ω-3 脂肪酸补充剂与健康老年人循环脂蛋白亚类的随机试验。
A Randomized Trial of ω-3 Fatty Acid Supplementation and Circulating Lipoprotein Subclasses in Healthy Older Adults.
机构信息
Endocrine Research Unit, Division of Endocrinology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA.
Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY, USA.
出版信息
J Nutr. 2022 Jul 6;152(7):1675-1689. doi: 10.1093/jn/nxac084.
BACKGROUND
Omega-3 (n-3) PUFAs are recognized for triglyceride-lowering effects in people with dyslipidemia, but it remains unclear if n-3-PUFA intake influences lipoprotein profiles in older adults without hypertriglyceridemia.
OBJECTIVES
The objective was to determine the effect of n-3-PUFA supplementation on plasma lipoprotein subfractions in healthy older men and women in the absence of cardiovascular disease (CVD) or hypertriglyceridemia. This was a secondary analysis and considered exploratory.
METHODS
Thirty young (20-35 y old) and 54 older (65-85 y old) men and women were enrolled in the study. Fasting plasma samples were collected. After baseline sample collection, 44 older adults were randomly assigned to receive either n-3-PUFA ethyl esters (3.9 g/d) or placebo (corn oil) for 6 mo. Pre- and postintervention plasma samples were used for quantitative lipoprotein subclass analysis using high-resolution proton NMR spectroscopy.
RESULTS
The number of large, least-dense LDL particles decreased 17%-18% with n-3 PUFAs compared with placebo (<1% change; P < 0.01). The number of small, dense LDL particles increased 26%-44% with n-3 PUFAs compared with placebo (∼11% decrease; P < 0.01). The cholesterol content of large HDL particles increased by 32% with n-3 PUFAs and by 2% in placebo (P < 0.01). The cholesterol content of small HDL particles decreased by 23% with n-3 PUFAs and by 2% in placebo (P < 0.01).
CONCLUSIONS
Despite increasing abundance of small, dense LDL particles that are associated with CVD risk, n-3 PUFAs reduced total triglycerides, maintained HDL, reduced systolic blood pressure, and shifted the HDL particle distribution toward a favorable cardioprotective profile in healthy older adults without dyslipidemia. This study suggests potential benefits of n-3-PUFA supplementation to lipoprotein profiles in healthy older adults without dyslipidemia, which should be considered when weighing the potential health benefits against the cost and ecological impact of widespread use of n-3-PUFA supplements.This trial was registered at clinicaltrials.gov as NCT03350906.
背景
ω-3（n-3）多不饱和脂肪酸已被证实可降低血脂异常人群的甘油三酯水平，但目前尚不清楚 n-3-PUFA 的摄入是否会影响无高甘油三酯血症的老年人群的脂蛋白谱。
目的
本研究旨在确定 n-3-PUFA 补充剂对无心血管疾病（CVD）或高甘油三酯血症的健康老年男性和女性血浆脂蛋白亚组分的影响。这是一项二次分析，被认为是探索性的。
方法
研究纳入了 30 名年轻（20-35 岁）和 54 名年长（65-85 岁）男性和女性。采集空腹血浆样本。基线样本采集后，44 名年长参与者被随机分配接受 n-3-PUFA 乙酯（3.9 g/d）或安慰剂（玉米油）治疗 6 个月。干预前后的血浆样本用于使用高分辨率质子 NMR 光谱法进行定量脂蛋白亚组分分析。
结果
与安慰剂相比，n-3PUFA 使大而密度最小的 LDL 颗粒减少 17%-18%（变化＜1%；P＜0.01）。小而密的 LDL 颗粒增加 26%-44%，而安慰剂组（减少约 11%；P＜0.01）。大 HDL 颗粒的胆固醇含量增加 32%，而安慰剂组增加 2%（P＜0.01）。小 HDL 颗粒的胆固醇含量减少 23%，而安慰剂组减少 2%（P＜0.01）。
结论
尽管小而密的 LDL 颗粒数量增加，与 CVD 风险相关，但 n-3PUFA 仍降低了总甘油三酯，维持了 HDL，降低了收缩压，并使 HDL 颗粒分布向有利于保护健康的方向转变，而无血脂异常的老年人群。这项研究表明，n-3-PUFA 补充剂对无血脂异常的健康老年人群的脂蛋白谱有潜在益处，在权衡广泛使用 n-3-PUFA 补充剂的潜在健康益处与成本和生态影响时，应考虑这一点。该试验在 clinicaltrials.gov 注册为 NCT03350906。
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