口服 ω-3 PUFA 补充剂可调节病态肥胖女性脂肪组织中炎症：一项随机试验。
Oral ω-3 PUFA supplementation modulates inflammation in adipose tissue depots in morbidly obese women: A randomized trial.
机构信息
Northwest Clinics, Department of Surgery, Alkmaar, The Netherlands; Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Surgery, Amsterdam, The Netherlands; Red Cross Hospital, Department of Surgery, Beverwijk, The Netherlands.
Division of Vascular and Endovascular Surgery, Department of Surgery and Cell Biology, New York University Langone Medical Center, New York, New York, United States.
出版信息
Nutrition. 2023 Jul;111:112055. doi: 10.1016/j.nut.2023.112055. Epub 2023 Apr 9.
OBJECTIVES
Obesity is characterized by local and systemic low-grade inflammatory responses. Adipose tissue macrophages (ATM) play decisive roles in inflammation, insulin signaling, and various metabolic dysfunctions. Diets enriched with ω-3 polyunsaturated fatty acids (PUFAs) have been shown to improve health and mitigate pathologic conditions. However, the effects of ω-3 PUFA on adipose tissue inflammation, ATM number, and phenotype are poorly defined in human obesity. The aim of this study was to examine differences in expression of metabolic-inflammatory markers in omental, mesenteric, and subcutaneous fat depots of obese women supplemented with ω-3 PUFAs for 4 wk compared with a low-calorie diet before bariatric surgery.
METHODS
In a randomized controlled trial, inflammatory markers in the abdominal adipose tissue and the systemic response in obese women were studied. Patients were treated with a 2-wk low-calorie diet (LCD) or a 4-wk ω-3 PUFA-enriched diet (920 mg eicosapentaenoic acid, 760 mg docosahexaenoic acid daily) before laparoscopic bypass surgery. Omental, mesenteric, and subcutaneous adipose tissue biopsies were collected during surgery and analyzed for quantity and phenotype of ATMs, and profiled for adipokines, cytokines, and signal transduction molecules.
RESULTS
The chronic inflammatory state characterized by ATM markers was mostly improved by ω-3 PUFAs in visceral adipose tissue. We observed a decreased expression of CD45, CCL2, and CD68, indicating a lower inflammatory state. In patients with type 2 diabetes, ω-3 PUFAs lowered the expression of Netrin-1.
CONCLUSIONS
Compared with an LCD, a diet enriched with ω-3 PUFAs influences the inflammatory state in different adipose tissue depots, by affecting markers of adipose tissue inflammation, macrophage phenotype, and retention. However, this was not reflected in clinical parameters such as insulin resistance and inflammatory cytokines. Subcutaneous adipose tissue and visceral adipose tissue have different responses to an LCD or a ω-3 PUFA-enriched diet. The presence of diabetes modifies the expression of inflammatory markers.
目的
肥胖的特征是局部和全身低度炎症反应。脂肪组织巨噬细胞（ATM）在炎症、胰岛素信号和各种代谢功能障碍中起决定性作用。富含 ω-3 多不饱和脂肪酸（PUFA）的饮食已被证明可改善健康状况并减轻病理状况。然而，ω-3 PUFA 对人类肥胖症中脂肪组织炎症、ATM 数量和表型的影响尚不清楚。本研究旨在比较肥胖女性在接受 ω-3 PUFA 补充 4 周和接受减肥手术前低热量饮食（LCD）时，网膜、肠系膜和皮下脂肪沉积中代谢炎症标志物的表达差异。
方法
在一项随机对照试验中，研究了肥胖女性腹部脂肪组织中的炎症标志物和全身反应。患者接受了 2 周的低热量饮食（LCD）或 4 周的 ω-3 PUFA 丰富饮食（每天 920 毫克二十碳五烯酸，760 毫克二十二碳六烯酸）治疗，然后进行腹腔镜旁路手术。手术期间采集网膜、肠系膜和皮下脂肪活检，并分析 ATM 的数量和表型，以及 profiling 脂联素、细胞因子和信号转导分子。
结果
ω-3 PUFA 主要改善了内脏脂肪组织中以 ATM 标志物为特征的慢性炎症状态。我们观察到 CD45、CCL2 和 CD68 的表达降低，表明炎症状态降低。在 2 型糖尿病患者中，ω-3 PUFA 降低了 Netrin-1 的表达。
结论
与 LCD 相比，富含 ω-3 PUFA 的饮食通过影响脂肪组织炎症标志物、巨噬细胞表型和保留，影响不同脂肪组织沉积中的炎症状态。然而，这并没有反映在胰岛素抵抗和炎症细胞因子等临床参数上。皮下脂肪组织和内脏脂肪组织对 LCD 或 ω-3 PUFA 丰富饮食有不同的反应。糖尿病的存在改变了炎症标志物的表达。
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