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

Agnieszka Mickiewicz; Joanna Marlęga-Linert; Monika Czapiewska; Marta Marcinkowska; Aleksandra Krzesińska; Agnieszka Kuchta; Marcin Fijałkowski; Marcin Gruchała; Adriana Mika

doi:10.1016/j.jacl.2023.11.011

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

J Clin Lipidol. 2024 Mar-Apr;18(2):e197-e206. doi: 10.1016/j.jacl.2023.11.011. Epub 2023 Nov 28.

Authors

Agnieszka Mickiewicz¹, Joanna Marlęga-Linert², Monika Czapiewska³, Marta Marcinkowska², Aleksandra Krzesińska⁴, Agnieszka Kuchta⁴, Marcin Fijałkowski², Marcin Gruchała², Adriana Mika⁵

Affiliations

¹ First Department of Cardiology, Medical University of Gdansk, Smoluchowskiego 17, 80-214 Gdansk, Poland (Drs Mickiewicz, Gruchała, Marlęga-Linert, Marcinkowska and Fijałkowski). Electronic address: amickiewicz@gumed.edu.pl.
² First Department of Cardiology, Medical University of Gdansk, Smoluchowskiego 17, 80-214 Gdansk, Poland (Drs Mickiewicz, Gruchała, Marlęga-Linert, Marcinkowska and Fijałkowski).
³ Department of Pharmaceutical Biochemistry, Medical University of Gdansk, Debinki 1, 80-211 Gdansk, Poland (Drs Czapiewska and Mika).
⁴ Department of Clinical Chemistry, Medical University of Gdansk, Dębinki 7, 80-211 Gdansk, Poland (Drs Krzesińska and Kuchta).
⁵ Department of Pharmaceutical Biochemistry, Medical University of Gdansk, Debinki 1, 80-211 Gdansk, Poland (Drs Czapiewska and Mika); Department of Environmental Analysis, University of Gdansk, Wita Stwosza 63, 80-308 Gdansk, Poland (Dr Mika). Electronic address: adriana.mika@gumed.edu.pl.

PMID: 38092592
DOI: 10.1016/j.jacl.2023.11.011

Abstract

Background: Lipoprotein apheresis (LA) is an extracorporeal treatment that transiently reduces lipoprotein (a) [Lp(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 a second tour of LA (2 weeks later), as well as after 1 year 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 low-density lipoprotein cholesterol (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 LA. After 1 year of regular LA, a substantial decrease in serum VLC-MUFAs and n3 polyunsaturated LA (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: Atherosclerosis; Fatty acids; Lipoprotein apheresis; Serum; VLC-MUFA; VLCFA.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Blood Component Removal*
Cardiovascular Diseases* / blood
Fatty Acids* / blood
Female
Humans
Lipoprotein(a)* / blood
Male
Middle Aged
Prospective Studies

Substances

Lipoprotein(a)
Fatty Acids