血浆脂肪酸与胰岛素抵抗患者和非胰岛素抵抗患者及心血管疾病二级预防中炎症标志物的关系：一项横断面研究。
Association between plasma fatty acids and inflammatory markers in patients with and without insulin resistance and in secondary prevention of cardiovascular disease, a cross-sectional study.
机构信息
Research Institute, Hospital do Coração (IP-HCor), São Paulo, SP, Brazil.
Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil.
出版信息
Nutr J. 2018 Feb 21;17(1):26. doi: 10.1186/s12937-018-0342-1.
BACKGROUND
Proinflammatory biomarkers levels are increased among patients with cardiovascular disease, and it is known that both the presence of insulin resistance and diet may influence those levels. However, these associations are not well studied among patients with established cardiovascular disease. Our objective is to compare inflammatory biomarker levels among cardiovascular disease secondary prevention patients with and without insulin resistance, and to evaluate if there is any association between plasma fatty acid levels and inflammatory biomarker levels among them.
METHODS
In this cross-sectional sub-study from the BALANCE Program Trial, we collected data from 359 patients with established cardiovascular disease. Plasma fatty acids and inflammatory biomarkers (interleukin (IL)-1β, IL-6, IL-8, IL-10, IL-12, high sensitive C-reactive protein (hs-CRP), adiponectin, and tumor necrosis factor (TNF)-alpha) were measured. Biomarkers and plasma fatty acid levels of subjects across insulin resistant and not insulin resistant groups were compared, and general linear models were used to examine the association between plasma fatty acids and inflammatory biomarkers.
RESULTS
Subjects with insulin resistance had a higher concentration of hs-CRP (p = 0.002) and IL-6 (p = 0.002) than subjects without insulin resistance. Among subjects without insulin resistance there was a positive association between stearic fatty acid and IL-6 (p = 0.032), and a negative association between alpha-linolenic fatty acid and pro-inflammatory biomarkers (p < 0.05). Among those with insulin resistance there was a positive association between monounsaturated fatty acids and arachidonic fatty acid and adiponectin (p < 0.05), and a negative association between monounsaturated and polyunsaturated fatty acids and pro-inflammatory biomarkers (p < 0.05), as well as a negative association between polyunsaturated fatty acids and adiponectin (p < 0.05). Our study has not found any association between hs-CRP and plasma fatty acids.
CONCLUSIONS
Subjects in secondary prevention for cardiovascular disease with insulin resistance have a higher concentration of hs-CRP and IL-6 than individuals without insulin resistance, and these inflammatory biomarkers are positively associated with saturated fatty acids and negatively associated with unsaturated fatty acids.
背景
心血管疾病患者的促炎生物标志物水平升高，已知胰岛素抵抗的存在和饮食都可能影响这些水平。然而，这些关联在已患有心血管疾病的患者中研究得还不够充分。我们的目的是比较伴有和不伴有胰岛素抵抗的心血管疾病二级预防患者的炎症生物标志物水平，并评估它们之间的血浆脂肪酸水平和炎症生物标志物水平之间是否存在任何关联。
方法
在 BALANCE 计划试验的这项横断面亚研究中，我们收集了 359 名患有已确立的心血管疾病患者的数据。测量了血浆脂肪酸和炎症生物标志物（白细胞介素 (IL)-1β、IL-6、IL-8、IL-10、IL-12、高敏 C 反应蛋白 (hs-CRP)、脂联素和肿瘤坏死因子 (TNF)-α）。比较了胰岛素抵抗和非胰岛素抵抗组中受试者的生物标志物和血浆脂肪酸水平，并使用一般线性模型来检查血浆脂肪酸和炎症生物标志物之间的关联。
结果
与无胰岛素抵抗的受试者相比，有胰岛素抵抗的受试者 hs-CRP（p=0.002）和 IL-6（p=0.002）的浓度更高。在无胰岛素抵抗的受试者中，硬脂酸与 IL-6 之间存在正相关（p=0.032），而 α-亚麻酸与促炎生物标志物之间存在负相关（p<0.05）。在有胰岛素抵抗的受试者中，单不饱和脂肪酸和花生四烯酸与脂联素之间存在正相关（p<0.05），单不饱和和多不饱和脂肪酸与促炎生物标志物之间存在负相关（p<0.05），多不饱和脂肪酸与脂联素之间也存在负相关（p<0.05）。我们的研究没有发现 hs-CRP 与血浆脂肪酸之间存在任何关联。
结论
患有心血管疾病二级预防的伴有胰岛素抵抗的受试者的 hs-CRP 和 IL-6 浓度高于无胰岛素抵抗的受试者，这些炎症生物标志物与饱和脂肪酸呈正相关，与不饱和脂肪酸呈负相关。
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