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Essential Fatty Acid Deficiency
Clinical signs of essential fatty acid deficiency include a dry scaly rash, decreased growth in infants and children, increased susceptibility to infection and poor wound healing. Omega-3, omega-6 and omega-9 fatty acids compete for the same desaturase enzymes. The desaturase enzymes show preference for the different series of fatty acids in the following order: omega-3 > omega-6 > omega-9. Consequently, synthesis of the omega-9 fatty acid eicosatrienoic acid (20:3n-9) increases only when dietary intakes of omega-3 and omega-6 fatty acids are very low. A plasma eicosatrienoic acid:arachidonic acid (triene:tetraene) ratio greater than 0.2 is generally considered indicative of essential fatty acid deficiency. In patients who were given total parenteral nutrition containing fat-free glucose amino acid mixtures, biochemical signs of essential fatty acid deficiency developed in as little as 7-10 days. In these cases, the continuous glucose infusion resulted in high circulating insulin levels, which inhibited the release of essential fatty acids stored in adipose tissue. When glucose-free amino acid solutions were used, parenteral nutrition up to 14 days did not result in biochemical signs of essential fatty acid deficiency. Essential fatty acid deficiency has also been found to occur in patients with chronic fat malabsorption and cystic fibrosis. Recently, it has been proposed that essential fatty acid deficiency may play a role in the pathology of protein energy malnutrition.
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