Effect of α-Linolenic Acid�Containing Linseed Oil on Coagulation in Type 2 Diabetes

In this letter to the editor of the Diabetes Care journal, the authors describes  reserahc that has been conduted to assess the effects of alpha linolenic acid (ALA) in linseed oil (flax) on blood coagulation (clotting) in diabetes. The aim of this study was to determine the effects of n3 PUFA supplementation on coagulation and fibrinolytic factors in type 2 diabetic subjects. He notes that, while it is not clear what the appropriate intake ratio of n6 to n3 PUFAs should be for diabetic subjects, it is known that the dietary intake ratio of n6 to n3 PUFAs is roughly 4:1 in Japanese subjects. Ten subjects (six women and four men, average age 59.6 years) with type 2 diabetes participated in this study. Their average BMI and HbA1c values were 20.9 plus and minus 3.8 kg/m2 and 10.8 plus and minus 1.1%, respectively. Their daily energy intake during the course of the study was 1,490 plus and minus 166 kcal. After 2 weeks on the control diet, subjects were placed on a diet in which 5 g linseed oil was added in exchange for 5 g cooking oil. The ratio of PUFAs to saturated fatty acids in the subjects� pre study and study diets were 1.2 and 1.6, respectively, while the ratios of n6 to n3 PUFAs in their pre study and study diets were 3.6 and 1.5, respectively. After 2 weeks on a linseed oil supplemented diet, plasmin 2 plasmin inhibitor complex (PPI) level and plasminogen activator inhibitor1 (PAI1) activity in plasma and thrombin anti thrombin III complex (TAT) level fell significantly (0.72 plus and minus 0.19 vs. 0.47 plus and minus 0.14 g/ml, P =0.0009; 73.3 plus and minus 37.5 vs. 51.6 plus and minus 25.0 ng/ml, P=0.02; and 9.6 plus and minus 9.1 vs. 2.5 plus and minus 1.1 ng/ml, P = 0.04; respectively). Thus, a diet induced reduction in the n6:n3 PUFA ratio affected parameters of blood coagulation and fibrinolysis, and showed that PPI level, PAI-1 activity, and TAT level were significantly reduced in type 2 diabetic subjects. (Editors comments)