亚麻籽油 ω-3 脂肪酸补充剂对糖尿病足溃疡患者的临床和代谢反应：一项随机、双盲、安慰剂对照试验。
Clinical and metabolic response to flaxseed oil omega-3 fatty acids supplementation in patients with diabetic foot ulcer: A randomized, double-blind, placebo-controlled trial.
机构信息
Department of Infectious Disease, school of medicine, Kashan University of Medical Sciences, Kashan, I.R., Iran.
Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, I.R., Iran.
出版信息
J Diabetes Complications. 2017 Sep;31(9):1394-1400. doi: 10.1016/j.jdiacomp.2017.06.010. Epub 2017 Jun 28.
BACKGROUND
Data on the effects of flaxseed oil omega-3 fatty acids supplementation on wound healing and metabolic status in subjects with diabetic foot ulcer (DFU) are scarce.
OBJECTIVE
This study was conducted to evaluate the effects of flaxseed oil omega-3 fatty acids supplementation on wound healing and metabolic status in subjects with DFU.
METHODS
The current randomized, double-blind, placebo-controlled trial was conducted among 60 subjects (aged 40-85years old) with grade 3 DFU. Subjects were randomly allocated into two groups (30 subjects each group) to receive either 1000mg omega-3 fatty acids from flaxseed oil supplements or placebo twice a day for 12weeks.
RESULTS
After the 12-week intervention, compared with the placebo, omega-3 fatty acids supplementation resulted in significant decreases in ulcer length (-2.0±2.3 vs. -1.0±1.1cm, P=0.03), width (-1.8±1.7 vs. -1.0±1.0cm, P=0.02) and depth (-0.8±0.6 vs. -0.5±0.5cm, P=0.01). Additionally, significant reductions in serum insulin concentrations (-4.4±5.5 vs. +1.4±8.3 μIU/mL, P=0.002), homeostasis model of assessment-estimated insulin resistance (-2.1±3.0 vs. +1.0±5.0, P=0.005) and HbA1c (-0.9±1.5 vs. -0.1±0.4%, P=0.01), and a significant rise in the quantitative insulin sensitivity check index (+0.01±0.01 vs. -0.005±0.02, P=0.002) were seen following supplementation with omega-3 fatty acids compared with the placebo. In addition, omega-3 fatty acids supplementation significantly decreased serum high sensitivity C-reactive protein (hs-CRP) (-25.5±31.5 vs. -8.2±18.9μg/mL, P=0.01), and significantly increased plasma total antioxidant capacity (TAC) (+83.5±111.7 vs. -73.4±195.5mmol/L, P<0.001) and glutathione (GSH) concentrations (+60.7±140.2 vs. -15.5±129.7μmol/L, P=0.03) compared with the placebo.
CONCLUSIONS
Overall, omega-3 fatty acids supplementation for 12weeks among subjects with DFU had beneficial effects on parameters of ulcer size, markers of insulin metabolism, serum hs-CRP, plasma TAC and GSH levels. In addition, flaxseed oil omega-3 fatty acids may have played an indirect role in wound healing due to its effects on improved metabolic profiles.
背景
关于亚麻籽油ω-3 脂肪酸补充剂对糖尿病足溃疡（DFU）患者伤口愈合和代谢状态的影响的数据很少。
目的
本研究旨在评估亚麻籽油 ω-3 脂肪酸补充剂对 DFU 患者伤口愈合和代谢状态的影响。
方法
本随机、双盲、安慰剂对照试验纳入了 60 名（年龄 40-85 岁）患有 3 级 DFU 的受试者。受试者随机分为两组（每组 30 名），每天两次分别服用 1000mg 亚麻籽油中的 ω-3 脂肪酸或安慰剂，持续 12 周。
结果
在 12 周的干预后，与安慰剂相比，ω-3 脂肪酸补充剂可显著降低溃疡长度（-2.0±2.3 与-1.0±1.1cm，P=0.03）、宽度（-1.8±1.7 与-1.0±1.0cm，P=0.02）和深度（-0.8±0.6 与-0.5±0.5cm，P=0.01）。此外，血清胰岛素浓度（-4.4±5.5 与+1.4±8.3μIU/mL，P=0.002）、稳态模型评估胰岛素抵抗（-2.1±3.0 与+1.0±5.0，P=0.005）和糖化血红蛋白（HbA1c）（-0.9±1.5 与-0.1±0.4%，P=0.01）显著降低，而定量胰岛素敏感性检查指数（+0.01±0.01 与-0.005±0.02，P=0.002）显著升高，这在补充 ω-3 脂肪酸后与安慰剂相比更为明显。此外，ω-3 脂肪酸补充剂可显著降低血清高敏 C 反应蛋白（hs-CRP）（-25.5±31.5 与-8.2±18.9μg/mL，P=0.01），并显著增加血浆总抗氧化能力（TAC）（+83.5±111.7 与-73.4±195.5mmol/L，P<0.001）和谷胱甘肽（GSH）浓度（+60.7±140.2 与-15.5±129.7μmol/L，P=0.03）与安慰剂相比。
结论
总体而言，DFU 患者补充 12 周 ω-3 脂肪酸对溃疡大小、胰岛素代谢标志物、血清 hs-CRP、血浆 TAC 和 GSH 水平等参数有有益影响。此外，亚麻籽油 ω-3 脂肪酸可能通过改善代谢谱间接影响伤口愈合。
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