); TNFα (-6.1±1.0%); IL-6 (-5.8±1.77%); IL-8 (-3.9±1.57%); IL-10 (-3.7±2.34%); TNFα/IL-10 (-0.5±2.3%) in patients from the group of comparison were found. The administration of ω-3 PUFA to patients with T2 DM and CAN promoted to the statistically significant decrease in hsCRP (-14.8±2.91%, p<0.05), TNFα (-14.1±2.15%, p<0.01), IL-6 (-13.5±2.7%, p<0.05), IL-8 (-9.8±2.13%, p<0.05), TNFα/IL-10 ratio (-34.6±1.93%, p<0.05); a slighty decrease in the content of the IRI (-10.3±1.1%, p>0.05), IL-10 (+7.9 ±6.42%, p>0.05), HOMA-IR was observed. Obtained results could witness, that prescription of ω-3 PUFA leads to decrease of the proinflammatory immune response activity and allows to consider ω-3 PUFA as a promising medicine in treatment and/or prevention of CAN in patients with DM 2.

Keywords:type 2 diabetes mellitus, cardiovascular autonomic neuropathy, ω-3 long-chain polyunsaturated fatty acids, insulin resistance, inflammation markers

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CHIEF EDITOR
CHIEF EDITOR
Viktor A. Tutelyan
Full Member of the Russian Academy of Sciences, Doctor of Medical Sciences, Professor, Scientific Director of the Federal Research Centre of Nutrition, Biotechnology and Food Safety (Moscow, Russia)

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