代谢综合征患者血清三酰甘油多不饱和脂肪酸谱与内脏脂肪的关系

Relationship between triglycerides polyunsaturated fatty acid composition and visceral fat in patients with metabolic syndrome

目的 探讨血清三酰甘油中的n-6与n-3必需多不饱和脂肪酸（PUFA）各组分及其比例与代谢综合征患者核磁共振测量的腹腔内脏脂肪面积（MRI-IAF）的关系.方法 比较在体检中新发现的代谢综合征和健康人群的代谢和体脂指标的差异,探讨代谢综合征患者血清三酰甘油脂肪酸谱各组分与MRI-IAF等体脂参数的相关性,并且以相关的血清脂肪酸谱组分为被筛选变量,逐步回归分析以上变量对MRI-IAF、腰围和体质指数（BMI）的影响.结果 代谢综合征组的各项体脂及代谢指标均较对照组差,其中MRI-IAF差距较大[（108.3±13.3）cm2 vs.（63.0±7.1）cm2,t=18.28,P＜0.05）],代谢综合征组血清三酰甘油的n-6/n-3 PUFA比值高于对照组（10.1±3.3vs.7.2±2.1,t=8.564,P＜0.05）,而C18∶3 n-3[（1.4±0.4）％vs.（1.7±0.6）％,t=-3.295]、C20∶5 n-3[（0.2±0.2）％vs.（0.6±0.6）％,t=-3.611]、C22∶6n-3[（0.9±0.5）％vs.（1.2±0.6）％,t=-2.920]及n-3PUFA低于对照组[（2.5±0.6）％vs.（3.7±1.2）％,t=-7.034]（P均＜0.05）,所有n-6 PUFA及C22∶5 n-3的差异无统计学意义;n-6/n-3 PUFA、n-3 PUFA、二十二碳六烯酸和二十碳五烯酸均与MRI-IAF （r=-0.377～0.565,P=0.024）相关,n-6/n-3 PUFA还与腰围（r=0.400,P=0.016）和BMI相关（r=0.357,P=0.033）,而n-6 PUFA与各体脂参数不相关;逐步回归分析提示n-6/n-3PUFA比值与MRI-IAF、腰围、BMI的相关性较强（校正的R2=0.102～0.299,P=0.033）.结论 血清三酰甘油n-6/n-3 PUFA比值和n-3 PUFA与代谢综合征患者MRI-IAF等体脂参数相关,补充膳食n-3 PUFA的同时可能还需要考虑避免n-6 PUFA的过量摄入.

Objective Essential polyunsaturated fatty acids（PUFA） can not been synthesized by the body-self.Serum triglycerides n-6 and n-3 PUFAs directly or indirectly reflect the corresponding unsaturated fatty acids intake from meals.This study was to investigate the relationship of serum triglycerides polyunsaturated fatty acid composition with the ratio of n-6 to n-3 PUFA（n-6/n-3 PUFA） and magnetic resonance imaging measured intra-abdominal fat（MRI-IAF） with other body fat parameters of patients with metabolic syndrome.Methods Thirty-six patients with metabolic syndrome and 41 healthy controls were enrolled in this investigation.The relevance of serum triglycerides polyunsaturated fatty acids with MRI-IAF was observed.A stepwise regression analysis was applied to determine which kind of triglycerides polyunsaturated fatty acid could predict MRI-IAF,waist circumference and body mass index （BMI） more potent.Results In the metabolic syndrome group,blood sugar,lipid profiles,blood pressure,visceral fat accumulation-related parameters and serum triglycerides polyunsaturated fatty acid composition was worse than those in the control group.Compared with the healthy controls,n-6/n-3 PUFA was significantly increased（t=8.564,P〈0.05）,although C18∶3 n-3,C20∶5 n-3（EPA）,C22∶6 n-3（DHA） and n-3PUFA were significantly declined（t=-2.920,-7.034,all P〈0.05） in metabolic syndrome group.The difference of n-6 PUFA showed no statistically significant difference（t=-0.957,-1.494,P〉0.05）.n-6/n-3 PUFA,n-3 PUFA,EPA and DHA were associated with MRI-IAF（r=-0.377,0.565,all P〈0.05）; n-6/n-3 PUFA was correlated with the waist circumference（r=0.400,P=0.016） and BMI（r=0.357,P=0.033）,while n6 PUFA showed no correlation with body fat parameters.N-6/n-3 PUFA was more potent to predict MRIIAF,waist circumference and BMI（adjusted R2=0.102,0.299,all P〈0.05） than other polyunsaturated fatty acids.Conclusions The ratio of n-6/n-3 PUFA and n-3 PUFA may be positively correlated with EPA and DHA could be inversely associated with MRI-IAF and other body fat-related parameters in patients with metabolic syndrome,while n-6 PUFA did not show such a relationship.The ratio of n-6/n-3 PUFA might be more potent to predict MRI-IAF and other body fat-related parameters.