Department of Nutrition and Movement Sciences, NUTRIM (School of Nutrition and Translational Research in Metabolism), Maastricht University Medical Center, Maastricht, the Netherlands.
Unilever Research and Development, Vlaardingen, the Netherlands.
Clin Nutr. 2021 Mar;40(3):804-811. doi: 10.1016/j.clnu.2020.08.016. Epub 2020 Aug 27.
The saturated fatty acid stearic acid (C18:0) lowers HDL cholesterol compared with palmitic acid (C16:0). However, the ability of HDL particles to promote cholesterol efflux from macrophages (cholesterol efflux capacity; CEC) may better predict coronary heart disease (CHD) risk than HDL cholesterol concentrations.
We examined effects of exchanging dietary palmitic acid for stearic acid on ATP-binding cassette transporter A1 (ABCA1)-mediated CEC, and other conventional and emerging cardiometabolic risk makers.
In a double-blind, randomized, crossover study with two 4-week isocaloric intervention periods, 34 healthy men and postmenopausal women (61.5 ± 5.7 years, BMI: 25.4 ± 2.5 kg/m) followed diets rich in palmitic acids or stearic acids. Difference in intakes was 6% of daily energy. ABCA1-mediated CEC was measured from J774 macrophages to apolipoprotein (apo)B-depleted serum.
Compared with the palmitic-acid diet, the stearic-acid diet lowered serum LDL cholesterol (-0.14 mmol/L; p = 0.010), HDL cholesterol (-0.09 mmol/L; p=<0.001), and apoA1 (-0.05 g/L; p < 0.001). ABCA1-mediated CEC did not differ between diets (p = 0.280). Cholesteryl ester transfer protein (CETP) mass was higher on stearic acid (0.11 mg/L; p = 0.003), but CETP activity was comparable. ApoB100 did not differ, but triacylglycerol concentrations tended to be higher on stearic acid (p = 0.100). Glucose concentrations were comparable. Effects on insulin and C-peptide were sex-dependent. In women, the stearic-acid diet increased insulin concentrations (1.57 μU/mL; p = 0.002), while in men, C-peptide concentrations were lower (-0.15 ng/mL; p = 0.037). Interleukin 6 (0.15 pg/mL; p = 0.039) and tumor necrosis factor alpha (0.18 pg/mL; p = 0.005), but not high-sensitivity C-reactive protein, were higher on stearic acid. Soluble intracellular adhesion molecule (9 ng/mL; p = 0.033), but not soluble vascular cell adhesion molecule and endothelial-selectin concentrations decreased after stearic-acid consumption.
As expected, stearic-acid intake lowered LDL cholesterol, HDL cholesterol, and apoA1. Insulin sensitivity in women and low-grade inflammation might be unfavorably affected by stearic-acid intake. However, palmitic-acid and stearic-acid intakes did not differently affect ABCA1-mediated CEC.
This trial was registered at clinicaltrials.gov as NCT02835651.
与棕榈酸（C16：0）相比，饱和脂肪酸硬脂酸（C18：0）降低了高密度脂蛋白胆固醇（HDL-C）。然而，高密度脂蛋白颗粒促进巨噬细胞内胆固醇外流的能力（胆固醇外流能力；CEC）可能比 HDL-C 浓度更好地预测冠心病（CHD）风险。
我们研究了用硬脂酸替代饮食中的棕榈酸对 ATP 结合盒转运蛋白 A1（ABCA1）介导的 CEC 以及其他传统和新兴的心血管代谢风险标志物的影响。
在一项双盲、随机、交叉研究中，有 34 名健康男性和绝经后女性（61.5±5.7 岁，BMI：25.4±2.5 kg/m）接受富含棕榈酸或硬脂酸的饮食，每个周期为 4 周。两种饮食的能量摄入相差 6%。从 J774 巨噬细胞到载脂蛋白（apo）B 耗尽的血清中测量 ABCA1 介导的 CEC。
与棕榈酸饮食相比，硬脂酸饮食降低了血清 LDL-C（-0.14mmol/L；p=0.010）、HDL-C（-0.09mmol/L；p<0.001）和 apoA1（-0.05g/L；p<0.001）。两种饮食之间的 ABCA1 介导的 CEC 没有差异（p=0.280）。胆固醇酯转移蛋白（CETP）质量在硬脂酸时更高（0.11mg/L；p=0.003），但 CETP 活性相当。apoB100 没有差异，但三酰甘油浓度在硬脂酸时趋于升高（p=0.100）。葡萄糖浓度相当。对胰岛素和 C 肽的影响存在性别依赖性。在女性中，硬脂酸饮食增加了胰岛素浓度（1.57μU/mL；p=0.002），而在男性中，C 肽浓度较低（-0.15ng/mL；p=0.037）。白细胞介素 6（0.15pg/mL；p=0.039）和肿瘤坏死因子-α（0.18pg/mL；p=0.005）升高，但高敏 C 反应蛋白没有升高。可溶性细胞间黏附分子（9ng/mL；p=0.033）降低，但可溶性血管细胞黏附分子和内皮选择素浓度没有降低。
正如预期的那样，硬脂酸摄入降低了 LDL-C、HDL-C 和 apoA1。女性的胰岛素敏感性和低度炎症可能会因硬脂酸的摄入而受到不利影响。然而，棕榈酸和硬脂酸的摄入并没有不同地影响 ABCA1 介导的 CEC。
该试验在 clinicaltrials.gov 上注册为 NCT02835651。
