Background
Nutrition in the intensive care unit (ICU) is vital for patient care; however, immunomodulatory diets rich in polyunsaturated fatty acids (PUFAs) like γ-linolenic acid (GLA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA) remain controversial among patients with acute respiratory distress syndrome (ARDS). We postulate that genetic variants impacting PUFA metabolism contribute to mixed responses to PUFA-rich diets.
Objective
In this study, we aimed to test the effects of single nucleotide polymorphism (SNP) rs174537 on differential responses to PUFA-rich diets.
Design
We performed a secondary analysis of the OMEGA trial (NCT00609180) where 129 subjects received placebo and 143 received omega-oil. DNA was extracted from buffy coats and used to genotype rs174537; plasma was used to quantitate PUFAs. We tested for SNP-diet interactions on PUFA levels, inflammatory biomarkers, and patient outcomes.
Results
We observed that all individuals receiving omega-oil, displayed significantly higher levels of GLA, EPA, and DHA (all P < 0.0001), but they did not vary by genotype at rs174537. Statistically significant SNP-diet interactions were observed on circulating DHA levels in African Americans. Specifically, African American T-allele carriers on placebo illustrated elevated DHA levels. Additionally, all individuals receiving omega-oil had higher levels of EPA-derived urinary F3-Isoprostane (Caucasians: P = 0.0011; African Americans: P = 0.0002). Despite these findings, we did not detect any significant SNP-diet interactions on pulmonary functional metrics, clinical outcomes, and mortality.
Conclusions
This study highlights the importance of genetic and racial contributions to PUFA metabolism and inflammation. In particular, rs174537 had a significant impact on circulating DHA and urinary isoprostane levels. Given our relatively small sample size, further investigations in larger multi-ethnic cohorts are needed to evaluate the impact of rs174537 on fatty acid metabolism and downstream inflammation.