Fatty acids of erythrocyte membranes as biomarkers of non-alcoholic fatty liver disease in men

The aim of the study was to identify fatty acids of erythrocyte membranes that are significant for distinguishing patients with non-alcoholic fatty liver disease from healthy men, to study their indices and to establish associations of fatty acid levels with clinical and biochemical parameters. 30 men (48.7 ± 3.4 years) with non-alcoholic fatty liver disease (NAFLD) were examined according to ultrasound of the abdominal cavity, confirmed by the NLFS index, the degree of liver fibrosis established by indirect elastometry did not exceed 1 degree. As a comparison group – 28 conditionally healthy men (47.3 ± 2.7 years). The levels of fatty acids of erythrocyte membranes were studied using GC/MS systems based on three quadrupoles. A higher content of a number of saturated (lauric, margarine, pentadecanoic), monounsaturated fatty acids (palmitoleic, oleic, elaidic, the total level of monounsaturated), linoleic acid, the ratio of omega-6 to omega-3 polyunsaturated fatty acids was found in patients with non-alcoholic fatty liver disease compared with those for the control group. On the contrary, the levels of two saturated fatty acids – arachinic acid, stearic acid, omega-3 polyunsaturated fatty acid – docosahexaenoic acid, the total content of sum eicosapentaenoic acid and docosahexaenoic acid, the total level of all omega-3 polyunsaturated fatty acids and the ratio of saturated and unsaturated fatty acids were lower in patients with NAFLD than in healthy men (p=0.004-0.05). Analysis of fatty acid indices reflecting their metabolism revealed an increase in the activity of elongase (protein ELOVL6) – C18:0/C16:0 (p < 0.001), de novo lipogenesis index – C16:0/C18:2n-6 (p = 0.03) and a decrease in the activity of stearoyl-CoA desaturase 1 (C16:1;7/C16:0 (p = 0.004); C18:1;c9/C18:0 (p < 0.0001)), delta-5-desaturase (C20:4n-6/C20:3n-6) (p = 0.022) for patients with NAFLD compared with the control group. The use of individual fatty acid levels as markers to distinguish patients with NAFLD from healthy individuals showed high diagnostic accuracy – for palmitoleic acid area under the curve (AUC) 0.877, sensitivity 87 %, specificity 83 %; for arachinic acid AUC 0.825, sensitivity 84 %, specificity 78 %; for the total content of monounsaturated FA AUC 0.821, sensitivity 81 %, specificity 78 %. The use of the “panel” of fatty acids (С16:1;9, total MUFA, С20:0, n6/n3 PUFA, С18:0) provided an increase in sensitivity (91 %) and specificity (95 %) (AUC 0.915). The multidirectional associations of the levels of fatty acids of erythrocyte membranes with the manifestations of metabolic syndrome, indicators of liver tests were revealed.

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