Alipoor Elham, Jazayeri Shima, Dahmardehei Mostafa, Salehi Shiva, Yaseri Mehdi, Emami Mohammad Reza, Rezayat Seyed Mahdi, Hosseinzadeh-Attar Mohammad Javad
Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran; Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran; Research Center for Prevention of Cardiovascular Disease, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran.
Clin Nutr. 2023 Mar;42(3):298-308. doi: 10.1016/j.clnu.2022.12.014. Epub 2023 Jan 6.
BACKGROUND & AIMS: This study investigated the effects of collagen hydrolysate and omega-3 fatty acids (FAs) on the rate and quality of wound healing, metabolic disorders, and adipose-derived peptides in patients with major burns.
In this randomized clinical trial, 66 patients with 20-45% deep partial or full-thickness burns were randomly assigned to three groups to receive either a beverage containing collagen (40 gr/d), collagen (40 gr/d) plus 3 gr/d omega-3 (ω-3) FAs, or placebo for four weeks. Wound healing rate, Vancouver scar scale (VSS), as well as baseline, weeks two and three serum concentrations of adiponectin, fibroblast growth factor 21 (FGF21), neuregulin 4 (NRG4), transforming growth factor (TGF)-β1, and pre-albumin/hs-CRP ratio were assessed.
The wound healing rate during the weeks post-burn (p = 0.006 and p = 0.01), and days of 95% (21.3 ± 6.8 and 22.9 ± 8.7 vs. 34.3 ± 14.8 days, p = 0.003 and p = 0.03) and complete (26 ± 7.7 and 27.4 ± 9.4 vs. 41.1 ± 16.6 days, p = 0.003 and p = 0.01) wound healing were significantly better with Collagen and Collagen. ω-3 compared to the placebo group. The VSS was significantly lower, indicated better scar status, in the both intervention groups compared to the placebo (p = 0.02 and p = 0.01). Wound healing outcomes were not statistically different between the Collagen and Collagen. ω-3 groups. Hs-CRP/pre-albumin ratio was significantly lower in the Collagen. ω-3 than the placebo group at week three (1.2 ± 1.9 vs. 4.8 ± 7.7 dl/l, p = 0.03). The significant decrease in serum adiponectin seen during the trial course within the placebo (10 ± 8.8 to 5.8 ± 4.9 mg/l, p = 0.03) and Collagen (11.8 ± 14 to 8.6 ± 11.7 mg/l, p = 0.03) groups was prevented in the Collagen. ω-3 group (p = 0.4). Circulating FGF21 decreased significantly within the Collagen (p = 0.005) and Collagen. ω-3 (p = 0.02) groups at the end of week three compared to the baseline.
Adding collagen hydrolysate as part of adjunctive therapy improved wound healing rate and quality. These findings as well as the efficacy of omega-3 FAs need to be further confirmed in larger populations. This study was registered with the Iranian Registry of Clinical Trials (IRCT20090901002394N42).
本研究调查了胶原蛋白水解物和ω-3脂肪酸（FAs）对重度烧伤患者伤口愈合速度和质量、代谢紊乱及脂肪源性肽的影响。
在这项随机临床试验中，66例烧伤面积为20%-45%的深度部分或全层烧伤患者被随机分为三组，分别接受含胶原蛋白的饮料（40克/天）、胶原蛋白（40克/天）加3克/天ω-3 FAs或安慰剂，为期四周。评估伤口愈合速度、温哥华瘢痕量表（VSS），以及基线、第二周和第三周血清脂联素、成纤维细胞生长因子21（FGF21）、神经调节蛋白4（NRG4）、转化生长因子（TGF）-β1和前白蛋白/hs-CRP比值。
烧伤后数周的伤口愈合速度（p = 0.006和p = 0.01），以及95%伤口愈合天数（21.3±6.8天和22.9±8.7天，对比34.3±14.8天，p = 0.003和p = 0.03）和完全伤口愈合天数（26±7.7天和27.4±9.4天，对比41.1±16.6天，p = 0.003和p = 0.01），胶原蛋白组和胶原蛋白+ω-3组均显著优于安慰剂组。与安慰剂组相比，两个干预组的VSS显著更低，表明瘢痕状况更好（p = 0.02和p = 0.01）。胶原蛋白组和胶原蛋白+ω-3组之间的伤口愈合结果无统计学差异。第三周时，胶原蛋白+ω-3组的hs-CRP/前白蛋白比值显著低于安慰剂组（1.2±1.9对比4.8±7.7 dl/l，p = 0.03）。在安慰剂组（10±8.8至5.8±4.9毫克/升，p = 0.03）和胶原蛋白组（11.8±14至8.6±11.7毫克/升，p = 0.03）试验过程中观察到的血清脂联素显著下降，在胶原蛋白+ω-3组中得到预防（p = 0.4）。与基线相比，第三周末胶原蛋白组（p = 0.005）和胶原蛋白+ω-3组（p = 0.02）的循环FGF21显著下降。
添加胶原蛋白水解物作为辅助治疗的一部分可提高伤口愈合速度和质量。这些发现以及ω-3 FAs的疗效需要在更大规模人群中进一步证实。本研究已在伊朗临床试验注册中心注册（IRCT20090901002394N42）。
