da Silva S G L, Terreri M T, Abad T T O, Machado D, Fonseca F L A, Hix S, Suano-Souza F I, Sarni R O S, Len C A
1 Department of Pediatrics, 28105 Federal University of São Paulo (Universidade Federal de São Paulo ; Unifesp), São Paulo, SP, Brazil.
2 Laboratory of Clinical Analysis, School of Medicine of ABC and Federal University of São Paulo, SP, Brazil.
Lupus. 2018 Apr;27(5):820-827. doi: 10.1177/0961203317751851. Epub 2018 Jan 10.
Objective This study sought to evaluate the effects of a nutritional intervention on the lipid metabolism biomarkers associated with cardiovascular risk, and their variation over time, in juvenile systemic lupus erythematosus (JSLE) patients. This study also investigated the relationships between these biomarkers and dietary intake, nutritional status, disease variables, and medication used. Methods A total of 31 10- to 19-year-old female adolescents with JSLE for at least six months were analyzed. The participants were randomly allocated to two groups: nutritional intervention or control. The intervention group received verbal and printed nutritional instructions once per month over nine months. Before and after the intervention, the participants underwent assessments of anthropometry; dietary intake; physical activity; socioeconomic status; total cholesterol and fractions; triglycerides; apolipoprotein A (Apo A-I); apolipoprotein B (Apo B); paraoxonase (PON) activity (a) and amount (q); myeloperoxidase (MPO); and small, dense LDL-c (sdLDL) particles. Results After nine months, we found significant reductions in the calorie, carbohydrate, total fat, saturated fat, and trans fat intakes in the intervention compared with the control group over time. The PONa/HDL-c ratio increased by 3.18 U/ml/mg/dl in the intervention group and by 0.63 U/ml/mg/dl in the control group ( p = 0.037). Unlike the intervention group, the sdLDL levels of the control group worsened over time ( p = 0.018). Conclusion The present study detected a reduction in calorie and fat intake, which indicates an improvement of HDL-c function and possible protection against cardiovascular risk for the intervention group.
目的 本研究旨在评估营养干预对青少年系统性红斑狼疮（JSLE）患者心血管风险相关脂质代谢生物标志物及其随时间变化的影响。本研究还调查了这些生物标志物与饮食摄入、营养状况、疾病变量和所用药物之间的关系。方法 对31名年龄在10至19岁、患JSLE至少6个月的女性青少年进行了分析。参与者被随机分为两组：营养干预组或对照组。干预组在9个月内每月接受一次口头和书面营养指导。在干预前后，对参与者进行了人体测量、饮食摄入、身体活动、社会经济状况、总胆固醇及其组分、甘油三酯、载脂蛋白A（Apo A-I）、载脂蛋白B（Apo B）、对氧磷酶（PON）活性（a）和含量（q）、髓过氧化物酶（MPO）以及小而密低密度脂蛋白胆固醇（sdLDL）颗粒的评估。结果 9个月后，我们发现随着时间的推移，与对照组相比，干预组的热量、碳水化合物、总脂肪、饱和脂肪和反式脂肪摄入量显著减少。干预组的PONa/HDL-c比值增加了3.18 U/ml/mg/dl，对照组增加了0.63 U/ml/mg/dl（p = 0.037）。与干预组不同，对照组的sdLDL水平随时间恶化（p = 0.018）。结论 本研究发现热量和脂肪摄入量减少，这表明干预组的高密度脂蛋白胆固醇（HDL-c）功能得到改善，并可能对心血管风险具有保护作用。
