Incorporation of deuterium-labeled cis- and trans-9-octadecenoic acids in humans: plasma, erythrocyte, and platelet phospholipids

Association between dietary fat quality indices with anthropometric measurements in children and adolescents

Background

The association between anthropometric measures and dietary fat quality indices is unclear in pediatric age groups. The present study aimed to assess the association between dietary lipophilic index (LI) and thrombogenic index (TI) as dietary fat quality indices with anthropometric measurements in children and adolescents.

Method

This nationwide cross-sectional study was conducted on 4323 students aged 6-18 years that were selected by multistage cluster sampling from 31 provinces of Iran. Dietary intake was collected using a validated food frequency questionnaire and dietary LI and TI were calculated by formula. Data on anthropometric measures were collected by standard protocols.

Results

The multivariate regression analysis revealed that TI and LI had inverse association with neck circumference Z-score (β = 0.11, p = 0.013 and β = 0.12 p = 0.006, respectively). There was a positive correlation between LI with height Z-score (β = 0.12, 95% CI: 0.01, p = 0.009). However, there was no significant association between LI and TI with other anthropometric indices (P > 0.05).

Conclusion

The quality of dietary fats was associated with some anthropometric indices. Further large-scale studies are required to highlight the importance of dietary fat quality indices in relation to cardio-metabolic risk factors in pediatric age groups. Reducing intake of saturated fatty acids, increasing consumption of monounsaturated fatty acids and a balanced intake of omega-3 and omega-6 to reduce the risk of cardiovascular diseases risk factors are recommended.

Higher Lipophilic Index Indicates Higher Risk of Coronary Heart Disease in Postmenopausal Women

Fatty acids (FAs) are essential components of cell membranes and play an integral role in membrane fluidity. The lipophilic index [LI, defined as the sum of the products between FA levels and melting points (°C), divided by the total amount of FA: [Formula: see text]] is thought to reflect membrane and lipoprotein fluidity and may be associated with the risk of coronary heart disease (CHD). Therefore, we examined the associations of dietary and plasma phospholipid (PL) LI with CHD risk among postmenopausal women. We determined dietary LI for the cohort with completed baseline food frequency questionnaires and free of prevalent cardiovascular diseases in the Women's Health Initiative (WHI) observational study (N = 85,563). We additionally determined plasma PL LI in a matched case-control study (N = 2428) nested within the WHI observational cohort study. Cox proportional hazard regression and multivariable conditional logistic regression were used to calculate HRs/ORs for CHD risk between quartiles of LI after adjusting for potential sources of confounding and selection bias. Higher dietary LI in the cohort study and plasma PL LI in the case-control study were significantly associated with increased risk of CHD: HR = 1.18 (95% CI 1.07-1.31, P for trend <0.01) and OR = 1.76 (95% CI 1.33-2.33, P for trend <0.01) comparing extreme quartiles and adjusting for potential confounders. These associations still persisted after adjusting for the polyunsaturated to saturated fat ratio. Our study indicated that higher LI based on either dietary or plasma measurements, representing higher FA lipophilicity, was associated with elevated risk of CHD among postmenopausal women.

Lipophilic index, kidney function, and kidney function decline

BACKGROUND AND AIMS

Unhealthy dietary fats are associated with faster kidney function decline. The cell membrane composition of phospholipid fatty acids (FAs) is a determinant of membrane fluidity and rheological properties. These properties, which have been linked to kidney damage, are thought to be reflected by the lipophilic index (LI). We prospectively investigated the associations of LI with kidney function and its decline.

METHODS AND RESULTS

Observational study from the Prospective Investigation of Vasculature in Uppsala Seniors including 975 men and women with plasma phospholipid FAs composition and cystatin-C estimate glomerular filtration rate (eGFR). Of these, 780 attended re-examination after 5 years, and eGFR changes were assessed. Participants with a 5-year eGFR reduction ≥30% were considered chronic kidney disease (CKD) progressors (n = 198). LI was calculated as the sum of the products of the FA proportions with the respective FAs melting points. Blood rheology/viscosity measurements were performed in a random subsample of 559 subjects at baseline. Increased LI showed a statistically significant but overall weak association with blood, plasma viscosity (both Spearman rho = 0.16, p < 0.01), and erythrocyte deformability (rho = -0.09, p < 0.05). In cross-sectional analyses, LI associated with lower eGFR (regression coefficient 3.00 ml/min/1.73 m² 1-standard deviation (SD) increment in LI, 95% CI: -4.31, -1.69, p < 0.001). In longitudinal analyses, LI associated with a faster eGFR decline (-2.13 [95% CI -3.58, -0.69] ml/min/1.73 m², p < 0.01) and with 32% increased odds of CKD progression (adjusted OR 1.32 [95%, CI 1.05-1.65]).

CONCLUSIONS

A high LI was associated with lower kidney function, kidney function decline, and CKD progression.

TransFatty Acids and Coronary Heart Disease

Epidemiologic evidence has linked trans fatty acids (TFAs) in the diet to coronary heart disease in human populations. It has been estimated that dietary TFAs from partially hydrogenated oils may be responsible for between 30,000 and 100,000 premature coronary deaths per year in the United States. Although it is known that TFAs increase low-density lipoprotein (LDL) cholesterol levels and decrease high-density lipoprotein (HDL) cholesterol levels (markers of coronary heart disease), there is little known about the mechanisms by which TFAs actually function at the cellular level. It is unknown what levels of TFAs are clinically significant and it is unclear how TFAs are associated with cardiac arrhythmias or sudden cardiac death. We hypothesize that TFAs affect membrane structure, thus altering enzymatic pathways that may subsequently induce cardiac arrhythmias and sudden death.

A novel fatty acid lipophilic index and risk of CHD in US men: the health professionals follow-up study

Few epidemiological studies have examined the association between an overall fatty acid (FA) profile and CHD risk. The aim of the present study was to examine a novel index that summarises individual FA levels based on FA affinity and fluidity in relation to CHD risk in men. In a prospective nested case–control study, FA in plasma and erythrocytes were measured in 459 CHD cases and 879 matched controls. Lipophilic index (LI) was computed by summing the products between FA levels and melting point of each FA to reflect the overall FA lipophilicity. Among controls, higher plasma LI was significantly correlated with adverse profiles of blood lipids, inflammatory markers and adiponectin. After multivariate adjustment for age, smoking, BMI and other CHD risk factors, plasma LI was significantly associated with an increased risk of CHD: the relative risk was 1·61 (95% CI 1·03, 2·53; P for trend¼0·04) comparing extreme quintiles. This association was attenuated to 1·21 (95% CI 0·48, 3·09; P for trend¼0·77) after adjusting for plasma levels of total trans-FA, long-chain n-3 FA and polyunsaturated:saturated fat ratio. Erythrocyte LI was not significantly associated with CHD risk. The present data indicate that a novel LI is associated with an adverse profile of cardiovascular risk markers and increased risk of CHD in men; its usefulness as a complement of individual FA in assessing disease risk needs to be elucidated in future studies.

Differences in partitioning of meal fatty acids into blood lipid fractions: a comparison of linoleate, oleate, and palmitate

There has been much interest in the health effects of dietary fat, but few studies have comprehensively compared the acute metabolic fate of specific fatty acids in vivo. We hypothesized that different classes of fatty acids would be variably partitioned in metabolic pathways and that this would become evident over 24 h. We traced the fate of fatty acids using equal amounts of [U-(13)C]linoleate, [U-(13)C]oleate, and [U-(13)C]palmitate given in a test breakfast meal in 12 healthy subjects. There was a tendency for differences in the concentrations of the tracers in plasma chylomicron-triacylglycerol (TG) (oleate > palmitate > linoleate). This pattern remained in plasma nonesterified fatty acid (NEFA) and very low-density lipoprotein (VLDL)-TG (P <or= 0.01 and P <or= 0.02 for [U-(13)C]oleate vs. both [U-(13)C]palmitate and [U-(13)C]linoleate for NEFA and VLDL-TG, respectively). There was significantly more [U-(13)C]linoleate than the other two tracers in plasma cholesteryl ester and phospholipid (PL). Using the values for isotopic enrichment in the different lipid fractions compared with the test meal, we calculated the contribution of meal fatty acids to the respective fractions. At 24 h, 10% of plasma PL-linoleate originated from the breakfast test meal. This was significantly greater than for oleate and palmitate (both 3 +/- 0.3%; P < 0.05). This pattern was also true for erythrocyte PL fatty acids. The marked rapid incorporation of linoleate from a single meal into blood PL fractions may have functional consequences such as maintenance of membrane fluidity and may explain why linoleate is a useful biomarker of dietary intake.

Phosphatidylcholine and sphingomyelin containing an elaidoyl fatty acid can form cholesterol-rich lateral domains in bilayer membranes

Elaidic acid is a trans-fatty acid found in many food products and implicated for having potentially health hazardous effects in humans. Elaidic acid is readily incorporated into membrane lipids in vivo and therefore affects processes regulating membrane physical properties. In this study the membrane properties of sphingomyelin and phosphatidylcholine containing elaidic acid (N-E-SM and PEPC) were determined in bilayer membranes with special emphasis on their interaction with cholesterol and participation in ordered domain formation. In agreement with previous studies the melting temperatures were found to be about 20 degrees C lower for the elaidoyl than for the corresponding saturated lipids. The trans-unsaturation increased the polarity at the membrane-water interface as reported by Laurdan fluorescence. Fluorescence quenching experiments using cholestatrienol as a probe showed that both N-E-SM and PEPC were incorporated in lateral membrane domains with sterol and saturated lipids. At low temperatures the elaidoyl lipids were even able to form sterol-rich domains without any saturated lipids present in the bilayer. We conclude from this study that the ability of N-E-SM and PEPC to form ordered domains together with cholesterol and saturated phospho- and sphingolipids in model membranes indicates that they might have an influence on raft formation in biological membranes.

Trans fatty acid derived phospholipids show increased membrane cholesterol and reduced receptor activation as compared to their cis analogs

The consumption of trans fatty acid (TFA) is linked to the elevation of LDL cholesterol and is considered to be a major health risk factor for coronary heart disease. Despite several decades of extensive research on this subject, the underlying mechanism of how TFA modulates serum cholesterol levels remains elusive. In this study, we examined the molecular interaction of TFA-derived phospholipid with cholesterol and the membrane receptor rhodopsin in model membranes. Rhodopsin is a prototypical member of the G-protein coupled receptor family. It has a well-characterized structure and function and serves as a model membrane receptor in this study. Phospholipid-cholesterol affinity was quantified by measuring cholesterol partition coefficients. Phospholipid-receptor interactions were probed by measuring the level of rhodopsin activation. Our study shows that phospholipid derived from TFA had a higher membrane cholesterol affinity than their cis analogues. TFA phospholipid membranes also exhibited a higher acyl chain packing order, which was indicated by the lower acyl chain packing free volume as determined by DPH fluorescence and the higher transition temperature for rhodopsin thermal denaturation. The level of rhodopsin activation was diminished in TFA phospholipids. Since membrane cholesterol level and membrane receptors are involved in the regulation of cholesterol homeostasis, the combination of higher cholesterol content and reduced receptor activation associated with the presence of TFA-phospholipid could be factors contributing to the elevation of LDL cholesterol.

Trans fatty acid derived phospholipids show increased membrane cholesterol and reduced receptor activation as compared to their cis analogs

The consumption of trans fatty acid (TFA) is linked to the elevation of LDL cholesterol and is considered to be a major health risk factor for coronary heart disease. Despite several decades of extensive research on this subject, the underlying mechanism of how TFA modulates serum cholesterol levels remains elusive. In this study, we examined the molecular interaction of TFA-derived phospholipid with cholesterol and the membrane receptor rhodopsin in model membranes. Rhodopsin is a prototypical member of the G-protein coupled receptor family. It has a well-characterized structure and function and serves as a model membrane receptor in this study. Phospholipid-cholesterol affinity was quantified by measuring cholesterol partition coefficients. Phospholipid-receptor interactions were probed by measuring the level of rhodopsin activation. Our study shows that phospholipid derived from TFA had a higher membrane cholesterol affinity than their cis analogues. TFA phospholipid membranes also exhibited a higher acyl chain packing order, which was indicated by the lower acyl chain packing free volume as determined by DPH fluorescence and the higher transition temperature for rhodopsin thermal denaturation. The level of rhodopsin activation was diminished in TFA phospholipids. Since membrane cholesterol level and membrane receptors are involved in the regulation of cholesterol homeostasis, the combination of higher cholesterol content and reduced receptor activation associated with the presence of TFA-phospholipid could be factors contributing to the elevation of LDL cholesterol.

Effect of dietary conjugated linoleic acid (CLA) on metabolism of isotope-labeled oleic, linoleic, and CLA isomers in women

The purpose of this study was to investigate the effect of dietary CLA on accretion of 9c-18:1, 9c,12c-18:2, 10t,12c-18:2, and 9c,11t-18:2 and conversion of these FA to their desaturated, elongated, and chain-shortened metabolites. The subjects were six healthy adult women who had consumed normal diets supplemented with 6 g/d of sunflower oil or 3.9 g/d of CLA for 63 d. A mixture of 10t,2c-18:2-d4, 9c,11t-18:2-d6, 9c-18:1-d8, and 9c,12c-18:2-d2, as their ethyl esters, was fed to each subject, and nine blood samples were drawn over a 48-h period. The results show that dietary CLA supplementation had no effect on the metabolism of the deuterium-labeled FA. These metabolic results were consistent with the general lack of a CLA diet effect on a variety of physiological responses previously reported for these women. The 2H-CLA isomers were metabolically different. The relative percent differences between the accumulation of 9c,11t-18:2-d6 and 10t,12c-18:2-d4 in plasma lipid classes ranged from 9 to 73%. The largest differences were a fourfold higher incorporation of 10t,12c-18:2-d4 than 9c,11t-18:2-d6 in 1-acyl PC and a two- to threefold higher incorporation of 9c,11t-18:2-d6 than 10t,12c-18:2-d4 in cholesterol esters. Compared to 9c-18:1-d8 and 9c,12c-18:2-d2, the 10t,12c-18:2-d4 and 9c,11t-18:2-d6 isomers were 20-25% less well absorbed. Relative to 9c-18:1, incorporation of the CLA isomers into 2-acyl PC and cholesterol ester was 39-84% lower and incorporation of 10t,12c-18:2 was 50% higher in 1-acyl PC. This pattern of selective incorporation and discrimination is similar to the pattern generally observed for trans and cis 18:1 positional isomers. Elongated and desaturated CLA metabolites were detected. The concentration of 6c,10t,12c-18:3-d4 in plasma TG was equal to 6.8% of the 10t,12c-18:2-d4 present, and TG was the only lipid fraction that contained a CLA metabolite present at concentrations sufficient for reliable quantification. In conclusion, no effect of dietary CLA was observed, absorption of CLA was less than that of 9c-18:1, CLA positional isomers were metabolically different, and conversion of CLA isomers to desaturated and elongated metabolites was low.

Dietary linoleic acid influences desaturation and acylation of deuterium-labeled linoleic and linolenic acids in young adult males

The purpose of this study was to investigate the effect of dietary linoleic acid (18:2(n - 6)) on the conversion of 18:2(n - 6) and 18:3(n - 3) to their respective n - 6 and n - 3 metabolites; to compare the incorporation of these fatty acids into human plasma lipids; to evaluate the importance of dietary 18:3(n - 3) as a precursor for the biosynthesis of long-chain length n - 3 fatty acids. The approach used was to feed young adult male subjects (n = 7) diets containing 2 levels of linoleic acid (SAT diet, 15 g/day; PUFA diet, 30 g/day) for 12 days. A mixture of triacylglycerols containing deuterated linolenic (18:3(n - 3)) and linoleic (18:2(n - 6)) acids was fed and blood samples were drawn over a 48 h period. Concentrations of deuterated 18:3(n - 3) in plasma total lipid ranged from 309.2 to 606.4 microgram/ml and concentrations of 18:2(n - 6) ranged from 949.2 to 1743.3 micrograms/ml. The sum of the deuterated n - 3 long-chain length fatty acid metabolites in plasma total lipid were 116 +/- 4.3 micrograms/ml (SAT diet) and 41.6 +/- 12.4 micrograms/ml (PUFA diet). The total deuterated n - 6 fatty acid metabolites were 34.6 +/- 12.2 micrograms/ml (SAT diet) and 9.8 +/- 5.9 micrograms/ml (PUFA diet). The total percent conversion of deuterated 18:3(n - 3) to n - 3 fatty acid metabolites and deuterated 18:2(n - 6) to n - 6 fatty acid metabolites were 11-18.5% and 1.0-2.2%, respectively. The percentages for deuterated 20:5(n - 3), 22:5(n - 3) and 22:6(n - 3) (6.0%, 3.5%, and 3.8%) were much higher than for 20:3(n - 6) and 20:4(n - 6) (0.9% and 0.5%). Overall, conversion of deuterated 18:3(n - 3) and 18:2(n - 6) was reduced by 40-54% when dietary intake of 18:2(n - 6) was increased from 15 to 30 g/day. Comparison of the deuterated 18:3(n - 3) and 18:2(n - 6) data for plasma triacylglycerol and phosphatidylcholine (PC) indicated that 18:2(n - 6) was preferentially incorporated into PC. Dietary 18:2(n - 6) intake did not alter acyltransferase selectivity but activity was reduced when 18:2(n - 6) intake was increased. Based on these results, conversion of the 18:3(n - 3) in the US diet (2 g) is estimated to provide 75-85% of the long-chain length n - 3 fatty acids needed to meet daily requirements for some (but not all) adults.

Effect of trans fatty acids on plasma lipids, platelet function and systolic blood pressure in stroke-prone spontaneously hypertensive rats

To investigate the effect of trans fatty acids on plasma lipid levels and systolic blood pressure, hydrogenated corn oil was fed to SHRSP (stroke-prone spontaneously hypertensive rats) and WKY (Wistar-Kyoto) rats for 30 days. Significantly lower systolic blood pressure and plasma total cholesterol were observed in SHRSP rats fed trans fatty acids when compared with rats fed cis fatty acids from olive oil. In addition, higher HDL cholesterol and lower VLDL plus chylomicron cholesterol levels were found in SHRSP rats fed trans fatty acids. Although no significant changes of systolic blood pressure and plasma total cholesterol levels were observed in WKY rats after trans fatty acids treatment, WKY rats fed trans fatty acids had lower plasma LDL cholesterol and higher HDL cholesterol levels. In addition, platelet aggregation induced by collagen was decreased in WKY rats fed trans fatty acids. It is interesting that trans fatty acids increased the activity of plasma lecithin:cholesterol acyltransferase (LCAT) in both SHRSP and WKY rats. The observed influence of trans fatty acids on plasma lipid levels, systolic blood pressure and platelet aggregation suggests that trans fatty acids might prevent thrombotic disorders in SHRSP rats.

Absorption and distribution of deuterium-labeled trans- and cis-11-octadecenoic acid in human plasma and lipoprotein lipids

Triglycerides of deuterium-labeled trans-11-, trans-11-cis-11- and cis-9-octadecenoic acid (11t-18:1-2H, 11c-18:1-2H) were simultaneously fed to two young adult male subjects. Plasma lipids from blood samples collected periodically for 48 hr were analyzed by gas chromatography-mass spectroscopy. The results indicate the delta 11-18:1-2H acids and 9c-18:1-2H were equally well absorbed; relative turnover rates were higher for the delta 11-18-1-2H acids in plasma triglycerides; incorporation of the delta 11-18:1-2H acids into plasma phosphatidylcholine was similar to 9c-18:1-2H, but distribution at the 1- and 2-acyl positions was substantially different; esterification of cholesterol with 11t-18:1 was extremely low; chain shortening of the delta 11-18:1-2H acids was 2-3 times greater than for 9c-18:1-2H; no evidence for desaturation or elongation of the 18:1-2H acids was detected; and a 40% isotopic dilution of the 18:1-2H acids in the chylomicron triglyceride fraction indicated the presence of a substantial intestinal triglyceride pool. Based on our present knowledge, these metabolic results for delta 11-18:1 acids present in hydrogenated oils and animal fats indicate that the delta 11 isomers are no more likely than 9c-18:1 to contribute to dietary fat-related health problems.

In vivo distribution and turnover of trans- and cis-10-octadecenoic acid isomers in human plasma lipids

Triacylglycerols containing deuterium-labeled trans-10- and cis-10-octadecenoic acid (10t-18:1, 10c-18:1) plus the triacylglycerol of deuterated cis-9-octadecenoic acid (9c-18:1) were fed as a mixture to two young, adult male subjects. Analysis by mass spectroscopy of the labeled fats in blood samples collected periodically for 48 h allowed the uptake, distribution and turnover of both 10-octadecenoic acid isomers to be directly compared to 9c-18:1. A feature of this study is that actual weight data for the labeled fats were obtained. These data allowed plasma triacylglycerol turnover rates of 3.47-5.13 mg/min per kg to be estimated. Plasma and chylomicron triacylglycerol data also provided evidence that absorption of the deuterated fats mobilized 10-12 g of a triacylglycerol pool present in the intestinal cells. Other results are summarized as follows: the 10t-, 10c- and 9c-18:1 fatty acids were equally well absorbed, both delta 10-18:1 isomers were oxidized more rapidly than 9c-18:1, conversion of the delta 10-18:1 isomers into their corresponding 16:1 isomers was about 3-times faster than for 9c-18:1, the delta 10-18:1 isomers were preferentially incorporated at the 1-acyl and excluded from the 2-acyl position of phosphatidylcholine, esterification of cholesterol with the delta 10-18:1 fatty acids was 2.5-4.3-times slower than for 9c-18:1 and desaturation and elongation rates for the delta 10-18:1 acids were very low.

Analysis of deuterium labeled blood lipids by chemical ionization mass spectrometry

A quantitative analytical method has been developed to analyze methyl esters of blood fatty acids derived from human subjects fed deuterium-labeled fats. The GCMS computer method provides for the analysis of the fed deuterium-labeled fatty acids, the naturally occurring blood fatty acids and new fatty acids formed by chain elongation or shortening of the fed labeled fats. Approximately 20 fatty acids including 16, 17, 18 and 20 carbon chain acids were analyzed with a relative standard deviation of 0.02 at the microgram level and a sensitivity of less than one nanogram. The method uses capillary GC to separate the fatty acid esters and isobutane chemical ionization mass spectrometry with multiple ion detection to determine the isotopic constituents of the GC peaks. The technique provides for the determination of overlapping GC peaks labeled with 2, 4 and 6 deuterium atoms and makes extensive use of computers both for data acquisition and processing.

Occurrence of octadecenoic fatty acid isomers from hydrogenated fats in human tissue lipid classes

The level of trans-18:1 isomers in several isolated lipid classes of human liver, heart, red blood cells and plasma was determined. Phospholipids contained substantially fewer trans-18:1 isomers than triglycerides. The double bond distribution of the cis and trans octadecenoate fraction of triglycerides and phosphatidylcholines from human liver and heart was determined. Whereas the double bond distribution of the triglycerides correlated closely with the pattern found in dietary hydrogenated vegetable oils, the phosphatidylcholine fraction showed evidence of selective incorporation or metabolism of specific trans positional isomers. In general, isomers with double bonds near the methyl terminus were present at levels higher than expected from their relative abundance in the diet. Refinements in methodology needed to analyze octadecenoate double bond configuration and location in human tissues are presented.

Distribution of deuterium-labeled cis- and trans-12-octadecenoic acids in human plasma and lipoprotein lipids

Triglycerides containing cis- and trans-12-octadecenoic acid (12c-18:1 and 12t-18:1) and cis-9-octadecenoic acid (9c-18:1) labeled with deuterium were fed to 2 young adult male subjects. These fatty isomers each contained a different number of deuterium lables, which allowed mass spectrometric analysis to distinguish among them after they were fed as a mixture. This approach results in a direct comparison of the absorption and distribution of these 3 monenoic acids into blood plasma and lipoprotein lipids. Plasma lipid data indicated that all phospholipid fractions selectively incorporate 12c-18:1 and 12t-18:1 in preference to 9c-18:1. Discrimination against 12c-18:1 and 12t-18:1 compared to 9c-18:1 was found in the plasma neutral lipids, with a strong discrimination against 12t-18:1 incorporation into the cholesteryl ester fraction. Considerable reduction in the percentage of linoleic and arachidonic acid was observed when 12-18:1 isomers were incorporated in plasma triglyceride, phosphatidylcholine and spingomyelin samples. Chylomicron lipid analyses indicated that all isomers were well absorbed. Variation was observed in the relative distribution of 12c-18:1, 12t-18:1 and 9c-18:1 between the very low density, low density and high density lipoprotein lipid classes. No desaturation of 12c-18:1 to linoleic acid was detected.