Simultaneous biopsies of liver and subcutaneous adipose tissue have been carried out in 228 patients with diabetes mellitus. In liver triglycerides a marked variability of the fatty acid pattern in relation to fatty degeneration of liver parenchyma has been confirmed. In adipose tissue fatty acid pattern was relatively constant. The most striking finding was a high content of eicosapentaenoic acid in normal liver and its decrease with the rise of lipid droplet size in the hepatocytes. No correlation with the quantity of liver fat or inflammatory liver diseases could be ascertained. When diabetes was associated with hyperlipoproteinemia (HLP) the percentage of eicosapentaenoic acid was significantly less. From the results the suggestion is obvious that a diminution of eicosapentaenoic acid in hepatic triglycerides is associated with lipid accumulation in the liver cells. A local mechanism, possibly the antilipolytic potency of prostaglandins, may be responsible for the creation of lipid droplets in liver cells of patients with metabolic disturbances. The alterations of eicosapentaenoic acid should be considered in view of recent data on the antiaggregatory effect of this fatty acid and its possibly preventive role for atherosclerosis.

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