Dai Jun, Su Yi-Xiang, Bartell Scott, Le Ngoc-Anh, Ling Wen-Hua, Liang Yi-Quan, Gao Ling, Wu Hai-Yan, Veledar Emir, Vaccarino Viola
Nutrition and Health Sciences Program, Emory University, Atlanta, GA 30322, USA.
Metabolism. 2009 Apr;58(4):510-8. doi: 10.1016/j.metabol.2008.11.010.
Elevated levels of postprandial triacylglycerol-rich lipoproteins (ppTRLs) are atherogenic. Patients with type 2 diabetes mellitus (T2DM) have exaggerated postprandial lipemia associated with elevation or prolonged residence of ppTRL remnants. We examined whether dietary fatty acid compositions (DFACs) decrease atherogenic lipid profiles in ppTRL subfractions in T2DM Chinese patients. A single-blind randomized controlled trial was conducted among 28 T2DM patients. Patients consumed 1 of 3 standardized DFAC-specific fat meals: equidominant (1:1:1), polyunsaturated fatty acid (PUFA)-dominant (PUFA-D, 1:1.7:2.3), or monounsaturated fatty acid (MUFA)-dominant (MUFA-D, 1:1.7:1.2) meals. Numbers in parenthesis, respectively, represent the ratio of saturated fatty acids, MUFA, and PUFA to saturated fatty acids. The MUFA-D meal was the control. Triacylglycerol and cholesterol levels were measured in Svedberg flotation rate (S(f)) greater than 400, S(f) 60 to 400, S(f) 20 to 60, and S(f) 12 to 20 ppTRL subfractions at fasting (0 hour) and 2, 4, and 6 hours after the consumption of the fat meals. Effects of DFACs on mean concentrations of triacylglycerols and cholesterol averaged over 0, 2, 4, and 6 hours in ppTRL subfractions were assessed using linear mixed models. Stability and robustness were validated with 1000 bootstrap replicates. Contrasted to the control, equidominant meal reduced 6-hour average triacylglycerol levels in S(f) greater than 400 (P = .002, bootstrap P < .05) and S(f) 20 to 60 (P = .02, bootstrap P < .05) subfractions, and decreased average S(f) 20 to 60 cholesterol (P = .04, bootstrap P < .05); PUFA-D decreased S(f) greater than 400 average triacylglycerol levels (P = .09, bootstrap P < .05). Bootstrap samples suggested that PUFA-D decreased average S(f) 20 to 60 cholesterol levels (bootstrap P < .05). Therefore, modifying DFACs attenuates the atherogenic lipid profile of ppTRLs in T2DM patients; but increasing PUFA ratio may be more feasible.
餐后富含三酰甘油的脂蛋白（ppTRLs）水平升高具有致动脉粥样硬化性。2型糖尿病（T2DM）患者存在餐后血脂异常，与ppTRL残粒升高或停留时间延长有关。我们研究了饮食脂肪酸组成（DFACs）是否会降低中国T2DM患者ppTRL亚组分中致动脉粥样硬化的脂质谱。对28例T2DM患者进行了一项单盲随机对照试验。患者食用3种标准化的特定DFAC脂肪餐中的一种：等优势（1:1:1）、多不饱和脂肪酸（PUFA）为主（PUFA-D，1:1.7:2.3）或单不饱和脂肪酸（MUFA）为主（MUFA-D，1:1.7:1.2）餐。括号中的数字分别代表饱和脂肪酸、MUFA和PUFA与饱和脂肪酸的比例。以MUFA-D餐作为对照。在空腹（0小时）以及食用脂肪餐后2、4和6小时，测量Svedberg漂浮率（S(f)）大于400、S(f) 60至400、S(f) 20至60以及S(f) 12至20的ppTRL亚组分中的三酰甘油和胆固醇水平。使用线性混合模型评估DFACs对ppTRL亚组分中0、2、4和6小时平均三酰甘油和胆固醇浓度的影响。通过1000次自抽样重复验证稳定性和稳健性。与对照组相比，等优势餐降低了S(f)大于400（P = .002，自抽样P < .05）和S(f) 20至60（P = .02，自抽样P < .05）亚组分中6小时的平均三酰甘油水平，并降低了S(f) 20至60的平均胆固醇水平（P = .04, 自抽样P < .05）；PUFA-D降低了S(f)大于400的平均三酰甘油水平（P = .09，自抽样P < .05）。自抽样样本表明PUFA-D降低了S(f) 20至60的平均胆固醇水平（自抽样P < .05）。因此，改变DFACs可减轻T2DM患者ppTRLs的致动脉粥样硬化脂质谱；但增加PUFA比例可能更可行。
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