通过测量红细胞20:3ω9（芥酸）、22:5ω6/20:4ω6和22:5ω6/22:6ω3评估必需脂肪酸和ω-3脂肪酸状态。

Assessment of essential fatty acid and omega3-fatty acid status by measurement of erythrocyte 20:3omega9 (Mead acid), 22:5omega6/20:4omega6 and 22:5omega6/22:6omega3.

作者信息

Fokkema M R, Smit E N, Martini I A, Woltil H A, Boersma E R, Muskiet F A J

机构信息

Department of Pathology and Laboratory Medicine, Groningen University Hospital, The Netherlands.

出版信息

Prostaglandins Leukot Essent Fatty Acids. 2002 Nov;67(5):345-56. doi: 10.1054/plef.2002.0440.

DOI:10.1054/plef.2002.0440

PMID:12445496

Abstract

BACKGROUND

Early suspicion of essential fatty acid deficiency (EFAD) or omega3-deficiency may rather focus on polyunsaturated fatty acid (PUFA) or long-chain PUFA (LCP) analyses than clinical symptoms. We determined cut-off values for biochemical EFAD, omega3-and omega3/22:6omega3 [docosahexaenoic acid (DHA)]-deficiency by measurement of erythrocyte 20:3omega9 (Mead acid), 22:5omega6/20:4omega6 and 22:5omega6/22:6omega3, respectively.

METHODS

Cut-off values, based on 97.5 percentiles, derived from an apparently healthy omnivorous group (six Dominica breast-fed newborns, 32 breast-fed and 27 formula+LCP-fed Dutch low-birth-weight infants, 31 Jerusalem infants, 33 Dutch 3.5-year-old infants, 69 omnivorous Dutch adults and seven Dominica mothers) and an apparently healthy group with low dietary LCP intake (81 formula-fed Dutch low-birth-weight infants, 12 Dutch vegans). Cut-off values were evaluated by their application in an EFAD suspected group of 108, mostly malnourished, Pakistani children, three pediatric patients with chronic fat-malabsorption (abetal-ipoproteinemia, congenital jejunal and biliary atresia) and one patient with a peroxisomal beta-oxidation disorder.

RESULTS

Erythrocyte 20:3omega9, 22:5omega6/20:4omega6 and 22:5omega6/22:6omega3 proved age-dependent up to 0.2 years. Cut-off values for ages above 0.2 years were: 0.46mol% 20:3omega9 for EFAD, 0.068mol/mol 22:5omega6/20:4omega6 for omega3-deficiency, 0.22mol/mol 22:5omega6/22:6omega3 for omega3/DHA-marginality and 0.48mol/mol 22:5omega6/22:6omega3 for omega3/DHA-deficiency. Use of RBC 20:3omega9 and 22:5omega6/20:4omega6 cut-off values identified 20.4% of the Pakistani subjects as EFAD+omega3-deficient, 12.9% as EFAD+omega3-sufficient, 38.9% as EFA-sufficient+omega3-deficient and 27.8% as EFA-sufficient+omega3-sufficient. The patient with the peroxisomal disorder was classified as EFA-sufficient, omega3-sufficient (based on RBC 22:5omega6/20:4omega6) and omega3/DHA-deficient (based on RBC 22:5omega6/22:6omega3). The three other pediatric patients were classified as EFAD, omega3-deficient and omega3/DHA-deficient.

CONCLUSION

Use of the combination of the present cut-off values for EFA, omega3 and omega3/DHA status assessment, as based on 97.5 percentiles, may serve for PUFA supplement intervention until better concepts have emerged.

摘要

背景

早期怀疑必需脂肪酸缺乏（EFAD）或ω-3缺乏时，可能更侧重于多不饱和脂肪酸（PUFA）或长链PUFA（LCP）分析，而非临床症状。我们通过分别测定红细胞20:3ω9（麦角硫因酸）、22:5ω6/20:4ω6和22:5ω6/22:6ω3 [二十二碳六烯酸（DHA）]，确定了生化性EFAD、ω-3和ω-3/22:6ω3（DHA）缺乏的临界值。

方法

临界值基于第97.5百分位数，来自一个明显健康的杂食组（6名多米尼克母乳喂养的新生儿、32名母乳喂养以及27名配方奶加LCP喂养的荷兰低体重婴儿、31名耶路撒冷婴儿、33名荷兰3.5岁婴儿、69名杂食的荷兰成年人以及7名多米尼克母亲）和一个饮食中LCP摄入量低的明显健康组（81名配方奶喂养的荷兰低体重婴儿、12名荷兰纯素食者）。通过将这些临界值应用于一个有108名大多营养不良的疑似EFAD的巴基斯坦儿童组、3名患有慢性脂肪吸收不良（无β-脂蛋白血症、先天性空肠和胆道闭锁）的儿科患者以及1名患有过氧化物酶体β-氧化障碍的患者，对临界值进行评估。

结果

红细胞20:3ω9、22:5ω6/20:4ω6和22:5ω6/22:6ω3在0.2岁之前显示出与年龄相关。0.2岁以上年龄的临界值为：EFAD的20:3ω9为0.46mol%，ω-3缺乏的22:5ω6/20:4ω6为0.068mol/mol，ω-3/DHA边缘状态的22:5ω6/22:6ω3为0.22mol/mol，ω-3/DHA缺乏的22 :5ω6/22:6ω3为0.48mol/mol。使用红细胞20:3ω9和22:5ω6/20:4ω6临界值，将20.4%的巴基斯坦受试者判定为EFAD + ω-3缺乏，12.9%判定为EFAD + ω-3充足，38.9%判定为EFA充足 + ω-3缺乏，27.8%判定为EFA充足 + ω-3充足。患有过氧化物酶体疾病的患者被分类为EFA充足、ω-3充足（基于红细胞22:5ω6/20:4ω6）和ω-3/DHA缺乏（基于红细胞22:5ω6/22:6ω3）。其他三名儿科患者被分类为EFAD、ω-3缺乏和ω-3/DHA缺乏。