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Fatty acid abnormalities in chronic pancreatitis: effect of concomitant diabetes mellitus

European Journal of Clinical Nutrition volume 57, pages 496–503 (2003)Cite this article

Abstract

Objective: Patients with chronic pancreatitis suffer from malabsorption and nutritional deficiencies. However there is little data available concerning the fatty acid profile in chronic pancreatitis. Diabetes mellitus, a common complication of this disease, could interfere with the metabolism of fatty acids.

Subjects: We therefore compared the fatty acid composition of LDL from four groups of male patients with (a) chronic pancreatitis without diabetes (ND-CP; n=12), (b) diabetes secondary to chronic pancreatitis and insulin-treated (CP-D; n=35); (c) type 1 diabetes (n=25); and (d) controls (n=20).

Results: The patients in both groups of chronic pancreatitis (ND-CP and CP-D) had lower mean values for linoleic acid than that seen in the type 1 DM and control groups, whereas monounsaturated fatty acids (MUFA; 18 : 1(n-9) and (16 : 1(n-7)) were significantly increased in these two groups (ND-CP and CP-D). Docosa-hexaenoic-acid (22 : 6(n-3)) was significantly decreased in the CP-D group (P>0.05), a response that could be explained by the effects of diabetes mellitus and by selenium deficiency. In this way, diabetes was associated with a decrease in the docosa-hexaenoic-acid (22 : 6(n-3); r=0.30, P=0.005), and selenium was correlated with DHA (r=0.28, P=0.029) and with the 22 : 6(n-3)/20 : 5(n-3) ratio (evaluating the delta 4 desaturation); r=0.31, P=0.022), independently of the diabetes effect. Selenium was negatively correlated with 20 : 4(n-6)/20 : 3(n-6) ratio (evaluating the delta 5 desaturase; r=–0.30; P=0.025). These results suggest that these two factors may have a role in the regulation of the desaturation process. If we consider that a ratio of 16 : 1(n-7)/18 : 2(n-6) greater than 0.086 in plasma indicates an EFAn-6 deficiency, 40% of our CP patients, 57.6% of CP-D patients and 13.6% of type 1 DM patients were involved.

Conclusions: The consequences of these deficiencies are not evaluated in this disease. However, correction of the fundamental deficiencies in essential fatty acids and in selenium seems desirable in chronic pancreatitis.

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References

  • Brown, JE, Lindsay, RM & Riemersma, RA (2000). Linoleic acid metabolism in the spontaneously diabetic rat: delta6-desaturase activity vs. product/precursor ratios. Lipids, 35, 1319–1323.

    Article  CAS  Google Scholar 

  • Cabre, E, Periago, JL, Mingorance, MD, Fernandez-Banares, F, Abad, A, Esteve, M, Gil, A, Lachicia, M, Gonzalez-Huix, F & Gassull, MA (1992). Factors related to the plasma fatty acid profile in healthy subjects, with special reference to antioxidant micronutrient status: a multivariate analysis. Am. J. Clin. Nutr., 55, 831–837.

    Article  CAS  Google Scholar 

  • Celik, S, Yilmaz, O, Asan, T, Naziroglu, M, Cay, M & Aksakal, M (1999). Influence of dietary selenium and vitamin E on the levels of fatty acids in brain and liver tissues of lambs. Cell Biochem. Funct., 17, 115–121.

    Article  CAS  Google Scholar 

  • Clandinin, MT, Zuberbuhler, P, Brown, NE, Kielo, ES & Goh, YK (1995). Fatty acid pool size in plasma lipoprotein fractions of cystic fibrosis patients. Am. J. Clin. Nutr., 62, 1268–1275.

    Article  CAS  Google Scholar 

  • Clark, DL & Queener, SF (1985). Effects of diabetes mellitus on renal fatty acid activation and desaturation. Biochem. Pharmac., 34, 4305–4310.

    Article  CAS  Google Scholar 

  • Clavel, JP, Chavignac, B & Thuillier, A (1983). Dosage du sélénium dans les liquides biologiques par spectrométrie d'absorption atomique électrothermique. J. Pharm. Clin., 2, 55

    CAS  Google Scholar 

  • Clejan, S, Castro-Magana, M, Collipp, PJ, Jonas, E & Maddaiah, VT (1982). Effects of zinc deficiency and castration on fatty acid composition and desaturation in rats. Lipids, 17, 129–135.

    Article  CAS  Google Scholar 

  • DiMango, EP, Go, VLW & Summerskill, WHJ (1973). Relations between pancreatic enzyme output and malabsorption in severe pancreatic insufficiency. New Engl. J. Med., 288, 813–815.

    Article  Google Scholar 

  • Eder, K & Kirchgessner, M (1996). Zinc deficiency and the desaturation of linoleic acid in rats force-fed fat-free diets. Biol. Trace Elem., 54, 173–183.

    Article  CAS  Google Scholar 

  • el Boustani, S, Causse, JE, Descomps, B, Monnier, L, Mendy, F, Crastes, de & Paulet, A (1989). Direct in vivo characterization of delta 5 desaturase activity in humans by deuterium labeling: effect of insulin. Metabolism, 38, 315–321.

    Article  CAS  Google Scholar 

  • Fernandez, E & Borgstrom, B (1989). Effects of tetrahydrolipstatin, a lipase inhibitor, on absorption of fat from the intestine of the rat. Biochim. Biophys. Acta, 1001, 249–255.

    Article  CAS  Google Scholar 

  • Folch, H, Less, M & Sloane-Stanley, GH (1957). A simple method for isolation and purification of total lipids from animal tissues. J. Biol. Chem., 226, 497–509.

    CAS  Google Scholar 

  • Friedwald, WT, Levy, RI & Frederickson, DS (1972). Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin. Chem., 18, 499–502.

    Google Scholar 

  • Glauert, HP, Beaty, MM, Clark, TD, Greenwell, WS & Chow, CK (1990). Effect of dietary selenium on the induction of altered hepatic foci and hepatic tumors by the peroxisome proliferator ciprofibrate. Nutr. Cancer, 14, 261–271.

    Article  CAS  Google Scholar 

  • Gullo, L, Stella, A, Labriola, E, Costa, PL, Descovich, G & Labo, G (1982). Cardiovascular lesions in chronic pancreatitis. A prospective study. Dig. Dis. Sci., 27, 716–722.

    Article  CAS  Google Scholar 

  • Infante, JP (1986). Vitamin E and selenium participation in fatty acid desaturation. A proposal for an enzymatic function of these nutrients. Cell Biochem. Mol., 69, 93–108.

    Article  CAS  Google Scholar 

  • Mimouni, V, Narce, M & Poisson, JP (1992). Evidence for insulin dependent hepatic microsomal gamma-linolenic acid chain elongation in spontaneously diabetic Wistar BB rats. Biochem. Biophys. Acta, 1133, 187–192.

    Article  CAS  Google Scholar 

  • Mimouni, V, Narce, M, Huang, YS, Horrobin, DF & Poisson, JP (1994). Adrenic acid delta 4 desaturation and fatty acid composition in liver microsomes of spontaneously diabetic Wistar BB rats. Prostaglandins Leukot. Essent. Fatty Acids, 50, 43–47.

    Article  CAS  Google Scholar 

  • Oliver, MF (1981). Diet and coronary heart disease. Br. Med. Bull., 37, 49–58.

    Article  CAS  Google Scholar 

  • Poisson, JP (1989). Essential fatty acid metabolism in diabetes. Nutrition, 5, 263–266.

    CAS  PubMed  Google Scholar 

  • Quilliot, D, Dousset, B, Guerci, B, Dubois, F, Drouin, P & Ziegler, O (2001). Evidence that diabetes mellitus favors impaired metabolism of zinc, copper, and selenium in chronic pancreatitis. Pancreas, 22, 299–306.

    Article  CAS  Google Scholar 

  • Report of the Expert Committee on the Diagnosis Classification of Diabetes Mellitus (1997). Diabetes Care, 20, 1183–1197.

  • Rosenlund, ML, Selekman, JA, Kim, HK & Kritchevsky, D (1977). Dietary essential fatty acids in cystic fibrosis. Pediatrics, 59, 428–432.

    CAS  PubMed  Google Scholar 

  • Salomaa, V, Ahola, I, Tuomilehto, J, Aro, A, Pietinen, P, Korhonen, HJ & Penttila, I (1990). Fatty acid compensation of serum cholesterol esters in different degrees of glucose intolerance: a population-based study. Metabolism, 39, 1285–1291.

    Article  CAS  Google Scholar 

  • Saviana, B, Quilliot, D, Ziegler, O, Drouin, P & Guéant, JL (1999). Diagnosis of lipid malabsorption in patients with chronic pancreatitis: a new indirect test using postprandial plasma apolipoprotein B-48. Am. J. Gastroenterol, 94, 3229–3235.

    Article  CAS  Google Scholar 

  • Siguel, EN & Lerman, RH (1994). Altered fatty acid metabolism in patients with angiographically documented coronary artery disease. Metabolism, 43, 982–993.

    Article  CAS  Google Scholar 

  • Siguel, EN & Lerman, RH (1996). Prevalence of essential fatty acid deficiency in patients with chronic gastrointestinal disorders. Metabolism, 45, 12–23.

    Article  CAS  Google Scholar 

  • Sjoberg, RJ & Kidd, GS (1989). Pancreatic diabetes mellitus. Diabetes Care, 12, 715–724.

    Article  CAS  Google Scholar 

  • Sprecher, H (1992). Interconversions Between 20- and 22-carbon w-3 and w-6 Fatty Acids via 4-Desaturase Independent Pathway, ed. R Gibson & A Sinclair, pp18–22.

  • Thomas, MJ & Rudel, LL (1996). Dietary fatty acids, low density lipoprotein composition and oxidation and primate atherosclerosis. J. Nutr., 126, 1058S–1062S.

    Article  CAS  Google Scholar 

  • Tomkin, GH & Owens, D (2001). Abnormalities in apo B-containing lipoproteins in diabetes and atherosclerosis. Diabetes Metab. Res. Rev., 17, 27–43.

    Article  CAS  Google Scholar 

  • Van, de, Kamer, JH, Bockel, H & Weijers, HA (1949). Rapid method for the determination of fat in feces. J. Biol. Chem., 177, 347–355.

    Google Scholar 

  • Vessby, B (2000). Dietary fat and insulin action in humans. Br. J. Nutr., 83, S91–96.

    Article  CAS  Google Scholar 

  • Vidgren, HM, Agren, JJ, Valve, RS, Karhunen, LJ, Rissanen, AM & Uusitupa, MI (1999). The effect of orlistat on the fatty acid composition of serum lipid fractions in obese subjects. Clin. Pharmac. Ther., 66, 315–322.

    Article  CAS  Google Scholar 

  • von Schacky, C (2000). n-3 Fatty acids and the prevention of coronary atherosclerosis. Am. J. Clin. Nutr., 71, 224S–227S.

    Article  CAS  Google Scholar 

  • Voss, A, Reinhart, M, Sankarappa, S & Sprecher, H (1991). The metabolism of 7,10,13,16,19-docosapentaenoic acid to 4,7,10,13,16,19-docosahexaenoic acid in rat liver is independent of a delta-4-desaturase. J. Biol. Chem., 266, 19995–20000.

    CAS  PubMed  Google Scholar 

  • Wiedman, TS, Pates, RD, Beach, JM, Salmon, A & Brown, MF (1988). Lipid–protein interactions mediate the photochemical function of rhodopsin. Biochemistry, 27, 6469–6474.

    Article  Google Scholar 

  • Ziegler, O, Candiloros, H, Guerci, B, Got, I, Crea, T & Drouin, P (1994). Lower-extremity arterial disease in diabetes mellitus due to chronic pancreatitis. Diabetes Metab., 20, 1–6.

    Google Scholar 

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Authors and Affiliations

  1. Centre d'Investigation Clinique, Centre Hospitalo Universitaire et INSERM, France

    D Quilliot & P Drouin

  2. Service de Diabétologie, Maladies Métaboliques et Nutrition, Hôpital Jeanne d'Arc, CHU de Nancy, Toul, France

    D Quilliot, P Böhme, P Drouin & O Ziegler

  3. Centre Universitaire de Mesure et d'Analyse, Faculté de Pharmacie, Université de Lille II, Lille, France

    B Lacroix & J P Bonte

  4. Département d'Athérosclérose, INSERM U325, Institut Pasteur de Lille et Faculté de Pharmacie, Université de Lille 2, Lille, France

    E Walters, J C Fruchart & P Duriez

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  1. D Quilliot
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  9. O Ziegler
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Guarantors: D Quilliot

Contributors: DQ formulated the idea for the present study, was involved in the day to day running of the study and wrote the paper, EW, BL, JPB, PDu and JCF were responsible and acted as supervisors for the laboratory analysis, PB was involved in study recruitment and in data analysis, PDr and OZ were involved in the design of the study and in writing the paper.

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Correspondence to D Quilliot.

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Quilliot, D., Walters, E., Böhme, P. et al. Fatty acid abnormalities in chronic pancreatitis: effect of concomitant diabetes mellitus. Eur J Clin Nutr 57, 496–503 (2003). https://doi.org/10.1038/sj.ejcn.1601556

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