title: LC-MS/MS analysis of plasma polyunsaturated fatty acids in type 2 diabetic patients after insulin analog initiation therapy.
abstract: BACKGROUND
  Eicosanoids derived from omega-6 (n6) polyunsaturated fatty acids (PUFAs) have proinflammatory functions whereas eicosanoids derived from omega-3 (n3) PUFAs have anti-inflammatory properties. This study was designed to evaluate the effect of insulin analog initiation therapy on n6 and n3 PUFAs in type 2 diabetic patients during early phase.
  
  
  METHODS
  Sixteen type 2 diabetic patients with glycosylated hemoglobin (HbA1c) levels above 10% despite ongoing combination therapy with sulphonylurea and metformin were selected. Former treatment regimen was continued for the first day followed by substitution of sulphonylurea therapy with different insulin analogs (0.4 U/kg/day) plus metformin. Blood samples were obtained from all patients at 24 and 72 hours. Plasma levels of arachidonic acid (AA, C20:4n6), dihomo-gamma-linolenic acid (DGLA, C20:3n6), eicosapentaenoic acid (EPA, C20:5n3) and docosahexaenoic acid (DHA, C22:6n3) were determined by an optimized multiple reaction monitoring (MRM) method using ultra fast-liquid chromatography (UFLC) coupled with tandem mass spectrometry (MS/MS). Prostaglandin E2 (PGE2) was measured in serum samples by enzyme immunoassay.
  
  
  RESULTS
  All measured PUFAs were significantly increased after treatment with insulin analogs plus metformin compared to before treatment levels. The mean AA/EPA ratio was significantly lower after treatment with insulin analogs plus metformin. A 22% decrease was observed in PGE2 levels after treatment with insulin analogs plus metformin compared to pretreatment levels (p > 0.05).
  
  
  CONCLUSIONS
  The significant decrease in AA/EPA ratio indicates that insulin analog initiation therapy has anti-inflammatory properties by favoring the increase of n3 fatty acid EPA.
authors.affiliation: Department of Medical Biochemistry, Akdeniz University Medical School, Antalya, Turkey. mutayaslan@akdeniz.edu.tr.
authors.forename: Mutay
authors.initials: M
authors.lastname: Aslan
authors.forename: Filiz
authors.initials: F
authors.lastname: Özcan
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Aslan
authors.forename: Gültekin
authors.initials: G
authors.lastname: Yücel
mesh_terms: D015126:8,11,14-Eicosatrienoic Acid / Q000097:blood; D000328:Adult; D000368:Aged; D016718:Arachidonic Acid / Q000097:blood; D002853:Chromatography, Liquid; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy; D015232:Dinoprostone / Q000097:blood; D004281:Docosahexaenoic Acids / Q000097:blood; D015118:Eicosapentaenoic Acid / Q000097:blood; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D008297:Male; D008687:Metformin / Q000627:therapeutic use; D008875:Middle Aged; D053719:Tandem Mass Spectrometry
chemical_list: D015126:8,11,14-Eicosatrienoic Acid; D016718:Arachidonic Acid; D015232:Dinoprostone; D004281:Docosahexaenoic Acids; D015118:Eicosapentaenoic Acid; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; D008687:Metformin; C517652:hemoglobin A1c protein, human