Simopoulos A P
Center for Genetics, Nutrition and Health, Washington, DC.
Free Radic Biol Med. 1994 Oct;17(4):367-72. doi: 10.1016/0891-5849(94)90023-x.
The incidence of obesity, noninsulin-dependent diabetes mellitus (NIDDM), hypertension, and coronary artery disease has increased in the developed world. At the same time, major changes in the type and amount of fatty acid intake have occurred over the past 40-50 years, reflected in increases in saturated fat (from both animal sources and hydrogenated vegetable sources), trans fatty acids, vegetable oils rich in linoleic acid, and an overall decrease in long chain polyunsaturated fatty acids (arachidonic acid, eicosapentaenoic acid, and docosahexaenoic acid--C20-C22). Recent findings that C20-C22 in muscle membrane phospholipids are inversely related to insulin resistance, whereas linoleic acid is positively related to insulin resistance, suggest that diet may influence the development of insulin resistance in obesity, insulin-dependent diabetes mellitus (IDDM), hypertension, and coronary artery disease (including asymptomatic atherosclerosis and microvascular angina). These conditions are known to have genetic determinants and have a common abnormality in smooth muscle response and insulin resistance. It is proposed that the current diet influences the expression of insulin resistance in those who are genetically predisposed. Therefore, clinical investigations are needed to evaluate if lowering or preventing insulin resistance through diet by increasing arachidonic acid, eicosapentaenoic acid, and docosahexaenoic acid, while lowering linoleic acid and decreasing trans fatty acids from the diet, will modify or prevent the development of these diseases.
在发达国家，肥胖症、非胰岛素依赖型糖尿病（NIDDM）、高血压和冠状动脉疾病的发病率有所上升。与此同时，在过去40至50年里，脂肪酸摄入的类型和数量发生了重大变化，表现为饱和脂肪（来自动物源和氢化植物油）、反式脂肪酸、富含亚油酸的植物油增加，以及长链多不饱和脂肪酸（花生四烯酸、二十碳五烯酸和二十二碳六烯酸——C20 - C22）总体减少。最近的研究发现，肌肉膜磷脂中的C20 - C22与胰岛素抵抗呈负相关，而亚油酸与胰岛素抵抗呈正相关，这表明饮食可能会影响肥胖症、胰岛素依赖型糖尿病（IDDM）、高血压和冠状动脉疾病（包括无症状动脉粥样硬化和微血管性心绞痛）中胰岛素抵抗的发展。已知这些病症具有遗传决定因素，并且在平滑肌反应和胰岛素抵抗方面存在共同异常。有人提出，当前的饮食会影响那些具有遗传易感性的人的胰岛素抵抗表达。因此，需要进行临床研究，以评估通过饮食增加花生四烯酸、二十碳五烯酸和二十二碳六烯酸，同时降低饮食中的亚油酸并减少反式脂肪酸，从而降低或预防胰岛素抵抗，是否会改变或预防这些疾病的发展。
