Alterations in Circulating Fatty Acid Composition in Patients with Systemic Lupus Erythematosus: A Pilot Study

Introduction: Circulating fatty acids (FAs) may play a role in the disease pathogenesis of patients with systemic lupus erythematosus (SLE). Objectives: To compare red blood cell (RBC) and plasma FA composition: (1) between female SLE patients and age-matched healthy female (HF) controls and in SLE with history of cardiovascular disease (CVD) and those with no history (SLE+CVD vs SLE-CVD); and (2) between SLE patients who were or were not receiving prednisone treatment at the time of blood sampling. Methods: This cross-sectional study consisted of 33 female patients with SLE (11 SLE+CVD, 22 SLE-CVD) and 20 HF controls. Demographics, CVD risk, medication profile, blood biochemistry, and FA composition of RBC and plasma total lipids were determined. Results: Waist circumference and body mass index were higher in SLE patients than in HF controls. These variables along with serum triglycerides, blood glucose, and systolic blood pressure were higher in SLE+CVD than SLE-CVD patients. RBC FA composition showed lower eicosapentaenoic acid (EPA, omega-3 active metabolite) and omega-3 index (EPA+ docosahexaenoic acid) in SLE patients compared with HF controls. The ratio of the RBC inflammatory metabolite, arachidonic acid, to the anti-inflammatory metabolite EPA was also significantly higher in SLE patients than in HF controls. No differences were seen in plasma FA between SLE and HF groups. However, SLE-CVD patients had a more favorable lipid profile than SLE+CVD patients. In SLE patients, the use of prednisone resulted in alteration of both RBC and plasma FA composition. Conclusion: SLE patients, regardless of their history of CVD, have altered plasma and RBC FA composition favoring inflammation. The use of prednisone was associated with differences in FA profile. (JPEN J Parenter Enteral Nutr. 2011;35:198-208)