极高饱和脂肪饮食对动脉粥样硬化性血脂异常成年人低密度脂蛋白颗粒的影响：一项随机对照试验。
Effects of a very high saturated fat diet on LDL particles in adults with atherogenic dyslipidemia: A randomized controlled trial.
作者信息
Chiu Sally, Williams Paul T, Krauss Ronald M
机构信息
Children's Hospital Oakland Research Institute, Oakland, California, United States of America.
出版信息
PLoS One. 2017 Feb 6;12(2):e0170664. doi: 10.1371/journal.pone.0170664. eCollection 2017.
BACKGROUND
Previous studies have shown that increases in LDL-cholesterol resulting from substitution of dietary saturated fat for carbohydrate or unsaturated fat are due primarily to increases in large cholesterol-enriched LDL, with minimal changes in small, dense LDL particles and apolipoprotein B. However, individuals can differ by their LDL particle distribution, and it is possible that this may influence LDL subclass response.
OBJECTIVE
The objective of this study was to test whether the reported effects of saturated fat apply to individuals with atherogenic dyslipidemia as characterized by a preponderance of small LDL particles (LDL phenotype B).
METHODS
Fifty-three phenotype B men and postmenopausal women consumed a baseline diet (55%E carbohydrate, 15%E protein, 30%E fat, 8%E saturated fat) for 3 weeks, after which they were randomized to either a moderate carbohydrate, very high saturated fat diet (HSF; 39%E carbohydrate, 25%E protein, 36%E fat, 18%E saturated fat) or low saturated fat diet (LSF; 37%E carbohydrate, 25%E protein, 37%E fat, 9%E saturated fat) for 3 weeks.
RESULTS
Compared to the LSF diet, consumption of the HSF diet resulted in significantly greater increases from baseline (% change; 95% CI) in plasma concentrations of apolipoprotein B (HSF vs. LSF: 9.5; 3.6 to 15.7 vs. -6.8; -11.7 to -1.76; p = 0.0003) and medium (8.8; -1.3 to 20.0 vs. -7.3; -15.7 to 2.0; p = 0.03), small (6.1; -10.3 to 25.6 vs. -20.8; -32.8 to -6.7; p = 0.02), and total LDL (3.6; -3.2 to 11.0 vs. -7.9; -13.9 to -1.5; p = 0.03) particles, with no differences in change of large and very small LDL concentrations. As expected, total-cholesterol (11.0; 6.5 to 15.7 vs. -5.7; -9.4 to -1.8; p<0.0001) and LDL-cholesterol (16.7; 7.9 to 26.2 vs. -8.7; -15.4 to -1.4; p = 0.0001) also increased with increased saturated fat intake.
CONCLUSIONS
Because medium and small LDL particles are more highly associated with cardiovascular disease than are larger LDL, the present results suggest that very high saturated fat intake may increase cardiovascular disease risk in phenotype B individuals. This trial was registered at clinicaltrials.gov (NCT00895141).
TRIAL REGISTRATION
Clinicaltrials.gov NCT00895141.
背景
先前的研究表明，用膳食饱和脂肪替代碳水化合物或不饱和脂肪导致的低密度脂蛋白胆固醇升高主要是由于富含胆固醇的大颗粒低密度脂蛋白增加，而小而密的低密度脂蛋白颗粒和载脂蛋白B变化极小。然而，个体的低密度脂蛋白颗粒分布可能存在差异，这有可能影响低密度脂蛋白亚类反应。
目的
本研究的目的是测试饱和脂肪的上述作用是否适用于以小颗粒低密度脂蛋白（低密度脂蛋白表型B）占优势为特征的致动脉粥样硬化血脂异常个体。
方法
53名表型B的男性和绝经后女性食用了3周的基线饮食（碳水化合物供能占55%，蛋白质供能占15%，脂肪供能占30%，饱和脂肪供能占8%），之后他们被随机分为两组，一组食用中等碳水化合物、极高饱和脂肪饮食（HSF；碳水化合物供能占39%，蛋白质供能占25%，脂肪供能占36%，饱和脂肪供能占18%），另一组食用低饱和脂肪饮食（LSF；碳水化合物供能占37%，蛋白质供能占25%，脂肪供能占37%，饱和脂肪供能占9%），为期3周。
结果
与LSF饮食相比，HSF饮食使血浆载脂蛋白B（HSF与LSF相比：9.5；3.6至15.7与-6.8；-11.7至-1.76；p = 0.0003）、中等大小（8.8；-1.3至20.0与-7.3；-15.7至2.0；p = 0.03）、小（6.1；-十.三至25.6与-20.8；-32.8至-6.7；p = 0.02）和总低密度脂蛋白（3.6；-3.2至11.0与-7.9；-13.9至-1.5；p = 0.03）颗粒的血浆浓度从基线水平显著升高（变化百分比；95%置信区间）,大颗粒和极小颗粒低密度脂蛋白浓度的变化无差异。正如预期的那样，总胆固醇（11.0；6.5至15.7与-5.7；-9.4至-1.8；p<0.000）和低密度脂蛋白胆固醇（16.7；7.9至26.2与-8.7；-15.4至-1.4；p = 0.0001）也随着饱和脂肪摄入量的增加而升高。
结论
由于中等大小和小颗粒低密度脂蛋白比大颗粒低密度脂蛋白与心血管疾病的关联更强，目前的结果表明，极高的饱和脂肪摄入量可能会增加表型B个体患心血管疾病的风险。本试验已在ClinicalTrials.gov上注册（NCT00895141）。
试验注册
ClinicalTrials.gov NCT00895141。
Zotero 插件