Serum Nervonic Acid as a Marker of Sarcopenia in Patients with Cardiovascular Disease

by | Jan 26, 2021 | 2020, Aging, Cardiovascular Health

Written by Angeline A. De Leon, Staff Writer. Nervonic acid, an n-9 monounsaturated fatty acid, was positively associated with sarcopenia diagnosis and may be a useful marker of sarcopenia.

woman helping an elderly woman walkSarcopenia refers to the generalized loss of muscle mass and strength, resulting in the deterioration of physical function and quality of life and ultimately leading to premature death 1,2. This condition can be a direct result of age (primary sarcopenia) or disease (secondary sarcopenia), with cardiovascular disease (CVD) being one of the most critical risk factors for secondary sarcopenia 3.  Based on the major role of long-chain fatty acids in the production of cellular energy and their ability to influence inflammatory processes related to pathophysiological conditions 4, a number of clinical studies have begun to explore the therapeutic potential of n-3 long-chain polyunsaturated fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) for sarcopenia patients 5,6. A growing body of evidence has revealed the correlation between dietary intake of fatty fish among older adults and measures of muscular strength (handgrip strength) 7 and the enhanced development of muscle tissue evident with EPA and DHA supplementation in the elderly 8. To determine whether other forms of fatty acids, like n-9 long-chain fatty acids, can also positively impact the pathophysiology of sarcopenia, a 2020 study 9 published in JCSM Clinical Reports examined the relationship between sarcopenia and serum levels of long-chain fatty acids in patients with CVD.

A total of 308 patients with CVD (mean age = 72 +/- 12 years) were enrolled in a retrospective cross-sectional study in which they were clinically evaluated for sarcopenia based on muscle mass (skeletal muscle index, SMI), muscle strength (handgrip strength), and physical performance (usual gait speed). Serum free fatty acid analysis was carried out based on venous blood samples to determine the weight percentages of 24 major fatty acid metabolites.

Approximately 25% of the study sample (77 patients) qualified for a clinical diagnosis of sarcopenia. This subgroup exhibited significantly lower body mass index (p < 0.001) and significantly higher heart rate (p = 0.001), compared to non-sarcopenia patients. Sarcopenia patients also showed higher weight percentages of nervonic acid (n-9 monounsaturated fatty acid) and its precursor, erucic acid, relative to the non-sarcopenia group (p < 0.001 for both). Serum weight percentage of nervonic acid was found to be positively associated with sarcopenia diagnosis (r = 0.366) and negatively correlated with SMI (r = -0.331), gait speed (r = -0.387), and handgrip strength (r = -0.372) (p < 0.001 for all).

Findings provide initial evidence suggesting a key role for long-chain fatty acids in CVD patients with sarcopenia. An assessment of fatty acid profile revealed that serum nervonic acid was an independent marker of sarcopenia and showed significant correlation with the diagnostic features of sarcopenia, including SMI, gait speed, and grip strength. Based on previous work linking nervonic acid levels to metabolic dysfunction, researchers hypothesize that nervonic acid status may serve as an indicator of malnutrition in sarcopenia patients 10,11. However, the pathophysiological role of the n-9 monounsaturated fatty acid requires further study in sarcopenia patients with CVD. Given the cross-sectional nature of the study, a primary limitation of the present trial relates to an inability to determine the longer-term effects of long-chain fatty acids on the progression of sarcopenia. Use of a large-scale prospective study would be valuable in the future, and it would be important to explore the potential efficacy of a dietary intervention based on long-chain fatty acids for sarcopenia patients.

Source: Katoh A, Ikeda H, Matsushima Y, et al. Long-chain fatty acids in sarcopenia patients with cardiovascular diseases: importance of n-9 monounsaturated fatty acids. JCSM Clinical Reports. 2020; 5: 121-128. DOI: 10.1002/crt2.27.

© 2020 The Authors. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided theoriginal work is properly cited.

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Posted January 26, 2021.

Angeline A. De Leon, MA, graduated from the University of Illinois at Urbana-Champaign in 2010, completing a bachelor’s degree in psychology, with a concentration in neuroscience. She received her master’s degree from The Ohio State University in 2013, where she studied clinical neuroscience within an integrative health program. Her specialized area of research involves the complementary use of neuroimaging and neuropsychology-based methodologies to examine how lifestyle factors, such as physical activity and meditation, can influence brain plasticity and enhance overall connectivity.

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