Makarewicz-Wujec Magdalena, Parol Gabriela, Parzonko Andrzej, Kozłowska-Wojciechowska Małgorzata
Department of Clinical Pharmacy and Pharmaceutical Care, Medical University of Warsaw, Warsaw, Poland, Poland.
Kardiol Pol. 2017;75(7):674-681. doi: 10.5603/KP.a2017.0072. Epub 2017 Apr 10.
Neuroendocrine activation, activation of proinflammatory cytokines and platelets, and endothelial dysfunction play a significant role in the development of heart failure (HF).
The aim of the work was to assess the effect of supplementation with EPA and DHA in a daily dose of 1 g on selected inflammatory markers and platelet activation in patients with HF after recent myocardial infarction in light of their diet.
This preliminary study was a randomised, double-blind trial involving 30 patients with post-infarction HF. One group received a product containing 1 g of omega-3 acids, while the other received placebo, i.e. corn oil 1 g daily for 12 weeks. At baseline and at week 12, venous blood was obtained in the fasted state in order to determine the following parameters: NT-proBNP, fibrinogen, INR, creatinine clearance, serum lipid profile, hsCRP, troponin, glucose, transaminases, GGTP, MCP-1, pentraxin 3, and CD-40. To evaluate the patient's diet and dietary intake of omega-3 acids, a 24-h dietary interview and the Block's Food Frequency Questionnaire (FFQ) were applied.
Supplementation of omega-3 acids in a dose of 1 g per day had no effect on lipid or inflammatory parameters, with the exception of pentraxin 3. In both groups, after three months of supplementation, overall consumption of energy and saturated fatty acids was significantly higher (p < 0.05).
Potential benefits associated with supplementation were nullified by a highly atherogenic diet. Apparently, supplementation of omega-3 acids without simultaneous dietary education and nutrition control does not bring the expected effect. Further research involving a larger group of patients is needed to better understand the relationship between patient's diet and the effectiveness of omega-3 supplementation.
神经内分泌激活、促炎细胞因子和血小板的激活以及内皮功能障碍在心力衰竭(HF)的发生发展中起重要作用。
本研究旨在根据近期心肌梗死后心力衰竭患者的饮食情况,评估每日补充1g EPA和DHA对选定炎症标志物和血小板激活的影响。
这项初步研究是一项随机双盲试验,涉及30例心肌梗死后心力衰竭患者。一组接受含1gω-3酸的产品,另一组接受安慰剂,即每天1g玉米油,持续12周。在基线和第12周时,在空腹状态下采集静脉血,以测定以下参数:NT-proBNP、纤维蛋白原、INR、肌酐清除率、血脂谱、hsCRP、肌钙蛋白、葡萄糖、转氨酶、GGTP、MCP-1、五聚素3和CD-40。为了评估患者的饮食和ω-3酸的膳食摄入量,采用了24小时饮食访谈和Block食物频率问卷(FFQ)。
每天补充1gω-3酸对脂质或炎症参数没有影响,但五聚素3除外。在两组中,补充三个月后,能量和饱和脂肪酸的总体摄入量显著更高(p<0.05)。
高度致动脉粥样硬化的饮食抵消了补充ω-3酸的潜在益处。显然,在没有同时进行饮食教育和营养控制的情况下补充ω-3酸不会带来预期效果。需要进一步开展涉及更多患者的研究,以更好地了解患者饮食与ω-3补充剂有效性之间的关系。