The Mechanism by Which Flaxseed Oil Consumption Increases Bleeding Time in Patients with Type 2 Diabetes in Cape Breton, Nova Scotia, Canada is Independent of Lipoprotein(a) Concentration

Abstract

Platelet hyper-aggregation is a serious manifestation of type 2 diabetes and a precipitating factor in the most frequent cause of death in patients with type 2 diabetesmyocardial infarction. Consumption of flaxseed oil as a dietary supplement containing alphalinolenic acid (ALA, 18:3 n-3) through its metabolism to eicosapentaenoic acid (EPA, 20:5 n-3) and subsequent production of antiaggregatory eicosanoids may reduce such aggregation in vivo. Lipoprotein(a) (Lp (a)) may also influence platelet aggregation in vivo. Furthermore, serum Lp(a) concentrations are increased and bleeding time is decreased in patients with type 2 diabetes, presenting an enhanced risk of myocardial infarction. It was hypothesized that Lp(a) and bleeding time would be correlated due to the considerable molecular homology between apolipoprotein(a) and plasminogen, which should decrease bleeding time. Bleeding time is an excellent measure of in vivo platelet aggregability. The purpose of this study was to determine, if as the result of flaxseed oil consumption, Lp(a) influences the mechanism of any change in bleeding time. A secondary purpose was to determine if gender differences exist in the response of bleeding time to Lp(a) in flaxseed oil consumers. Subjects (n = 40) were randomized to treatment with flaxseed oil (n = 20) or a safflower oil placebo (n = 20). Each of groups contained equal numbers of males (n = 10) and females (n= 10). Some subjects dropped from the study due to reasons not related to treatment side effects. Subjects came for three visits, each three months apart. On each visit, age, gender, and BMI were recorded, bleeding time was performed, and serum Lp(a) concentrations were determined. At the completion of visit 2, subjects were randomized to 1 g of oil per 10 kg body weight each day for three months. Compared with pretreatment measurements, there was a statistically significant increase in bleeding time in the flaxseed oil group among both males and females posttreatment. In contrast, there was no change in the safflower group regardless of gender. Males had a statistically shorter bleeding time pretreatment while males and females showed no difference posttreatment with flaxseed oil consumption. Pretreatment values for Lp(a) and bleeding time showed a nonsignificant correlation among males and a statistically significant correlation among females. A statistically significant correlation also held when all males and females in the study were combined though at a lower value than in females. Significant correlations were lost and/or maintained upon administration of flaxseed oil and safflower oil, respectively. It is also concluded that serum Lp(a) concentrations remain unchanged following flaxseed oil consumption; thus, at least in part

The Role of Consumption of Alpha-Linolenic, Eicosapentaenoic and Docosahexaenoic Acids in Human Metabolic Syndrome and Type 2 Diabetes- A Mini-Review

“…There are no studies indicating the impact of pure ALA in type 2 diabetics on any of the parameters covered by this paper. However, Barre et al (2005aBarre et al ( , 2005b) 55,56) have demonstrated that 60 mg/kg body weight of ALA in the form of flaxseed oil given for 3 months substantially increases bleeding time in both male and female type 2 diabetics (more so in males than females). There is an indication that increased fish consumption, pure EPA or DHA or fish oils may lower death rates in type 2 diabetics 10,59) .…”

“…(2005 a,b) 55,56) There is no published evidence that pure ALA or ALA-containing oils or foods will reduce death rates in type 2 diabetics.…”

High Dose Flaxseed Oil Supplementation May Affect Fasting Blood Serum Glucose Management in Human Type 2 Diabetics

“…As ALA is, to some extent, desaturated and elongated to EPA and DHA it was reasoned that higher doses of ALA should be examined, given that high doses of flaxseed oil dramatically reduce platelet reactivity 28,29) suggesting significant accumulation of EPA and DHA. High dose EPA and DHA deteriorates glycemic control [20][21][22] , thus rationalizing the current study on high dose ALA.…”