Bagdade J D, Buchanan W E, Levy R A, Subbaiah P V, Ritter M C
Department of Medicine, Rush Medical College, Chicago, Illinois.
Diabetes. 1990 Apr;39(4):426-31. doi: 10.2337/diab.39.4.426.
Because the apparent reduction in cardiovascular risk noted in nondiabetic populations that ingest diets rich in marine lipids containing omega-3 fatty acids is believed to result in part from their capacity to modify the composition and physicochemical behavior of lipoproteins, we sought to determine whether dietary supplementation with marine lipids might favorably affect lipoprotein composition in insulin-dependent diabetes mellitus (IDDM). Eight normolipidemic IDDM women (mean +/- SD age 29.8 +/- 4.7 yr) were studied before and 3 mo after receiving a marine-lipid concentrate (Super-EPA) containing 6 g omega-3 fatty acids and a total of 12 mg of cholesterol daily. Weight, insulin requirements, and glycosylated hemoglobin remained stable. After treatment, mean +/- SD plasma triglyceride (TG) levels fell (before, 81.7 +/- 22 mg/dl; after, 69.19 +/- 17; P less than 0.025). High-density lipoprotein2 (HDL2) cholesterol (before, 10.98 +/- 5.45 mg/dl; after, 18.43 +/- 7.93; P less than 0.01), its major apolipoprotein A-I (apoAI), and the major phospholipids (sphingomyelin and lecithin) all rose significantly. ApoB and plasma and low-density lipoprotein cholesterol levels and HDL3 composition were unchanged. Postheparin hepatic and lipoprotein lipase activities were unaffected by marine lipids. These data indicate that women with IDDM experience apparently beneficial effects on TG and HDL2 from dietary supplementation with omega-3 fatty acids administered in a low-cholesterol-containing oil without adversely affecting overall diabetes management. If these changes in lipoprotein concentration and composition prove to have antiatherogenic consequences and are free of long-term toxicity, these agents may have a role in the therapy of IDDM patients.
由于在摄入富含含ω-3脂肪酸的海洋脂质饮食的非糖尿病人群中观察到心血管风险明显降低,部分原因被认为是它们能够改变脂蛋白的组成和物理化学行为,因此我们试图确定补充海洋脂质饮食是否会对胰岛素依赖型糖尿病(IDDM)患者的脂蛋白组成产生有利影响。对8名血脂正常的IDDM女性(平均±标准差年龄29.8±4.7岁)在接受一种海洋脂质浓缩物(超级EPA)之前和之后3个月进行了研究,该浓缩物每天含有6克ω-3脂肪酸和总共12毫克胆固醇。体重、胰岛素需求量和糖化血红蛋白保持稳定。治疗后,平均±标准差血浆甘油三酯(TG)水平下降(治疗前,81.7±22毫克/分升;治疗后,69.19±17;P<0.025)。高密度脂蛋白2(HDL2)胆固醇(治疗前,10.98±5.45毫克/分升;治疗后,18.43±7.93;P<0.01)、其主要载脂蛋白A-I(apoAI)以及主要磷脂(鞘磷脂和卵磷脂)均显著升高。载脂蛋白B、血浆和低密度脂蛋白胆固醇水平以及HDL3组成未发生变化。肝素后肝脏和脂蛋白脂肪酶活性不受海洋脂质影响。这些数据表明,IDDM女性通过在低胆固醇油中补充ω-3脂肪酸进行饮食补充,对TG和HDL2有明显的有益作用,且不会对整体糖尿病管理产生不利影响。如果脂蛋白浓度和组成的这些变化被证明具有抗动脉粥样硬化的后果且无长期毒性,这些药物可能在IDDM患者的治疗中发挥作用。