Kim N V, Zotov V A, Alekseev V A, Sheveleva S A
Federal Research Centre of Nutrition, Biotechnology and Food Safety, 109240, Moscow, Russian Federation.
Vopr Pitan. 2023;92(2):18-25. doi: 10.33029/0042-8833-2023-92-2-18-25. Epub 2023 Mar 1.
Dyslipidemias are a risk factor for cardiovascular diseases, especially at a young age. It is known from modern sources that shortchain fatty acids (SCFA) synthesized in the intestine are actively involved in the genesis of dyslipidemia, the spectrum and ratio of which depends on the consumed food substrates. In particular, it has been found that food components such as dietary fiber can affect the lowering of blood lipids by affecting the intestinal microbiota. Therefore, dietary correction can be an important step in the prevention and treatment of dyslipidemia, and as a result, help reduce the risk of developing cardiovascular disease (CD). of the research was to study the content of the main SCFAs (acetate, propionate, butyrate) in the feces of people with dyslipidemia, including taking into account the actual nutrition and consumption of the carbohydrate fraction of the diet (starch, mono- and disaccharides, dietary fiber) as precursors of SCFAs. . 70 patients aged 18 to 45 years with dyslipidemia were selected as stool donors. All subjects were divided into 2 groups: the main group with the risk of CD (the risk was determined by the risk scale for CD) and the comparison group with established cardiovascular pathology (CVP). SCFAs in stool samples collected after natural defecation and subjected to immediate freezing at -70 °C were determined by gas chromatography. The diet was analyzed by the 24-hour food recall method. . The frequency of occurrence of the optimal ratio acetate - acetic acid : propionate - propionic acid : butyrate - butyric acid (60:20:20) in all groups was no more than 25%. At the same time, in persons at risk of CD, in the SCFA pool there was a pronounced decrease in the proportion of butyrate, which is characterized by cardioprotective properties, up to 15% (with an optimal proportion of 20%) compared with the levels for healthy people noted in the works of M.D. Ardatskaya et al. and A.A. Kurmangulov. And in persons with CVP, the levels of fecal acetate, which is a regulator of metabolic processes, namely lipogenesis, differed insignificantly compared with the values obtained in the studies of the above authors. In all examined individuals, the content of acetate in feces depended on the carbohydrate component of the diet, primarily on the total amount of carbohydrates consumed. And increasing the amount of dietary fiber intake contributed to the elevation of this SCFA. In individuals at risk of CD a significant correlation was found between the content of acetate and the atherogenic index (r=0,695). And in persons with CVP, there was a high negative correlation between the level of acetate in the feces and the amount of mono- and disaccharides in the diet (r=-0,934). . In individuals with dyslipidemia and CVD risk factors, the results obtained in this study confirm the need for targeted correction of diets in order to increase the proportion of food substrates, which are potential precursors of butyrate.
血脂异常是心血管疾病的一个危险因素，尤其是在年轻时。现代资料表明，肠道中合成的短链脂肪酸（SCFA）积极参与血脂异常的发生，其种类和比例取决于所摄入的食物底物。特别是，已发现膳食纤维等食物成分可通过影响肠道微生物群来影响血脂降低。因此，饮食调整可能是预防和治疗血脂异常的重要一步，从而有助于降低患心血管疾病（CD）的风险。本研究的目的是研究血脂异常患者粪便中主要SCFA（乙酸盐、丙酸盐、丁酸盐）的含量，包括考虑实际营养情况以及饮食中碳水化合物部分（淀粉、单糖和双糖、膳食纤维）作为SCFA前体的摄入量。选取了70名年龄在18至45岁的血脂异常患者作为粪便供体。所有受试者分为2组：有CD风险的主要组（风险由CD风险量表确定）和已确诊心血管病变（CVP）的对照组。通过气相色谱法测定自然排便后立即在-70°C冷冻的粪便样本中的SCFA。通过24小时食物回忆法分析饮食情况。所有组中乙酸盐-乙酸：丙酸盐-丙酸：丁酸盐-丁酸最佳比例（60:20:20）的出现频率均不超过25%。同时，在有CD风险的人群中，SCFA库中具有心脏保护特性的丁酸盐比例明显下降，与M.D.阿尔达茨卡娅等人和A.A.库尔曼古洛夫著作中记录的健康人水平相比，降至15%（最佳比例为20%）。而在患有CVP的人群中，作为代谢过程（即脂肪生成）调节剂的粪便乙酸盐水平与上述作者研究中获得的值相比，差异不显著。在所有受检个体中，粪便中乙酸盐的含量取决于饮食中的碳水化合物成分，主要取决于所摄入碳水化合物的总量。增加膳食纤维摄入量有助于提高这种SCFA的水平。在有CD风险的个体中，发现乙酸盐含量与致动脉粥样硬化指数之间存在显著相关性（r = 0.695）。而在患有CVP的人群中，粪便中乙酸盐水平与饮食中单糖和双糖含量之间存在高度负相关（r = -0.934）。在患有血脂异常和CVD风险因素的个体中，本研究获得的结果证实了有针对性地调整饮食的必要性，以增加作为丁酸盐潜在前体的食物底物的比例。
