影响心血管疾病的营养机制
摘要
现有证据显示：导致心脏病的大多数重要危险因素已经确定。尽管年龄、性别、遗传是重要的和不可改变的危险因素，但今天大多数急性心肌梗塞病例可以通过易于评定且最为重要的是易于改良的现有和同等水平的9个危险（或心脏保护）因素所预报。这些危险因素几乎在每个地理区域和世界范围的每个人种群体中都是相同的，并且对于男性和女性这些危险因素都一样。这9个危险因素中的8个受饮食的影响，大多数则通过引起动脉粥样硬化的形成而发挥作用，而动脉粥样硬化的形成是引起心血管疾病最为重要的背景条件。饮食干预可通过在细胞水平对引起和长久维持内皮功能障碍、斑块形成和最终的斑块破裂的炎症前期过程的调节来影响动脉粥样硬化的形成。例如现在在流行病学和临床上有关于n–3脂肪酸有益影响的充足证据。作为正常的低脂饮食或作为营养补充，这些脂肪酸现在都被推荐用于预防心血管疾病。这篇综述总结了饮食可能通过在动脉粥样硬化的早期发生、发展和出现临床症状的整个过程来影响动脉粥样硬化形成的机制，本中特别突出了n–3脂肪酸的作用。
关键词：动脉粥样硬化 糖尿病 内皮功能障碍 胰岛素抵抗 肥胖 ω-3脂肪酸 n–3脂肪酸 油酸盐 二十二碳六烯酸 二十碳五烯酸 花生四烯酸 5-脂氧合酶 多形性 白三烯
Nutritional mechanisms that influence cardiovascular disease
American Journal of Clinical Nutrition, Vol. 83, No. 2, 421S-426S, February 2006
Raffaele De Caterina, Antonella Zampolli, Serena Del Turco, Rosalinda Madonna and Marika Massaro
ABSTRACT
Current evidence suggests that most significant risk factors for heart disease have been identified. Although age, sex, and genetics are important unmodifiable risk factors, most new cases of acute myocardial infarctions today can be predicted by the presence and level of 9 risk (or cardioprotective) factors that can easily be assessed and, most importantly, modified. These risk factors are the same in almost every geographic region and in every racial/ethnic group worldwide and are consistent in men and women. Eight of these 9 risk factors are influenced by diet, and most act by promoting atherogenesis, which is the most important background condition for cardiovascular disease. Dietary interventions mostly affect atherogenesis by modulating, at the cellular level, proinflammatory processes that initiate and perpetuate endothelial dysfunction, plaque formation, and, eventually, plaque rupture. For example, there is now enough evidence, both epidemiologic and clinical, of the beneficial effects of n–3 fatty acids. Either as part of a normal low-fat diet or as supplements, these fatty acids are now recommended to prevent cardiovascular disease. This review will summarize the mechanisms by which diet may influence atherogenesis through the early inception, progression, and clinical emergence of atherosclerosis, with a special focus on n–3 fatty acids.
Key Words: Atherosclerosis • diabetes • endothelial dysfunction • insulin resistance • obesity • omega-3 fatty acids • n–3 fatty acids • oleate • docosahexaenoic acid • eicosapentaenoic acid • arachidonic acid • 5-lipoxygenase polymorphisms • leukotrienes
