Li Ling, Zhao Zhenjuan, Wang Yini, Gao Xueqin, Liu Guojie, Yu Bo, Lin Ping
Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China.
Front Nutr. 2022 Jun 14;9:920892. doi: 10.3389/fnut.2022.920892. eCollection 2022.
Although studies have proven that diet has a critical role in preventing or delaying atherosclerosis and is far simpler to adjust and adhere to than other risk factors, the underlying mechanisms behind this effect remain not well comprehended. The purpose of this investigation was to determine the impact of inflammatory factors on the connection between dietary ingestion and coronary plaque fragility as measured via optical coherence tomography (OCT) in patients with coronary heart disease (CHD). This research eventually comprised 194 participants with CHD who met the inclusion and exclusion criteria. Semi-quantitative food frequency questionnaire (SQFFQ) was utilized to investigate dietary consumption status, serum levels of inflammatory biomarkers were analyzed using enzyme-linked immunosorbent assay, and OCT was employed to identify the plaque susceptibility of causative lesions in the body. Following correction for statistically meaningful possible confounders in univariate analysis, quartiles of soy and nuts, fruits and vitamin C were negatively associated with coronary plaque vulnerability. Conversely, the upper quartile group of sodium intake had 2.98 times the risk of developing vulnerable plaques compared with the most minimal quartile group. Meanwhile, we observed an inverse dose-response connection between vitamin C consumption and inflammatory biomarkers as well as plaque vulnerability. More importantly, tumor necrosis factor- α (TNF-α) and interleukin-6 (IL-6) were significant mediators of the connection between vitamin C and plaque vulnerability, suggesting that vitamin C may inhibit the atherosclerotic inflammatory process by decreasing the expression of IL-6 and TNF-α, thereby reducing the risk of vulnerable plaques. These new findings provide crucial clues to identify anti-inflammatory dietary components as effective therapeutic approaches in the management of CHD, while also providing some insights into their mechanisms of action.
尽管研究已证明饮食在预防或延缓动脉粥样硬化中起关键作用，且比其他风险因素更易于调整和坚持，但这种作用背后的潜在机制仍未被充分理解。本研究的目的是确定炎症因子对冠心病（CHD）患者饮食摄入与通过光学相干断层扫描（OCT）测量的冠状动脉斑块脆弱性之间联系的影响。本研究最终纳入了194名符合纳入和排除标准的CHD患者。采用半定量食物频率问卷（SQFFQ）调查饮食消费状况，使用酶联免疫吸附测定法分析炎症生物标志物的血清水平，并采用OCT识别体内致病病变的斑块易损性。在单变量分析中对具有统计学意义的可能混杂因素进行校正后，大豆和坚果、水果和维生素C的四分位数与冠状动脉斑块易损性呈负相关。相反，钠摄入量的上四分位数组发生易损斑块的风险是最低四分位数组的2.98倍。同时，我们观察到维生素C摄入量与炎症生物标志物以及斑块易损性之间存在反向剂量反应关系。更重要的是，肿瘤坏死因子-α（TNF-α）和白细胞介素-6（IL-6）是维生素C与斑块易损性之间联系的重要介导因子，这表明维生素C可能通过降低IL-6和TNF-α的表达来抑制动脉粥样硬化炎症过程，从而降低易损斑块的风险。这些新发现为识别抗炎饮食成分作为CHD管理中的有效治疗方法提供了关键线索，同时也为其作用机制提供了一些见解。
