中链脂肪酸对高甘油三酯血症合并不同水平HDL-C患者血脂和脂蛋白的影响

Effect of medium-chain fatty acid on blood lipid and lipoprotein in patients with hyper-triglyceridemia complicated with different HDL-C levels

目的观察含有中链脂肪酸(MCFA)的食用油对高甘油三酯(TG)合并不同水平高密度脂蛋白胆固醇(HDL-C)血症者脂代谢的影响。方法采用双盲随机临床对照法,将112名高甘油三酯血症患者分为含MCFA食用油组(MCT)和含长链脂肪酸(LCFA)食用油组(LCT),每组按人群初始HDL-C浓度进行低(<1.04mmol/L)、中(1.04-1.54mmol/L)、高(≥1.55mmol/L)水平分层,控制每日膳食摄入量、运动时间及食用油摄入量,每人25-30g/d,分别在研究开始前和8周后,检测研究对象的空腹血生化指标:总胆固醇(TC)、TG、HDL-C、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白A1(ApoA1)、ApoB、ApoA2、ApoC2、ApoC3及ApoE。结果获得有效数据101例,LCT组50例,MCT组51例,按HDL-C水平分层后两组人群性别分配比例、平均每日饮食中三大产热营养素和总能量摄入、运动时间指标均无统计学差异(P>0.05)。低水平HDL-C的MCT组人群研究结束时的TG、LDL-C、ApoB浓度显著低于LCT组(P<0.05),血HDL-C和HDL-C/LDL-C、(ApoA1+ApoA2)/ApoB显著高于LCT组(P<0.05);高水平HDL-C人群各项指标两组间均无统计学差异(P>0.05)。结论合理膳食条件下,含MCFA食用油可降低高TG合并低水平HDL-C人群血脂浓度,改善其脂蛋白、载脂蛋白水平。

Objective To observe the effect of edible oil containing medium-chain fatty acid（MCFA） on blood lipid metabolism in patients with hypertrigliceridemia complicated with different HDL-C levels. Methods One hundred and twelve patients with hypertriglyceridemia were randomly divided into MCFA group and long-chain fat acid （LCFA）group according to their initial HDL-C levels（〈l.04mmol/L, =1.04-1.54mmol/L, and/≥1.55mmol/L）. Their daily intake of food and edible oil （25-30g/ d）, and physical activity time were controlled. Their fasting biochemical indexes including TC, TG, HDL-C, LDL-C, ApoA1, ApoB, ApoA2, ApoC2, ApoC3 and ApoE levels were measured before beginning and 8 weeks after study with the double blind control method. Results Efficient data were obtained from 101 patients （50 in LCFA group and 51 in MCFA group）. No significant difference was observed in gender, daily nutrient intake, and physical activity time between the two groups（P〉0.05）. The TG, LDL-C, and ApoB levels were significantly lower while the HDL-C, HDL-C/LDL-C, （ApoAl＋ApoA2）/ApoB levels were significantly higher in MCFA group with a low HDL-C level than in LCFA group（P〈0.05）. No significant difference was observed in all indexes of MCFA group with a high HDL-C level（P〉0.05）. Conclusion Rational intake of MCFA can reduce the blood TG level in those with a low HDL-C level and improve their lipoprotein and apolipoprotein levels in patients with hypertrigliceridemia.