Comparison of plasma and erythrocyte membrane fatty acid compositions in patients with end-stage renal disease and type 2 diabetes mellitus

• We assessed three different patient groups (T2DM, ESRD and T2DM + ESRD) and controls.
• We used GC-FID to determine FA compositions in plasma and erythrocyte membrane.
• Membrane DHA levels in ESRD patient groups were lower than the healthy subjects.
• EPA/AA and ω3/ω6 ratios in plasma were significantly lower in patients with T2DM.
• Because membrane PUFA content affects membrane fluidity, these findings are worthy.

BackgroundIn this study, we aimed to compare the serum lipid profile and fatty acid (FA) compositions of erythrocyte membrane (EM) and plasma in three different patient groups (group 1: type 2 diabetes mellitus (T2DM) + end-stage renal disease (ESRD), group 2: ESRD, group 4: T2DM) and healthy controls (group 3) simultaneously.Methods40 ESRD patients treated with hemodialysis (HD) in Gulhane School of Medicine (20 with T2DM) and 32 controls (17 with T2DM, 15 healthy controls) were included in the study. Plasma and EM FA concentrations were measured by gas chromatography-flame ionization detector (GC-FID).ResultsPlasma and EM palmitic acid (PA) and stearic acid (SA) levels were significantly higher in T2DM patients compared to controls (p = 0.040 and p = 0.002 for plasma, p = 0.001 and p = 0.010 for EM, respectively). EM docosahexaenoic acid (DHA) levels were also significantly lower in patients with ESRD + T2DM and ESRD compared to controls (p = 0.004 and p = 0.037, respectively).ConclusionsPatients with insulin resistance display a pattern of high long chain saturated FAs (PA, SA and arachidic acids). However, while there are no recognized standards for normal EM DHA content, decreased levels of EM DHA in ESRD patient groups (groups 1 and 2) suggest that there may be reduced endogenous synthesis of DHA in HD subjects, due to the decreased functionality of desaturase and elongase enzymes. Because membrane PUFA content affects membrane fluidity and cell signaling, these findings are worthy of further investigation.