补充地中海饮食对 PREDIMED 试验干预 1 年后血浆磷脂脂肪酸谱和心血管疾病风险的影响。

Effects of Supplemented Mediterranean Diets on Plasma-Phospholipid Fatty Acid Profiles and Risk of Cardiovascular Disease after 1 Year of Intervention in the PREDIMED Trial.

机构信息

Department of Preventive Medicine and Public Health, University of Navarra, IdiSNA, Pamplona, Spain.

Centro de Investigación Biomédica En Red (CIBER), M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.

出版信息

Clin Chem. 2023 Mar 1;69(3):283-294. doi: 10.1093/clinchem/hvac221.

DOI:10.1093/clinchem/hvac221

PMID:36683466

Abstract

BACKGROUND

Plasma fatty acids (FAs) have been associated with cardiovascular disease (CVD) risk. Diet and endogenous metabolism influence the FA profile of the plasma phospholipid (PL) fraction. In the PREDIMED trial, we examined 1-year changes in the FA profile of plasma PL according to a nutritional intervention with Mediterranean diets, either supplemented with extra-virgin olive oil (MedDiet + EVOO) or mixed nuts (MedDiet + nuts), in a high cardiovascular risk population. We also analyzed if 1-year changes in PL FAs were associated with subsequent cardiovascular risk.

METHODS

We included 779 participants in our case-cohort study: 185 incident cases and 594 participants in the subcohort (including 31 overlapping cases). The end point was the incidence of CVD. We measured the FAs of plasma PL at baseline and after 1 year of intervention.

RESULTS

MedDiet + EVOO increased C17:0 and C20:3n9 in linear regression models [β coefficientperSD : 0.215 (95% CI, 0.032-0.399) and 0.271 (0.107-0.434), respectively] and decreased 16:1n7 and C22:4n6 [βperSD: -0.239 (95% CI, -0.416 to -0.061) and -0.287 (95% CI, -0.460 to -0.113), respectively] vs the control group. MedDiet + nuts increased C18:3n3 [βperSD: 0.382 (95% CI, 0.225 - 0.539)], C18:2n6 [βper SD: 0.250 (95% CI, 0.073 - 0.428)], C18:0 [βperSD: 0.268 (95% CI, 0.085-0.452)], and C22:0 [βper SD: 0.216 (95% CI, 0.031-0.402)]; and decreased the sum of six n6 FAs [βper SD: -0.147 (95% CI, -0.268 to -0.027)] vs the control group. The 1-year increase in C18:2n6 was inversely associated with the subsequent CVD risk (HRperSD: 0.64 (95% CI, 0.44-0.92)).

CONCLUSIONS

MedDiet interventions changed n6 FAs and C16:1n7c; other changes were specific for each group: MedDiet + EVOO increased C17:0 and C20:3n9, and MedDiet + Nuts C18:3n3, C18:2n6, C18:0, and C22:0 FAs.

摘要

背景

血浆脂肪酸（FAs）与心血管疾病（CVD）风险相关。饮食和内源性代谢会影响血浆磷脂（PL）部分的 FA 谱。在 PREDIMED 试验中，我们研究了富含地中海饮食的营养干预对血浆 PL FA 谱的 1 年变化，这些干预措施分别补充特级初榨橄榄油（MedDiet+EVOO）或混合坚果（MedDiet+nuts），研究对象为心血管疾病风险较高的人群。我们还分析了 PL FA 的 1 年变化是否与随后的心血管风险相关。

方法

我们在病例-队列研究中纳入了 779 名参与者：185 例新发病例和 594 名亚队列参与者（包括 31 例重叠病例）。终点是 CVD 的发生。我们在基线和干预 1 年后测量了血浆 PL 的 FA。

结果

MedDiet+EVOO 增加了 C17:0 和 C20:3n9，在线性回归模型中，每标准差的β系数分别为 0.215（95%CI，0.032-0.399）和 0.271（0.107-0.434），同时降低了 16:1n7 和 C22:4n6，每标准差的β系数分别为-0.239（95%CI，-0.416 至-0.061）和-0.287（95%CI，-0.460 至-0.113），与对照组相比。MedDiet+nuts 增加了 C18:3n3，每标准差的β系数为 0.382（95%CI，0.225-0.539）、C18:2n6，每标准差的β系数为 0.250（95%CI，0.073-0.428）、C18:0，每标准差的β系数为 0.268（95%CI，0.085-0.452）和 C22:0，每标准差的β系数为 0.216（95%CI，0.031-0.402）；同时降低了 6 种 n6 FA 的总和，每标准差的β系数为-0.147（95%CI，-0.268 至-0.027），与对照组相比。C18:2n6 的 1 年增长率与随后的 CVD 风险呈负相关（每标准差的 HR 为 0.64（95%CI，0.44-0.92））。