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富含钾、γ-氨基丁酸和血管紧张素转换酶抑制剂的功能性面包对血压、糖代谢及内皮功能的影响:一项双盲随机交叉临床试验

Effect of Functional Bread Rich in Potassium, γ-Aminobutyric Acid and Angiotensin-Converting Enzyme Inhibitors on Blood Pressure, Glucose Metabolism and Endothelial Function: A Double-blind Randomized Crossover Clinical Trial.

作者信息

Becerra-Tomás Nerea, Guasch-Ferré Marta, Quilez Joan, Merino Jordi, Ferré Raimon, Díaz-López Andrés, Bulló Mònica, Hernández-Alonso Pablo, Palau-Galindo Antoni, Salas-Salvadó Jordi

机构信息

From the Human Nutrition Unit, Faculty of Medicine and Health Sciences, Biochemistry and Biotechnology Department, Universitat Rovira i Virgili, and Hospital Universitari de Sant Joan de Reus, IISPV, Reus (NB-T, MG-F, AD-L, MB, PH-A, JS-S); CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid (NB-T, MG-F, JQ, AD-L, MB, PH-A, JS-S); Blanquerna School of Health Science, Universitat Ramon Llull (JQ); Vascular Medicine and Metabolism Unit, Lipids and Atherosclerosis Research Unit, Sant Joan University Hospital, IISPV, Faculty of Medicine, Universitat Rovira i Virgili, The Biomedical Research Network in Diabetes and Associated Metabolic Disorders (CIBERDEM), Barcelona (JM, RF); and ABS Reus V. Centre d'Assistència Primària Marià Fortuny, SAGESSA, Reus, Spain (AP-G).

出版信息

Medicine (Baltimore). 2015 Nov;94(46):e1807. doi: 10.1097/MD.0000000000001807.

Abstract

Because it has been suggested that food rich in γ-aminobutyric acid (GABA) or angiotensin-converting enzyme inhibitor (ACEI) peptides have beneficial effects on blood pressure (BP) and other cardiovascular risk factors, we tested the effects of low-sodium bread, but rich in potassium, GABA, and ACEI peptides on 24-hour BP, glucose metabolism, and endothelial function.A randomized, double-blind, crossover trial was conducted in 30 patients with pre or mild-to-moderate hypertension, comparing three 4-week nutritional interventions separated by 2-week washout periods. Patients were randomly assigned to consume 120 g/day of 1 of the 3 types of bread for each nutritional intervention: conventional wheat bread (CB), low-sodium wheat bread enriched in potassium (LSB), and low-sodium wheat bread rich in potassium, GABA, and ACEI peptides (LSB + G). For each period, 24-hour BP measurements, in vivo endothelial function, and biochemical samples were obtained.After LSB + G consumption, 24-hour ambulatory BP underwent a nonsignificant greater reduction than after the consumption of CB and LSB (0.26 mm Hg in systolic BP and -0.63 mm Hg in diastolic BP for CB; -0.71 mm Hg in systolic BP and -1.08 mm Hg in diastolic BP for LSB; and -0.75 mm Hg in systolic BP and -2.12 mm Hg in diastolic BP for LSB + G, respectively). Diastolic BP at rest decreased significantly during the LSB + G intervention, although there were no significant differences in changes between interventions. There were no significant differences between interventions in terms of changes in in vivo endothelial function, glucose metabolism, and peripheral inflammatory parameters.Compared with the consumption of CB or LSB, no greater beneficial effects on 24-hour BP, endothelial function, or glucose metabolism were demonstrated after the consumption of LSB + G in a population with pre or mild-to-moderate hypertension. Further studies are warranted to clarify the effect of GABA on BP, preferably using a specific design for noninferiority trials and ambulatory BP monitoring as a measure of BP.This study was registered at Current Controlled Trials as ISRCTN31436822.

摘要

因为有人提出富含γ-氨基丁酸(GABA)或血管紧张素转换酶抑制剂(ACEI)肽的食物对血压(BP)和其他心血管危险因素有有益影响,所以我们测试了富含钾、GABA和ACEI肽的低钠面包对24小时血压、糖代谢和内皮功能的影响。对30例原发性或轻度至中度高血压患者进行了一项随机、双盲、交叉试验,比较了三种为期4周的营养干预措施,中间间隔2周的洗脱期。患者被随机分配在每种营养干预措施中每天食用120克三种类型面包中的一种:传统小麦面包(CB)、富含钾的低钠小麦面包(LSB)和富含钾、GABA和ACEI肽的低钠小麦面包(LSB+G)。在每个阶段,进行24小时血压测量、体内内皮功能检测并采集生化样本。食用LSB+G后,24小时动态血压下降幅度比食用CB和LSB后略大,但差异无统计学意义(CB收缩压下降0.26毫米汞柱,舒张压下降0.63毫米汞柱;LSB收缩压下降0.71毫米汞柱,舒张压下降1.08毫米汞柱;LSB+G收缩压下降0.75毫米汞柱,舒张压下降2.12毫米汞柱)。在LSB+G干预期间,静息舒张压显著下降,尽管各干预措施之间的变化无显著差异。在体内内皮功能、糖代谢和外周炎症参数的变化方面,各干预措施之间无显著差异。在原发性或轻度至中度高血压人群中,与食用CB或LSB相比,食用LSB+G后对24小时血压、内皮功能或糖代谢未显示出更大的有益作用。有必要进行进一步研究以阐明GABA对血压的影响,最好采用非劣效性试验的特定设计,并将动态血压监测作为血压测量指标。本研究在当前对照试验注册平台注册,注册号为ISRCTN31436822。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fbd5/4652806/d6a21f723668/medi-94-e1807-g001.jpg

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