Zeman M, Zák A, Vecka M, Tvrzická E, Písaríková A, Stanková B
IV. interní klinika 1. LF UK a VFN, Praha.
Cas Lek Cesk. 2005;144(11):737-41.
The aim of the study was to determine how addition of n-3 polyenic fatty acids (PUFA) to the present treatment with statin + fibrate combination in diabetic dyslipidemia effects plasma lipids and lipoproteins, LDL lipoperoxidation, glucose homeostasis, concentration of serum homocysteine and selected inflammation indicators.
24 patients with type 2 diabetes, who after the combined hypolipidemic treatment (pravastatin 20 mg + micronized fenofibrate 200 mg per day) cannot reach the recommended target values for long time, received for three consecutive months supplementation of 3,6 g PUFA n-3 per day or a placebo (olive oil). At the beginning of the study, after three months of PUFA supplementation and after another three months of placebo administration, concentrations of plasma lipids, composition of fatty acids, plasma phosphatidylcholine (PC), cholesterol esters (CE) and triglycerides (TG), concentration of tHcy, conjugated diens (CD) in LDL and selected inflammation indicators (IL-6, TNFalpha, VCAM-1) were determined. n-3 PUFA supplementation resulted in the significant decrease of tHcy concentration (-29%, P < 0.01) and TG (-28%, P < 0.05) in plasma. During the period of placebo administration, values returned to base line levels. CD concentration in LDL after n-3 PUFA increased by 15% (P < 0.15, not significant), meanwhile after the placebo containing oleic acid it decreased by 18% (P < 0.05).
Our results show that n-3 PUFA supplementation together with statin + fibrate combination in DDL patients can significantly decrease the risk of cardiovascular diseases.
本研究旨在确定在糖尿病血脂异常患者中,在当前他汀类药物与贝特类药物联合治疗的基础上加用n-3多不饱和脂肪酸(PUFA)对血浆脂质和脂蛋白、低密度脂蛋白脂质过氧化、葡萄糖稳态、血清同型半胱氨酸浓度及选定的炎症指标有何影响。
24例2型糖尿病患者在接受联合降脂治疗(普伐他汀20mg+微粒化非诺贝特200mg/天)后长期无法达到推荐的目标值,连续三个月每天补充3.6g n-3 PUFA或安慰剂(橄榄油)。在研究开始时、补充PUFA三个月后及再给予安慰剂三个月后,测定血浆脂质浓度、脂肪酸组成、血浆磷脂酰胆碱(PC)、胆固醇酯(CE)和甘油三酯(TG)、总同型半胱氨酸(tHcy)浓度、低密度脂蛋白中的共轭二烯(CD)以及选定的炎症指标(白细胞介素-6、肿瘤坏死因子α、血管细胞黏附分子-1)。补充n-3 PUFA导致血浆中tHcy浓度显著降低(-29%,P<0.01)和TG降低(-28%,P<0.05)。在给予安慰剂期间,数值恢复到基线水平。补充n-3 PUFA后低密度脂蛋白中的CD浓度增加了15%(P<0.15,无统计学意义),而给予含油酸的安慰剂后则降低了18%(P<0.05)。
我们的结果表明,在糖尿病血脂异常患者中,补充n-3 PUFA与他汀类药物+贝特类药物联合使用可显著降低心血管疾病风险。