可可粉对心血管疾病高危患者炎症生物标志物调节的影响。

Effect of cocoa powder on the modulation of inflammatory biomarkers in patients at high risk of cardiovascular disease.

机构信息

Department of Internal Medicine, Hospital Clínic, Institut d'Investigació Biomèdica August Pi i Sunyer, University of Barcelona, Barcelona, Spain.

出版信息

Am J Clin Nutr. 2009 Nov;90(5):1144-50. doi: 10.3945/ajcn.2009.27716. Epub 2009 Sep 23.

DOI:10.3945/ajcn.2009.27716

PMID:19776136

Abstract

BACKGROUND

Epidemiologic studies have suggested that flavonoid intake plays a critical role in the prevention of coronary heart disease. Because atherosclerosis is considered a low-grade inflammatory disease, some feeding trials have analyzed the effects of cocoa (an important source of flavonoids) on inflammatory biomarkers, but the results have been controversial.

OBJECTIVE

The objective was to evaluate the effects of chronic cocoa consumption on cellular and serum biomarkers related to atherosclerosis in high-risk patients.

DESIGN

Forty-two high-risk volunteers (19 men and 23 women; mean +/- SD age: 69.7 +/- 11.5 y) were included in a randomized crossover feeding trial. All subjects received 40 g cocoa powder with 500 mL skim milk/d (C+M) or only 500 mL skim milk/d (M) for 4 wk. Before and after each intervention period, cellular and serum inflammatory biomarkers related to atherosclerosis were evaluated.

RESULTS

Adherence to the dietary protocol was excellent. No significant changes in the expression of adhesion molecules on T lymphocyte surfaces were found between the C+M and M groups. However, in monocytes, the expression of VLA-4, CD40, and CD36 was significantly lower (P = 0.005, 0.028, and 0.001, respectively) after C+M intake than after M intake. In addition, serum concentrations of the soluble endothelium-derived adhesion molecules P-selectin and intercellular adhesion molecule-1 were significantly lower (both P = 0.007) after C+M intake than after M intake.

CONCLUSIONS

These results suggest that the intake of cocoa polyphenols may modulate inflammatory mediators in patients at high risk of cardiovascular disease. These antiinflammatory effects may contribute to the overall benefits of cocoa consumption against atherosclerosis. This trial was registered in the Current Controlled Trials at London, International Standard Randomized Controlled Trial Number, at controlled-trials.com as ISRCTN75176807.

摘要

背景

流行病学研究表明，黄酮类化合物的摄入对预防冠心病起着至关重要的作用。由于动脉粥样硬化被认为是一种低度炎症性疾病，因此一些喂养试验分析了可可（黄酮类化合物的重要来源）对炎症生物标志物的影响，但结果存在争议。

目的

评估慢性可可消费对高危患者与动脉粥样硬化相关的细胞和血清生物标志物的影响。

设计

42 名高危志愿者（19 名男性和 23 名女性；平均年龄 +/- SD 为 69.7 +/- 11.5 岁）被纳入一项随机交叉喂养试验。所有受试者均接受 40 g 可可粉加 500 mL 脱脂牛奶/d（C+M）或仅 500 mL 脱脂牛奶/d（M），持续 4 周。在每个干预期前后，评估与动脉粥样硬化相关的细胞和血清炎症生物标志物。

结果

对饮食方案的依从性非常好。在 C+M 和 M 组之间，T 淋巴细胞表面黏附分子的表达没有明显变化。然而，在单核细胞中，VLA-4、CD40 和 CD36 的表达在 C+M 摄入后明显低于 M 摄入后（P = 0.005、0.028 和 0.001）。此外，血清可溶性内皮细胞来源的黏附分子 P-选择素和细胞间黏附分子-1 的浓度在 C+M 摄入后明显低于 M 摄入后（均 P = 0.007）。