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Bayram SŞ, Kızıltan G. The Role of Omega- 3 Polyunsaturated Fatty Acids in Diabetes Mellitus Management: A Narrative Review. Curr Nutr Rep 2024; 13:527-551. [PMID: 39031306 PMCID: PMC11327211 DOI: 10.1007/s13668-024-00561-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/09/2024] [Indexed: 07/22/2024]
Abstract
PURPOSE OF REVIEW Diabetes mellitus (DM) is a group of metabolic illnesses characterized by elevated levels of glucose in the bloodstream as a result of abnormalities in the generation or function of insulin. Medical Nutrition Therapy (MNT) is an essential component of diabetes management. Dietary fats are essential in both the prevention and progression of chronic diseases. Omega-3 polyunsaturated fatty acids are recognized for their advantageous impact on health. They assist in controlling blood sugar levels and lipid profile in patients with all types of diabetes. Furthermore, they reduce the occurrence of cardiovascular events and death linked to DM. RECENT FINDINGS After evaluating the antioxidant, anti-inflammatory, antilipidemic, and antidiabetic mechanisms of omega-3 fatty acid supplements, as well as the results from randomized controlled studies, it is clear that these supplements have positive effects in both preventing and treating diabetes, as well as preventing and treating complications related to diabetes, specifically cardiovascular diseases. However, current evidence does not support the use of omega-3 supplementation in people with diabetes for the purpose of preventing or treating cardiovascular events. People with all types of diabetes are suggested to include fatty fish and foods high in omega-3 fatty acids in their diet twice a week, as is prescribed for the general population.
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Affiliation(s)
- Sümeyra Şahin Bayram
- Faculty of Health Sciences, Nutrition and Dietetics Department, Selcuk University, Konya, Turkey.
| | - Gül Kızıltan
- Faculty of Health Sciences, Nutrition and Dietetics Department, Baskent University, Ankara, Turkey
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Lu D, Yao D, Hu G, Zhou J, Shen X, Qian L. Maternal docosahexaenoic acid supplementation during lactation improves exercise performance, enhances intestinal glucose absorption and modulates gut microbiota in weaning offspring mice. Front Nutr 2024; 11:1423576. [PMID: 39036494 PMCID: PMC11258037 DOI: 10.3389/fnut.2024.1423576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Accepted: 06/19/2024] [Indexed: 07/23/2024] Open
Abstract
Introduction Intestinal dysfunction induced by weaning stress is common during breastfeeding period. Docosahexaenoic acid (DHA) is well known for promoting visual and brain development, but its effects on early intestinal development remain unknown. This study investigated the impact of maternal DHA supplementation during lactation on intestinal glucose absorption and gut microbiota in weaning offspring mice. Materials and methods Dams were supplemented with vehicle (control), 150 mg/(kg body weight · day) DHA (L-DHA), or 450 mg/(kg body weight · day) DHA (H-DHA) throughout lactation by oral administration. After weaning, pups were randomly divided into three groups for athletic analysis, microbial and proteomic analysis, biochemical analysis, 4-deoxy-4-fluoro-D-glucose (4-FDG) absorption test, and gene expression quantitation of glucose transport-associated proteins and mTOR signaling components. Results The H-DHA group exhibited enhanced grip strength and prolonged swimming duration compared to the control group. Additionally, there were significant increases in jejunal and ileal villus height, and expanded surface area of jejunal villi in the H-DHA group. Microbial analyses revealed that maternal DHA intake increased the abundance of beneficial gut bacteria and promoted metabolic pathways linked to carbohydrate and energy metabolism. Proteomic studies indicated an increased abundance of nutrient transport proteins and enrichment of pathways involved in absorption and digestion in the H-DHA group. This group also showed higher concentrations of glucose in the jejunum and ileum, as well as elevated glycogen levels in the liver and muscles, in contrast to lower glucose levels in the intestinal contents and feces compared to the control group. The 4-FDG absorption test showed more efficient absorption after oral 4-FDG gavage in the H-DHA group. Moreover, the expressions of glucose transport-associated proteins, GLUT2 and SGLT1, and the activation of mTOR pathway were enhanced in the H-DHA group compared to the control group. The L-DHA group also showed similar but less pronounced improvements in these aspects relative to the H-DHA group. Conclusion Our findings suggested that maternal DHA supplementation during lactation improves the exercise performance, enhances the intestinal glucose absorption by increasing the expressions of glucose transporters, and beneficially alters the structure of gut microbiome in weaning offspring mice.
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Affiliation(s)
- Dalu Lu
- Shanghai Key Laboratory of Pediatric Gastroenterology and Nutrition, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Institute for Pediatric Research, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Die Yao
- Department of Clinical Nutrition, College of Health Science and Technology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Gaoli Hu
- Shanghai Key Laboratory of Pediatric Gastroenterology and Nutrition, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Institute for Pediatric Research, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiefei Zhou
- Shanghai Key Laboratory of Pediatric Gastroenterology and Nutrition, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Institute for Pediatric Research, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiuhua Shen
- Department of Clinical Nutrition, College of Health Science and Technology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Linxi Qian
- Shanghai Key Laboratory of Pediatric Gastroenterology and Nutrition, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Institute for Pediatric Research, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Clinical Nutrition, College of Health Science and Technology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Kaur G, Mason RP, Steg PG, Bhatt DL. Omega-3 fatty acids for cardiovascular event lowering. Eur J Prev Cardiol 2024; 31:1005-1014. [PMID: 38169319 DOI: 10.1093/eurjpc/zwae003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 12/28/2023] [Accepted: 12/31/2023] [Indexed: 01/05/2024]
Abstract
Low-density lipoprotein cholesterol (LDL-C) is the main target for therapeutics aimed at reducing the risk of atherosclerotic cardiovascular disease (ASCVD) and downstream cardiovascular (CV) events. However, multiple studies have demonstrated that high-risk patient populations harbour residual risk despite effective LDL-C lowering. While data support the causal relationship between triglycerides and ASCVD risk, triglyceride-lowering therapies such as omega-3 fatty acids have shown mixed results in CV outcomes trials. Notably, icosapent ethyl, a purified formulation of eicosapentaenoic acid (EPA), has garnered compelling evidence in lowering residual CV risk in patients with hypertriglyceridaemia and treated with statins. In this review, we summarize studies that have investigated omega-3-fatty acids for CV event lowering and discuss the clinical implementation of these agents based on trial data and guidelines.
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Affiliation(s)
- Gurleen Kaur
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - R Preston Mason
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Elucida Research LLC, Beverly, MA, USA
| | - Ph Gabriel Steg
- Paris Cité University, Public Hospitals of Paris (AP-HP), Bichat Hospital, Paris, France
| | - Deepak L Bhatt
- Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Mohammadi T. Ameliorative effects of omega-3 and omega-6 on spermatogenesis, testicular antioxidant status and in vivo fertility index in heat-stressed rats. J Therm Biol 2024; 122:103885. [PMID: 38861860 DOI: 10.1016/j.jtherbio.2024.103885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 05/31/2024] [Accepted: 06/03/2024] [Indexed: 06/13/2024]
Abstract
The current study aimed to investigate the use of omega-6 (ω6) or omega-3 (ω3) in reducing heat-induced damage to the testicles. This is due to the known detrimental effects of heat and the potential protective properties of ω6 and ω3. In the study, 48 male rats were divided into eight groups, each containing 6 rats. Group I (control) received normal saline. Group 2 was exposed to high temperatures (43 °C for 20 min/day) and also received normal saline for 60 days. Groups 3-7 underwent identical HS conditions and received varying doses of ω6 or ω3 (0.5 mg/kg DHPG, 1 mg/kg DHPG, 5 mg/kg HT, 0.5 mg/kg DHPG + 5 mg/kg HT, and 1 mg/kg DHPG + 5 mg/kg HT), respectively. After 60 days, various tests were conducted on the testicular tissue, sperm quality, oxidative status, gene activity, and in vivo fertility indexes to evaluate the effects of the treatments. Treatment with ω6 and ω3 could reduce abnormal morphology and DNA damage while increasing total and progressive motility, characteristics motility, viability, and plasma membrane functional impairment compared with HS-exposed groups. Antioxidant status levels in testicular tissue were improved after administration of ω6 and ω3. Furthermore, after receiving ω6 and ω3, there were significantly lower expression levels of P53 and Caspase-3 and significantly higher expression levels of Bcl-2 compared to the HS-exposed group. Furthermore, the results showed that administration of ω6 and ω3 to rats exposed to HS could increase their in vivo fertility indexes compared to the group not exposed to HS. According to our data, all doses of ω6 and ω3 (particularly doses of ω6-1.25 and ω3-300) can improve the testicular damage, testicular antioxidant defense mechanism, regulate germ cell apoptosis, and increase in vivo fertility indexes.
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Affiliation(s)
- Tohid Mohammadi
- Department of Basic Science, Faculty of Veterinary Medicine, Urmia Branch, Islamic Azad University, Urmia, Iran.
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Khwarg J, Lee S, Jang IJ, Kang WH, Lee HJ, Kim KY, Jeong KS, Won C, Choi YW, Ha DC, Jung R, Han MG, Jung WT, Nam KY, Kim Y, Yu KS, Oh J. Pharmacokinetic Comparison Between a Fixed-Dose Combination of Atorvastatin/Omega-3-Acid Ethyl Esters and the Corresponding Loose Combination in Healthy Korean Male Subjects. Drug Des Devel Ther 2024; 18:395-406. [PMID: 38352172 PMCID: PMC10861834 DOI: 10.2147/dddt.s435885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 01/03/2024] [Indexed: 02/16/2024] Open
Abstract
Purpose Statins are widely used in combination with omega-3 fatty acids for the treatment of patients with dyslipidemia. The aim of this study was to compare the pharmacokinetic (PK) profiles of atorvastatin and omega-3-acid ethyl esters between fixed-dose combination (FDC) and loose combination in healthy subjects. Methods A randomized, open-label, single-dose, 2-sequence, 2-treatment, 4-period replicated crossover study was performed. Subjects were randomly assigned to one of the 2 sequences and alternately received four FDC soft capsules of atorvastatin/omega-3-acid ethyl esters (10/1000 mg) or a loose combination of atorvastatin tablets (10 mg × 4) and omega-3-acid ethyl ester soft capsules (1000 mg× 4) for four periods, each period accompanied by a high-fat meal. Serial blood samples were collected for PK analysis of atorvastatin, eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA). PK parameters were calculated by a non-compartmental analysis. The geometric mean ratio (GMR) and its 90% confidence interval (CI) of the FDC to the loose combination were calculated to compare PK parameters. Results A total of 43 subjects completed the study as planned. The GMR (90% CI) of FDC to loose combination for maximum concentration (Cmax) and area under the time-concentration curve from zero to the last measurable point (AUClast) were 1.0931 (1.0054-1.1883) and 0.9885 (0.9588-1.0192) for atorvastatin, 0.9607 (0.9068-1.0178) and 0.9770 (0.9239-1.0331) for EPA, and 0.9961 (0.9127-1.0871) and 0.9634 (0.8830-1.0512) for DHA, respectively. The intra-subject variability for Cmax and AUClast of DHA was 30.8% and 37.5%, respectively, showing high variability. Both the FDC and the loose combination were safe and well tolerated. Conclusion The FDC of atorvastatin and omega-3-acid ethyl esters showed comparable PK characteristics to the corresponding loose combination, offering a convenient therapeutic option for the treatment of dyslipidemia.
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Affiliation(s)
- Juyoung Khwarg
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, Republic of Korea
| | - Soyoung Lee
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, Republic of Korea
- Integrated Major in Innovative Medical Science, Seoul National University Graduate School, Seoul, Republic of Korea
| | - In-Jin Jang
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, Republic of Korea
| | - Won-Ho Kang
- R&D Center, Korea United Pharm. Inc., Seoul, Republic of Korea
| | | | | | | | - Chongho Won
- Caleb Multilab, Inc., Seoul, Republic of Korea
| | - Youn Woong Choi
- R&D Center, Korea United Pharm.Inc., Sejong, Republic of Korea
| | - Dae Chul Ha
- R&D Center, Korea United Pharm.Inc., Sejong, Republic of Korea
| | - RaeHoon Jung
- R&D Center, Korea United Pharm.Inc., Sejong, Republic of Korea
| | - Min-Gu Han
- R&D Center, Korea United Pharm.Inc., Sejong, Republic of Korea
| | - Won Tae Jung
- Global R&D, Korea United Pharm. Inc., Seoul, Republic of Korea
| | - Kyu-Yeol Nam
- Global R&D, Korea United Pharm. Inc., Seoul, Republic of Korea
| | - YeSeul Kim
- Global R&D, Korea United Pharm. Inc., Seoul, Republic of Korea
| | - Kyung-Sang Yu
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, Republic of Korea
| | - Jaeseong Oh
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, Republic of Korea
- Department of Pharmacology, Jeju National University College of Medicine, Jeju, Republic of Korea
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Safaei P, Bayat G, Mohajer A. Comparison of fish oil supplements and corn oil effects on serum lipid profile: a systematic review and meta-analysis of randomized controlled trials. Syst Rev 2024; 13:54. [PMID: 38317191 PMCID: PMC10840298 DOI: 10.1186/s13643-023-02426-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 12/11/2023] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND The present study aimed to investigate the effects of fish oil supplements compared to corn oil on serum lipid profiles by performing a meta-analysis of randomized controlled trials (RCTs). METHODS Online databases including PubMed, Web of Science, and Scopus were searched until 30 December 2022. Pooled effect sizes were reported as the weighted mean difference (WMD) with 95% confidence intervals (CI). The Cochrane Collaboration's risk-of-bias tool was utilized to evaluate the quality of the studies. Lipid parameters, including triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL), and high-density lipoprotein cholesterol (HDL), were assessed in the meta-analysis. RESULTS Overall, 16 eligible trials were included in this systematic review and meta-analysis. The results revealed that the fish oil supplements significantly reduced TG (WMD: - 25.50 mg/dl, 95% CI: - 42.44, - 8.57, P = 0.000) levels compared to corn oil. Also, in this study, fish oil supplements had a positive and significant effect on HDL (WMD: 2.54 mg/dl, 95% CI: 0.55, 4.52). There were no significant changes in TC and LDL. CONCLUSIONS Our findings showed the effects of fish oil supplements on reducing TG and increasing HDL-c compared to corn oil. Further larger and well-designed RCTs are required to confirm these data.
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Affiliation(s)
- Payam Safaei
- Division of Food Safety and Hygiene, Department of Environmental Health Engineering, School of Public Heath, Tehran University of Medical Sciences, Tehran, Iran
| | - Ghazal Bayat
- Department of Clinical Pathology, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran
| | - Afsaneh Mohajer
- Division of Food Safety and Hygiene, Department of Environmental Health Engineering, School of Public Heath, Tehran University of Medical Sciences, Tehran, Iran.
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Wang S, Guo Z, Wang X, Wang N, Wang J, Zheng N, Zheng R, Fang W, Chen Y, Wang Q, Zhang D. Dietary L-carnitine supplementation changes lipid metabolism and glucose utilization of Rhynchocypris lagowskii fed diets with different lipid sources. FISH PHYSIOLOGY AND BIOCHEMISTRY 2024; 50:77-96. [PMID: 36604356 DOI: 10.1007/s10695-022-01166-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 12/21/2022] [Indexed: 06/17/2023]
Abstract
The widely available crop oil is an effective alternative to the increasingly scarce marine fish oil. However, simple alternative strategies have led to declining growth and the edible value of farmed fish. It is worthwhile to explore the effects of micro supplements in diets to improve the tolerance of fish to different dietary lipid sources, which finally optimizes the feeding strategies. This study aimed to investigate the regulation of L-carnitine and dietary oil conditions on nutrient composition, lipid metabolism, and glucose regulation of Rhynchocypris lagowskii. Four diets were prepared according to fish oil, fish oil supplemented with L-carnitine, corn oil, and corn oil supplemented with L-carnitine, and FO, LCFO, CO, and LCCO were labeled, respectively. R. lagowskii was fed experimental diets for 8 weeks, and the glucose tolerance test was performed. The CO diet significantly resulted in higher crude lipid content in muscle but a lower level of serum lipid parameters of R. lagowskii than the FO diet. However, dietary L-carnitine supplementation significantly reduced the crude lipid content in the hepatopancreas and muscle of the fish fed with the CO diet yet increased the serum lipid parameters. Additionally, the crude lipid content of muscle was reduced in the fish fed with an FO diet supplemented with L-carnitine. Compared with the FO diet, the CO diet significantly reduced the ratio of n3/n6 polyunsaturated fatty acid in the hepatopancreas and muscle of R.lagowskii. Dietary L-carnitine supplementation significantly reduced the contents of total saturated fatty acids and total monounsaturated fatty acids in hepatopancreas under both dietary lipid sources. The CO diet significantly up-regulated the expression of genes related to lipid uptake and adipogenesis in hepatopancreas, including lipoprotein lipase (lpl), acetyl-coenzyme A carboxylase alpha (accα), and sterol regulatory element binding protein-1 (srebp1), compared with the FO diet. While dietary L-carnitine supplementation significantly down-regulated the expressions of lpl, accα, srebp1, and fatty acid synthase in hepatopancreas and muscle of fish under both dietary lipid sources, along with up-regulated expression of carnitine palmitoyltransferase 1 in hepatopancreas. Moreover, the fish fed with a CO diet significantly increased the expression of glucose uptake and clearance and significantly down-regulated the expressions of glucose regulation-related genes, including glucose transporter 1, glycogen synthase 1, and phosphofructokinase in hepatopancreas and muscle, resulting in slower glucose uptake and clearance than fish fed with FO diet. Nevertheless, dietary L-carnitine supplementation up-regulated the expression of gluconeogenesis-related genes, including glucose-6-phosphatase and phosphoenolpyruvate carboxykinase in the hepatopancreas of R. lagowskii under both dietary lipid sources. In conclusion, a higher dietary n6 PUFA resulted in lipid deposition, decreased serum lipid parameters, and limited serum glucose utilization of R. lagowskii. While the regulatory effect of L-carnitine on lipid metabolism and glucose utilization of R. lagowskii varies with dietary lipid sources and tissues.
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Affiliation(s)
- Sen Wang
- College of Animal Science and Technology, Jilin Agricultural University, Jilin Changchun, 130118, China
| | - Zhixin Guo
- College of Life Science, Tonghua Normal University, Jilin, 134001, Tonghua, China
| | - Xin Wang
- College of Animal Science and Technology, Jilin Agricultural University, Jilin Changchun, 130118, China
| | - Ning Wang
- College of Animal Science and Technology, Jilin Agricultural University, Jilin Changchun, 130118, China
| | - Jiajing Wang
- College of Animal Science and Technology, Jilin Agricultural University, Jilin Changchun, 130118, China
| | - Nan Zheng
- College of Animal Science and Technology, Jilin Agricultural University, Jilin Changchun, 130118, China
| | - Rongxin Zheng
- College of Animal Science and Technology, Jilin Agricultural University, Jilin Changchun, 130118, China
| | - Wenhao Fang
- College of Animal Science and Technology, Jilin Agricultural University, Jilin Changchun, 130118, China
| | - Yuke Chen
- College of Animal Science and Technology, Jilin Agricultural University, Jilin Changchun, 130118, China
| | - Qiuju Wang
- College of Animal Science and Technology, Jilin Agricultural University, Jilin Changchun, 130118, China.
| | - Dongming Zhang
- College of Animal Science and Technology, Jilin Agricultural University, Jilin Changchun, 130118, China.
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Zhang M, Yang F, Feng Q, Ou Y, Zhang J, Wan H, Cao H, Ning P. Comparison of the efficacy of fish oil and probiotic supplementation on glucose and lipid metabolism in patients with type 2 diabetes: a systematic review and network meta-analysis. Diabetol Metab Syndr 2024; 16:25. [PMID: 38254166 PMCID: PMC10804729 DOI: 10.1186/s13098-024-01266-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 01/11/2024] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND Abnormalities in glucose and lipid metabolism contribute to the progression and exacerbation of type 2 diabetes mellitus (T2DM). Fish oil and probiotics are dietary supplements that have the potential to improve glucose and lipid metabolism. However, their efficacy remains unclear in T2DM patients. METHODS PubMed, Embase, and the Cochrane Library were retrieved to collect randomized controlled trials (RCTs) on the efficacy of fish oil or probiotic supplementation in T2DM patients from the database inception to December 13, 2023. Primary outcome indicators encompassed glycated hemoglobin (HbA1c), homeostatic model assessment for insulin resistance (HOMA-IR) and blood lipid profile (triglyceride (TG) and total cholesterol (TC). Secondary outcome indicators included inflammatory markers such as tumor necrosis factor -α (TNF-α) and adipocytokine (including leptin and adiponectin). The R software was used for statistical analysis, and GraphPad Prism was used for figure rendering. RESULTS A total of 60 RCTs involving 3845 T2DM patients were included in the analysis. The results showed that the probiotics (Bifidobacterium, Lactobacillus, Lactococcus, Propionibacterium, etc.) were more effective in reducing HOMA-IR than fish oil (Surca = 0.935). Bifidobacterium demonstrated the highest efficacy in reducing HbA1c levels (Surca = 0.963). Regarding lipid metabolism, fish oil was superior to probiotics in lowering TG and TC levels (Surca values of 0.978 and 0.902, respectively). Furthermore, fish oil outperformed probiotics in reducing TNF-α (Surca = 0.839) and leptin (Surca = 0.712), and increasing adiponectin levels (Surca = 0.742). Node-splitting analysis showed good consistency (P > 0.05 for direct, indirect, and network comparison across various interventions). CONCLUSIONS In T2DM patients, fish oil was more effective than probiotics in regulating lipid metabolism. Probiotics outperformed fish oil in regulating glucose metabolism particularly; specifically, Bifidobacterium showed higher efficacy in reducing blood glucose.
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Affiliation(s)
- Mei Zhang
- Department of Endocrine and Metabolism, Chengdu Fifth People's Hospital (The Second Clinical Medical College, Affiliated Fifth People's Hospital of Chengdu University of Traditional Chinese Medicine), Geriatric Diseases Institute of Chengdu, Chengdu, China
| | - Fan Yang
- Department of Endocrine and Metabolism, Chengdu Fifth People's Hospital (The Second Clinical Medical College, Affiliated Fifth People's Hospital of Chengdu University of Traditional Chinese Medicine), Geriatric Diseases Institute of Chengdu, Chengdu, China
| | - Qiu Feng
- Department of Endocrine and Metabolism, Chengdu Fifth People's Hospital (The Second Clinical Medical College, Affiliated Fifth People's Hospital of Chengdu University of Traditional Chinese Medicine), Geriatric Diseases Institute of Chengdu, Chengdu, China
| | - Yanghong Ou
- Department of Endocrine and Metabolism, Chengdu Fifth People's Hospital (The Second Clinical Medical College, Affiliated Fifth People's Hospital of Chengdu University of Traditional Chinese Medicine), Geriatric Diseases Institute of Chengdu, Chengdu, China
| | - Jiaxing Zhang
- Department of Endocrine and Metabolism, Chengdu Fifth People's Hospital (The Second Clinical Medical College, Affiliated Fifth People's Hospital of Chengdu University of Traditional Chinese Medicine), Geriatric Diseases Institute of Chengdu, Chengdu, China
| | - Haiyan Wan
- Department of Endocrine and Metabolism, Chengdu Fifth People's Hospital (The Second Clinical Medical College, Affiliated Fifth People's Hospital of Chengdu University of Traditional Chinese Medicine), Geriatric Diseases Institute of Chengdu, Chengdu, China
| | - Hongyi Cao
- Department of Endocrine and Metabolism, Chengdu Fifth People's Hospital (The Second Clinical Medical College, Affiliated Fifth People's Hospital of Chengdu University of Traditional Chinese Medicine), Geriatric Diseases Institute of Chengdu, Chengdu, China
| | - Peng Ning
- Department of Endocrine and Metabolism, Chengdu Fifth People's Hospital (The Second Clinical Medical College, Affiliated Fifth People's Hospital of Chengdu University of Traditional Chinese Medicine), Geriatric Diseases Institute of Chengdu, Chengdu, China.
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Sandoval C, Nahuelqueo K, Mella L, Recabarren B, Souza-Mello V, Farías J. Role of long-chain polyunsaturated fatty acids, eicosapentaenoic and docosahexaenoic, in the regulation of gene expression during the development of obesity: a systematic review. Front Nutr 2023; 10:1288804. [PMID: 38024342 PMCID: PMC10665854 DOI: 10.3389/fnut.2023.1288804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 10/23/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction There exists a correlation between obesity and the consumption of an excessive amount of calories, with a particular association between the intake of saturated and trans fats and an elevated body mass index. Omega-3 fatty acids, specifically eicosapentaenoic and docosahexaenoic acids, have been identified as potential preventive nutrients against the cardiometabolic hazards that are commonly associated with obesity. The objective of this comprehensive review was to elucidate the involvement of long-chain polyunsaturated fatty acids, specifically eicosapentaenoic acid and docosahexaenoic acid, in the modulation of gene expression during the progression of obesity. Methods The present analysis focused on primary studies that investigated the association between long-chain polyunsaturated fatty acids, gene expression, and obesity in individuals aged 18 to 65 years. Furthermore, a comprehensive search was conducted on many databases until August 2023 to identify English-language scholarly articles utilizing MeSH terms and textual content pertaining to long-chain polyunsaturated fatty acids, gene expression, obesity, and omega-3. The protocol has been registered on PROSPERO under the registration number CRD42022298395. A comprehensive analysis was conducted on a total of nine primary research articles. All research collected and presented quantitative data. Results and Discussion The findings of our study indicate that the incorporation of eicosapentaenoic and docosahexaenoic acid may have potential advantages and efficacy in addressing noncommunicable diseases, including obesity. This can be attributed to their anti-inflammatory properties and their ability to regulate genes associated with obesity, such as PPARγ and those within the ALOX family. Systematic Review Registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022298395, CRD42022298395.
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Affiliation(s)
- Cristian Sandoval
- Escuela de Tecnología Médica, Facultad de Salud, Universidad Santo Tomás, Osorno, Chile
- Departamento de Ingeniería Química, Facultad de Ingeniería y Ciencias, Universidad de La Frontera, Temuco, Chile
- Departamento de Ciencias Preclínicas, Facultad de Medicina, Universidad de La Frontera, Temuco, Chile
| | - Karen Nahuelqueo
- Carrera de Tecnología Médica, Facultad de Medicina, Universidad de La Frontera, Temuco, Chile
| | - Luciana Mella
- Carrera de Tecnología Médica, Facultad de Medicina, Universidad de La Frontera, Temuco, Chile
| | - Blanca Recabarren
- Carrera de Tecnología Médica, Facultad de Medicina, Universidad de La Frontera, Temuco, Chile
| | - Vanessa Souza-Mello
- Laboratorio de Morfometría, Metabolismo y Enfermedades Cardiovasculares, Centro Biomédico, Instituto de Biología, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Jorge Farías
- Departamento de Ingeniería Química, Facultad de Ingeniería y Ciencias, Universidad de La Frontera, Temuco, Chile
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Chen HM, Su DS, Li HY, Guo XZ, Qi XS. Lipid-lowering therapy for hypertriglyceridemia-induced acute pancreatitis: Recent advances. Shijie Huaren Xiaohua Zazhi 2023; 31:882-888. [DOI: 10.11569/wcjd.v31.i21.882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 10/27/2023] [Accepted: 11/01/2023] [Indexed: 11/08/2023] Open
Abstract
With the improvement of the living standard, hypertriglyceridemia (HTG) has become the second major cause of acute pancreatitis (AP) in China. Hypertriglyceridemia-induced acute pancreatitis (HTG-AP) has its own unique characteristics. First, the elevation of blood amylase and lipase levels is not significant. Second, the severity of the disease positively correlates with blood triglyceride (TG) level. The goal of treatment of HTG-AP is to lower blood lipids rapidly. Common lipid-lowering methods include dietary modification, lipid-lowering drugs, low-molecular heparin combined with insulin, blood purification, and combined Chinese and Western medicine. This article reviews the recent advances on lipid-lowering approaches used in HTG-AP patients.
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Affiliation(s)
- Hui-Min Chen
- Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang 110840, Liaoning Province, China
- Graduate School of Dalian Medical University, Dalian 116044, Liaoning Province, China
| | - Dong-Shuai Su
- Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang 110840, Liaoning Province, China
- The 963rd Hospital of The Joint Logistics Support Force of the Chinese People's Liberation Army, Jiamusi 154000, Heilongjiang Province, China
| | - Hong-Yu Li
- Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang 110840, Liaoning Province, China
| | - Xiao-Zhong Guo
- Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang 110840, Liaoning Province, China
| | - Xing-Shun Qi
- Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang 110840, Liaoning Province, China
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11
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Gesner M, Frishman WH. Drug Therapy for Hypertriglyceridemia and Familial Chylomicronemia Syndrome: Focus on Volnesorsen. Cardiol Rev 2023; 31:325-329. [PMID: 36129324 DOI: 10.1097/crd.0000000000000468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Volanesorsen is a new medication that may soon be used in the treatment of hypertriglyceridemia and familial chylomicronemia syndrome (FCS). Volanesorsen works via binding to Apo C-III mRNA and degrading that mRNA, thus decreasing the synthesis of Apo C-III. This decreased synthesis of Apo C-III will increase the binding of triglycerides to LDL receptors and decrease triglyceride plasma levels. It is important to note that currently there are 3 other medication classes available for the treatment of hypertriglyceridemia, including niacin, fish oil/omega-3-fatty acids, and fibrates. However, there are no Food and Drug Administration-approved medications to treat FCS. Recently, volanesorsen was approved in the European Union for the treatment of FCS, but that indication was denied in the United States by the Food and Drug Administration. This was due to the side effects of the drug. Volanesorsen may cause a decrease in platelet count, renal toxicity, and elevate liver enzymes. The current drug regimen for volanesorsen consists of 285 mg once a week by subcutaneous injection, with a recommendation to immediately stop the medication if any of these side effects are noted, to prevent long-term complications. With these side effects reported, fish oil/omega-3-fatty acids seem likely the best choice when it comes to treating hypertriglyceridemia. If FCS is debilitating or greatly affecting the patient's life, then one could recommend volanesorsen. Otherwise, at this time, the side effects of volanesorsen may be too severe to justify its use for mild episodes of FCS or hypertriglyceridemia.
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Affiliation(s)
| | - William H Frishman
- Departments of Medicine and Cardiology, New York Medical College/Westchester Medical Center, Valhalla, NY
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Pourrajab B, Sharifi-Zahabi E, Soltani S, Shahinfar H, Shidfar F. Comparison of canola oil and olive oil consumption on the serum lipid profile in adults: a systematic review and meta-analysis of randomized controlled trials. Crit Rev Food Sci Nutr 2023; 63:12270-12284. [PMID: 35866510 DOI: 10.1080/10408398.2022.2100314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND AND AIMS Several randomized clinical trials have investigated the effects of canola oil (CO) compared to olive oil (OO) on the serum lipid profiles in adults. However, the results of these studies are inconsistent. Thus, this study aimed to assess the comparison of CO and OO consumption on the serum lipid components in adults. METHODS AND RESULTS The following online databases were searched until February 4th, 2022: PubMed/Medline, Scopus, Clarivate Analytics Web of Science, Cochrane Central Register of Controlled Trials, and Google Scholar. The effect sizes were stated as the weighted mean difference (WMD) with 95% confidence intervals (CI). A total of 13 eligible trials were included in this meta-analysis. The results showed that the CO consumption, significantly reduced serum LDL-c (WMD: -6.13 mg/dl, 95%CI: -9.79, -2.46, p = 0.001), TC (WMD: -8.92 mg/dl, 95% CI: -13.52, -4.33, P < 0.001) and LDL-c/HDL-c ratio (WMD: -0.30; 95% CI, -0.53, -0.06, p = 0.01) levels compared to OO. There were no significant changes in the other components of the blood lipids. CONCLUSION The results of this review suggest that CO consumptionhas beneficial effects on LDL-c, TC, and LDL-c/HDL-c ratio compared to OO. Therefore, its replacement with OO can have cardioprotective impacts.
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Affiliation(s)
- Behnaz Pourrajab
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Elham Sharifi-Zahabi
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Sepideh Soltani
- Yazd Cardiovascular Research Center, Non-communicable Diseases Research Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Hossein Shahinfar
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Farzad Shidfar
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
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13
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Laupsa-Borge J, Grytten E, Bohov P, Bjørndal B, Strand E, Skorve J, Nordrehaug JE, Berge RK, Rostrup E, Mellgren G, Dankel SN, Nygård OK. Sex-specific responses in glucose-insulin homeostasis and lipoprotein-lipid components after high-dose supplementation with marine n-3 PUFAs in abdominal obesity: a randomized double-blind crossover study. Front Nutr 2023; 10:1020678. [PMID: 37404855 PMCID: PMC10315503 DOI: 10.3389/fnut.2023.1020678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 06/01/2023] [Indexed: 07/06/2023] Open
Abstract
Background Clinical studies on effects of marine-derived omega-3 (n-3) polyunsaturated fatty acids (PUFAs), mainly eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), and the plant-derived omega-6 (n-6) PUFA linoleic acid (LA) on lipoprotein-lipid components and glucose-insulin homeostasis have shown conflicting results, which may partly be explained by differential responses in females and males. However, we have lacked data on sexual dimorphism in the response of cardiometabolic risk markers following increased consumption of n-3 or n-6 PUFAs. Objective To explore sex-specific responses after n-3 (EPA + DHA) or n-6 (LA) PUFA supplementation on circulating lipoprotein subfractions, standard lipids, apolipoproteins, fatty acids in red blood cell membranes, and markers of glycemic control/insulin sensitivity among people with abdominal obesity. Methods This was a randomized double-blind crossover study with two 7-week intervention periods separated by a 9-week washout phase. Females (n = 16) were supplemented with 3 g/d of EPA + DHA (fish oil) or 15 g/d of LA (safflower oil), while males (n = 23) received a dose of 4 g/d of EPA + DHA or 20 g/d of LA. In fasting blood samples, we measured lipoprotein particle subclasses, standard lipids, apolipoproteins, fatty acid profiles, and markers of glycemic control/insulin sensitivity. Results The between-sex difference in relative change scores was significant after n-3 for total high-density lipoproteins (females/males: -11%*/-3.3%, p = 0.036; *: significant within-sex change), high-density lipoprotein particle size (+2.1%*/-0.1%, p = 0.045), and arachidonic acid (-8.3%*/-12%*, p = 0.012), and after n-6 for total (+37%*/+2.1%, p = 0.041) and small very-low-density lipoproteins (+97%*/+14%, p = 0.021), and lipoprotein (a) (-16%*/+0.1%, p = 0.028). Circulating markers of glucose-insulin homeostasis differed significantly after n-3 for glucose (females/males: -2.1%/+3.9%*, p = 0.029), insulin (-31%*/+16%, p < 0.001), insulin C-peptide (-12%*/+13%*, p = 0.001), homeostasis model assessment of insulin resistance index 2 (-12%*/+14%*, p = 0.001) and insulin sensitivity index 2 (+14%*/-12%*, p = 0.001), and quantitative insulin sensitivity check index (+4.9%*/-3.4%*, p < 0.001). Conclusion We found sex-specific responses after high-dose n-3 (but not n-6) supplementation in circulating markers of glycemic control/insulin sensitivity, which improved in females but worsened in males. This may partly be related to the sex differences we observed in several components of the lipoprotein-lipid profile following the n-3 intervention. Clinical trial registration https://clinicaltrials.gov/, identifier [NCT02647333].
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Affiliation(s)
- Johnny Laupsa-Borge
- Hormone Laboratory, Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway
- Mohn Nutrition Research Laboratory, Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Elise Grytten
- Hormone Laboratory, Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway
- Mohn Nutrition Research Laboratory, Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Pavol Bohov
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Bodil Bjørndal
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Elin Strand
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Jon Skorve
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Jan Erik Nordrehaug
- Department of Clinical Science, University of Bergen, Bergen, Norway
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
| | - Rolf K. Berge
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Espen Rostrup
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
| | - Gunnar Mellgren
- Hormone Laboratory, Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway
- Mohn Nutrition Research Laboratory, Department of Clinical Science, University of Bergen, Bergen, Norway
- Mohn Research Center for Diabetes Precision Medicine, Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Simon N. Dankel
- Hormone Laboratory, Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway
- Mohn Nutrition Research Laboratory, Department of Clinical Science, University of Bergen, Bergen, Norway
- Mohn Research Center for Diabetes Precision Medicine, Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Ottar K. Nygård
- Mohn Nutrition Research Laboratory, Department of Clinical Science, University of Bergen, Bergen, Norway
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
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Lee YQ, Chia A, Whitton C, Cameron-Smith D, Sim X, van Dam RM, F-F Chong M. Isocaloric Substitution of Plant-Based Protein for Animal-Based Protein and Cardiometabolic Risk Factors in a Multiethnic Asian Population. J Nutr 2023; 153:1555-1566. [PMID: 36963499 PMCID: PMC10196602 DOI: 10.1016/j.tjnut.2023.03.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 03/15/2023] [Indexed: 03/26/2023] Open
Abstract
BACKGROUND Evidence is accumulating that intake of animal-based and plant-based proteins has different effects on cardiometabolic health, but less is known about the health effect of isocaloric substitution of animal-based and plant-based proteins. Data from Asian populations are limited. OBJECTIVES This study aimed to evaluate the effects of isocaloric substitution of total plant-based proteins for total and various animal-based protein food groups and to evaluate the effects of substituting protein from legumes and pulses for various animal-based protein food groups on cardiovascular disease (CVD) risk factors and predicted 10-y CVD risk. METHODS We conducted a cross-sectional analysis using data collected from 9211 Singapore residents (aged 21-75 y) from the Singapore Multi-Ethnic Cohort. Data on sociodemographic and lifestyle factors were collected using questionnaires. Dietary intakes were assessed using a validated FFQ. BMI, waist circumference, and blood pressure were measured during a physical examination, and blood samples were collected to measure lipid profiles. Associations were assessed by substitution models using a multiple linear regression analysis. RESULTS Isocaloric substitution of total plant-based proteins for total and all specific animal-based protein food groups were associated with lower BMI (β: -0.30; 95% CI: -0.38, -0.22), waist circumference (β: -0.85; 95% CI: -1.04, -0.66), and LDL cholesterol concentrations (β: -0.06; 95% CI: -0.08, -0.05) (P < 0.0056). Replacement of processed meat and processed seafood proteins with total plant-based proteins was associated with improvement in most CVD risk factors and predicted 10-y CVD risk. Replacement of oily fish with legume proteins was associated with lower HDL cholesterol and higher TG concentrations. CONCLUSIONS The substitution of plant-based proteins for animal-based proteins, especially from processed meat and processed seafood, was inversely associated with the established CVD risk factors such as BMI, waist circumference, and lipid concentrations and predicted 10-y CVD risk. These findings warrant further investigation in independent studies in other Asian populations.
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Affiliation(s)
- Yu Qi Lee
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore.
| | - Airu Chia
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Clare Whitton
- School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - David Cameron-Smith
- College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, Australia
| | - Xueling Sim
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Rob M van Dam
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore; Departments of Exercise and Nutrition Sciences and Epidemiology, Milken Institute School of Public Health, George Washington University, Washington DC, United States
| | - Mary F-F Chong
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore; Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
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15
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Mahla AS, Bunkar SK, Kumawat BL, Kumar Saxena V, Selvaraju S, Bhatt RS, Singh R, Kumar A. Dietary n-3 PUFA augments pre-ovulatory follicle turnover and prolificacy in well-fed ewes. Anim Reprod Sci 2023; 252:107231. [PMID: 37086576 DOI: 10.1016/j.anireprosci.2023.107231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 04/03/2023] [Accepted: 04/09/2023] [Indexed: 04/24/2023]
Abstract
The present study evaluated the effect of dietary supplementation with n-3 polyunsaturated fatty acids (PUFA) on preovulatory follicle (POF) turnover, prolificacy, and endocrine and metabolic milieu in Malpura sheep. Fifty cyclic ewes with 3-3.5 body condition scores on a five-point scale were allocated equally to two groups (n = 25) following estrus synchronization and were supplemented with 0.6 mL/kg body weight of n-3 PUFA-rich fish oil (FO) or palm oil (PO) as control, for 60 d following an acclimatization period of 7 d. All ewes were mated with sexually active rams at the end of the supplementation period. On ultrasonographic ovarian scanning at the last fourth estrus, the mean number of POFs was 77.8% greater (P < 0.01) in FO ewes than in the PO ewes. The proportion of ewes with multiple ovulations two months after the beginning of supplementation was 56% in the FO group as compared to 8% in the PO group. The number of fetuses was 46% higher (P < 0.01) in the FO than in the PO ewes at d 45 of gestation. At lambing, the twinning percent in the FO ewes was three times greater than in the PO ewes (27.3 vs. 9.1%). Plasma cholesterol, estradiol, and insulin concentrations were lower (P < 0.01) in ewes fed with FO than those offered PO group at the end of the feeding period. It was concluded that the dietary supplementation of n-3 PUFA-rich FO in well-fed Malpura ewes improved the number of follicles and ovulation rate which led to an increased prolificacy, accompanied by a reduction of plasma cholesterols, estradiol, and insulin.
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Affiliation(s)
- Ajit Singh Mahla
- Animal Physiology and Biochemistry Division, ICAR-Central Sheep and Wool Research, Avikanagar 304 501, Rajasthan, India.
| | - Suresh Kumar Bunkar
- Animal Physiology and Biochemistry Division, ICAR-Central Sheep and Wool Research, Avikanagar 304 501, Rajasthan, India
| | - Babu Lal Kumawat
- Animal Physiology and Biochemistry Division, ICAR-Central Sheep and Wool Research, Avikanagar 304 501, Rajasthan, India; Department of Animal Reproduction, Gynaecology and Obstetrics, College of Veterinary and Animal Sciences, Parbhani, MAFSU, Nagpur 431 402, Maharashtra, India
| | - Vijay Kumar Saxena
- Protein Science Laboratory, Department of Pharmacy, University of Eastern Finland, Kuopio, Northern Savonia, Finland
| | - Sellappan Selvaraju
- Reproductive Physiology Laboratory, Animal Physiology Division, ICAR-National Institute of Animal Nutrition and Physiology, Adugodi, Bengaluru 560 030, Karnataka, India
| | - Randhir Singh Bhatt
- Animal Nutrition Division, ICAR-Central Sheep and Wool Research Institute, Avikanagar 304 501, Rajasthan, India
| | - Raghvendar Singh
- Animal Physiology and Biochemistry Division, ICAR-Central Sheep and Wool Research, Avikanagar 304 501, Rajasthan, India
| | - Arun Kumar
- ICAR-Central Sheep and Wool Research Institute, Avikanagar 304 501, Rajasthan, India
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16
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Miles JM. Hepatic dysfunction in patients receiving intravenous lipid emulsions. Curr Opin Clin Nutr Metab Care 2023; 26:278-283. [PMID: 36943142 DOI: 10.1097/mco.0000000000000924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
PURPOSE Until recently, intravenous lipid emulsions (ILEs) have consisted of soybean oil (SO) only. This review addresses recent developments in the field, including the problem of intestinal failure associated liver disease (IFALD) that can occur with the use of ILEs in children and adults, and newer ILEs that may minimize and reverse IFALD. RECENT FINDINGS Cholestasis is the primary manifestation of IFALD in premature infants receiving ILEs, whereas in older children and adults, steatosis is predominant. Two alternative ILEs have been extensively investigated for both safety and efficacy. SMOF, an ILE containing medium chain triglyceride, soybean oil, olive oil and fish oil (FO), is now widely used in both children and adults. A newer FO ILE is approved for use in children only. However, in case reports FO ILE has been shown to improve IFALD in adults. A number of new studies suggest that cholestasis from ILEs is dose-related. IFALD does not improve in many patients after transition from SO to SMOF, but partial or complete replacement with FO can halt and reverse IFALD. SUMMARY Adverse hepatic effects from ILEs are to some extent dose-related. Overfeeding with fat or with carbohydrate, or simply providing excessive calories in general, may be responsible. More research is needed investigating dose-related effects of macronutrients on liver injury.
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Affiliation(s)
- John M Miles
- Division of Endocrinology, Diabetes and Clinical Pharmacology, Department of Medicine, University of Kansas School of Medicine, Kansas City, Kansas, USA
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17
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Omega-3-Rich Fish-Oil-Influenced Mouse Gut Microbiome Shaped by Intermittent Consumption of Beef. Curr Microbiol 2023; 80:119. [PMID: 36855004 DOI: 10.1007/s00284-023-03223-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 02/11/2023] [Indexed: 03/02/2023]
Abstract
Beef consumption can provide various amino acids, lipids, vitamins, and minerals; however, excessive intake causes metabolic disorders and increases the probability of obesity, atherosclerosis, and colorectal cancer. The intake of omega-3 fatty acids can ameliorate metabolic disorders by lowering blood glucose and triglyceride levels. In the present study, we investigated the effect of omega-3-rich fish oil on body performance and the gut microbiome in a beef-rich diet. Four-week-old C57BL/6 mice were distributed into four groups (chow diet [Chow], chow with beef diet [Beef], chow with omega-3 diet [Cw3], and chow with beef and omega-3 diet [Bw3]). We observed that body weight was unaltered between groups, and serum triglyceride levels were reduced in the omega-3 supplemented groups. The beta diversity indices, unweighted UniFrac distance (P = 0.001), and Jaccard distance (P = 0.001) showed statistically significant differences, and the principal coordinates analysis plot showed a clear separation between groups. In addition, the taxonomic comparison revealed that beef consumption increased numerous potentially pathogenic bacteria, including Escherichia-Shigella, Mucispirillum, Helicobacter, and Desulfovibrio, which were decreased following omega-3 supplementation. Metabolic comparison based on 16S rRNA revealed that energy and glucose metabolism were higher in omega-3 supplemented groups. Our findings suggest that the omega-3 supplementation under intermittent beef consumption contributes to changes in the gut microbiome and microbial metabolic pathways.
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Satokar VV, Derraik JGB, Harwood M, Okesene-Gafa K, Beck K, Cameron-Smith D, Garg ML, O'Sullivan JM, Sundborn G, Pundir S, Mason RP, Cutfield WS, Albert BB. Fish oil supplementation during pregnancy and postpartum in mothers with overweight and obesity to improve body composition and metabolic health during infancy: A double-blind randomized controlled trial. Am J Clin Nutr 2023; 117:883-895. [PMID: 36781129 DOI: 10.1016/j.ajcnut.2023.02.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 02/01/2023] [Accepted: 02/08/2023] [Indexed: 02/13/2023] Open
Abstract
BACKGROUND Maternal obesity during pregnancy is associated with an increased risk of obesity and metabolic disease in the offspring. Supplementation with fish oil (FO), which is insulin sensitizing, during pregnancy in mothers with overweight or obesity may prevent the development of greater adiposity and metabolic dysfunction in their children. OBJECTIVES To determine the effects of FO supplementation throughout the second half of pregnancy and lactation in mothers with overweight or obesity on infant body composition and metabolism. METHODS A double-blind randomized controlled trial of 6 g FO (3.55 g/d of n-3 PUFAs) compared with olive oil (control) from mid-pregnancy until 3 mo postpartum. Eligible women had singleton pregnancies at 12-20 wk of gestation, and BMI ≥ 25 kg/m2. The primary outcome was the infant body fat percentage (DXA scans) at 2 wk of age. Secondary outcomes included maternal metabolic markers during pregnancy, infant anthropometry at 2 wk and 3 mo of age, and metabolic markers at 3 mo. RESULTS A total of 129 mothers were randomized, and 98 infants had a DXA scan at 2 wk. PRIMARY OUTCOME Imputed and nonimputed analyses showed no effects of FO supplementation on infant body fat percentage at age 2 wk. SECONDARY OUTCOMES There were no treatment effects on infant outcomes at 2 wk, but FO infants had a higher BMI z-score (P = 0.025) and ponderal index (P = 0.017) at age 3 mo. FO supplementation lowered maternal triglycerides by 17% at 30 wk of pregnancy (P = 0.0002) and infant triglycerides by 21% at 3 mo of age (P = 0.016) but did not affect maternal or infant insulin resistance. The rate of emergency cesarean section was lower with FO supplementation [aRR = 0.38 (95%CI 0.16, 0.90); P = 0.027]. CONCLUSIONS FO supplementation of mothers with overweight or obesity during pregnancy did not impact infant body composition. There is a need to follow up the offspring to determine whether the observed metabolic effects persist. CLINICAL TRIAL REGISTRY NUMBER This study was registered with the Australian New Zealand Clinical Trials Registry (ACTRN12617001078347p). In addition, the Universal Trial Number, WHO, was obtained (U1111-1199-5860).
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Affiliation(s)
- Vidit V Satokar
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - José G B Derraik
- Liggins Institute, University of Auckland, Auckland, New Zealand; Department of Paediatrics: Child and Youth Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand; Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden; Environmental - Occupational Health Sciences and Non-Communicable Diseases Research Group, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Matire Harwood
- Department of General Practice and Primary Care, University of Auckland, Auckland, New Zealand
| | - Karaponi Okesene-Gafa
- Department of Obstetrics and Gynaecology, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Kathryn Beck
- School of Sport Exercise and Nutrition, College of Health, Massey University, Auckland, New Zealand
| | - David Cameron-Smith
- Liggins Institute, University of Auckland, Auckland, New Zealand; College of Engineering, Science and Environment, University of Newcastle, New South Wales, Australia; School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, University of Newcastle, New South Wales, Australia
| | - Manohar L Garg
- School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, University of Newcastle, New South Wales, Australia
| | | | - Gerhard Sundborn
- Department of Pacific Health, School of Population Health, University of Auckland, Auckland, New Zealand
| | - Shikha Pundir
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - R Preston Mason
- Department of Medicine, Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, USA
| | - Wayne S Cutfield
- Liggins Institute, University of Auckland, Auckland, New Zealand; A Better Start - National Science Challenge, University of Auckland, New Zealand
| | - Benjamin B Albert
- Liggins Institute, University of Auckland, Auckland, New Zealand; A Better Start - National Science Challenge, University of Auckland, New Zealand.
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Takeda Y, Sakuma I, Hiramitsu S, Okada M, Ueda S, Sakurai M. The effects of pemafibrate and omega-3 fatty acid ethyl on apoB-48 in dyslipidemic patients treated with statin: A prospective, multicenter, open-label, randomized, parallel group trial in Japan (PROUD48 study). Front Cardiovasc Med 2023; 10:1094100. [PMID: 36760560 PMCID: PMC9905248 DOI: 10.3389/fcvm.2023.1094100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 01/06/2023] [Indexed: 01/27/2023] Open
Abstract
Background We compared the lowering effects of pemafibrate and omega-3 fatty acid ethyl on fasting apolipoprotein (apo) B-48 (apoB-48), a marker that reflects postprandial hypertriglyceridemia, which is one of the residual risks for atherosclerotic cardiovascular disease (ASCVD) with statin treatment. Methods This prospective, multicenter, open-label, randomized, parallel group trial was conducted at 4 medical institutions between April 2020 and May 2022. A total of 126 ambulatory patients with dyslipidemia receiving statin treatment for more than 4 weeks, aged 20-79 years with fasting triglyceride (TG) levels of ≥177 mg/dl were randomly assigned to 16-week pemafibrate 0.4 mg per day treatment group (PEMA, n = 63) or omega-3 fatty acid ethyl 4 g per day treatment group (OMEGA-3, n = 63). The primary endpoint was the percentage change in fasting apoB-48 from baseline to week 16. Results The percentage changes in fasting apoB-48 in PEMA and OMEGA-3 were -50.8% (interquartile range -62.9 to -30.3%) and -17.5% (-38.3 to 15.3%) (P < 0.001), respectively. As the secondary endpoints, the changes in fasting apoB-48 in PEMA and OMEGA-3 were -3.10 μg/ml (-5.63 to -1.87) and -0.90 μg/ml (-2.95 to 0.65) (P < 0.001), respectively. Greater decreases with significant differences in the percentage changes in TG, remnant lipoprotein cholesterol, apoC-III, fasting plasma glucose, alanine aminotransferase, gamma-glutamyl transpeptidase, and alkaline phosphatase were observed in PEMA, compared with OMEGA-3. Greater increases with significant differences in those in high-density lipoprotein (HDL) cholesterol, apoA-I, and apoA-II were observed in PEMA, compared with OMEGA-3. PEMA showed anti-atherosclerotic lipoprotein profiles in gel-permeation high-performance liquid chromatography analyses, compared with OMEGA-3. Although adverse events occurred in 9 of 63 (14.3%) patients in PEMA and 3 of 63 (4.8%) patients in OMEGA-3, no serious adverse events associated with drug were observed in either group. Conclusions This is the first randomized trial to compare the lowering effects of pemafibrate and omega-3 fatty acid ethyl on fasting apoB-48. We concluded that pemafibrate was superior to omega-3 fatty acid ethyl in lowering effect of fasting apoB-48. Pemafibrate is expected to reduce the residual risk for ASCVD with statin treatment. Clinical trial registration https://rctportal.niph.go.jp/en, identifier jRCTs071200011.
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Affiliation(s)
- Yasutaka Takeda
- Division of Metabolism and Biosystemic Science, Gastroenterology, and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Asahikawa, Japan,*Correspondence: Yasutaka Takeda,
| | - Ichiro Sakuma
- Caress Sapporo Hokko Memorial Clinic, Sapporo, Japan
| | | | | | - Shinichiro Ueda
- Department of Clinical Pharmacology and Therapeutics, University of the Ryukyus, Nishihara, Japan
| | - Masaru Sakurai
- Department of Social and Environmental Medicine, Kanazawa Medical University, Uchinada, Japan
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20
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Calzada C, Vors C, Penhoat A, Cheillan D, Michalski MC. Role of circulating sphingolipids in lipid metabolism: Why dietary lipids matter. Front Nutr 2023; 9:1108098. [PMID: 36712523 PMCID: PMC9874159 DOI: 10.3389/fnut.2022.1108098] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 12/21/2022] [Indexed: 01/13/2023] Open
Abstract
Sphingolipids are structural components of cell membranes and lipoproteins but also act as signaling molecules in many pathophysiological processes. Although sphingolipids comprise a small part of the plasma lipidome, some plasma sphingolipids are recognized as implicated in the development of metabolic diseases and cardiovascular diseases. Plasma sphingolipids are mostly carried out into lipoproteins and may modulate their functional properties. Lipids ingested from the diet contribute to the plasma lipid pool besides lipids produced by the liver and released from the adipose tissue. Depending on their source, quality and quantity, dietary lipids may modulate sphingolipids both in plasma and lipoproteins. A few human dietary intervention studies investigated the impact of dietary lipids on circulating sphingolipids and lipid-related cardiovascular risk markers. On the one hand, dietary saturated fatty acids, mainly palmitic acid, may increase ceramide concentrations in plasma, triglyceride-rich lipoproteins and HDL. On the other hand, milk polar lipids may decrease some molecular species of sphingomyelins and ceramides in plasma and intestine-derived chylomicrons. Altogether, different dietary fatty acids and lipid species can modulate circulating sphingolipids vehicled by postprandial lipoproteins, which should be part of future nutritional strategies for prevention of cardiovascular diseases.
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Affiliation(s)
- Catherine Calzada
- Univ-Lyon, CarMeN Laboratory, Inserm U1060, INRAE UMR1397, Université Claude Bernard Lyon 1, Pierre Bénite, France,*Correspondence: Catherine Calzada ✉
| | - Cécile Vors
- Univ-Lyon, CarMeN Laboratory, Inserm U1060, INRAE UMR1397, Université Claude Bernard Lyon 1, Pierre Bénite, France
| | - Armelle Penhoat
- Univ-Lyon, CarMeN Laboratory, Inserm U1060, INRAE UMR1397, Université Claude Bernard Lyon 1, Pierre Bénite, France
| | - David Cheillan
- Univ-Lyon, CarMeN Laboratory, Inserm U1060, INRAE UMR1397, Université Claude Bernard Lyon 1, Pierre Bénite, France,Service de Biochimie et de Biologie Moléculaire, Centre de Biologie et de Pathologie Est, Hospices Civils de Lyon, Bron, France
| | - Marie-Caroline Michalski
- Univ-Lyon, CarMeN Laboratory, Inserm U1060, INRAE UMR1397, Université Claude Bernard Lyon 1, Pierre Bénite, France
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Role of Omega-3 Fatty Acids in Cardiovascular Disease: the Debate Continues. Curr Atheroscler Rep 2023; 25:1-17. [PMID: 36580204 PMCID: PMC9834373 DOI: 10.1007/s11883-022-01075-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/15/2022] [Indexed: 12/30/2022]
Abstract
PURPOSE OF REVIEW The omega-3 fatty acids (n3-FAs), eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), have recently undergone testing for their ability to reduce residual cardiovascular (CV) risk among statin-treated subjects. The outcome trials have yielded highly inconsistent results, perhaps attributable to variations in dosage, formulation, and composition. In particular, CV trials using icosapent ethyl (IPE), a highly purified ethyl ester of EPA, reproducibly reduced CV events and progression of atherosclerosis compared with mixed EPA/DHA treatments. This review summarizes the mechanistic evidence for differences among n3-FAs on the development and manifestations of atherothrombotic disease. RECENT FINDINGS Large randomized clinical trials with n3-FAs have produced discordant outcomes despite similar patient profiles, doses, and triglyceride (TG)-lowering effects. A large, randomized trial with IPE, a prescription EPA only formulation, showed robust reduction in CV events in statin treated patients in a manner proportional to achieved blood EPA concentrations. Multiple trials using mixed EPA/DHA formulations have not shown such benefits, despite similar TG lowering. These inconsistencies have inspired investigations into mechanistic differences among n3-FAs, as EPA and DHA have distinct membrane interactions, metabolic products, effects on cholesterol efflux, antioxidant properties, and tissue distribution. EPA maintains normal membrane cholesterol distribution, enhances endothelial function, and in combination with statins improves features implicated in plaque stability and reduces lipid content of plaques. Insights into reductions in residual CV risk have emerged from clinical trials using different formulations of n3-FAs. Among high-risk patients on contemporary care, mixed n3-FA formulations showed no reduction in CV events. The distinct benefits of IPE in multiple trials may arise from pleiotropic actions that correlate with on-treatment EPA levels beyond TG-lowering. These effects include altered platelet function, inflammation, cholesterol distribution, and endothelial dysfunction. Elucidating such mechanisms of vascular protection for EPA may lead to new interventions for atherosclerosis, a disease that continues to expand worldwide.
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22
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So J, Asztalos BF, Horvath K, Lamon-Fava S. Ethyl EPA and ethyl DHA cause similar and differential changes in plasma lipid concentrations and lipid metabolism in subjects with low-grade chronic inflammation. J Clin Lipidol 2022; 16:887-894. [DOI: 10.1016/j.jacl.2022.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 06/06/2022] [Accepted: 10/11/2022] [Indexed: 11/06/2022]
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Association of Fish and Omega-3 Fatty Acid Intake with Carotid Intima-Media Thickness in Middle-Aged to Elderly Japanese Men and Women: The Toon Health Study. Nutrients 2022; 14:nu14173644. [PMID: 36079901 PMCID: PMC9460211 DOI: 10.3390/nu14173644] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 08/22/2022] [Accepted: 08/31/2022] [Indexed: 12/25/2022] Open
Abstract
Fish and omega-3 fatty acid consumption is known to be beneficial for cardiometabolic health. However, the related evidence for individuals with a relatively higher intake of fish or omega-3 unsaturated fatty acids, e.g., Japanese individuals, is scarce. Therefore, this study aimed to examine the association of fish and omega-3 fatty acid intakes with the carotid intima-media thickness (C-IMT) in the Japanese population. In total, 1803 Japanese men and women aged 30–84 years without a history of myocardial infarction or angina pectoris were included in the study. The fish and omega-3 fatty acid intakes were estimated using food frequency questionnaires. The C-IMT was measured using ultrasound imaging, and the participants were classified into three groups: normal, moderate (1.1 to 1.4 mm of maximum C-IMT), and severely increased C-IMT (≥1.5 mm). Multinomial logistic regression models were used to calculate the odds ratio (OR) and 95% confidence intervals (95% CI) of the presence of moderately and severely increased C-IMT. The omega-3 fatty acid intake was shown to be associated with lower odds of severely increased C-IMT. The multivariable-adjusted OR (95%CI) was 0.55 (0.31–0.97; p for trend = 0.04). We also found a borderline significant negative association between fish intake and the presence of severely increased C-IMT. In conclusion, omega-3 fatty acid intake might protect against the development of atherosclerosis in the Japanese population.
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24
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Patel A, Patni N. Evaluation and Management of Lipids and Lipoproteins in Children and Adolescents. Endocrinol Metab Clin North Am 2022; 51:573-588. [PMID: 35963629 DOI: 10.1016/j.ecl.2022.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Cardiovascular disease (CVD) is the leading cause of mortality in the United States. Universal screening in all children aged 9 to 11 years and 17 to 21 years, and targeted screening in children with high-risk factors, can help in early identification and treatment of dyslipidemia during the youth, significantly reducing clinical CVD risk in adult life. Lifestyle modifications with heart-healthy diet and moderate-vigorous activity are fundamental in the management of pediatric dyslipidemia. Pharmacotherapy has been evolving in children, and statins, bile acid sequestrants, ezetimibe and PCSK9 inhibitors, fibrates, niacin, and omega-3 fish oils are available for use in pediatric population.
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Affiliation(s)
- Amisha Patel
- Department of Pediatrics, UT Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA
| | - Nivedita Patni
- Division of Pediatric Endocrinology, Department of Pediatrics, UT Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390-9063, USA.
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25
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Dogay Us G, Mushtaq S. N-3 fatty acid supplementation mediates lipid profile, including small dense LDL, when combined with statins: a randomized double blind placebo controlled trial. Lipids Health Dis 2022; 21:84. [PMID: 36050695 PMCID: PMC9434850 DOI: 10.1186/s12944-022-01686-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 08/02/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Epidemiological and clinical evidence suggests that high-dose intake of omega 3 fatty acids (n-3 FA) have a favorable role in altering serum triglycerides (TG) and non-high density lipoprotein cholesterol (non-HDL-C) when combined with statins in hyperlipidemic patients. Their efficacy in altering low-density lipoprotein cholesterol (LDL-C) particle size is yet to be established. AIM This study evaluated the effects of supplementing 4 g/day Eicosapentaenoic acid (EPA) and Docosahexaenoic acid (DHA) on serum blood lipids, including small, dense LDL-C particle concentration, in hyperlipidemic patients receiving stable statin therapy. METHODS In this randomized, placebo-controlled, double-blind parallel group study, 44 patients on statin therapy for > 8 weeks with non-HDL-C concentrations above 130 mg/dL were randomized into two groups. For 8 weeks, together with their prescribed statin, the intervention group received 4 g/day EPA + DHA (3000 mg EPA + 1000 mg DHA in ethyl ester form) and the placebo group received 4 g/day olive oil (OO). Measurements of serum non-HDL-C, TG, total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), LDL-C (including large - LDL I; intermediate - LDL II; and small - LDL III subclasses), very-low-density lipoprotein cholesterol (VLDL-C) concentration, were taken at baseline and post-intervention. Dietary intake was assessed with a weighed intake, 3-day food diary at week 4. Primary outcome measures were percent change in LDL III, non-HDL-C and LDL particle number. RESULTS At the end of treatment, the median percent change in serum LDL III concentration was significantly greater in the n-3 FA group plus atorvastatin compared to placebo (- 67.5% vs - 0%, respectively; P < 0.001). Supplementation with n-3 FA plus atorvastatin led to significant reductions in serum non-HDL-C (- 9.5% vs 4.7%, P < 0.01), TG (- 21.5% vs 6.2%, P < 0.001) and VLDL-C (- 36.9% vs 4.0%, P < 0.001) and TC (- 6.6% vs 2.1%, P < 0.001). Between the groups, no significant difference in percent change in the serum concentration of LDL-C, HDL-C, as well as in the LDL I and LDL II subclasses was observed. CONCLUSION In this group of hyperlipidemic patients on a stable statin prescription, OM3 plus atorvastatin improved small dense LDL concentrations, non-HDL-C, VLDL-C and TG to a greater extent than atorvastatin alone. Further studies are warranted in this area. TRIAL REGISTRATION This trial was retrospectively registered on 23 May 2019 on ClinicalTrials.gov with ID: NCT03961763.
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Affiliation(s)
- Gediz Dogay Us
- University of Chester, Parkgate Road, Chester, CH1 4BJ, UK. .,NUTRIM School of Nutrition and Translational Research In Metabolism, Maastricht University, Maastricht, Netherlands.
| | - Sohail Mushtaq
- University of Chester, Parkgate Road, Chester, CH1 4BJ, UK.,University of Chester, Faculty of Medicine, Dentistry and Life Sciences, Parkgate Road, Chester, CH1 4BJ, UK
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26
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Chan AP, Robinson DT, Calkins KL. Hypertriglyceridemia in Preterm Infants. Neoreviews 2022; 23:e528-e540. [PMID: 35909103 DOI: 10.1542/neo.23-8-e528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Preterm and critically ill infants are at risk for hypertriglyceridemia (HTG). Common risk factors for HTG include prematurity, intravenous lipid emulsion dose and oil composition, reduced lipoprotein lipase activity, fetal growth restriction, sepsis, and renal failure. Despite these risk factors, clinicians lack a universally agreed upon definition for HTG and evidence-based approach to HTG management. This review provides a detailed overview of triglyceride and intravenous lipid emulsion metabolism and how this relates to specific HTG risk factors, along with some practical considerations for managing HTG in the neonatal population.
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Affiliation(s)
- Alvin P Chan
- Department of Pediatrics, Division of Pediatric Gastroenterology, David Geffen School of Medicine UCLA, Los Angeles, CA
| | - Daniel T Robinson
- Department of Pediatrics, Northwestern University Feinberg School of Medicine; Division of Neonatology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
| | - Kara L Calkins
- Department of Pediatrics, Division of Neonatology & Developmental Biology, Neonatal Research Center of the UCLA Children's Discovery and Innovation Institute, David Geffen School of Medicine UCLA, Los Angeles, CA
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27
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Grant JK, Snow S, Kelsey M, Rymer J, Schaffer AE, Patel MR, McGarrah RW, Pagidipati NJ, Shah NP. Lipid-Lowering Therapy in Woman of Childbearing Age: a Review and Stepwise Clinical Approach. Curr Cardiol Rep 2022; 24:1373-1385. [PMID: 35904667 DOI: 10.1007/s11886-022-01751-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/17/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE OF REVIEW Women are less often recognized to have cardiovascular disease (CVD) risk and are underrepresented in randomized trials of lipid-lowering therapy. Here, we summarize non-pharmacologic and pharmacologic strategies for lipid-lowering in women of childbearing age, lipid changes during pregnancy and lactation, discuss sex-specific outcomes in currently available literature, and discuss future areas of research. RECENT FINDINGS While lifestyle interventions form the backbone of CVD prevention, some women of reproductive age have an indication for pharmacologic lipid-lowering. Sex-based evidence is limited but suggests that both statin and non-statin lipid-lowering agents are beneficial regardless of sex, especially at high cardiovascular risk. Pharmacologic lipid-lowering therapies, both during the pregnancy period and during lactation, have historically been and continue to be limited by safety concerns. This oftentimes limits lipid-lowering options in women of childbearing age. In this review, we summarize lipid-lowering strategies in women of childbearing age and the impact of therapies during pregnancy and lactation. The limited sex-specific data regarding efficacy, adverse events, and cardiovascular outcomes underscore the need for a greater representation of women in randomized controlled trials. More data on lipid-lowering teratogenicity are needed, and through increased clinician awareness and reporting to incidental exposure registries, more data can be harvested.
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Affiliation(s)
- Jelani K Grant
- Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Sarah Snow
- Division of Cardiology, Duke University School of Medicine, 2301 Erwin Rd, Durham, NC, 27705, USA
| | - Michelle Kelsey
- Division of Cardiology, Duke University School of Medicine, 2301 Erwin Rd, Durham, NC, 27705, USA
| | - Jennifer Rymer
- Division of Cardiology, Duke University School of Medicine, 2301 Erwin Rd, Durham, NC, 27705, USA
| | - Anna E Schaffer
- Division of Endocrinology, Metabolism, and Nutrition, Duke University School of Medicine, Durham, NC, USA
| | - Manesh R Patel
- Division of Cardiology, Duke University School of Medicine, 2301 Erwin Rd, Durham, NC, 27705, USA
| | - Robert W McGarrah
- Division of Cardiology, Duke University School of Medicine, 2301 Erwin Rd, Durham, NC, 27705, USA
| | - Neha J Pagidipati
- Division of Cardiology, Duke University School of Medicine, 2301 Erwin Rd, Durham, NC, 27705, USA
| | - Nishant P Shah
- Division of Cardiology, Duke University School of Medicine, 2301 Erwin Rd, Durham, NC, 27705, USA.
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28
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Huang S, Wang H, Wang S, Sha X, Chen N, Hu Y, Tu Z. Pectin Stabilized Fish Gelatin Emulsions: Physical Stability, Rheological, and Interaction Properties. Front Nutr 2022; 9:961875. [PMID: 35911094 PMCID: PMC9326445 DOI: 10.3389/fnut.2022.961875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Accepted: 06/23/2022] [Indexed: 11/13/2022] Open
Abstract
Pectin, a kind of natural polysaccharide, shows the attractive potential as a natural stabilizer for protein emulsion. The aim of this study is to investigate the effect of pectin on the physical stability, rheology, interface, and interaction properties of the fish gelatin (FG) emulsion, as pectin was utilized to improve the stability of FG, fish oil emulsion. During the study, when pH < 6, the FG-pectin emulsion displayed better storage stability and salinity tolerance. Analyzing the result, pectin could avoid phase separation at the freeze-thaw process and prevent the liquid-gel transition of FG emulsions during storage. On the other hand, when pH ≥ 6, the emulsion displayed high viscosity due to the complex flocculation and stratified during long-term storage. Electrostatic interactions, hydrophobic interactions, and hydrogen bonding of the FG-pectin complexes in the emulsion were all reduced. Overall, pectin improved the stability of FG emulsions through electrostatic repulsion, hydrophobic interactions, and steric hindrance.
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Affiliation(s)
- Sheng Huang
- State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang, China
- National R&D Center for Freshwater Fish Processing, Jiangxi Normal University, Nanchang, China
| | - Hui Wang
- State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang, China
- National R&D Center for Freshwater Fish Processing, Jiangxi Normal University, Nanchang, China
| | - Shu Wang
- State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang, China
- National R&D Center for Freshwater Fish Processing, Jiangxi Normal University, Nanchang, China
| | - Xiaomei Sha
- National R&D Center for Freshwater Fish Processing, Jiangxi Normal University, Nanchang, China
- Engineering Research Center for Freshwater Fish High-Value Utilization of Jiangxi, Jiangxi Normal University, Nanchang, China
| | - Ning Chen
- State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang, China
- National R&D Center for Freshwater Fish Processing, Jiangxi Normal University, Nanchang, China
| | - Yueming Hu
- State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang, China
- National R&D Center for Freshwater Fish Processing, Jiangxi Normal University, Nanchang, China
| | - Zongcai Tu
- State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang, China
- National R&D Center for Freshwater Fish Processing, Jiangxi Normal University, Nanchang, China
- Engineering Research Center for Freshwater Fish High-Value Utilization of Jiangxi, Jiangxi Normal University, Nanchang, China
- *Correspondence: Zongcai Tu,
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Calder PC. Omega-3 fatty acids and metabolic partitioning of fatty acids within the liver in the context of nonalcoholic fatty liver disease. Curr Opin Clin Nutr Metab Care 2022; 25:248-255. [PMID: 35762160 DOI: 10.1097/mco.0000000000000845] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE OF REVIEW Nonalcoholic fatty liver disease (NAFLD) is now the most prevalent form of liver disease globally, affecting about 25% of the world's adult population. It is more common in those living with obesity, where it may affect as many as 80% of individuals. The aim of this article is to describe recent human studies evaluating the influence of omega-3 fatty acids on de novo lipogenesis (DNL) and hepatic fatty acid partitioning between incorporation into triacylglycerols (TAGs) and β-oxidation, to discuss the relevance of these effects in the context of NAFLD, and to provide an overview of the mechanisms that might be involved. RECENT FINDINGS The omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) decrease hepatic DNL and partition fatty acids away from TAG synthesis and toward β-oxidation. EPA and DHA affect multiple hepatic transcription factors resulting in down-regulation of the DNL pathway and upregulation of β-oxidation. The net result is decreased accumulation of hepatic TAG and lowering of circulating TAG concentrations. Human trials demonstrate that EPA and DHA can decrease liver fat in patients with NAFLD. SUMMARY Increased intake of EPA and DHA may reduce the likelihood of hepatic TAG accumulation and could be used to reduce liver fat in patients with NAFLD.
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Affiliation(s)
- Philip C Calder
- School of Human Development and Health, Faculty of Medicine, University of Southampton
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, UK
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Ruscica M, Sirtori CR, Carugo S, Calder PC, Corsini A. OMEGA-3 AND CARDIOVASCULAR PREVENTION – IS THIS STILL A CHOICE? Pharmacol Res 2022; 182:106342. [DOI: 10.1016/j.phrs.2022.106342] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 07/01/2022] [Accepted: 07/01/2022] [Indexed: 02/07/2023]
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Mason RP, Sherratt SCR, Eckel RH. Omega-3-fatty acids: Do they prevent cardiovascular disease? Best Pract Res Clin Endocrinol Metab 2022; 37:101681. [PMID: 35739003 DOI: 10.1016/j.beem.2022.101681] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Despite cardiovascular disease (CVD) reductions with high-intensity statins, there remains residual risk among patients with metabolic disorders. Alongside low-density lipoproteins (LDL-C), elevated triglycerides (TG) are associated with incident CVD events. Omega-3 fatty acids (n3-FAs), specifically eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), lower TG levels, but their ability to reduce CV risk has been highly inconsistent. Trials using icosapent ethyl (IPE), a purified EPA ethyl ester, produced reductions in CVD events and atherosclerotic plaque regression compared with mixed EPA/DHA formulations despite similar TG-reductions. The separate effects of EPA and DHA on tissue distribution, oxidative stress, inflammation, membrane structure and endothelial function may contribute to these discordant outcomes. Additional mechanistic trials will provide further insights into the role of n3-FAs in reducing CVD risk beyond TG lowering.
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Affiliation(s)
- R Preston Mason
- Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA.
| | - Samuel C R Sherratt
- Department of Molecular, Cellular and Biomedical Sciences, University of New Hampshire, Durham, NH 03823, USA
| | - Robert H Eckel
- Division of Endocrinology, Metabolism & Diabetes, Division of Cardiology, University of Colorado Anschutz Medical Campus, 1635 Aurora Court, Aurora, CO 80045, USA
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Quispe R, Alfaddagh A, Kazzi B, Zghyer F, Marvel FA, Blumenthal RS, Sharma G, Martin SS. Controversies in the Use of Omega-3 Fatty Acids to Prevent Atherosclerosis. Curr Atheroscler Rep 2022; 24:571-581. [PMID: 35499805 DOI: 10.1007/s11883-022-01031-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/28/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW We discuss current controversies in the clinical use of omega-3 fatty acids (FA), primarily eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), and examine discrepancies between recent trials. Furthermore, we discuss potential side effects reported in these studies and the role of mixed omega-3 FA dietary supplements and concerns about their use. RECENT FINDINGS REDUCE-IT showed that addition of icosapent ethyl, a highly purified form of EPA, can reduce risk of cardiovascular events among statin-treated individuals with high triglycerides. Additional supportive evidence for EPA has come from other trials and meta-analyses of omega-3 FA therapy. In contrast, trials of mixed EPA/DHA products have consistently failed to improve cardiovascular outcomes. Discrepancies in results reported in RCTs could be explained by differences in omega-3 FA products, dosing, study populations, and study designs including the placebo control formulation. Evidence obtained from highly purified forms should not be extrapolated to other mixed formulations, including "over-the-counter" omega-3 supplements. Targeting TG-rich lipoproteins represents a new frontier for mitigating ASCVD risk. Clinical and basic research evidence suggests that the use of omega-3 FA, specifically EPA, appears to slow atherosclerosis by reducing triglyceride-rich lipoproteins and/or inflammation, therefore addressing residual risk of clinical ASCVD.
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Affiliation(s)
- Renato Quispe
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, 600 N. Wolfe St, Carnegie 591, Baltimore, MD, 21287, USA
| | - Abdulhamied Alfaddagh
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, 600 N. Wolfe St, Carnegie 591, Baltimore, MD, 21287, USA
| | - Brigitte Kazzi
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, 600 N. Wolfe St, Carnegie 591, Baltimore, MD, 21287, USA
| | - Fawzi Zghyer
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, 600 N. Wolfe St, Carnegie 591, Baltimore, MD, 21287, USA
| | - Francoise A Marvel
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, 600 N. Wolfe St, Carnegie 591, Baltimore, MD, 21287, USA
| | - Roger S Blumenthal
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, 600 N. Wolfe St, Carnegie 591, Baltimore, MD, 21287, USA
| | - Garima Sharma
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, 600 N. Wolfe St, Carnegie 591, Baltimore, MD, 21287, USA
| | - Seth S Martin
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, 600 N. Wolfe St, Carnegie 591, Baltimore, MD, 21287, USA.
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Basak S, Banerjee A, Pathak S, Duttaroy AK. Dietary Fats and the Gut Microbiota: Their impacts on lipid-induced metabolic syndrome. J Funct Foods 2022. [DOI: 10.1016/j.jff.2022.105026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
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Suh JH, Zyba SJ, Shigenaga M, McDonald CM, King JC. Marginal Zinc Deficiency Alters Essential Fatty Acid Metabolism in Healthy Men. J Nutr 2022; 152:671-679. [PMID: 34919682 PMCID: PMC9076996 DOI: 10.1093/jn/nxab425] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 09/29/2021] [Accepted: 12/09/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Rice biofortification with Zinc (Zn) can improve the Zn status of rice-consuming populations. However, the metabolic impact in humans consuming Zn-biofortified rice is unknown. OBJECTIVES To determine the effects of Zn-biofortified rice on lipid metabolism in normolipidemic men. METHODS The men consumed a rice-based diet containing 6 mg Zn/d and 1.5 g phytate (phytate/Zn ratio = 44) for 2 wk followed by a 10-mg Zn/d diet without phytate for 4 wk. An ad libitum diet supplemented with 25 mg Zn/d was then fed for 3 wk. Fasting blood samples were taken at baseline and at the end of each metabolic period for measuring plasma zinc, glucose, insulin, triglyceride (TG), LDL and HDL cholesterol, fatty acids, oxylipins, and fatty acid desaturase activities. Statistical differences were assessed by linear mixed model. RESULTS Fatty acid desaturase (FADS) 1 activity decreased by 29.1% (P = 0.007) when the 6-mg Zn/d diet was consumed for 2 wk. This change was associated with significant decreases in HDL and LDL cholesterol. The alterations in FADS1, HDL cholesterol, and TG remained unchanged when Zn intakes were increased to 10 mg/d for 4 wk. Supplementation with 25 mg Zn/d for 3 wk normalized these metabolic changes and significantly increased LDL cholesterol at the end of this metabolic period compared with baseline. FADS1 activity was inversely correlated with FADS2 (rmcorr = -0.52; P = 0.001) and TG (rmcorr = -0.55; P = 0.001) at all time points. CONCLUSIONS A low-zinc, high-phytate rice-based diet reduced plasma HDL cholesterol concentrations and altered fatty acid profiles in healthy men within 2 wk. Consuming 10 mg Zn/d without phytate for 4 wk did not improve the lipid profiles, but a 25-mg Zn/d supplement corrects these alterations in lipid metabolism within 3 wk.
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Affiliation(s)
- Jung H Suh
- UCSF Benioff Children's Hospital Oakland Research Institute, Oakland, CA, USA
| | - Sarah J Zyba
- UCSF Benioff Children's Hospital Oakland Research Institute, Oakland, CA, USA
- Institute for Global Nutrition Department of Nutrition University of California, Davis, CA, USA
| | - Mark Shigenaga
- UCSF Benioff Children's Hospital Oakland Research Institute, Oakland, CA, USA
| | | | - Janet C King
- UCSF Benioff Children's Hospital Oakland Research Institute, Oakland, CA, USA
- Department of Nutritional Sciences and Toxicology, University of California, Berkeley, CA, USA
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Comparative proteomic analysis reveals the effects of different fatty acid forms on high-fat diet mice. FOOD SCIENCE AND HUMAN WELLNESS 2022. [DOI: 10.1016/j.fshw.2021.11.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Peng D, Liang XF, Chai F, Feng H, Li J, Tang S, Lu K, Zhang Q. Effects of dietary carbohydrate to lipid ratios on growth, biochemical indicators, lipid metabolism, and appetite in Chinese perch (Siniperca chuatsi). FISH PHYSIOLOGY AND BIOCHEMISTRY 2022; 48:101-116. [PMID: 34997383 DOI: 10.1007/s10695-021-01043-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 12/23/2021] [Indexed: 06/14/2023]
Abstract
An 8-week feeding trial was conducted to evaluate the effects of dietary carbohydrate to lipid (CHO:L) ratios on growth performance, body composition, serum biochemical indexes, lipid metabolism, and gene expression of central appetite regulating factors in Chinese perch (Siniperca chuatsi) (mean initial weight: 12.86 ± 0.10 g). Five isonitrogenous and isoenergetic diets (fish meal, casein as main protein sources) were formulated to contain different graded CHO:L ratio diets ranging from 0.12, 0.86, 1.71, 3.29, and 7.19. Each diet was assigned to triplicate groups of 18 experimental fish. Our results revealed that final body weight (FBW), weight gain rate (WGR), specific growth rate (SGR), and protein efficiency ratio (PER) increased with dietary CHO:L ratio from 0.12 to 1.71 and then decreased with further increases in dietary CHO:L ratio. A two-slope broken-line regression analysis based on WGR showed that the optimal dietary CHO:L level for maximum growth performance of fish was 1.60. Crude lipid and crude protein content in the liver and glycogen concentration in the muscle and liver were significantly influenced by the dietary CHO:L ratios (P < 0.05). The lowest crude lipid content in the liver was observed in fish fed the diet with a CHO:L ratio of 1.71(P < 0.05). Dietary CHO:L ratios significantly induced the glucose concentration of serum (P < 0.05). The relative expression levels of genes involved in lipid metabolism, such as srebp1 and fas in the liver, showed a trend of first decreased and then increased with the increase of dietary CHO:L ratio levels. Appropriate CHO:L ratio in the diet can effectively reduce the accumulation of liver fat. We observed in fish fed the 1.71 CHO:L ratio diet showed higher feed intake, up-regulated mRNA expression of neuropeptide Y (npy) and agouti gene-related protein (agrp), and down-regulated mRNA expression of cocaine- and amphetamine-regulated transcript (cart) and pro-opiomelanocorticoid (pomc) significantly as compared to control group. Thus, these results provide the theoretical basis for feed formulation to determine the appropriate CHO:L ratio requirement of Chinese perch.
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Affiliation(s)
- Di Peng
- College of Fisheries, Chinese Perch Research Center, Huazhong Agricultural University, Wuhan, 430070, China
- Ministry of Education, Engineering Research Center of Green Development for Conventional Aquatic Biological Industry in the Yangtze River Economic Belt, Wuhan, 430070, China
| | - Xu-Fang Liang
- College of Fisheries, Chinese Perch Research Center, Huazhong Agricultural University, Wuhan, 430070, China.
- Ministry of Education, Engineering Research Center of Green Development for Conventional Aquatic Biological Industry in the Yangtze River Economic Belt, Wuhan, 430070, China.
| | - Farui Chai
- College of Fisheries, Chinese Perch Research Center, Huazhong Agricultural University, Wuhan, 430070, China
- Ministry of Education, Engineering Research Center of Green Development for Conventional Aquatic Biological Industry in the Yangtze River Economic Belt, Wuhan, 430070, China
| | - Hexiong Feng
- College of Fisheries, Chinese Perch Research Center, Huazhong Agricultural University, Wuhan, 430070, China
- Ministry of Education, Engineering Research Center of Green Development for Conventional Aquatic Biological Industry in the Yangtze River Economic Belt, Wuhan, 430070, China
| | - Jiao Li
- College of Fisheries, Chinese Perch Research Center, Huazhong Agricultural University, Wuhan, 430070, China
- Ministry of Education, Engineering Research Center of Green Development for Conventional Aquatic Biological Industry in the Yangtze River Economic Belt, Wuhan, 430070, China
| | - Shulin Tang
- College of Fisheries, Chinese Perch Research Center, Huazhong Agricultural University, Wuhan, 430070, China
- Ministry of Education, Engineering Research Center of Green Development for Conventional Aquatic Biological Industry in the Yangtze River Economic Belt, Wuhan, 430070, China
| | - Ke Lu
- College of Fisheries, Chinese Perch Research Center, Huazhong Agricultural University, Wuhan, 430070, China
- Ministry of Education, Engineering Research Center of Green Development for Conventional Aquatic Biological Industry in the Yangtze River Economic Belt, Wuhan, 430070, China
| | - Qiwei Zhang
- College of Fisheries, Chinese Perch Research Center, Huazhong Agricultural University, Wuhan, 430070, China
- Ministry of Education, Engineering Research Center of Green Development for Conventional Aquatic Biological Industry in the Yangtze River Economic Belt, Wuhan, 430070, China
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Schutte S, Esser D, Siebelink E, Michielsen CJR, Daanje M, Matualatupauw JC, Boshuizen HC, Mensink M, Afman LA, Esser D, Siebelink E, Fick H, Grootte Bromhaar MM, Wang Y, de Bruijn SEM, Mars M, Meijerink J, Mensink M, Afman LA, Feskens EJM, Müller M. Diverging metabolic effects of 2 energy-restricted diets differing in nutrient quality: a 12-week randomized controlled trial in subjects with abdominal obesity. Am J Clin Nutr 2022; 116:132-150. [PMID: 35102369 PMCID: PMC9257474 DOI: 10.1093/ajcn/nqac025] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 01/24/2022] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Despite the established relation between energy restriction (ER) and metabolic health, the most beneficial nutrient composition of a weight-loss diet is still a subject of debate. OBJECTIVES The aim of the study was to examine the additional effects of nutrient quality on top of ER. METHODS A parallel-designed, 12-week 25% ER dietary intervention study was conducted (clinicaltrials.gov: NCT02194504). Participants aged 40-70 years with abdominal obesity were randomized over 3 groups: a 25% ER high-nutrient-quality diet (n = 40); a 25% ER low-nutrient-quality diet (n = 40); or a habitual diet (n = 30). Both ER diets were nutritionally adequate, and the high-nutrient-quality ER diet was enriched in MUFAs, n-3 PUFAs, fiber, and plant protein and reduced in fructose. Before and after the intervention, intrahepatic lipids, body fat distribution, fasting and postprandial responses to a mixed-meal shake challenge test of cardiometabolic risk factors, lipoproteins, vascular measurements, and adipose tissue transcriptome were assessed. RESULTS The high-nutrient-quality ER diet (-8.4 ± 3.2) induced 2.1 kg more weight loss (P = 0.007) than the low-nutrient-quality ER diet (-6.3 ± 3.9), reduced fasting serum total cholesterol (P = 0.014) and plasma triglycerides (P < 0.001), promoted an antiatherogenic lipoprotein profile, and induced a more pronounced decrease in adipose tissue gene expression of energy metabolism pathways than the low-quality ER diet. Explorative analyses showed that the difference in weight loss between the two ER diets was specifically present in insulin-sensitive subjects (HOMA-IR ≤ 2.5), in whom the high-nutrient-quality diet induced 3.9 kg more weight loss than the low-nutrient-quality diet. CONCLUSIONS A high-nutrient-quality 25% ER diet is more beneficial for cardiometabolic health than a low-nutrient-quality 25% ER diet. Overweight, insulin-sensitive subjects may benefit more from a high- than a low-nutrient-quality ER diet with respect to weight loss, due to potential attenuation of glucose-induced lipid synthesis in adipose tissue.
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Affiliation(s)
- Sophie Schutte
- Division of Human Nutrition and Health, Wageningen University, Division of Human Nutrition and Health, Wageningen, The Netherlands
| | - Diederik Esser
- Division of Human Nutrition and Health, Wageningen University, Division of Human Nutrition and Health, Wageningen, The Netherlands
| | - Els Siebelink
- Division of Human Nutrition and Health, Wageningen University, Division of Human Nutrition and Health, Wageningen, The Netherlands
| | - Charlotte J R Michielsen
- Division of Human Nutrition and Health, Wageningen University, Division of Human Nutrition and Health, Wageningen, The Netherlands
| | - Monique Daanje
- Division of Human Nutrition and Health, Wageningen University, Division of Human Nutrition and Health, Wageningen, The Netherlands
| | - Juri C Matualatupauw
- Division of Human Nutrition and Health, Wageningen University, Division of Human Nutrition and Health, Wageningen, The Netherlands
| | - Hendriek C Boshuizen
- Division of Human Nutrition and Health, Wageningen University, Division of Human Nutrition and Health, Wageningen, The Netherlands
| | - Marco Mensink
- Division of Human Nutrition and Health, Wageningen University, Division of Human Nutrition and Health, Wageningen, The Netherlands
| | | | - The Wageningen Belly Fat Study team
SchutteSophiePhDDivision of Human Nutrition and Health, Wageningen University, Division of Human Nutrition and Health, Wageningen, The NetherlandsEsserDiederikPhDDivision of Human Nutrition and Health, Wageningen University, Division of Human Nutrition and Health, Wageningen, The NetherlandsSiebelinkElsBScSenior Research DieticianDivision of Human Nutrition and Health, Wageningen University, Division of Human Nutrition and Health, Wageningen, The NetherlandsFickHenriëtteBScCoordinator Human ResearchDivision of Human Nutrition and Health, Wageningen University, Division of Human Nutrition and Health, Wageningen, The NetherlandsGrootte BromhaarMechteld MBScLaboratory Technician Human ResearchDivision of Human Nutrition and Health, Wageningen University, Division of Human Nutrition and Health, Wageningen, The NetherlandsWangYaPhDDivision of Human Nutrition and Health, Wageningen University, Division of Human Nutrition and Health, Wageningen, The Netherlandsde BruijnSuzanne E MPhDDivision of Human Nutrition and Health, Wageningen University, Division of Human Nutrition and Health, Wageningen, The NetherlandsMarsMonicaPhDAssociate ProfessorDivision of Human Nutrition and Health, Wageningen University, Division of Human Nutrition and Health, Wageningen, The NetherlandsMeijerinkJocelijnPhDAssistant ProfessorDivision of Human Nutrition and Health, Wageningen University, Division of Human Nutrition and Health, Wageningen, The Netherlandshttps://orcid.org/0000-0002-9725-5709MensinkMarcoPhD, MDAssistant ProfessorDivision of Human Nutrition and Health, Wageningen University, Division of Human Nutrition and Health, Wageningen, The Netherlandshttps://orcid.org/0000-0002-7939-6217AfmanLydia APhDAssociate ProfessorDivision of Human Nutrition and Health, Wageningen University, Division of Human Nutrition and Health, Wageningen, The NetherlandsFeskensEdith J MPhDProfessorDivision of Human Nutrition and Health, Wageningen University, Division of Human Nutrition and Health, Wageningen, The NetherlandsMüllerMichaelPhDDirector of the Food and Metabolic Health Alliance & Professor at the University of East Anglia, Former Professor at Wageningen UniversityDivision of Human Nutrition and Health, Wageningen University, Division of Human Nutrition and Health, Wageningen, The Netherlands
| | - Diederik Esser
- Division of Human Nutrition and Health, Wageningen University, Division of Human Nutrition and Health , Wageningen, The Netherlands
| | - Els Siebelink
- Division of Human Nutrition and Health, Wageningen University, Division of Human Nutrition and Health , Wageningen, The Netherlands
| | - Henriëtte Fick
- Division of Human Nutrition and Health, Wageningen University, Division of Human Nutrition and Health , Wageningen, The Netherlands
| | - Mechteld M Grootte Bromhaar
- Division of Human Nutrition and Health, Wageningen University, Division of Human Nutrition and Health , Wageningen, The Netherlands
| | - Ya Wang
- Division of Human Nutrition and Health, Wageningen University, Division of Human Nutrition and Health , Wageningen, The Netherlands
| | - Suzanne E M de Bruijn
- Division of Human Nutrition and Health, Wageningen University, Division of Human Nutrition and Health , Wageningen, The Netherlands
| | - Monica Mars
- Division of Human Nutrition and Health, Wageningen University, Division of Human Nutrition and Health , Wageningen, The Netherlands
| | - Jocelijn Meijerink
- Division of Human Nutrition and Health, Wageningen University, Division of Human Nutrition and Health , Wageningen, The Netherlands
| | - Marco Mensink
- Division of Human Nutrition and Health, Wageningen University, Division of Human Nutrition and Health , Wageningen, The Netherlands
| | - Lydia A Afman
- Division of Human Nutrition and Health, Wageningen University, Division of Human Nutrition and Health , Wageningen, The Netherlands
| | - Edith J M Feskens
- Division of Human Nutrition and Health, Wageningen University, Division of Human Nutrition and Health , Wageningen, The Netherlands
| | - Michael Müller
- Division of Human Nutrition and Health, Wageningen University, Division of Human Nutrition and Health , Wageningen, The Netherlands
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Plant and marine N3-PUFA regulation of fatty acid trafficking along the adipose tissue-liver axis varies according to nutritional state. J Nutr Biochem 2022; 102:108940. [PMID: 35017005 DOI: 10.1016/j.jnutbio.2022.108940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 11/26/2021] [Accepted: 12/07/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Marine sourced N3-PUFA regulate lipid metabolism in adipose tissue and liver; however, less is known about plant sourced N3-PUFA. The goal of this study was to investigate plant and marine N3-PUFA regulation of fatty acid trafficking along the adipose tissue-liver axis according to nutritional state. METHODS Mice were fed low-fat diets (7% w/w) containing either lard, flaxseed, or menhaden oils for 8 weeks, and were euthanized in either fed or fasted states. Substrate utilization and physical activity were assessed during the transition from a fed to fasted state. Plasma biomarkers (triglycerides (TAG), non-esterified fatty acids (NEFA)), as well as liver and epididymal adipose tissue (eWAT) lipogenic and lipolytic markers, were measured. RESULTS Neither plant nor marine N3-PUFA influenced substrate utilization or activity during the transition from a fed to fasted state. In the fed state, marine N3-PUFA reduced plasma TAG levels compared to the other diets, with no further reduction seen in fasted mice. Hepatic lipogenic markers (Fasn, Acc, Scd1, and Elovl6) were reduced in the fed state with marine N3-PUFA, but not plant N3-PUFA. In the fasted state, mice fed either N3-PUFA accumulated less liver TAG, had lower plasma NEFA, and suppressed eWAT HSL activity compared to lard. CONCLUSION Marine N3-PUFA are more potent regulators of lipogenesis than plant N3-PUFA in the fed state, whereas both N3-PUFA influence eWAT lipolysis and plasma NEFA in the fasted state. This work provides novel insights regarding N3-PUFA regulation of fatty acid trafficking along the adipose tissue-liver axis according to nutritional state.
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Tall AR, Thomas DG, Gonzalez-Cabodevilla AG, Goldberg IJ. Addressing dyslipidemic risk beyond LDL-cholesterol. J Clin Invest 2022; 132:148559. [PMID: 34981790 PMCID: PMC8718149 DOI: 10.1172/jci148559] [Citation(s) in RCA: 51] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Despite the success of LDL-lowering drugs in reducing cardiovascular disease (CVD), there remains a large burden of residual disease due in part to persistent dyslipidemia characterized by elevated levels of triglyceride-rich lipoproteins (TRLs) and reduced levels of HDL. This form of dyslipidemia is increasing globally as a result of the rising prevalence of obesity and metabolic syndrome. Accumulating evidence suggests that impaired hepatic clearance of cholesterol-rich TRL remnants leads to their accumulation in arteries, promoting foam cell formation and inflammation. Low levels of HDL may associate with reduced cholesterol efflux from foam cells, aggravating atherosclerosis. While fibrates and fish oils reduce TRL, they have not been uniformly successful in reducing CVD, and there is a large unmet need for new approaches to reduce remnants and CVD. Rare genetic variants that lower triglyceride levels via activation of lipolysis and associate with reduced CVD suggest new approaches to treating dyslipidemia. Apolipoprotein C3 (APOC3) and angiopoietin-like 3 (ANGPTL3) have emerged as targets for inhibition by antibody, antisense, or RNAi approaches. Inhibition of either molecule lowers TRL but respectively raises or lowers HDL levels. Large clinical trials of such agents in patients with high CVD risk and elevated levels of TRL will be required to demonstrate efficacy of these approaches.
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Affiliation(s)
- Alan R Tall
- Division of Molecular Medicine, Department of Medicine, Columbia University, New York, New York, USA
| | - David G Thomas
- Division of Molecular Medicine, Department of Medicine, Columbia University, New York, New York, USA
| | - Ainara G Gonzalez-Cabodevilla
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, New York University Grossman School of Medicine, New York, New York, USA
| | - Ira J Goldberg
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, New York University Grossman School of Medicine, New York, New York, USA
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Rosenson RS, Shaik A, Song W. New Therapies for Lowering Triglyceride-Rich Lipoproteins: JACC Focus Seminar 3/4. J Am Coll Cardiol 2021; 78:1817-1830. [PMID: 34711341 DOI: 10.1016/j.jacc.2021.08.051] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 08/25/2021] [Accepted: 08/31/2021] [Indexed: 12/25/2022]
Abstract
Emerging evidence suggests that elevated concentrations of triglyceride-rich lipoprotein remnants (TRLs) derived from hepatic and intestinal sources contribute to the risk of atherosclerotic cardiovascular events. Natural selection studies support a causal role for elevated concentrations of remnant cholesterol and the pathways contributing to perturbations in metabolic pathways regulating TRLs with an increased risk of atherosclerotic cardiovascular disease events. New therapies targeting select catalytic pathways in TRL metabolism reduce atherosclerosis in experimental models, and concentrations of TRLs in patients with a vast range of triglyceride levels. Clinical trials with inhibitors of angiopoietin-like 3 protein and apolipoprotein C-III will be required to provide further guidance on the potential contribution of these emerging therapies in the paradigm of cardiovascular risk management in patients with elevated remnant cholesterol.
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Affiliation(s)
- Robert S Rosenson
- Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
| | - Aleesha Shaik
- Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Wenliang Song
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
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Abstract
BackgroundThe 2018 American College of Cardiology/American Heart Association (ACC/AHA) guidelines and 2021 ACC Expert Consensus Decision Pathway recommend nonpharmacological interventions and initiation of statin therapy for patients with moderate hypertriglyceridemia and addition of fibrates or omega-3 fatty acids in severe hypertriglyceridemia. Although the association between triglyceride (TG) lowering and atherosclerotic cardiovascular disease (ASCVD) risk reduction remains controversial, patients with hypertriglyceridemia may represent a subgroup that require additional therapy to further reduce residual ASCVD risk. Moreover, medications that target novel pathways could provide alternative options for patients who are intolerant of existing therapies or doses needed to provide adequate triglyceride lowering. Objective: Assess recent evidence for TG-lowering agents including omega-3 fatty acid-based therapies, PPARα modulators, apoC-III mRNA antisense inhibitors, angiopoietin-like 3 (ANGPTL3) antibodies, and herbal supplements. Methods: A literature search was performed using PubMed with hypertriglyceridemia specified as a MeSH term or included in the title or abstract of the article along with each individual agent. For inclusion, trials needed to have a primary or secondary outcome of TG levels or TG lowering. Conclusion: Currently, the only US Food and Drug Administration approved medication for CV risk reduction in patients with hypertriglyceridemia is icosapent ethyl. Results from phase 3 trials for CaPre, pemafibrate, and volanesorsen as well as additional evidence for pipeline pharmacotherapies with novel mechanisms of action (e.g., ApoC-III mRNA antisense inhibitors and ANGPTL3 antibodies) will help to guide future pharmacotherapy considerations for patients with hypertriglyceridemia.
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Affiliation(s)
- Jiashan Xu
- Department of Pharmacy, Michigan Medicine21614, Ann Arbor, MI, USA.,15514University of Michigan College of Pharmacy, Ann Arbor, MI, USA
| | - Emily Ashjian
- 15514University of Michigan College of Pharmacy, Ann Arbor, MI, USA.,21614Michigan Medicine, Ann Arbor, MI, USA
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The Impact of Short-Term Shark Liver Oil Supplementation on the Fatty Acid Composition of Erythrocyte Membranes. Nutrients 2021; 13:nu13103329. [PMID: 34684329 PMCID: PMC8540316 DOI: 10.3390/nu13103329] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 09/14/2021] [Accepted: 09/17/2021] [Indexed: 02/06/2023] Open
Abstract
Fatty acid (FA) balance is strictly related to human health. The composition of fatty acids in lipid membranes seems to be influenced by diet. Shark liver oil (SLO) supplementation has been widely used recently in the prevention and treatment of human diseases. We analyzed the impact of short-term SLO supplementation on certain biochemical parameters and erythrocyte FA composition in a group of young healthy women. Our results showed that 6 weeks of SLO supplementation led to a significant decrease in C-reactive protein levels in sera and intracellular cholesterol levels in peripheral blood mononuclear cells. SLO supplementation caused a significant increase in the content of the polyunsaturated omega-3 FAs: docosahexaenoic acid, docosapentaenoic acid and α-linolenic acid. In the group of omega-6 FAs, we observed a significant elevation of arachidonic and dihomo-gamma-linoleic acid content. Due to these alterations, the omega-3 index increased significantly from 3.6% (before) to 4.2% (after supplementation). We also observed the impact of SLO supplementation on the membrane fluidity index. The ratio between saturated and unsaturated FAs decreased significantly from 13.1 to 9.9. In conclusion, our results show that even short-term SLO supplementation can improve human erythrocyte fatty acid composition and other parameters that may have health-promoting consequences.
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Liang B, Cai XY, Gu N. Marine Natural Products and Coronary Artery Disease. Front Cardiovasc Med 2021; 8:739932. [PMID: 34621803 PMCID: PMC8490644 DOI: 10.3389/fcvm.2021.739932] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 08/24/2021] [Indexed: 12/18/2022] Open
Abstract
Coronary artery disease is the major cause of mortality worldwide, especially in low- and middle-income earners. To not only reduce angina symptoms and exercise-induced ischemia but also prevent cardiovascular events, pharmacological intervention strategies, including antiplatelet drugs, anticoagulant drugs, statins, and other lipid-lowering drugs, and renin-angiotensin-aldosterone system blockers, are conducted. However, the existing drugs for coronary artery disease are incomprehensive and have some adverse reactions. Thus, it is necessary to look for new drug research and development. Marine natural products have been considered a valuable source for drug discovery because of their chemical diversity and biological activities. The experiments and investigations indicated that several marine natural products, such as organic small molecules, polysaccharides, proteins, and bioactive peptides, and lipids were effective for treating coronary artery disease. Here, we particularly discussed the functions and mechanisms of active substances in coronary artery disease, including antiplatelet, anticoagulant, lipid-lowering, anti-inflammatory, and antioxidant activities.
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Affiliation(s)
- Bo Liang
- Nanjing University of Chinese Medicine, Nanjing, China
| | - Xin-Yi Cai
- Nanjing University of Chinese Medicine, Nanjing, China
| | - Ning Gu
- Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine, Nanjing, China
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Ginsberg HN, Packard CJ, Chapman MJ, Borén J, Aguilar-Salinas CA, Averna M, Ference BA, Gaudet D, Hegele RA, Kersten S, Lewis GF, Lichtenstein AH, Moulin P, Nordestgaard BG, Remaley AT, Staels B, Stroes ESG, Taskinen MR, Tokgözoğlu LS, Tybjaerg-Hansen A, Stock JK, Catapano AL. Triglyceride-rich lipoproteins and their remnants: metabolic insights, role in atherosclerotic cardiovascular disease, and emerging therapeutic strategies-a consensus statement from the European Atherosclerosis Society. Eur Heart J 2021; 42:4791-4806. [PMID: 34472586 PMCID: PMC8670783 DOI: 10.1093/eurheartj/ehab551] [Citation(s) in RCA: 320] [Impact Index Per Article: 106.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 05/21/2021] [Accepted: 07/30/2021] [Indexed: 12/20/2022] Open
Abstract
Recent advances in human genetics, together with a large body of epidemiologic, preclinical, and clinical trial results, provide strong support for a causal association between triglycerides (TG), TG-rich lipoproteins (TRL), and TRL remnants, and increased risk of myocardial infarction, ischaemic stroke, and aortic valve stenosis. These data also indicate that TRL and their remnants may contribute significantly to residual cardiovascular risk in patients on optimized low-density lipoprotein (LDL)-lowering therapy. This statement critically appraises current understanding of the structure, function, and metabolism of TRL, and their pathophysiological role in atherosclerotic cardiovascular disease (ASCVD). Key points are (i) a working definition of normo- and hypertriglyceridaemic states and their relation to risk of ASCVD, (ii) a conceptual framework for the generation of remnants due to dysregulation of TRL production, lipolysis, and remodelling, as well as clearance of remnant lipoproteins from the circulation, (iii) the pleiotropic proatherogenic actions of TRL and remnants at the arterial wall, (iv) challenges in defining, quantitating, and assessing the atherogenic properties of remnant particles, and (v) exploration of the relative atherogenicity of TRL and remnants compared to LDL. Assessment of these issues provides a foundation for evaluating approaches to effectively reduce levels of TRL and remnants by targeting either production, lipolysis, or hepatic clearance, or a combination of these mechanisms. This consensus statement updates current understanding in an integrated manner, thereby providing a platform for new therapeutic paradigms targeting TRL and their remnants, with the aim of reducing the risk of ASCVD.
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Affiliation(s)
- Henry N Ginsberg
- Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University, 630 West 168th Street, PH-10-305, New York, NY 10032, USA
| | - Chris J Packard
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, 126 University Place, Glasgow G12 8TA, UK
| | - M John Chapman
- Sorbonne University Endocrinology-Metabolism Division, Pitié-Salpetriere University Hospital, and National Institute for Health and Medical Research (INSERM), 47 Hôpital boulevard, Paris 75013, France
| | - Jan Borén
- Department of Molecular and Clinical Medicine, University of Gothenburg and Sahlgrenska University Hospital, Blå Stråket 5, Gothenburg 413 45, Sweden
| | - Carlos A Aguilar-Salinas
- Unidad de Investigación en Enfermedades Metabólicas and Departamento de Endocrinología y Metabolismo, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Belisario Domínguez Secc 16, Tlalpan, Mexico City 14080, Mexico.,Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Ave. Morones Prieto, Monterrey, Nuevo León 3000, Mexico
| | - Maurizio Averna
- Department of Health Promotion Sciences Maternal and Infantile Care, Internal Medicine and Medical Specialities, University of Palermo, Marina Square, 61, Palermo 90133, Italy
| | - Brian A Ference
- Centre for Naturally Randomized Trials, University of Cambridge, Cambridge, UK
| | - Daniel Gaudet
- Clinical Lipidology and Rare Lipid Disorders Unit, Community Genomic Medicine Center, Department of Medicine, Université de Montréal, ECOGENE, Clinical and Translational Research Center, and Lipid Clinic, Chicoutimi Hospital, 305 Rue St Vallier, Chicoutimi, Québec G7H 5H6, Canada
| | - Robert A Hegele
- Department of Medicine and Robarts Research Institute, Schulich School of Medicine and Dentistry, Western University, 1151 Richmond Street, London, Ontario N6A 3K7, Canada
| | - Sander Kersten
- Division of Human Nutrition and Health, Wageningen University, Wageningen, the Netherlands
| | - Gary F Lewis
- Division of Endocrinology, Department of Medicine, Banting & Best Diabetes Centre, University of Toronto, Eaton Building, Room 12E248, 200 Elizabeth St, Toronto, Ontario M5G 2C4, Canada
| | - Alice H Lichtenstein
- Cardiovascular Nutrition, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, 711 Washington St Ste 9, Boston, MA 02111, USA
| | - Philippe Moulin
- Department of Endocrinology, GHE, Hospices Civils de Lyon, CarMeN Laboratory, Inserm UMR 1060, CENS-ELI B, Univ-Lyon1, Lyon 69003, France
| | - Børge G Nordestgaard
- Department of Clinical Biochemistry, Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev Ringvej 75, Herlev 2730, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, Copenhagen DK-2200, Denmark
| | - Alan T Remaley
- Lipoprotein Metabolism Section, Translational Vascular Medicine Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, 31 Center Dr Ste 10-7C114, Bethesda, MD 20892, USA
| | - Bart Staels
- Univ. Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1011-EGID, Lille, France
| | - Erik S G Stroes
- Department of Vascular Medicine, Academic Medical Center, 1541 Kings Hwy, Amsterdam 71103, The Netherlands
| | - Marja-Riitta Taskinen
- Research Programs Unit, Clinical and Molecular Metabolism, University of Helsinki, Helsinki, Finland
| | - Lale S Tokgözoğlu
- Department of Cardiology, Hacettepe University Faculty of Medicine, 06100 Sıhhiye, Ankara, Turkey
| | - Anne Tybjaerg-Hansen
- Department of Clinical Biochemistry, Blegdamsvej 9, Rigshospitalet, Copenhagen 2100, Denmark.,Copenhagen General Population Study, Herlev and Gentofte Hospital, Herlev, Denmark.,Copenhagen City Heart Study, Frederiksberg Hospital, Nordre Fasanvej, Frederiksberg 57 2000, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej, Copenhagen 3B 2200, Denmark
| | - Jane K Stock
- European Atherosclerosis Society, Mässans Gata 10, Gothenburg SE-412 51, Sweden
| | - Alberico L Catapano
- Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano and IRCCS MultiMedica, Via Festa del Perdono 7, Milan 20122, Italy
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Maternal DHA Supplementation during Pregnancy and Lactation in the Rat Protects the Offspring against High-Calorie Diet-Induced Hepatic Steatosis. Nutrients 2021; 13:nu13093075. [PMID: 34578953 PMCID: PMC8468499 DOI: 10.3390/nu13093075] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 08/29/2021] [Accepted: 08/30/2021] [Indexed: 12/16/2022] Open
Abstract
Maternal supplementation during pregnancy with docosahexaenoic acid (DHA) is internationally recommended to avoid postpartum maternal depression in the mother and improve cognitive and neurological outcomes in the offspring. This study was aimed at determining whether this nutritional intervention, in the rat, protects the offspring against the development of obesity and its associated metabolic disorders. Pregnant Wistar rats received an extract of fish oil enriched in DHA or saline (SAL) as placebo by mouth from the beginning of gestation to the end of lactation. At weaning, pups were fed standard chow or a free-choice, high-fat, high-sugar (fc-HFHS) diet. Compared to animals fed standard chow, rats exposed to the fc-HFHS diet exhibited increased body weight, liver weight, body fat and leptin in serum independently of saline or DHA maternal supplementation. Nevertheless, maternal DHA supplementation prevented both the glucose intolerance and the rise in serum insulin resulting from consumption of the fc-HFHS diet. In addition, animals from the DHA-fc-HFHS diet group showed decreased hepatic triglyceride accumulation compared to SAL-fc-HFHS rats. The beneficial effects on glucose homeostasis declined with age in male rats. Yet, the preventive action against hepatic steatosis was still present in 6-month-old animals of both sexes and was associated with decreased hepatic expression of lipogenic genes. The results of the present work show that maternal DHA supplementation during pregnancy programs a healthy phenotype into the offspring that was protective against the deleterious effects of an obesogenic diet.
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Impact of Amerind ancestry and FADS genetic variation on omega-3 deficiency and cardiometabolic traits in Hispanic populations. Commun Biol 2021; 4:918. [PMID: 34321601 PMCID: PMC8319323 DOI: 10.1038/s42003-021-02431-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 06/22/2021] [Indexed: 12/31/2022] Open
Abstract
Long chain polyunsaturated fatty acids (LC-PUFAs) have critical signaling roles that regulate dyslipidemia and inflammation. Genetic variation in the FADS gene cluster accounts for a large portion of interindividual differences in circulating and tissue levels of LC-PUFAs, with the genotypes most strongly predictive of low LC-PUFA levels at strikingly higher frequencies in Amerind ancestry populations. In this study, we examined relationships between genetic ancestry and FADS variation in 1102 Hispanic American participants from the Multi-Ethnic Study of Atherosclerosis. We demonstrate strong negative associations between Amerind genetic ancestry and LC-PUFA levels. The FADS rs174537 single nucleotide polymorphism (SNP) accounted for much of the AI ancestry effect on LC-PUFAs, especially for low levels of n-3 LC-PUFAs. Rs174537 was also strongly associated with several metabolic, inflammatory and anthropomorphic traits including circulating triglycerides (TGs) and E-selectin in MESA Hispanics. Our study demonstrates that Amerind ancestry provides a useful and readily available tool to identify individuals most likely to have FADS-related n-3 LC-PUFA deficiencies and associated cardiovascular risk.
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47
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Djuricic I, Calder PC. Beneficial Outcomes of Omega-6 and Omega-3 Polyunsaturated Fatty Acids on Human Health: An Update for 2021. Nutrients 2021; 13:nu13072421. [PMID: 34371930 PMCID: PMC8308533 DOI: 10.3390/nu13072421] [Citation(s) in RCA: 287] [Impact Index Per Article: 95.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 07/03/2021] [Accepted: 07/13/2021] [Indexed: 12/14/2022] Open
Abstract
Oxidative stress and inflammation have been recognized as important contributors to the risk of chronic non-communicable diseases. Polyunsaturated fatty acids (PUFAs) may regulate the antioxidant signaling pathway and modulate inflammatory processes. They also influence hepatic lipid metabolism and physiological responses of other organs, including the heart. Longitudinal prospective cohort studies demonstrate that there is an association between moderate intake of the omega-6 PUFA linoleic acid and lower risk of cardiovascular diseases (CVDs), most likely as a result of lower blood cholesterol concentration. Current evidence suggests that increasing intake of arachidonic acid (up to 1500 mg/day) has no adverse effect on platelet aggregation and blood clotting, immune function and markers of inflammation, but may benefit muscle and cognitive performance. Many studies show that higher intakes of omega-3 PUFAs, especially eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), are associated with a lower incidence of chronic diseases characterized by elevated inflammation, including CVDs. This is because of the multiple molecular and cellular actions of EPA and DHA. Intervention trials using EPA + DHA indicate benefit on CVD mortality and a significant inverse linear dose-response relationship has been found between EPA + DHA intake and CVD outcomes. In addition to their antioxidant and anti-inflammatory roles, omega-3 fatty acids are considered to regulate platelet homeostasis and lower risk of thrombosis, which together indicate their potential use in COVID-19 therapy.
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Affiliation(s)
- Ivana Djuricic
- Department of Bromatology, Faculty of Pharmacy, University of Belgrade, 11221 Belgrade, Serbia;
| | - Philip C. Calder
- School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton SO16 6YD, UK
- Correspondence:
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Effect of Omega-3 or Omega-6 Dietary Supplementation on Testicular Steroidogenesis, Adipokine Network, Cytokines, and Oxidative Stress in Adult Male Rats. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2021; 2021:5570331. [PMID: 34257810 PMCID: PMC8260291 DOI: 10.1155/2021/5570331] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 05/15/2021] [Accepted: 06/09/2021] [Indexed: 11/17/2022]
Abstract
This study was undertaken to elucidate the effect of omega-3 and omega-6 supplementation on the levels of different adipokines and cytokines, as well as the antioxidant system, in relation to male reproductive hormones and testicular functions. Adult male Sprague-Dawley rats were daily gavaged with either physiological saline (control group), sunflower oil (omega 6 group; 1 mL/kg body weight), or fish oil (omega-3 group; 1000 mg/kg body weight) for 12 weeks. The administration of omega-3 or omega-6 resulted in decreased serum concentrations of kisspeptin 1, gonadotropin-releasing hormone, luteinizing hormone, follicle-stimulating hormone, and testosterone. In addition, it downregulated the mRNA expression levels of steroidogenic genes. The intratesticular levels of apelin, adiponectin, and irisin were elevated while chemerin, leptin, resistin, vaspin, and visfatin were declined following the administration of either omega-3 or omega-6. The testicular concentration of interleukin 10 was increased while interleukin 1 beta, interleukin 6, tumor necrosis factor α, and nuclear factor kappa B were decreased after consumption of omega-3 or omega-6. In the testes, the levels of superoxide dismutase, catalase, glutathione peroxidase 1, and the total antioxidant capacity were improved. In conclusion, the administration of omega-3 or omega-6 adversely affects the process of steroidogenesis but improves the antioxidant and anti-inflammatory status of the reproductive system via modulating the levels of testicular adipokines.
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49
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Isaac AR, de Velasco PC, Fraga KYD, Tavares-do-Carmo MDG, Campos RMP, Iannotti FA, Verde R, Martins DBG, Santos TA, Ferreira BK, de Mello FG, Di Marzo V, Andrade-da-Costa BLDS, de Melo Reis RA. Maternal omega-3 intake differentially affects the endocannabinoid system in the progeny`s neocortex and hippocampus: Impact on synaptic markers. J Nutr Biochem 2021; 96:108782. [PMID: 34038760 DOI: 10.1016/j.jnutbio.2021.108782] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 03/16/2021] [Accepted: 04/29/2021] [Indexed: 12/16/2022]
Abstract
Omega-3 (n-3) polyunsaturated fatty acids (PUFA) and the endocannabinoid system (ECS) modulate several functions through neurodevelopment including synaptic plasticity mechanisms. The interplay between n-3PUFA and the ECS during the early stages of development, however, is not fully understood. This study investigated the effects of maternal n-3PUFA supplementation (n-3Sup) or deficiency (n-3Def) on ECS and synaptic markers in postnatal offspring. Female rats were fed with a control, n-3Def, or n-3Sup diet from 15 days before mating and during pregnancy. The cerebral cortex and hippocampus of mothers and postnatal 1-2 days offspring were analyzed. In the mothers, a n-3 deficiency reduced CB1 receptor (CB1R) protein levels in the cortex and increased CB2 receptor (CB2R) in both cortex and hippocampus. In neonates, a maternal n-3 deficiency reduced the hippocampal CB1R amount while it increased CB2R. Additionally, total GFAP isoform expression was increased in both cortex and hippocampus in neonates of the n-3Def group. Otherwise, maternal n-3 supplementation increased the levels of n-3-derived endocannabinoids, DHEA and EPEA, in the cortex and hippocampus and reduced 2-arachidonoyl-glycerol (2-AG) concentrations in the cortex of the offspring. Furthermore, maternal n-3 supplementation also increased PKA phosphorylation in the cortex and ERK phosphorylation in the hippocampus. Synaptophysin immunocontent in both regions was also increased. In vitro assays showed that the increase of synaptophysin in the n-3Sup group was independent of CB1R activation. The findings show that variations in maternal dietary omega-3 PUFA levels may impact differently on the ECS and molecular markers in the cerebral cortex and hippocampus of the progeny.
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Affiliation(s)
- Alinny Rosendo Isaac
- Instituto de Biofísica Carlos Chagas Filho (IBCCF), Centro de Ciências da Saúde, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
| | | | - Karla Yasmin Dias Fraga
- Instituto de Nutrição Josué de Castro (INJC), Centro de Ciências da Saúde, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Maria das Graças Tavares-do-Carmo
- Instituto de Nutrição Josué de Castro (INJC), Centro de Ciências da Saúde, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Raquel Maria Pereira Campos
- Instituto de Biofísica Carlos Chagas Filho (IBCCF), Centro de Ciências da Saúde, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Fabio Arturo Iannotti
- Endocannabinoid Research Group, Istituto di Chimica Biomolecolare (ICB), Consiglio Nazionale delle Ricerche (CNR), Pozzuoli (NA), Italy
| | - Roberta Verde
- Endocannabinoid Research Group, Istituto di Chimica Biomolecolare (ICB), Consiglio Nazionale delle Ricerche (CNR), Pozzuoli (NA), Italy
| | - Danyelly Bruneska Gondim Martins
- Grupo de Bioinformática e prospecção molecular, Laboratório de Imunopatologia Keizo Asami, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil
| | - Thaysa Aragão Santos
- Grupo de Bioinformática e prospecção molecular, Laboratório de Imunopatologia Keizo Asami, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil
| | - Bruna Klippel Ferreira
- Departamento de Bioquímica, Centro de Ciências da Saúde, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Fernando Garcia de Mello
- Instituto de Biofísica Carlos Chagas Filho (IBCCF), Centro de Ciências da Saúde, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Vincenzo Di Marzo
- Endocannabinoid Research Group, Istituto di Chimica Biomolecolare (ICB), Consiglio Nazionale delle Ricerche (CNR), Pozzuoli (NA), Italy; Canada Exellence Research Chair on the Microbiome-Endocannabinoidome Axis in Metabolic Health, CRIUCPQ and NUTRISS-INAF Universitè Laval, Quebec City, Canada
| | | | - Ricardo Augusto de Melo Reis
- Instituto de Biofísica Carlos Chagas Filho (IBCCF), Centro de Ciências da Saúde, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
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50
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Tou JC, Gucciardi E, Young I. Lipid-modifying effects of lean fish and fish-derived protein consumption in humans: a systematic review and meta-analysis of randomized controlled trials. Nutr Rev 2021; 80:91-112. [PMID: 33942085 DOI: 10.1093/nutrit/nuab003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 12/21/2020] [Accepted: 01/15/2021] [Indexed: 12/28/2022] Open
Abstract
CONTEXT Consumption of lean fish and fish-derived proteins were effective for improving lipid profiles in published studies; however, evidence remains inconclusive. OBJECTIVE To evaluate the effectiveness of lean fish or fish-derived protein on serum/plasma lipid and lipoprotein levels by conducting a systematic review of the literature and meta-analysis of available randomized controlled trials (RCTs). DATA SOURCES Medline (Ovid), Scopus, CINAHL, and Food and Nutritional Sciences databases were searched from the start date of each database to September 2019 to identify RCTs determining the effect of lean fish on lipid profile. STUDY SELECTION INCLUDED RCTs investigated lean fish and fish-derived proteins intake and determined at least 1 major lipid or lipoprotein measurement. DATA EXTRACTION Two reviewers independently evaluated 1217 studies against the inclusion and exclusion criteria. Relevant studies were assessed for risks of bias, and random-effects meta-analysis was conducted to generate average estimates of effect. RESULTS A total of 24 studies met the inclusion criteria. Meta-analysis of data from 18 to 21 eligible crossover and parallel-design RCTs with a total of 1392 to 1456 participants found triacylglycerol-lowering effects for lean fish compared with no fish consumption. Lean fish intake showed no significant differences related to total cholesterol or lipoprotein levels. Subanalysis showed that parallel-group RCTs tended to find greater reduction effects on circulating triacylglycerol than did crossover RCTs. CONCLUSION Additional better-designed, longer, and larger RCTs, particularly crossover RCTs, are needed to clarify the impact of lean fish and fish proteins on the serum/plasma lipid profile. Findings from such studies would enable practitioners to provide their patients evidence-based recommendations to meet the American Heart Association guidelines for fish consumption to reduce cardiovascular disease risk.
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Affiliation(s)
- Janet C Tou
- J.C. Tou is with the Human Nutrition and Foods, Division of Animal and Nutritional Sciences, West Virginia University, Morgantown, West Virginia, USA. E. Gucciardi is with the School of Nutrition, Ryerson University, Toronto, Ontario, Canada. I. Young is with the School of Occupational Health and Public Health, Ryerson University, Toronto, Ontario, Canada
| | - Enza Gucciardi
- J.C. Tou is with the Human Nutrition and Foods, Division of Animal and Nutritional Sciences, West Virginia University, Morgantown, West Virginia, USA. E. Gucciardi is with the School of Nutrition, Ryerson University, Toronto, Ontario, Canada. I. Young is with the School of Occupational Health and Public Health, Ryerson University, Toronto, Ontario, Canada
| | - Ian Young
- J.C. Tou is with the Human Nutrition and Foods, Division of Animal and Nutritional Sciences, West Virginia University, Morgantown, West Virginia, USA. E. Gucciardi is with the School of Nutrition, Ryerson University, Toronto, Ontario, Canada. I. Young is with the School of Occupational Health and Public Health, Ryerson University, Toronto, Ontario, Canada
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