The measurement of serum polyunsaturated fatty acid (PUFA) levels in type 2 diabetes (T2DM) patients may be useful for evaluating not only the dietary habits, but also metabolic abnormalities, as high dihomo-γ-linolenic acid (DGLA) levels or low arachidonic acid (AA)/DGLA ratios are associated with obesity-related abnormalities. However, the impact of PUFA levels on glycemic control remains unknown. This retrospective study analyzed the association between serum PUFA levels and glycemic control one year after discharge from admission. Data from 480 T2DM patients admitted to our hospital from 2011 to 2016 were analyzed. Patients with renal dysfunction (eGFR < 30 mL/min/1.73 m2) or insulin deficiency [fasting C-peptide (CPR) < 0.5 ng/mL or two-hour postprandial CPR < 1.0 ng/mL] were excluded. Patients achieving < 7.0% glycated hemoglobin (HbA1c) at one year after discharge were defined as achievers, and the others, as non-achievers. Multiple baseline factors, including the PUFA levels between the two groups were analyzed. Of 480 patients, 206 were achievers and 274 were non-achievers. The achievers were younger (59.4±12.8 vs. 62.0±13.7 years, p = 0.0188), and had a higher two-hour postprandial CPR (4.98±2.46 vs. 4.26±2.10 ng/mL, p = 0.002), lower DGLA level (36.2±15.6 vs. 39.8±13.5 μg/mL, p = 0.002), and higher AA/DGLA ratio (6.09±2.39 vs. 5.12±1.73, p <0.001) than non-achievers, while the body mass index, HbA1c at admission, fasting CPR, omega-3 PUFA levels between the groups did not differ. The two-hour postprandial CPR and DGLA levels (or AA/DGLA ratios) also showed significant associations in the multivariate logistic regression model. Sensitivity analyses excluding the patients ≥ 75 years old or those treated with insulin showed similar results. Our results show that high DGLA levels and low AA/DGLA ratios, as well as decreased postprandial insulin secretion are predictors of glycemic control deterioration after discharge from admission.
T. Sunouchi: None. Y. Tsurutani: Research Support; Self; Astellas Pharma Inc. T. Takiguchi: None. J. Saito: None. T. Nishikawa: None.