Antoniazi Luiza, Arroyo-Olivares Raquel, Mata Pedro, Santos Raul D
Heart Institute (InCor) University of Sao Paulo Medical School Hospital, Sao Paulo, Brazil.
Fundación Hipercolesterolemia Familiar, Madrid, Spain.
Curr Opin Lipidol. 2022 Apr 1;33(2):89-94. doi: 10.1097/MOL.0000000000000813.
Familial hypercholesterolemia (FH) is a relatively common genetic disorder associated with elevated atherosclerotic risk. Dietary interventions can modulate processes associated with cardiovascular risk and potentiate the impact of pharmacological lipid-lowering therapies. This review evaluates recent findings of dietary patterns and their components on risk biomarkers in people with FH.
Diets lower in saturated fatty acids (SFA) may reduce low-density lipoprotein-cholesterol (LDL-C); however, their effects seem to be modest. A Mediterranean style diet apparently exerts more robust effects on plasma LDL-C, apolipoprotein B and C reactive protein concentrations than one restricted in SFA. Supplementation of plant sterols and stanols reduces LDL-C especially in children with FH. Caloric restricted diets may reduce weight and improve triglyceride levels in individuals with FH and excess body weight.
Despite the strong impact of genetic variants, dietary patterns mostly low in SFA and especially the Mediterranean diet may influence risk biomarkers in FH. However, most available studies are limited by cross-sectional design, small number of study subjects and short-term follow-ups. Robust interventional studies are necessary to test the impact of dietary patterns in people with FH.
家族性高胆固醇血症（FH）是一种相对常见的遗传性疾病，与动脉粥样硬化风险升高相关。饮食干预可以调节与心血管风险相关的过程，并增强药物降脂治疗的效果。本综述评估了饮食模式及其成分对FH患者风险生物标志物的最新研究结果。
饱和脂肪酸（SFA）含量较低的饮食可能会降低低密度脂蛋白胆固醇（LDL-C）；然而，其效果似乎较为有限。地中海式饮食对血浆LDL-C、载脂蛋白B和C反应蛋白浓度的影响显然比限制SFA的饮食更为显著。补充植物甾醇和甾烷醇可降低LDL-C，尤其是在FH儿童中。热量限制饮食可能会减轻FH且体重超标的个体的体重，并改善甘油三酯水平。
尽管基因变异有很大影响，但SFA含量大多较低的饮食模式，尤其是地中海饮食，可能会影响FH患者的风险生物标志物。然而，大多数现有研究受到横断面设计、研究对象数量少和短期随访的限制。有必要进行有力的干预性研究，以测试饮食模式对FH患者的影响。
