Arthritis & Rheumatism, Volume 63,
November 2011 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Chicago, Illinois November 4-9, 2011.


The Role of Fatty Acid Composition in Antiphospholipid Syndrome and Systemic Lupus Erythematosus.

Balitsky1,  Amaris K., Aghdassi2,  Ellie, Ma3,  David WL., Morrison4,  Stacey, Su4,  Jiandong, Fortin4,  Paul R.

The University of Toronto, Toronto, ON
University Health Network, Toronto, ON
University of Guelph, Guelph, ON
Toronto Western Hospital, Toronto, ON

Background/Purpose:

Despite similar traditional Framingham risk scores, systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS) patients present with greater thrombovascular disease compared to the general population. APS can occur alone, as primary APS (PAPS), or be associated with SLE, referred to as secondary APS (SAPS). Dietary fat composition and metabolism play an important role in inflammatory reactions. For example, omega-3 polyunsaturated fatty acids (w-3 PUFA), including alpha-linoleic acid (ALA) and its metabolites, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), have been shown to have anti-inflammatory and cardioprotective effects. On the other hand, arachidonic acid (AA, w-6 PUFA), derived from linoleic acid (LA), leads to formation of inflammatory mediators. The purpose of this study was to determine and compare an association between the red blood cell (RBC) FA profile and: the presence of APS, TE and aPL.

Methods:

Fifty-nine individuals were selected from the lupus and antiphospholipid outpatient specialty clinics and divided into 4 groups: 1) primary APS (PAPS, n=15) as defined by the revised Sydney criteria, 2) SAPS (n=14), 3) SLE with a previous TE (n=15), and 4) SLE without previous history of TE and no aPL (n=15). All SLE patients met at least four of the American College of Rheumatology (ACR) classification criteria. Demographics, Framingham risk score and RBC profile including phospholipids, phosphatidylcholine (PC) and phosphatidylethanolamine (PE), and their respective FA compositions were reported. RBC FA compositions were determined using thin-layer and gas chromatography.

Results:

The mean (±SD) age (years) of the 4 groups were similar (PAPS: 51.7 ± 16.8; SAPS: 53.0 ± 11.7; SLE+TE: 52.1 ± 10.5; SLE-TE: 53.5 ± 10.3, p> 0.05). Framingham risk scores were also similar across the four groups. The PAPS group had less arterial events (40.0%) compared to SAPS (71.4%) and SLE+TE (80.0%). RBC-PC and PE values were similar across PAPS, SAPS, SLE+TE, and SLE-TE. The PAPS group, compared to the three SLE groups, had a higher RBC-PE ALA:DHA+EPA ratio (PAPS: 0.06 ± 0.02; SLE: 0.04 ± 0.02, p< 0.05), indicating less efficient conversion of ALA to its anti-inflammatory metabolites, EPA and DHA. In patients with the history of TE, RBC-PE w-6 PUFA (inflammatory) was higher than the levels of total w-3 PUFA (anti-inflammatory) (TE: 36.40 ± 3.92; no TE: 34.98 ± 2.26, p= 0.09). The presence of aPL tended to be associated with a lower RBC-PC LA:AA ratio, indicating more efficient conversion of LA to its pro-inflammatory metabolite (aPL: 2.40 ± 0.65; no aPL: 2.79 ± 0.97, p= 0.08). Those taking w-3 PUFA supplements had higher levels of RBC-PC EPA+DHA (w-3: 4.1 ± 1.7 vs. no w-3: 3.0 ± 1.1; p= 0.08).

Conclusion:

In patients with APS and SLE, FA composition is in favour of an inflammatory process. Presence of TE, aPL and PAPS were associated with a less favourable FA composition, while those individuals who took w-3 supplements were associated with a more favourable FA composition.

To cite this abstract, please use the following information:
Balitsky, Amaris K., Aghdassi, Ellie, Ma, David WL., Morrison, Stacey, Su, Jiandong, Fortin, Paul R.; The Role of Fatty Acid Composition in Antiphospholipid Syndrome and Systemic Lupus Erythematosus. [abstract]. Arthritis Rheum 2011;63 Suppl 10 :22
DOI:

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