地中海饮食对心血管疾病高危成年人的长期免疫调节作用：“预防地中海饮食（PREDIMED）”随机对照试验
Long-Term Immunomodulatory Effects of a Mediterranean Diet in Adults at High Risk of Cardiovascular Disease in the PREvención con DIeta MEDiterránea (PREDIMED) Randomized Controlled Trial.
作者信息
Casas Rosa, Sacanella Emilio, Urpí-Sardà Mireia, Corella Dolores, Castañer Olga, Lamuela-Raventos Rosa-María, Salas-Salvadó Jordi, Martínez-González Miguel-Angel, Ros Emilio, Estruch Ramon
机构信息
Department of Internal Medicine, Hospital Clinic, August Pi i Sunyer Biomedical Research Institute, University of Barcelona, Barcelona, Spain; CIBEROBN Fisiopatología de la Obesidad y Nutrición (Spanish Biomedical Research Centre in Physiopathology of Obesity and Nutrition), Instituto de Salud Carlos III (Carlos III Health Institute), Madrid, Spain;
Department of Nutrition and Food Science School of Pharmacy, University of Barcelona, Barcelona, Spain;
出版信息
J Nutr. 2016 Sep;146(9):1684-93. doi: 10.3945/jn.115.229476. Epub 2016 Jul 20.
BACKGROUND
The Mediterranean diet (MedDiet) has demonstrated short-term anti-inflammatory effects, but little is known about its long-term immunomodulatory properties.
OBJECTIVE
Our goal was to assess the long-term effects of the MedDiet on inflammatory markers related to atherogenesis in adults at high risk of cardiovascular disease (CVD) compared with the effects of a low-fat diet (LFD).
METHODS
We randomly assigned 165 high-risk participants (one-half men; mean age: 66 y) without overt CVD to 1 of 3 diets: a MedDiet supplemented with extra-virgin olive oil, a MedDiet supplemented with nuts, or an LFD. Follow-up data were collected at 3 and 5 y. Repeated-measures ANOVA, adjusted for potential confounding variables, was used to evaluate changes in diet adherence, CVD risk factors, and inflammatory variables.
RESULTS
The 2 MedDiet groups achieved a high degree of adherence to the intervention, and the LFD group had reduced energy intake from fat by 13% by 5 y. Compared with baseline, at 3 and 5 y, both MedDiet groups had significant reductions of ≥16% in plasma concentrations of high-sensitivity C-reactive protein, interleukin-6, tumor necrosis factor α, and monocyte chemoattractant protein 1 (P ≤ 0.04), whereas there were no significant changes in the LFD group. The reductions in CD49d and CD40 expressions in T lymphocytes and monocytes at 3 y were ≥16% greater in both MedDiet groups than were the changes in the LFD group (P < 0.001) at 3 y. Compared with baseline, at 3 y, the MedDiet groups had increased HDL-cholesterol (≥8%) and decreased blood pressure (>4%) and total cholesterol, LDL-cholesterol, and triglyceride (≥8%) concentrations. At 5 y, concentrations of glucose (13%) and glycated hemoglobin (8%) had increased with the LFD.
CONCLUSIONS
The MedDiet participants had lower cellular and plasma concentrations of inflammatory markers related to atherosclerosis at 3 and 5 y. This anti-inflammatory role of the MedDiet could explain in part the long-term cardioprotective effect of the MedDiet against CVD. This trial was registered at controlled-trials.com as ISRCTN35739639.
背景
地中海饮食（MedDiet）已显示出短期抗炎作用，但其长期免疫调节特性知之甚少。
目的
我们的目标是评估与低脂饮食（LFD）相比，MedDiet对心血管疾病（CVD）高危成年人动脉粥样硬化相关炎症标志物的长期影响。
方法
我们将165名无明显CVD的高危参与者（一半为男性；平均年龄：66岁）随机分配到三种饮食中的一种：补充特级初榨橄榄油的MedDiet、补充坚果的MedDiet或LFD。在3年和5年时收集随访数据。使用重复测量方差分析，并对潜在混杂变量进行校正，以评估饮食依从性、CVD危险因素和炎症变量的变化。
结果
两个MedDiet组对干预的依从性很高，LFD组到5年时脂肪能量摄入减少了13%。与基线相比，在3年和5年时，两个MedDiet组的高敏C反应蛋白、白细胞介素-6、肿瘤坏死因子α和单核细胞趋化蛋白1的血浆浓度均显著降低≥16%（P≤0.04），而LFD组无显著变化。在3年时，两个MedDiet组T淋巴细胞和单核细胞中CD49d和CD40表达的降低比LFD组在3年时的变化大≥16%（P<0.001）。与基线相比，在3年时，MedDiet组的高密度脂蛋白胆固醇升高（≥8%），血压降低（>4%），总胆固醇、低密度脂蛋白胆固醇和甘油三酯浓度降低（≥8%）。在5年时，LFD组的葡萄糖（13%）和糖化血红蛋白（8%）浓度升高。
结论
MedDiet参与者在3年和5年时与动脉粥样硬化相关的炎症标志物的细胞和血浆浓度较低。MedDiet的这种抗炎作用可能部分解释了MedDiet对CVD的长期心脏保护作用。该试验在controlled-trials.com上注册，注册号为ISRCTN35739639。
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