ESSENTIAL FATTY-ACID METABOLISM IN PATIENTS WITH ESSENTIAL-HYPERTENSION, DIABETES-MELLITUS AND CORONARY HEART-DISEASE

Mortality and morbidity from coronary heart disease (CHD), diabetes me llitus (DM) and essential hypertension (HTN) are higher in people of S outh Asian descent than in other groups. There is evidence to believe that essential fatty acids (EFAs) and their metabolites may have a rol e in the pathobiology of CHD, DM and HTN. Fatty acid analysis of the p lasma phospholipid fraction revealed that in CHD the levels of gamma-l inolenic acid (GLA), arachidonic acid (AA), eicosapentaenoic acid (EPA ) and docosahexaenoic acid (DHA) are low, in patients with HTN linolei c acid (LA) and AA are low, and in patients with non-insulin dependent diabetes mellitus (NIDDM) and diabetic nephropathy the levels of diho mo-gamma-linolenic acid (DGLA), AA, alapha-linolenic acid (ALA) and DH A are low, all compared to normal controls. These results are interest ing since DGLA, AA and EPA form precursors to prostaglandin E(1), (PGE (1)), prostacyclin (PGI(2)), and PGI(3), which are potent platelet ant i-aggregators and vasodilators and can prevent thrombosis and atherosc lerosis. Further, the levels of lipid peroxides were found to be high in patients with CHD, HTN, NIDDM and diabetic nephropathy. These resul ts suggest that increased formation of lipid peroxides and an alterati on in the metabolism of EFAs are closely associated with CHD, HTN and NIDDM in Indians. Since insulin resistance and hyperinsulinemia and fe atures of obesity, NIDDM, HTN and CHD, diseases that are common in Ind ians, and as decreased insulin sensitivity is associated with decrease d concentrations of polyunsaturated fatty acids (PUFAs) in skeletal mu scle phospholipids and, possibly, in the plasma, the possibility is ra ised that changes in the metabolism of EFAs may have a fundamental rol e in the pathobiology of these conditions. If this is true, this sugge sts that supplementation of GLA, DGLA, AA, EPA and/or DHA may be indic ated to prevent CHD, HTN and NIDDM in Indians.