Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy.
Curr Opin Clin Nutr Metab Care. 2013 Nov;16(6):662-8. doi: 10.1097/MCO.0b013e3283659a51.
Relationship between cocoa consumption and cardiovascular disease, particularly focusing on clinical implications resulting from the beneficial effects of cocoa consumption on endothelial function and insulin resistance. This could be of clinical relevance and may suggest the mechanistic explanation for the reduced risk of cardiovascular events reported in the different studies after cocoa intake.
Increasing evidence supports a protective effect of cocoa consumption against cardiovascular disease. Cocoa and flavonoids from cocoa have been described to improve endothelial function and insulin resistance. A proposed mechanism could be considered in the improvement of the endothelium-derived vasodilator nitric oxide by enhancing nitric oxide synthesis or by decreasing nitric oxide breakdown.
The endothelium plays a pivotal role in the arterial homeostasis, and insulin resistance is the most important pathophysiological feature in various prediabetic and diabetic states. Reduced nitric oxide bioavailability with endothelial dysfunction is considered the earliest step in the pathogenesis of atherosclerosis. Further, insulin resistance could account, at least in part, for the endothelial dysfunction. Endothelial dysfunction has been considered an important and independent predictor of future development of cardiovascular risk and events. Cocoa and flavonoids from cocoa might positively modulate these mechanisms with a putative role in cardiovascular protection.
可可消费与心血管疾病之间的关系，尤其着重于可可消费对内皮功能和胰岛素抵抗有益影响所产生的临床意义。这可能具有临床相关性，并可能提示在摄入可可后不同研究报告的心血管事件风险降低的机制解释。
越来越多的证据支持可可消费对心血管疾病的保护作用。可可和可可黄烷醇已被描述为可改善内皮功能和胰岛素抵抗。一种可能的机制可以被认为是通过增强一氧化氮合成或减少一氧化氮分解来改善内皮衍生的血管舒张性一氧化氮。
内皮在动脉稳态中起着关键作用，胰岛素抵抗是各种糖尿病前期和糖尿病状态下最重要的病理生理特征。内皮功能障碍导致的一氧化氮生物利用度降低被认为是动脉粥样硬化发病机制的最早步骤。此外，胰岛素抵抗至少可以部分解释内皮功能障碍。内皮功能障碍被认为是未来心血管风险和事件发展的一个重要且独立的预测因素。可可和可可黄烷醇可能通过对心血管保护的潜在作用来积极调节这些机制。
