Adipose tissue fatty acid composition, serum lipids, and serum alpha-tocopherol in continuous ambulatory peritoneal dialysis patients living on the island of Crete

(O)bjective: A pilot study to explore diet-related atherogenic patterns in continuous ambulatory peritoneal dialysis (CAPD) patients on the island of Crete. Cretans are well known for their high olive consumption and low athe rosclerotic heart disease mortality, in general. Designs Case-control study. Setting: This was a hospital-based study initiated in 1991. Catchment area was the island of Crete, Greece. Participants: Seventeen patients admitted for treatment to the General Stat e Hospital of Rethimnon. Controls were selected from the general population of the island and consisted of a random sample of 27 subjects from a total of 168 healthy subjects who visited the Preventive Medicine Clinic of the University Hospital for routine checkup. The control group was age- and sex -matched with patients. Both CAPD patients and controls had been residents of Crete for at least the last 10 years. Main Outcome Measures: Adipose tissue was aspirated, and a 12-hour fasting blood sample was collected for determination of serum lipid parameters and serum a-tocopherol levels; dietary data from a 3-day recall were recorded. Results: No significant differences between the two groups were observed wi th respect to the mean macronutrient intake. The mean levels of serum trigl ycerides (p = 0.016) and serum ol-tocopherol (p = 0.001) were significantly higher in CAPD patients compared to controls. Mean levels of total serum c holesterol, high density lipoprotein (HDL) cholesterol, and low density lip oprotein (LDL) cholesterol were not significantly different. In CAPD patien ts the mean total percentage of monounsaturated fatty acids (MUFA) was sign ificantly higher (p = 0.006) than in controls,The mean total percentage of saturated fatty acids (p = 0.004), along with the mean percentage of omega- 6 (p = 0.002), the mean value of the ratio omega-6/omega-3 (p < 0.0001), an d the percentage of linoleic acid (p = 0.001) were significantly lower in C APD patients than in the controls. Among subjects with higher levels of MUF A in the adipose tissue, the CAPD patients were twice as likely to have hig h serum ol-tocopherol (p < 0.001), and 2.6 times more likely to be in high risk of high total cholesterol (TC)/HDL (p = 0.08); compared to the control s. However, CAPD patients with high levels of MUFA in the adipose tissue (a bove the average of 65%) were unlikely [odds ratio (OR) = 0.001, p < 0.001] to be at risk of high TC/HDL (above the average of 4.1), and maybe unlikel y (OR = 0.08, but p = 0.1) to have low serum alpha-tocopherol, when compare d with the CAPD patients with low levels of MUFA. CAPD patients with high T C/HDL are 0.15 times less likely (p = 0.1) to have high levels of serum alp ha-tocopherol compared to those with low TC/HDL. Conclusion: Cretan CAPD patients demonstrate an interesting profile consist ing of unexpectedly positive aspects when atherogenesis-related factors suc h as those of adipose tissue fatty acid composition, serum lipids, and seru m antioxidant alpha-tocopherol are considered.