Polyunsaturated fatty acids and cognitive outcomes in paediatric liver disease

PURPOSE: Polyunsaturated Fatty Acids (PUFAs) serve important structural and functional roles in the central nervous system, which may modulate cognitive function. This study used a liver disease and transplant (Tx) model to evaluate whether sub-optimal concentrations of PUFAs, as a result of fat malabsorption or dependence on inadequate dietary sources, is associated with PUFA deficiency and deficits in cognitive abili.METHOD: In 28 paediatric patients (14 pre-Tx, mean age 12.1; 14 post-Tx, mean age 15.0) and 11 healthy controls (mean age 12.2), erythrocyte biomarkers of fatty acid status, including the major omega-6 (linoleic and arachidonic), omega-3 (docosohexaenoic and eicosapentaenoic) fatty acids and defciency markers (osbond and mead acid), were quantifiedusing standard gas chromatography-mass spectrometry. Full-scale IQ (FSIQ) and Information Processing Speed (IPS) were assessed using standard Wechsler psychometric assessment batteries.RESULTS: Compared to controls, no signs of PUFA defciency were observed in the pre- or post-Tx groups, suggesting that: (1) neither sets of patients were deficientin their dietary intake of PUFA precursors, linoleic and alpha-linolenic acid, and (2) these patients are able to sufficientlysynthesise PUFAs from these precursors to levels comparable to controls. Strong negative correlations were observed between omega-6 fatty acids and FSIQ and IPS scores (r=-.620 and -.39; p<.001), independent of disease diagnosis and Tx (n= 39).CONCLUSION: These fndings suggest no signifcant defciency of important omega-3 fatty acids in liver disease patients. The relationship between pro-infammatory omega-6 fatty acids and FSIQ requires further investigation. Longitudinal studies of Tx patients assessing dietary intake and PUFA and IQ will help clarify the role of PUFAs in cognitive development in paediatric liver disease.