Scientific Direction, Italian National Research Center on Aging (INRCA), Ancona, Italy.
Curr Pharm Des. 2009;15(36):4126-34. doi: 10.2174/138161209789909782.
The prevalence of type 2 diabetes is increasing continuously, especially in older people. Such a rapidly rising risk has been linked to physical inactivity and evolutionary changes in dietary patterns (mainly characterized by a greater intake in dietary fat). Increased physical activity in any age group is associated with a lower risk of developing type 2 diabetes. Epidemiological studies also reported a lower incidence of type 2 diabetes in individuals who consumed n-3 polyunsaturated fatty acids (PUFA), while intake of total, saturated and/or monounsaturated fat was associated with increased risk of type 2 diabetes in glucose-intolerant individuals. Furthermore, the beneficial effects of PUFA consumption on cardiovascular disease were mainly attributed to their effects on reducing triglyceride levels, increasing high density lipoprotein cholesterol, and improving endothelial function through anti-inflammatory mechanisms and reduced platelet aggregation. In addition to common diabetic complications such as dyslipidemia and cardiovascular disease, elderly people with type 2 diabetes are at greater risk of specific geriatric syndromes, such as cognitive decline and physical disability. The threats of physical disability, loss of independence and loss of cognitive performance which diminish quality of life may ultimately be the greatest concern for those with type 2 diabetes. In this review we will address: i) specific dietary fat intake patterns and the development of insulin resistance and type 2 diabetes, ii) the effects of PUFA supplementation on glucose metabolism, diabetic dyslipidemia and cardiovascular disease, iii) the potential advantages of PUFA supplementation on cognitive decline and physical disability in the elderly.
2 型糖尿病的患病率持续上升，尤其是在老年人中。这种风险的迅速上升与身体活动不足和饮食模式的进化变化（主要表现为饮食中脂肪摄入增加）有关。任何年龄段的人增加身体活动都与较低的 2 型糖尿病发病风险相关。流行病学研究还报告称，摄入 n-3 多不饱和脂肪酸（PUFA）的个体 2 型糖尿病发病率较低，而总脂肪、饱和脂肪和/或单不饱和脂肪的摄入与葡萄糖耐量异常个体 2 型糖尿病发病风险增加有关。此外，PUFA 消费对心血管疾病的有益影响主要归因于其降低甘油三酯水平、增加高密度脂蛋白胆固醇以及通过抗炎机制和减少血小板聚集改善内皮功能的作用。除了常见的糖尿病并发症，如血脂异常和心血管疾病外，老年 2 型糖尿病患者还面临着特定老年综合征的更大风险，如认知能力下降和身体残疾。身体残疾、丧失独立性和认知能力下降的威胁会降低生活质量，这可能是 2 型糖尿病患者最关心的问题。在这篇综述中，我们将讨论：i）特定的膳食脂肪摄入模式与胰岛素抵抗和 2 型糖尿病的发展，ii）PUFA 补充对葡萄糖代谢、糖尿病血脂异常和心血管疾病的影响，iii）PUFA 补充对老年人认知能力下降和身体残疾的潜在益处。
