低碳水化合物高脂肪饮食对正常体重年轻成年人 LDL 胆固醇和基因表达的影响：一项随机对照研究。

Effect of low carbohydrate high fat diet on LDL cholesterol and gene expression in normal-weight, young adults: A randomized controlled study.

机构信息

Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, PB 1046, Blindern, 0317, Oslo, Norway; Lipid Clinic, Department of Endocrinology, Obesity and Preventive Medicine, Oslo, University Hospital, Norway.

Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, PB 1046, Blindern, 0317, Oslo, Norway; Section for Preventive Cardiology, Department of Endocrinology, Obesity and Preventive Medicine, Oslo University Hospital, Norway.

出版信息

Atherosclerosis. 2018 Dec;279:52-61. doi: 10.1016/j.atherosclerosis.2018.10.013. Epub 2018 Oct 17.

DOI:10.1016/j.atherosclerosis.2018.10.013

PMID:30408717

Abstract

BACKGROUND AND AIMS

The effects of a low carbohydrate/high fat (LCHF) diet on health are debated. This study aims to explore the effects of a diet with less than 20 g carbohydrates per day (LCHF) on plasma low density lipoprotein cholesterol (LDL-C) in young and healthy adults. The secondary aim is the assessment of lipid profile and peripheral blood mononuclear cells (PBMC) gene expression.

METHODS

This was a randomized controlled parallel-designed intervention study. Participants were either assigned to a three-week LCHF diet or a control group continuing habitual diet ad libitum, in both groups.

RESULTS

In total, 30 healthy normal weight participants completed the study. Nine subjects did not complete it due to adverse events or withdrawn consent. In the LCHF diet group (n = 15), plasma LDL-C increased from (mean ± SD) 2.2 ± 0.4 mmol/l before intervention to 3.1 ± 0.8 after, while in the control group (n = 15), LDL-C remained unchanged: 2.5 ± 0.8 mmol/l (p < 0.001 between groups). There was a significant increase in apolipoprotein B, total cholesterol, high-density lipoprotein cholesterol, free fatty acids, uric acid and urea in the LCHF group versus controls. Plasma levels of triglycerides, lipoprotein (a), glucose, C-peptide or C-reactive protein (CRP), blood pressure, body weight or body composition did not differ between the groups. PBMC gene expression of sterol regulator element binding protein 1 (SREBP-1) was increased in the LCHF group versus controls (p ≤ 0.01). The individual increase in LDL-C from baseline varied between 5 and 107% in the LCHF group.

CONCLUSIONS

An LCHF diet for three weeks increased LDL-C with 44% versus controls. The individual response on LCHF varied profoundly.

摘要

背景和目的

低碳水化合物/高脂肪（LCHF）饮食对健康的影响存在争议。本研究旨在探讨每天摄入少于 20 克碳水化合物的饮食（LCHF）对年轻健康成年人血浆低密度脂蛋白胆固醇（LDL-C）的影响。次要目的是评估血脂谱和外周血单核细胞（PBMC）基因表达。

方法

这是一项随机对照平行设计的干预研究。参与者被分配到为期三周的 LCHF 饮食组或继续随意摄入习惯饮食的对照组。

结果

共有 30 名健康正常体重的参与者完成了这项研究。由于不良事件或撤回同意，有 9 名受试者未能完成研究。在 LCHF 饮食组（n=15）中，血浆 LDL-C 从干预前的（均值±标准差）2.2±0.4mmol/L 增加到 3.1±0.8mmol/L，而对照组（n=15）中 LDL-C 保持不变：2.5±0.8mmol/L（组间差异 p<0.001）。LCHF 组与对照组相比，载脂蛋白 B、总胆固醇、高密度脂蛋白胆固醇、游离脂肪酸、尿酸和尿素均显著升高。LCHF 组与对照组之间的血浆甘油三酯、脂蛋白（a）、葡萄糖、C 肽或 C 反应蛋白（CRP）、血压、体重或身体成分无差异。LCHF 组 PBMC 固醇调节元件结合蛋白 1（SREBP-1）的基因表达较对照组增加（p≤0.01）。LCHF 组 LDL-C 从基线的个体增加幅度在 5%至 107%之间。