Nutraceuticals Research Program, School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW, Australia.
Food Funct. 2018 Jul 17;9(7):3576-3596. doi: 10.1039/c8fo00348c.
Lower incidence of cardiovascular disease (CVD) in the Greenland Inuit, Northern Canada and Japan has been attributed to their consumption of seafood rich in long chain omega-3 polyunsaturated fatty acids (LCn-3PUFA). While a large majority of pre-clinical and intervention trials have demonstrated heart health benefits of LCn-3PUFA, some studies have shown no effects or even negative effects. LCn-3PUFA have been shown to favourably modulate blood lipid levels, particularly a reduction in circulating levels of triglycerides. High density lipoprotein-cholesterol (HDL-C) levels are elevated following dietary supplementation with LCn-3PUFA. Although LCn-3PUFA have been shown to increase low-density lipoprotein-cholesterol (LDL-C) levels, the increase is primarily in the large-buoyant particles that are less atherogenic than small-dense LDL particles. The anti-inflammatory effects of LCn-3PUFA have been clearly outlined with inhibition of NFkB mediated cytokine production being the main mechanism. In addition, reduction in adhesion molecules (intercellular adhesion molecule, ICAM and vascular cell adhesion molecule 1, VCAM-1) and leukotriene production have also been demonstrated following LCn-3PUFA supplementation. Anti-aggregatory effects of LCn-3PUFA have been a subject of controversy, however, recent studies showing sex-specific effects on platelet aggregation have helped resolve the effects on hyperactive platelets. Improvements in endothelium function, blood flow and blood pressure after LCn-3PUFA supplementation add to the mechanistic explanation on their cardio-protective effects. Modulation of adipose tissue secretions including pro-inflammatory mediators and adipokines by LCn-3PUFA has re-ignited interest in their cardiovascular health benefits. The aim of this narrative review is to filter out the reasons for possible disparity between cohort, mechanistic, pre-clinical and clinical studies. The focus of the article is to provide possible explanation for the observed controversies surrounding heart health benefits of LCn-3PUFA.
格陵兰因纽特人、加拿大北部和日本因食用富含长链欧米伽-3 多不饱和脂肪酸（LCn-3PUFA）的海鲜，心血管疾病（CVD）发病率较低。虽然绝大多数临床前和干预试验都表明 LCn-3PUFA 对心脏健康有益，但有些研究表明没有效果，甚至有负面影响。LCn-3PUFA 已被证明能有利地调节血脂水平，特别是降低循环中的甘油三酯水平。高密度脂蛋白胆固醇（HDL-C）水平在 LCn-3PUFA 膳食补充后升高。尽管 LCn-3PUFA 已被证明会增加低密度脂蛋白胆固醇（LDL-C）水平，但这种增加主要是在大而浮力的颗粒中，这些颗粒比小而密集的 LDL 颗粒的致动脉粥样硬化程度低。LCn-3PUFA 的抗炎作用已被明确阐明，NFkB 介导的细胞因子产生的抑制是主要机制。此外，LCn-3PUFA 补充后还能减少粘附分子（细胞间粘附分子、ICAM 和血管细胞粘附分子 1、VCAM-1）和白三烯的产生。LCn-3PUFA 的抗聚集作用一直存在争议，然而，最近的研究表明，LCn-3PUFA 对血小板聚集的性别特异性影响有助于解决对过度活跃血小板的影响。LCn-3PUFA 补充后改善内皮功能、血流和血压，进一步说明了其对心脏的保护作用的机制。LCn-3PUFA 对脂肪组织分泌的调节，包括促炎介质和脂肪因子，重新引发了人们对其心血管健康益处的兴趣。本综述的目的是筛选出可能导致队列、机制、临床前和临床研究之间存在差异的原因。本文的重点是提供可能的解释，以说明围绕 LCn-3PUFA 对心脏健康益处的争议。
