Higher body fat percentage is associated with enhanced temperature perception in NAFLD: results from the randomised Wessex Evaluation of fatty Liver and Cardiovascular markers in NAFLD with OMacor thErapy trial (WELCOME) trial

Abstract

Aims/hypothesis

The effect of n-3 fatty acid treatment on temperature perception as a sensory nerve function modality is uncertain. In patients with non-alcoholic fatty liver disease (NAFLD) both with and without type 2 diabetes, we: (1) tested whether 15–18 months’ treatment with 4 g/day of docosahexaenoic plus eicosapentaenoic acid (DHA+EPA) improved hot (HPT) and cold (CPT) temperature perception thresholds and (2) explored factors associated with HPT and CPT, in a randomised, double-blind, placebo-controlled trial.

Methods

The effect of treatment (n=44) on HPT, CPT and temperature perception index (TPI: difference between HPT and CPT) was measured at the big toe in 90 individuals without neuropathy (type 2 diabetes; n=30). Participants were randomised 1:1, using sequential numbering, by personnel independent from the trial team. All participants and all members of the research team were blinded to group assignment. Data were collected in the Southampton National Institute for Health Research Biomedical Research Centre. Treatment effects and the independence of associations were testing by regression modelling.

Results

Mean±SD age was 50.9±10.6 years. In men (n=53) and women (n=37), HPTs (°C) were 46.1±5.1 and 43.1±6.4 (p=0.02), CPTs (°C) were 22.7±3.4 and 24.5±3.6 (p=0.07) and TPIs (°C) were 23.4±7.4 and 18.7±9.5 (p=0.008), respectively. In univariate analyses, total body fat percentage (measured by dual-energy x-ray absorptiometry [DXA]) was associated with HPT (r=–0.36 p=0.001), CPT (r=0.35 p=0.001) and TPI (r=0.39 p=0.0001). In multivariable-adjusted regression models, adjusting for age, sex and other potential confounders, only body fat percentage was independently associated with HPT, CPT or TPI (p=0.006, p=0.006 and p=0.002, respectively). DHA+EPA treatment did not modify HPT, CPT or TPI (p=0.93, p=0.44 and p=0.67, respectively). There were no important adverse effects or side effects reported.

Conclusions/interpretation

Higher body fat percentage is associated with enhanced temperature perception. There was no benefit of treatment with high-dose n-3 fatty acids on the thresholds to detect hot or cold stimuli.
Trial registration:

ClinicalTrials.gov NCT00760513

More information

Identifiers

ORCID for Geraldine Clough: orcid.org/0000-0002-6226-8964

ORCID for Philip Calder: orcid.org/0000-0002-6038-710X

ORCID for Michael Griffin: orcid.org/0000-0003-0743-9502

ORCID for Christopher Byrne: orcid.org/0000-0001-6322-7753

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