基于脂肪酸和PBMC免疫表型探索运动联合节食对肥胖慢性炎症的影响

Exploring the impact of exercise combined with diet intervention on obesity chronic inflammation based on fatty acid profiles and PBMC immune phenotypes

目的:基于脂肪酸和外周血单个核细胞(PBMC)免疫表型探索运动联合节食对慢性炎症的影响。方法:从扬州市励攀减肥训练营招募了31名志愿者,年龄30.1±5.5岁,身高170.1±8.1 cm,体重101.13±21.40 kg,体重指数(BMI)34.66±5.01 kg/m^(2)。采用5周运动联合节食方案对肥胖志愿者进行减肥干预,运动采用60%~75%HRmax强度,每天训练3小时,节食采用中高能量限制模式,第1周每天减少250 kcal能量摄入,第2~5周每天减少600 kcal能量摄入。测试干预前后形态指标(体重、BMI、去脂体重、体脂百分比、腰臀比、内脏脂肪指数)、血脂四项(总胆固醇、甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇)、超敏C-反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、内脂素(VF)及血中脂肪酸的含量。同时,测试干预前后PBMC亚群细胞表面受体CD36、TLR4及核转录因子NF-κB的表达情况。结果:经过5周的干预后,与干预前比较,肥胖志愿者形态指标显著降低,血脂四项显著降低,慢性炎症因子hsCRP、VF、TNF-α水平显著降低(P<0.01);除C6:0、C11:0、C12:0、C23:0、C24:0外,其他脂肪酸水平显著降低(P<0.05,P<0.01)。所测得的脂肪酸中,分别有13个、31个、15个与hs-CRP、VF、TNF-α显著正相关(P<0.05,P<0.01)。同时发现,与干预前比较,PBMC亚群细胞中的单核细胞白细胞分化抗原36(CD36)、Toll样受体4(TLR4)、核转录因子κB(NF-κB)在干预后均显著下降(P<0.05),淋巴细胞在干预后CD36和TLR4显著下降(P<0.05,P<0.01),粒细胞CD36和NF-κB显著下降(P<0.01,P<0.05)。结论:运动结合节食可改善肥胖人群的体形和身体机能,还能有效缓解慢性炎症。慢性炎症的缓解与血液中脂肪酸含量的降低密切相关。当血液中的脂肪酸含量下降时,PBMC表面受体CD36和TLR4的表达也随之减少,伴随NF-κB信号通路的抑制。这些变化参与了运动结合节食改善慢性炎症的过程。

Objective To explore the effect of exercise combined with dieting on chronic inflamma-tion based on fatty acids and peripheral blood mononuclear cell(PBMC)immunophenotypes.Methods Thirty-one obese volunteers(age:30.1±5.5 years,height:170.1±8.1 cm,weight:101.13±21.40 kg,BMI:34.66±5.01 kg/m^(2))were recruited and given a 5-week program of exercise combined with diet-ing.The exercise regimen consisted of daily 3-hour training at 60%-75%HRmax intensity,while the di-eting regimen was a moderate to high energy restriction model,with a daily reduction of 250 kcal in the 1st week and 600 kcal from the 2nd to 5th weeks.Before and after the intervention,all volunteers were measured morphological indicators(body weight,BMI,fat-free mass,body fat percentage,waist-to-hip ratio and visceral fat index),blood lipids(total cholesterol,triglycerides,high-density lipopro-tein cholesterol and low-density lipoprotein cholesterol),high-sensitivity C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α),visfatin(VF),and the content of fatty acids in the blood.Moreover,the expression of cell surface receptors CD36,TLR4,and nuclear factor-κB(NF-κB)on PBMC sub-sets was tested before and after intervention.Results After intervention,a significant decrease was ob-served in the body composition indices,as well as in the four major blood lipid parameters.Levels of chronic inflammatory markers,including hs-CRP,VF and TNF-α,decreased significantly(P<0.01).Except for C6:0,C11:0,C12:0,C23:0,and C24:0,the levels of other fatty acids also decreased sig-nificantly(P<0.05,P<0.01).Among the measured fatty acids,13,31,and 15 were found to be signif-icantly and positively correlated with hs-CRP,VF,and TNF-α,respectively(P<0.05,P<0.01).More-over,the expression of monocyte cluster of differentiation 36(CD36),Toll-like receptor 4(TLR4),and nuclear factor-κB(NF-κB)in PBMC subsets decreased significantly after the intervention(P<0.05).In lymphocytes,CD36 and TLR4 expression lowered significantly after intervention(P<0.05 and P<0.01),while in granulocytes,CD36 and NF-κB expression decreased significantly(P<0.01 and P<0.05).Conclusion Exercise combined with dietary intervention can better body composition and physi-cal function in obese individuals,alleviating their chronic inflammation.The reduction in chronic in-flammation is closely related to the decrease in circulating fatty acid levels,which results in the re-duced expression of CD36 and TLR4 receptors on the surface of PBMC and the inhibition of the NF-κB signaling pathway.