Petersen Kristina S, Bowen Kate J, Tindall Alyssa M, Sullivan Valerie K, Johnston Emily A, Fleming Jennifer A, Kris-Etherton Penny M
Department of Nutritional Sciences, Texas Tech University, Lubbock, TX, USA.
Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, USA.
Curr Dev Nutr. 2020 Oct 15;4(11):nzaa160. doi: 10.1093/cdn/nzaa160. eCollection 2020 Nov.
Lipids and lipoproteins are major targets for cardiovascular disease (CVD) prevention. Findings from a limited number of clinical trials suggest diet-induced atherogenic lipoprotein lowering can be altered in the presence of chronic low-grade inflammation or insulin resistance. This review summarizes results from randomized controlled trials that have examined diet-induced changes in lipids/lipoproteins by inflammatory or insulin sensitivity status. In addition, mechanisms to explain these clinical observations are explored. Post hoc analyses of data from a limited number of randomized controlled trials suggest attenuation of diet-induced lipid/lipoprotein lowering in individuals with inflammation and/or insulin resistance. These findings are supported by experimental studies showing that inflammatory stimuli and hyperinsulinemia alter genes involved in endogenous cholesterol synthesis and cholesterol uptake, reduce cholesterol efflux, and increase fatty acid biosynthesis. Further a priori defined research is required to better characterize how chronic low-grade inflammation and insulin resistance modulate lipid and lipoprotein responsiveness to guide CVD risk reduction in individuals presenting with these phenotypes.
脂质和脂蛋白是心血管疾病（CVD）预防的主要靶点。有限数量的临床试验结果表明，在存在慢性低度炎症或胰岛素抵抗的情况下，饮食诱导的致动脉粥样硬化脂蛋白降低可能会发生改变。本综述总结了通过炎症或胰岛素敏感性状态研究饮食诱导的脂质/脂蛋白变化的随机对照试验结果。此外，还探讨了解释这些临床观察结果的机制。对有限数量随机对照试验数据的事后分析表明，炎症和/或胰岛素抵抗个体中饮食诱导的脂质/脂蛋白降低作用减弱。这些发现得到了实验研究的支持，实验研究表明炎症刺激和高胰岛素血症会改变参与内源性胆固醇合成和胆固醇摄取的基因，减少胆固醇流出，并增加脂肪酸生物合成。需要进一步进行先验定义的研究，以更好地表征慢性低度炎症和胰岛素抵抗如何调节脂质和脂蛋白反应性，从而指导具有这些表型的个体降低CVD风险。
