接受肠外营养的糖尿病患者体内氧化、炎症和肠道渗透性的生物标志物：一项多中心随机试验。

IF 6.6 2区医学 Q1 NUTRITION & DIETETICS

Clinical nutrition Pub Date : 2025-01-01 DOI:10.1016/j.clnu.2024.11.044

Virginia Soria-Utrilla , Corina Verónica Sasso , Silvana Yanina Romero-Zerbo , Antonio Adarve-Castro , Rafael López-Urdiales , Sandra Herranz-Antolín , José Manuel García-Almeida , Katherine García-Malpartida , Mercedes Ferrer-Gómez , Alicia Moreno-Borreguero , Luis Miguel Luengo-Pérez , Julia Álvarez-Hernández , Carmen Aragón-Valera , María Julia Ocón-Bretón , Álvaro García-Manzanares , Irene Bretón-Lesmes , Pilar Serrano-Aguayo , Natalia Pérez-Ferre , Juan José López-Gómez , Josefina Olivares-Alcolea , Gabriel Olveira

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引用次数: 0

摘要

背景和目的：肠外营养（PN）成分可能在全身性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脂质配方治疗的2型糖尿病（T2DM）患者炎症、氧化状态和肠通透性生物标志物的变化。方法：这是一项前瞻性研究，包括94例T2DM患者，他们接受了富含omega (n)-3多不饱和脂肪酸（PUFA）的PN，中长链甘油三酯（MCT/LCT）的混合物PN或橄榄油基PN。在PN启动后第1天和第5天测定血清氧化状态、肠通透性和炎症生物标志物水平。注册编号：ClinicalTrials.govNCT02706119。结果：在PN发病后第5天，MCT/LCT组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，zonulin和吲哚基硫酸盐升高。橄榄油组5种促炎因子[IL-1β、IL-17A、IL-6、细胞因子-白血病抑制因子（LIF）、肿瘤坏死因子α (TNF-α)]降低，抗炎因子IL-1RA浓度降低，而n-3 pufa富集组8种促炎因子（干扰素- γ、IL-1β、IL-15、IL-17A、IL-6、LIF、单核细胞趋化蛋白1、TNF-α）降低，具有统计学意义。在组间比较中，与n-3 pufa富集组相比，MCT/LCT组的吲哚基硫酸显著升高，MCT/LCT组的8-异前列腺素和吲哚基硫酸显著升高，MCT/LCT组的超氧化物歧化酶显著降低。结论：在T2DM患者中，PN脂质组成对促炎、促氧化和肠通透性生物标志物有深远影响。

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Biomarkers of oxidation, inflammation and intestinal permeability in persons with diabetes mellitus with parenteral nutrition: A multicenter randomized trial

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.

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来源期刊

Clinical nutrition 医学-营养学

CiteScore

14.10

自引率

6.30%

发文量

356

审稿时长

28 days

期刊介绍： Clinical Nutrition, the official journal of ESPEN, The European Society for Clinical Nutrition and Metabolism, is an international journal providing essential scientific information on nutritional and metabolic care and the relationship between nutrition and disease both in the setting of basic science and clinical practice. Published bi-monthly, each issue combines original articles and reviews providing an invaluable reference for any specialist concerned with these fields.