Dietary fatty acids and ischaemic heart disease

Fatty acid composition of serum and adipose tissue lipids in males with chronic renal failure. Relations to serum lipoproteins and clinical factors

We have analysed the fatty acid composition of serum cholesterol esters (CE), phospholipids (PL) and triglycerides (TG) and of adipose tissue (AT) lipids in 72 males and chronic renal failure (CRF). Sixteen patients were treated with protein-poor diet. 16 with hemodialysis. The results have been related to clinical aspects of the disease and to abnormalities in serum lipid and lipoprotein concentrations. The major findings were high relative content of oleic acid and a low relative content of linoleic acid in all lipids in the diet-treated group compared to both controls and to the untreated and dialysed patients. Tendencies in the same directions were seen also in the untreated subjects, significant for oleic and linoleic acid in CE and for oleic acid in PL. These changes did not correlate to serum of lipoprotein lipids, or to serum creatinine concentrations in patients not on diet or dialysis, indicating that other factors are more important in modifying the fatty acid metabolism in CRF. The composition of the protein-poor diet, which was rich in fat but low in linoleic acid in relation to oleic acid, is probably a major factor explaining our findings in the diet-treated group. Since low levels of linoleic acid in plasma and AT lipids have been suggested to be a risk factor for atherosclerosis, more attention should be paid to the content and composition of dietary fat in order to prevent the occurrence of such low levels.