Department of Cardiology, Medical University of Silesia, Ziołowa 45/47, 40-635 Katowice, Poland.
Clin Nutr. 2011 Feb;30(1):79-85. doi: 10.1016/j.clnu.2010.07.011. Epub 2010 Aug 12.
BACKGROUND & AIMS: Our aim was to evaluate early initiated one month n-3 polyunsaturated fatty acids (PUFA) supplementation effects on ultrasound indices of endothelial function and serum asymmetric dimethylarginine (ADMA) levels in patients with acute myocardial infarction (AMI).
Forty patients with AMI and successful percutaneous coronary intervention (PCI) were recruited into the study and randomized to the study group (group P; n = 20; standard therapy + n-3 PUFA 1 g daily) or the control group (group C; n = 20; standard therapy). Ultrasound indices of endothelial function: flow-mediated dilatation (FMD), nitroglycerin-mediated dilatation (NMD) and serum ADMA concentrations (ELISA) were obtained before and after one month (30 ± 1 days) therapy (presented as means ± standard deviations).
There was a significant difference between both groups in mean delta (baseline/after one month) FMD (P: 8.1 ± 12.6% vs C: -2.2 ± 11.8%; p = 0.02) with no difference in mean delta NMD (P: 3.3 ± 11.9% vs 0.66 ± 14.3%; p = 0.53). We found also a significant increase in mean FMD (7.4 ± 6.4 to 15.5 ± 10.5%; p = 0.02) with a nonsignificant change in mean NMD values (26.9 ± 12.1 to 30.2 ± 14.0%; p = 0.24) after 1-month therapy with n-3 PUFA. FMD and NMD mean values did not change in control patients (FMD: 11.6 ± 6.1% to 9.4 ± 8.0%; p = 0.5 NMD: 25.1 ± 11.4% to 25.8 ± 14.0%; p = 0.84). The comparison of mean delta ADMA values for both groups revealed no differences (P: 6.2 ± 9.7 μmol/l vs C: 3.6 ± 9.5 μmol/l; p = 0.43). Mean serum ADMA concentrations were significantly increased after 1-month therapy in the group P (P: 2.1 ± 1.8 to 8.3 ± 9.7 μmol/l; p = 0.001; C: 4.5 ± 7.1 to 8.1 ± 9.5 μmol/l; p = 0.09). However, there was a nonsignificant difference in mean baseline serum ADMA levels between both groups (P: 2.1 ± 1.8 μmol/l vs C: 4.5 ± 7.1 μmol/l; p = 0.32). There were no significant correlations between FMD, NMD, ADMA levels and demographic, clinical or biochemical parameters.
Early and short-term n-3 PUFA supplementation improved ultrasound indices of endothelial function without affecting serum ADMA levels in patients with AMI and successful primary PCI.
我们旨在评估早期开始的一个月 n-3 多不饱和脂肪酸（PUFA）补充对急性心肌梗死（AMI）患者超声内皮功能指标和血清不对称二甲基精氨酸（ADMA）水平的影响。
将 40 名接受成功经皮冠状动脉介入治疗（PCI）的 AMI 患者纳入研究，并随机分为研究组（P 组；n=20；标准治疗+n-3 PUFA 1 g 每日）或对照组（C 组；n=20；标准治疗）。治疗前和治疗后一个月（30±1 天）（表示为平均值±标准差）获得超声内皮功能指标：血流介导的扩张（FMD）、硝酸甘油介导的扩张（NMD）和血清 ADMA 浓度（ELISA）。
两组间平均（基线/一个月后）FMD 的差值有显著差异（P：8.1±12.6%比 C：-2.2±11.8%；p=0.02），但 NMD 的平均差值无差异（P：3.3±11.9%比 0.66±14.3%；p=0.53）。我们还发现，在接受 n-3 PUFA 治疗一个月后，FMD 的平均值显著增加（7.4±6.4 至 15.5±10.5%；p=0.02），而 NMD 的平均值变化不显著（26.9±12.1 至 30.2±14.0%；p=0.24）。对照组患者的 FMD 和 NMD 平均值没有变化（FMD：11.6±6.1%至 9.4±8.0%；p=0.5；NMD：25.1±11.4%至 25.8±14.0%；p=0.84）。两组间平均 ADMA 值的差值无差异（P：6.2±9.7 μmol/l 比 C：3.6±9.5 μmol/l；p=0.43）。治疗一个月后，P 组的血清 ADMA 浓度显著升高（P：2.1±1.8 至 8.3±9.7 μmol/l；p=0.001；C：4.5±7.1 至 8.1±9.5 μmol/l；p=0.09）。然而，两组间的基线血清 ADMA 水平无显著差异（P：2.1±1.8 μmol/l 比 C：4.5±7.1 μmol/l；p=0.32）。FMD、NMD、ADMA 水平与人口统计学、临床或生化参数之间无显著相关性。
AMI 患者和成功接受直接 PCI 治疗的患者早期和短期 n-3 PUFA 补充可改善超声内皮功能指标，而不影响血清 ADMA 水平。
