营养对银屑病关节炎患者脂蛋白及其亚组分的影响:为期 12 周的随机试验--DIETA 试验。

IF 2 4区 医学 Q3 RHEUMATOLOGY
Daniele Scherer, Beatriz Figueiredo Leite, Melissa Aparecida Morimoto, Thauana Luiza Oliveira, Barbara N Carvalho Klemz, Rosana A M Soares Freitas, Caroline Pappiani, Nágila R Teixeira Damasceno, Marcelo de Medeiros Pinheiro
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引用次数: 0

摘要

导言:银屑病关节炎患者的脂质代谢发生了一些变化,而且患代谢综合征(MetS)和心血管疾病的风险较高,与传统的风险因素无关,这表明慢性炎症本身在动脉粥样硬化中起着核心作用。目的:评估银屑病关节炎(PsA)患者接受营养干预后的高密度脂蛋白和低密度脂蛋白胆固醇血浆水平及其亚组分:这是一项为期12周的营养干预随机、安慰剂对照临床试验。PsA患者被随机分配到1-安慰剂:每天1克大豆油,不进行饮食干预;2-饮食+补充剂:个性化饮食,补充604毫克ω-3脂肪酸,每天三次;3-饮食+安慰剂:个性化饮食+1克大豆油。低密度脂蛋白亚组分被分为非致动脉粥样硬化(NAth)、致动脉粥样硬化(Ath)和高致动脉粥样硬化(HAth),而高密度脂蛋白亚组分则根据脂蛋白电泳的现行建议分为小颗粒、中等颗粒和大颗粒:研究共纳入 91 名患者。约62%的患者(n = 56)有Ath或HAth特征,与之相关的主要风险因素是男性性别、皮肤病持续时间较长和体重指数较高。尽管低密度脂蛋白浆水平低于 100 毫克/分升,但仍有 32 名患者(35%)具有高风险脂蛋白特征。为期 12 周的营养干预并未改变低密度脂蛋白亚组分。然而,高密度脂蛋白亚组分却有明显改善:结论:无论低密度脂蛋白浆总水平和疾病活动性如何,识别促动脉粥样硬化的低密度脂蛋白亚组分模式可能是识别心血管风险较高的 PsA 患者的相关策略。此外,在监督和个性化饮食的基础上添加欧米伽-3脂肪酸的短期营养干预对HDLLARGE亚组分有积极的改变,而高胆固醇血症患者的LDLLARGE亚组分则有所改善:NCT03142503 ( http://www.Clinicaltrials: gov/ ).
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Nutritional effect on lipoproteins and their subfractions in patients with Psoriatic Arthritis: a 12-week randomized trial-the DIETA trial.

Introduction: Patients with psoriatic arthritis have some lipid metabolism changes and higher risk of metabolic syndrome (MetS) and cardiovascular diseases, regardless of traditional risk factors, suggesting that chronic inflammation itself plays a central role concerning the atherosclerosis. However, there is a lack of information regarding atherogenic pattern and lipoprotein subfractions burden in these individuals.

Aim: To evaluate the HDL and LDL-cholesterol plasmatic levels and their subfractions after a nutritional intervention in patients with psoriatic arthritis (PsA).

Methods: This was a randomized, placebo-controlled clinical trial of a 12-week nutritional intervention. PsA patients were randomly assigned to 1-Placebo: 1 g of soybean oil daily, no dietetic intervention; 2-Diet + Supplementation: an individualized diet, supplemented with 604 mg of omega-3 fatty acids, three times a day; and 3-Diet + Placebo: individualized diet + 1 g of soybean oil. The LDL subfractions were classified as non-atherogenic (NAth), atherogenic (Ath) or highly atherogenic (HAth), whereas the HDL subfractions were classified as small, medium, or large particles, according to the current recommendation based on lipoproteins electrophoresis.

Results: A total of 91 patients were included in the study. About 62% of patients (n = 56) had an Ath or HAth profile and the main risk factors associated were male gender, longer skin disease duration and higher BMI. Thirty-two patients (35%) had a high-risk lipoprotein profile despite having LDL plasmatic levels below 100 mg/dL. The 12-week nutritional intervention did not alter the LDL subfractions. However, there were significant improvement of HDL subfractions.

Conclusion: Recognizing the pro-atherogenic subfractions LDL pattern could be a relevant strategy for identifying PsA patients with higher cardiovascular risk, regardless total LDL plasmatic levels and disease activity. In addition, a short-term nutritional intervention based on supervised and individualized diet added to omega-3 fatty acids changed positively the HDLLARGE subfractions, while LDLLARGE subfraction was improved in hypercholesterolemic individuals.

Clinicaltrials: gov identifier: NCT03142503 ( http://www.

Clinicaltrials: gov/ ).

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来源期刊
Advances in Rheumatology
Advances in Rheumatology Medicine-Rheumatology
CiteScore
4.00
自引率
4.30%
发文量
41
审稿时长
53 weeks
期刊介绍: Formerly named Revista Brasileira de Reumatologia, the journal is celebrating its 60th year of publication. Advances in Rheumatology is an international, open access journal publishing pre-clinical, translational and clinical studies on all aspects of paediatric and adult rheumatic diseases, including degenerative, inflammatory and autoimmune conditions. The journal is the official publication of the Brazilian Society of Rheumatology and welcomes original research (including systematic reviews and meta-analyses), literature reviews, guidelines and letters arising from published material.
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