Relationship between Free Fatty Acid Spectrum, Blood Stasis Score, and Macroangiopathy in Patients with Type 2 Diabetes

De‑Liang Liu<sup>a</sup>; Shu‑Fang Chu<sup>a</sup>; Hui‑Lin Li<sup>a</sup>; Heng‑Xia Zhao<sup>a</sup>; Xue‑Mei Liu<sup>a</sup>; Xin Qu<sup>a</sup>; Yi‑Nan Zhou<sup>b</sup>; Zhe Chen<sup>b</sup>; Xue‑Wen Zhang<sup>c</sup>

Relationship between Free Fatty Acid Spectrum, Blood Stasis Score, and Macroangiopathy in Patients with Type 2 Diabetes

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DOI：10.4103/wjtcm.wjtcm_5_18

KeyWord:Blood stasis, diabetic macroangiopathy, lipotoxicity, type 2 diabetes

Author	Institution
De‑Liang Liu^a	a.Department of Endocrinology, Shenzhen TCM Hospital, Shenzhen，China
Shu‑Fang Chu^a	a.Department of Endocrinology, Shenzhen TCM Hospital, Shenzhen，China
Hui‑Lin Li^a	a.Department of Endocrinology, Shenzhen TCM Hospital, Shenzhen，China
Heng‑Xia Zhao^a	a.Department of Endocrinology, Shenzhen TCM Hospital, Shenzhen，China
Xue‑Mei Liu^a	a.Department of Endocrinology, Shenzhen TCM Hospital, Shenzhen，China
Xin Qu^a	a.Department of Endocrinology, Shenzhen TCM Hospital, Shenzhen，China
Yi‑Nan Zhou^b	b.Department of Endocrinology , 4th Clinical College of Guangzhou University of Chinese Medicine, Shenzhen, Guangzhou
Zhe Chen^b	b.Department of Endocrinology , 4th Clinical College of Guangzhou University of Chinese Medicine, Shenzhen, Guangzhou
Xue‑Wen Zhang^c	c.Institute of National Master of TCM, Shaanxi University of Chinese Medicine, Xianyang, Shanxi University of Traditional Chinese Medicine, Taiyuan, China

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Abstract:

Objective: Our aim was to investigate the correlation between free fatty acid (FFA) spectrum, blood stasis (BS) score, and macroangiopathy in type 2 diabetic patients with or without BS, as well as the possible relationship between BS and lipotoxicity. Methods: A total of 50 type 2 diabetes (T2D) patients with or without BS were enrolled from June to December 2014 in Shenzhen Traditional Chinese Medicine (TCM) Hospital, with 25 patients allocated to each of two groups. Basic information, BS score, blood glucose, blood lipids, etc., were measured for each patient. In addition, we tested the levels of interleukin (IL)‑6, tumor necrosis factor α (TNF‑α), and IL‑18 with enzyme‑linked immunosorbent assay. The macroangiopathy status of patients in the two groups was examined by color ultrasound and all factors related to BS scores were analyzed. Gas chromatography‑mass spectrometry was used to explore the difference in the serum FFA spectra between the two different groups. In addition, the relationship between FFA spectra, BS scores, and macroangiopathy was analyzed. Results: BS scores, total cholesterol (TC), total triglyceride (TG), low‑density lipoprotein cholesterol, IL‑6, TNF‑α, IL‑18, carotid and femoral artery plaque, carotid intima‑media thickness, carotid plaque area, and femoral artery plaque area were all significantly increased in T2D patients with BS syndrome (P < 0.05). A positive correlation was observed between age, duration of diabetes, carotid intima‑media thickness, carotid plaque area, femoral artery plaque area, and BS score (P < 0.05). A total of 21 fatty acids were found in the serum, and total FFA (TFFA), saturated fatty acid (SFA), lauric acid (C12:0), palmitic acid (16:0), stearic acid (C18:0), arachidonic acid (C20:4n6), behenic acid (C22:0), and lignoceric acid (C24:0) scores were all found to contribute to the difference between FFA spectrums of the two groups; of the fatty acids, C12:0, C16:0, C18:0, C22:0, TFFA, and SFA positively correlated with BS scores as evaluated by Pearson’s or Spearman’s correlation analysis (P < 0.05). Only SFA entered the regression equation in the multiple linear regression analysis. C12:0, C16:0, C18:0, C20:4n6, TFFA, and SFA were positively correlated with carotid plaque area, whereas linoleic acid (C18:3n3), Cis‑5, 8, 11, 14, and 17‑eicosapentaenoic acids (C20:5n3) were negatively correlated (P < 0.05). C16:0 was positively correlated with the femoral artery plaque area and C18:3n3, cis‑4, 7, 10, 13, 16, and 19‑docosahexaenoic acids (C22:6) and nervonic acid were negatively correlated (P < 0.05). Conclusion: Serum FFA spectra were significantly different between T2D patients with BS and those without, and long‑chain SFA made the greatest contribution. Serum FFA spectra were correlated with BS scores and diabetic macroangiopathy, which means that lipotoxicity and BS are correlated in T2D.