title: Polyunsaturated fatty acids in plasma lipids of diabetic children during and after diabetic ketoacidosis.
abstract: OBJECTIVE
  Previously we reported significantly higher plasma values of the essential fatty acids but significantly lower values of their longer-chain metabolites in diabetic children than in healthy controls. Here, we report data on the acute effect of diabetic ketoacidosis (DKA) on the fatty acid composition of plasma lipids.
  
  
  METHODS
  Diabetic children (n=9; age: 16.1 [3.3] y; duration of diabetes: 5.0 [5.3.] y; daily insulin dose: 0.87 [0.66] unit/kg body weight/d; glycated haemoglobin: 13.4 [2.8] %; median [IQR]) were investigated at admission for DKA (during DKA) and at the end of the treatment of DKA (after DKA). Fatty acid composition of plasma lipid classes was determined by high-resolution capillary gas-liquid chromatography.
  
  
  RESULTS
  Blood glucose (27.0 [8.5] vs 6.5 [1.6] mmol/l), pH (7.28 [0.35] vs 7.36 [0.06]) and base excess (-8.9 [15.1] vs -2.2 [6.3] mmol/l) were grossly abnormal during but not after DKA. Values of linoleic acid were significantly lower after than during DKA (non-esterifed fatty acids (NEFA): 15.55 [1.47] vs 12.27 [5.74] % wt/wt; triacylglycerols (TG): 20.84 [9.23] vs 17.40 [5.78]; p<0.05). In contrast, values of gamma-linolenic acid (NEFA: 0.87 [0.54] vs 2.34 [1.85]; p<0.05) and arachidonic acid (TG: 1.37 [0.71] vs 1.74 [0.57]; p<0.05) were significantly lower during than after DKA. The product/substrate ratios for delta-6 desaturation were significantly lower during than after DKA.
  
  
  CONCLUSIONS
  Successful treatment of diabetic ketoacidosis is associated with a significant increase of long-chain polyunsaturated fatty acid values in blood plasma in diabetic children. This observation suggests that disturbances of essential fatty acid metabolism in diabetic children are related not only to diet but to hypoinsulinaemia as well.
authors.affiliation: Department of Paediatrics, University of Pécs, Jószef A. u.7, H-7623 Pécs, Hungary. tamas.decsi@aok.pte.hu
authors.forename: Tamás
authors.initials: T
authors.lastname: Decsi
authors.forename: Eva
authors.initials: E
authors.lastname: Szabó
authors.forename: Adrienn
authors.initials: A
authors.lastname: Kozári
authors.forename: Eva
authors.initials: E
authors.lastname: Erhardt
authors.forename: Tamás
authors.initials: T
authors.lastname: Marosvölgyi
authors.forename: Gyula
authors.initials: G
authors.lastname: Soltész
mesh_terms: D000293:Adolescent; D016883:Diabetic Ketoacidosis / Q000097:blood*; D005231:Fatty Acids, Unsaturated / Q000097:blood*; D005260:Female; D006801:Humans; D019787:Linoleic Acid / Q000097:blood; D008297:Male; D010743:Phospholipids / Q000737:chemistry
chemical_list: D005231:Fatty Acids, Unsaturated; D010743:Phospholipids; D019787:Linoleic Acid