糖尿病患者肠外营养时氧化、炎症及肠通透性的生物标志物：一项多中心随机试验
Biomarkers of oxidation, inflammation and intestinal permeability in persons with diabetes mellitus with parenteral nutrition: A multicenter randomized trial.
作者信息
Soria-Utrilla Virginia, Sasso Corina Verónica, Romero-Zerbo Silvana Yanina, Adarve-Castro Antonio, López-Urdiales Rafael, Herranz-Antolín Sandra, García-Almeida José Manuel, García-Malpartida Katherine, Ferrer-Gómez Mercedes, Moreno-Borreguero Alicia, Luengo-Pérez Luis Miguel, Álvarez-Hernández Julia, Aragón-Valera Carmen, Ocón-Bretón María Julia, García-Manzanares Álvaro, Bretón-Lesmes Irene, Serrano-Aguayo Pilar, Pérez-Ferre Natalia, López-Gómez Juan José, Olivares-Alcolea Josefina, Moreno-Martínez Macarena, Tejera-Pérez Cristina, García-Arias Sara, Abad-González Ángel Luis, Alhambra-Expósito María Rosa, Zugasti-Murillo Ana, Parra-Barona Juan, Torrejón-Jaramillo Sara, Abuin José, Fernández-García José Carlos, Olveira Gabriel
机构信息
Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA)-BIONAND Platform, Málaga, Spain; Department of Medicine and Dermatology, Faculty of Medicine, University of Malaga, Malaga, Spain.
Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA)-BIONAND Platform, Málaga, Spain; Department of Human Physiology, Faculty of Medicine, University of Malaga, Malaga, Spain; Centro de Investigación Biomédica en Red (CIBER) de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, Málaga, Spain.
出版信息
Clin Nutr. 2025 Jan;44:155-164. doi: 10.1016/j.clnu.2024.11.044. Epub 2024 Dec 3.
BACKGROUND AND AIMS
Parenteral nutrition (PN) composition could play a role in the management of systemic inflammatory response and intestinal barrier disruption. We aimed to evaluate changes in biomarkers of inflammation, oxidative status and intestinal permeability in patients with type 2 diabetes mellitus (T2DM) who received different PN lipid formulas.
METHODS
This was a prospective study, including 94 patients with T2DM who received omega (n)-3 polyunsaturated fatty acids (PUFA)-enriched PN, a mixture of medium and long chain triglycerides (MCT/LCT) PN, or an olive oil-based PN. Serum levels of biomarkers of oxidative status, intestinal permeability and inflammation biomarkers were determined at day 1 and day 5 after PN initiation. Registered under ClinicalTrials.gov Identifier no. NCT02706119.
RESULTS
At day 5 after the onset of PN, the MCT/LCT group had a significant reduction of 2 proinflammatory cytokines [interleukin (IL)-15, IL-17A], elevation of the anti-inflammatory cytokine IL-13 and increase of zonulin and indoxylsulfate. The olive oil group showed a statistically significant reduction of 5 proinflammatory cytokines [IL-1β, IL-17A, IL-6, cytokine-leukemia inhibitory factor (LIF) and tumor necrosis factor alpha (TNF-α)] and reduced concentrations of the anti-inflammatory cytokine IL-1RA, while the n-3 PUFA-enriched group presented a statistically significant reduction of 8 proinflammatory cytokines (interferon-gamma, IL-1β, IL-15, IL-17A, IL-6, LIF, monocyte chemoattractant protein 1, and TNF-α). In the between-group comparisons, indoxylsulfate significantly increased in the MCT/LCT group compared to the n-3 PUFA-enriched group, while 8-isoprostane and indoxylsulfate significantly increased in the MCT/LCT group compared to the other groups and superoxide dismutase significantly decreased in the MCT/LCT group compared to the other groups.
CONCLUSION
In patients with T2DM, PN lipid composition exerts a profound impact on proinflammatory, prooxidative and intestinal permeability biomarkers.
背景与目的
肠外营养（PN）的成分可能在全身炎症反应和肠屏障破坏的管理中发挥作用。我们旨在评估接受不同PN脂质配方的2型糖尿病（T2DM）患者炎症、氧化状态和肠道通透性生物标志物的变化。
方法
这是一项前瞻性研究，纳入94例T2DM患者，他们接受富含ω（n）-3多不饱和脂肪酸（PUFA）的PN、中长链甘油三酯（MCT/LCT）混合PN或橄榄油基PN。在PN开始后的第1天和第5天测定氧化状态生物标志物、肠道通透性生物标志物和炎症生物标志物的血清水平。在ClinicalTrials.gov上注册，标识符为NCT02706119。
结果
在PN开始后的第5天，MCT/LCT组的2种促炎细胞因子[白细胞介素（IL）-15、IL-17A]显著降低，抗炎细胞因子IL-13升高，以及连蛋白和硫酸吲哚酚增加。橄榄油组显示5种促炎细胞因子[IL-1β、IL-17A、IL-6、细胞因子-白血病抑制因子（LIF）和肿瘤坏死因子α（TNF-α）]有统计学意义的降低，抗炎细胞因子IL-1RA浓度降低，而富含n-3 PUFA组有8种促炎细胞因子（干扰素-γ、IL-1β、IL-15、IL-17A、IL-6、LIF、单核细胞趋化蛋白1和TNF-α）有统计学意义的降低。在组间比较中，与富含n-3 PUFA组相比，MCT/LCT组的硫酸吲哚酚显著增加，与其他组相比，MCT/LCT组的8-异前列腺素和硫酸吲哚酚显著增加，与其他组相比，MCT/LCT组的超氧化物歧化酶显著降低。
结论
在T2DM患者中，PN脂质成分对促炎、促氧化和肠道通透性生物标志物有深远影响。
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