Dietary fat and heart failure: moving from lipotoxicity to lipoprotection.
Dietary fat and heart failure: moving from lipotoxicity to lipoprotection.
复制标题
饮食脂肪和心力衰竭：从脂肪毒性转变为脂肪保护。
DOI：
10.1161/circresaha.111.253104
复制
发表时间：
2012-03-02
影响因子：
20.1
通讯作者：
O'Connell KA
中科院分区：
文献类型：
--
作者：
Stanley WC;Dabkowski ER;Ribeiro RF Jr;O'Connell KA
越来越多的证据表明，饮食中脂肪的摄入会影响心力衰竭的发生和发展。对啮齿动物的研究表明，在没有肥胖的情况下，用脂肪代替精制碳水化合物可以减轻或预防高血压、梗死或遗传性心肌病引起的心室扩张和收缩功能障碍。相对较低的海洋来源n-3多不饱和脂肪酸摄入量改变了心膜磷脂脂肪酸组成，减少了新发心力衰竭的发生，减缓了已建立的心力衰竭的进展。这种作用与减少炎症和改善线粒体通透性转变的抵抗力有关。在啮齿动物研究中，大量摄入饱和脂肪酸、单不饱和脂肪酸或n-6多不饱和脂肪酸也显示出有益的效果。其潜在的机制是复杂的，需要对正常和衰竭心脏的磷脂、脂质代谢物和代谢通量的影响有更深入的了解。总之，控制膳食脂肪摄入量在预防和治疗心力衰竭方面显示出希望。临床研究普遍支持从海洋来源大量摄入n-3多不饱和脂肪酸来预防和治疗心力衰竭。需要进一步的临床和动物研究来确定针对这一脆弱患者群体的饱和、单不饱和和n-6多不饱和脂肪酸摄入量的最佳饮食。
There is growing evidence suggesting that dietary fat intake affects the development and progression of heart failure. Studies in rodents show that in the absence of obesity replacing refined carbohydrate with fat can attenuate or prevent ventricular expansion and contractile dysfunction in response to hypertension, infarction or genetic cardiomyopathy. Relatively low intake of n-3 polyunsaturated fatty acids from marine sources alters cardiac membrane phospholipid fatty acid composition, decreases the onset of new heart failure, and slows the progression of established heart failure. This effect is associated with decreased inflammation and improved resistance to mitochondrial permeability transition. High intake of saturated, monounsaturated or n-6 polyunsaturated fatty acids has also shown beneficial effects in rodent studies. The underlying mechanisms are complex and a more thorough understanding is needed of the effects on cardiac phospholipids, lipid metabolites and metabolic flux in the normal and failing heart. In summary, manipulation of dietary fat intake shows promise in the prevention and treatment of heart failure. Clinical studies generally support high intake of n-3 polyunsaturated fatty acids from marine sources to prevent and treat heart failure. Additional clinical and animals studies are needed to determine the optimal diet in terms of saturated, monounsaturated and n-6 polyunsaturated fatty acids intake for this vulnerable patient population.