Fish oils and plasma lipid and lipoprotein metabolism in humans: a critical review.
Fish oils and plasma lipid and lipoprotein metabolism in humans: a critical review.
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发表时间：
1989-06
影响因子：
6.5
通讯作者：
W. S. Harris
中科院分区：
文献类型：
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作者：
W. S. Harris
格陵兰爱斯基摩人的流行病学研究导致了一种假设，即富含n-3脂肪酸(也称为omega(Omega)-3脂肪酸)的海洋油具有降血脂作用，最终具有抗动脉粥样硬化作用。对正常志愿者和高脂血症患者喂食大量鱼油的代谢控制试验表明，这些脂肪酸(FAs)在降低血浆胆固醇和甘油三酯水平方面有效。虽然最近使用更小、更实用剂量的鱼油补充剂的试验证实了降甘油三酯的效果，但它们对总胆固醇水平几乎没有影响；高甘油三酯血症患者在服用n-3FA补充剂时，低密度脂蛋白胆固醇(LDL-C)水平甚至增加了10-20%。关于n-3脂肪酸对低密度脂蛋白胆固醇水平的影响的鱼油研究之间的差异可以通过注意到，在报告低密度脂蛋白胆固醇水平降低的大多数研究中，当从对照饮食转向鱼油饮食时，饱和脂肪摄入量减少。当喂食鱼油且饱和脂肪摄入量不变时，低密度脂蛋白胆固醇水平要么不变，要么可能增加。高密度脂蛋白胆固醇水平随着鱼油摄入量的增加而略有增加(约5-10%)。血浆载脂蛋白水平的变化与其相关的脂蛋白胆固醇水平一致。虽然甘油三酯水平的降低似乎是由于肝脏甘油三酯合成受到抑制，但导致低密度脂蛋白和高密度脂蛋白升高的机制尚未确定。最后，富含脂肪的鱼或亚麻酸可能是长链n-3脂肪酸的替代来源，但还需要进一步的研究来证明它们的降血脂和/或抗动脉粥样硬化作用。
Epidemiological studies in Greenland Eskimos led to the hypothesis that marine oils rich in n-3 fatty acids (also referred to as omega (omega)-3 fatty acids) are hypolipidemic and ultimately antiatherogenic. Metabolically controlled trials in which large amounts of fish oil were fed to normal volunteers and hyperlipidemic patients showed that these fatty acids (FAs) are effective at lowering plasma cholesterol and triglyceride levels. Although more recent trials using smaller, more practical doses of fish oil supplements have confirmed the hypotriglyceridemic effect, they have shown little effect on total cholesterol levels; hypertriglyceridemic patients have even experienced increases in low density lipoprotein cholesterol (LDL-C) levels of 10-20% while taking n-3 FA supplements. Discrepancies among fish oil studies regarding the effects of n-3 FAs on LDL-C levels may be understood by noting that, in the majority of studies reporting reductions in LDL-C levels, saturated fat intake was lowered when switching from the control diet to the fish oil diet. When fish oil is fed and saturated fat intake is constant, LDL-C levels either do not change or may increase. Levels of high density lipoprotein cholesterol have been found to increase slightly (about 5-10%) with fish oil intake. Plasma apolipoprotein levels change in concert with their associated lipoprotein cholesterol levels. Although the decrease in triglyceride levels appears to result from an inhibition in hepatic triglyceride synthesis, the mechanisms leading to the increases in LDL and HDL have not been determined. Finally, fatty fish or linolenic acid may serve as alternative sources of long-chain n-3 FAs, but further studies will be needed to document their hypolipidemic and/or antiatherogenic effects.