Fatty acid analysis in serum of patients with elevated lipoprotein(a) and cardiovascular disease undergoing lipoprotein apheresis

Elsevier

Available online 28 November 2023

Journal of Clinical LipidologyAuthor links open overlay panel, , , , , , , , Highlights•

Serum VLCFAs and VLC-MUFAs were eluted at 57% after lipoprotein apheresis (LA)

Serum VLCFAs and VLC-MUFAs remained low for 7 days after LA

LA induces an acute increase in the serum levels of anti-inflammatory BCFAs

Long-term regular biweekly LA decreased the serum levels of VLC-MUFAs and n3 PUFAs

AbstractBackground

Lipoprotein apheresis (LA) is an extracorporeal treatment that transiently reduces lipoprotein (a) by 60% and leads to an 80–92% reduction in major adverse cardiovascular events. LA has a significant impact on lipid profile in serum of patients with atherosclerotic cardiovascular disease.

Objective

To investigate the effects of LA on the composition of serum fatty acids (FAs), focusing on those which could have an impact on cardiovascular disease (CVD).

Methods

This is a prospective study in the First Department of Cardiology of the Medical University of Gdansk, Poland. Serum samples were collected from 28 patients before LA, just after the procedure, and 7 days after LA. Additionally, in a smaller group of patients, the samples were collected after second tour of LA (2 weeks later), as well as after 1year from the first procedure. The serum FA profile was analyzed using gas chromatography-mass spectrometry.

Results

After the LA procedure, a substantial change in serum FA composition along with LDL-C and Lp(a) decrease were observed 7 days after procedure, but these parameters returned to the values similar to those before procedure after 14 days. Very long-chain FAs (VLCFAs) and very long-chain monounsaturated FAs (VLC-MUFAs) were eluted at 57% and remained low even 7 days after LA (p=0.027 and p<0.001, respectively). We also observed an increase in the percentage of total branched-chain FAs (BCFAs) (p=0.004) and anteiso BCFAs (p=0.012) after FA. After 1year of regular LA, a substantial decrease in serum VLC-MUFAs and n3 polyunsaturated FA (PUFAs) were noted.

Conclusions

Decreased VLCFAs and VLC-MUFAs involved in CVD development remained low even 7 days after LA. An acute increase in the levels of anti-inflammatory BCFAs was observed. In turn long-term regular administration of LA substantially decreased VLC-MUFA and n3 PUFA.

Keywords

fatty acids

VLCFA

VLC-MUFA

lipoprotein apheresis

atherosclerosis

serum

© 2023 Published by Elsevier Inc. on behalf of National Lipid Association.

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