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鱼油可降低超重/肥胖 2 型糖尿病患者的亚临床炎症、胰岛素抵抗和动脉粥样硬化因素:一项前后试点研究。

Fish oil reduces subclinical inflammation, insulin resistance, and atherogenic factors in overweight/obese type 2 diabetes mellitus patients: A pre-post pilot study.

机构信息

Laboratory of Exercise Biochemistry and Physiology, Graduate Program in Health Sciences, Extremo Sul Catarinense University, Criciúma, SC, Brazil.

Department of Internal Medicine, Medicine School, Federal University of Juiz de Fora, Juiz de Fora, MG, Brazil.

出版信息

J Diabetes Complications. 2020 May;34(5):107553. doi: 10.1016/j.jdiacomp.2020.107553. Epub 2020 Jan 28.

Abstract

OBJECTIVE

Insulin resistance-associated obesity and type 2 diabetes mellitus (T2DM) are commonly accompanied with metabolic lipid abnormalities and are characterized by hypertriglyceridemia and low HDL-c levels (atherogenic index plasma, AIP). The primary molecular mechanism that is known to cause insulin resistance is chronic low-grade inflammation. Considering that omega-3 fatty acid reduces subclinical inflammation, we hypothesized that fish oil could affect insulin resistance and AIP. Therefore, the present study evaluated the effects of fish oil supplementation on the inflammatory, insulin resistance, and atherogenic factors in overweight/obese T2DM patients.

RESEARCH DESIGNS AND METHODS

In this study, we recruited 32 overweight and/or obese patients diagnosed with T2DM for over one year and who exhibited hypertriglyceridemia. These patients received fish oil supplementation (4.0 g/day) for eight weeks. Anthropometric and body composition measurements were obtained. In addition, blood samples were collected before and after omega-3 supplementation for the evaluation of lipid profile, glycemia, insulin, and inflammation.

RESULTS

As expected, patients showed reduction in the TNFα, IL-1β, and Il-6 levels after fish oil supplementation and showed improved insulin sensitivity (HOMA-IR) without observed alterations in anthropometric and body composition. These observations were followed by reduction in the levels of triglycerides and non-esterified fatty acids, increase in HDL cholesterol levels, and a significant reduction in triglycerides/HDL-c ratio, and total cholesterol/HDL-c ratio.

CONCLUSION

Fish oil supplementation is effective in reducing the levels of proinflammatory cytokines, improving insulin resistance, and reducing atherogenic factors in overweight/obese and T2DM patients independent of weight loss.

摘要

目的

胰岛素抵抗相关肥胖和 2 型糖尿病(T2DM)通常伴有代谢脂质异常,其特征为高三酰甘油血症和低 HDL-c 水平(致动脉粥样硬化指数血浆,AIP)。已知导致胰岛素抵抗的主要分子机制是慢性低度炎症。鉴于ω-3 脂肪酸可减轻亚临床炎症,我们假设鱼油可能会影响胰岛素抵抗和 AIP。因此,本研究评估了鱼油补充对超重/肥胖 T2DM 患者炎症、胰岛素抵抗和致动脉粥样硬化因素的影响。

研究设计和方法

本研究招募了 32 名超重和/或肥胖且患有 T2DM 超过一年且表现出高三酰甘油血症的患者。这些患者接受了为期八周的鱼油补充(4.0g/天)。进行了人体测量和身体成分测量。此外,在 omega-3 补充前后采集了血液样本,用于评估血脂谱、血糖、胰岛素和炎症。

结果

正如预期的那样,患者在鱼油补充后 TNFα、IL-1β 和 Il-6 水平降低,并且胰岛素敏感性(HOMA-IR)得到改善,而体重和身体成分没有观察到变化。随之而来的是甘油三酯和非酯化脂肪酸水平降低,HDL 胆固醇水平升高,甘油三酯/HDL-c 比值和总胆固醇/HDL-c 比值显著降低。

结论

鱼油补充可有效降低促炎细胞因子水平,改善超重/肥胖和 T2DM 患者的胰岛素抵抗,并降低致动脉粥样硬化因素,而与体重减轻无关。

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