Axelrod L
Diabetes Unit, Massachusetts General Hospital, Boston 02114.
Diabetes. 1989 May;38(5):539-43.
The potential role of omega-3 fatty acids in the prevention of atherosclerotic disease in the nondiabetic population currently engenders interest, enthusiasm, and controversy. Some apparently beneficial effects of omega-3 fatty acids on platelet function, eicosanoid formation, plasma triglyceride levels, and blood pressure have been described in patients with diabetes mellitus. However, enthusiasm for the use of omega-3 fatty acids in diabetes has been dampened by reports of potentially deleterious effects of these agents, including increased plasma glucose, glycosylated hemoglobin, plasma total cholesterol and LDL cholesterol, and serum apolipoprotein B levels. These adverse effects have been achieved with large, perhaps excessive, doses of omega-3 fatty acids, in the range of 4-10 g/day. The magnitude of these adverse effects has been small (typically 10-36%). It cannot be assumed that the effects of omega-3 fatty acids are the same in patients with diabetes mellitus as in nondiabetic subjects or patients with primary hyperlipidemia. First, the biosynthesis and composition of fatty acids is abnormal in diabetic animals and possibly in diabetic patients. Second, many potential mechanisms implicated in the pathogenesis of atherosclerosis are present in diabetic but not necessarily in nondiabetic subjects. Third, the mechanisms of many of the risk factors in diabetic patients differ from the mechanisms of these abnormalities in nondiabetic subjects, reflecting the effects of insulin deficiency, hyperglycemia, and their sequelae. Finally, because diabetes is a heterogeneous group of diseases, the effects of omega-3 fatty acids must be addressed separately for patients with insulin-dependent diabetes mellitus, non-insulin-dependent diabetes mellitus, and possibly other forms of diabetes.(ABSTRACT TRUNCATED AT 250 WORDS)
目前，ω-3脂肪酸在非糖尿病患者群体中预防动脉粥样硬化疾病的潜在作用引发了人们的兴趣、热情以及争议。在糖尿病患者中，已经有报道称ω-3脂肪酸对血小板功能、类花生酸形成、血浆甘油三酯水平及血压具有一些明显的有益作用。然而，这些药物存在潜在有害作用的报道，包括血浆葡萄糖、糖化血红蛋白、血浆总胆固醇和低密度脂蛋白胆固醇以及血清载脂蛋白B水平升高，这使得人们对糖尿病患者使用ω-3脂肪酸的热情有所降低。这些不良反应是在大剂量（可能过量）的ω-3脂肪酸（4 - 10克/天）作用下出现的。这些不良反应的程度较小（通常为10% - 36%）。不能假定ω-3脂肪酸在糖尿病患者中的作用与非糖尿病受试者或原发性高脂血症患者相同。首先，糖尿病动物以及可能的糖尿病患者体内脂肪酸的生物合成和组成是异常的。其次，许多与动脉粥样硬化发病机制相关的潜在机制存在于糖尿病患者中，但不一定存在于非糖尿病受试者中。第三，糖尿病患者许多危险因素的机制与非糖尿病受试者这些异常情况的机制不同，这反映了胰岛素缺乏、高血糖及其后遗症的影响。最后，由于糖尿病是一组异质性疾病，对于胰岛素依赖型糖尿病、非胰岛素依赖型糖尿病以及可能的其他形式糖尿病患者，必须分别探讨ω-3脂肪酸的作用。（摘要截选至250词）
