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


METHODS
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.
Quilliot
D
D
Centre d'Investigation Clinique, Centre Hospitalo Universitaire et INSERM, France. d.quillot@chu-nancy.fr
Walters
E
E
Böhme
P
P
Lacroix
B
B
Bonte
J P
JP
Fruchart
J C
JC
Drouin
P
P
Duriez
P
P
Ziegler
O
O
D000328:Adult; D016022:Case-Control Studies; D008078:Cholesterol, LDL / Q000032:analysis*; D002908:Chronic Disease; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000209:etiology; D005228:Fatty Acids, Essential / Q000097:blood*; D006801:Humans; D008286:Malabsorption Syndromes / Q000097:blood / Q000150:complications; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000097:blood* / Q000150:complications; D012643:Selenium / Q000097:blood
D008078:Cholesterol, LDL; D005228:Fatty Acids, Essential; D012643:Selenium