Colussi GianLuca, Catena Cristiana, Dialti Valeria, Mos Lucio, Sechi Leonardo A
Hypertension Unit, Clinica Medica, Department of Experimental and Clinical Medical Science, University of Udine.
J Atheroscler Thromb. 2014;21(9):941-56. doi: 10.5551/jat.22921. Epub 2014 Apr 12.
The composition of dietary fat affects various modifiable cardiovascular risk factors and cardiovascular outcomes in the general population. We investigated the effects of the regular consumption of fish meals on the fatty acid composition of red blood cell (RBC) membranes and the relationship of this parameter with the carotid intima-media thickness (IMT), an early marker of atherosclerosis.
In 56 hypertensive patients, we measured the carotid IMT using ultrasound imaging and the RBC membrane fatty acid composition using gas-chromatography and calculated the polyunsaturated to saturated fatty acid (PUFA/SFA) ratio. The patients received intensive nutritional counseling and three weekly meals of fish containing elevated amounts of PUFA, in order to increase the membrane PUFA content. The RBC membrane fatty acid composition and IMT were reassessed after one year.
At baseline, the membrane PUFA/SFA ratio was inversely related to the carotid IMT, and the relationship was independent of all major cardiovascular risk factors. At follow-up, the PUFA/SFA ratio increased in the RBC membranes of 25 (45%) of 56 patients. The regular consumption of fish meals resulted in a decreased carotid IMT only in the patients with an increased membrane PUFA/SFA ratio. Changes in the PUFA/SFA ratio induced by the dietary intervention were inversely related to the changes in the IMT, independent of variations in body mass, blood pressure and plasma lipids.
In hypertensive patients, a low RBC membrane PUFA/SFA ratio is associated with more prominent vascular damage, and the regular consumption of fish reduces the carotid IMT in patients in whom dietary intervention affects the membrane fatty acid composition.
膳食脂肪的组成会影响普通人群中各种可改变的心血管危险因素及心血管结局。我们研究了定期食用鱼餐对红细胞（RBC）膜脂肪酸组成的影响，以及该参数与颈动脉内膜中层厚度（IMT）（动脉粥样硬化的早期标志物）之间的关系。
在56例高血压患者中，我们使用超声成像测量颈动脉IMT，使用气相色谱法测量RBC膜脂肪酸组成，并计算多不饱和脂肪酸与饱和脂肪酸（PUFA/SFA）的比值。患者接受强化营养咨询，并每周食用三次富含大量PUFA的鱼餐，以增加膜中PUFA含量。一年后重新评估RBC膜脂肪酸组成和IMT。
基线时，膜PUFA/SFA比值与颈动脉IMT呈负相关，且该关系独立于所有主要心血管危险因素。随访时，56例患者中有25例（45%）的RBC膜中PUFA/SFA比值升高。仅在膜PUFA/SFA比值升高的患者中，定期食用鱼餐导致颈动脉IMT降低。饮食干预引起的PUFA/SFA比值变化与IMT变化呈负相关，独立于体重、血压和血脂的变化。
在高血压患者中，低RBC膜PUFA/SFA比值与更明显的血管损伤相关，定期食用鱼可降低饮食干预影响膜脂肪酸组成的患者的颈动脉IMT。
