Higher intakes of lysine,threonine and valine are inversely associated with non-alcoholic fatty liver disease risk:a community-based case-control study in the Chinese elderly

The associations of individual amino acid with non-alcoholic fatty liver disease(NAFLD)risk remained unclear.The present study aimed to investigate the associations between the two in the Chinese elderly.Methods:A community-based health check-up program was conducted in Qingdao,China.NAFLD was diagnosed by ultrasonography accompanied by epidemiological investigation.The dietary intakes of amino acids were investigated with 3-day,24-h dietary records and calculated by Nutrition Calculator software.Restricted cubic spline model was used to evaluate a nonlinear relationship between amino acid intake and NAFLD risk.Results:400 NAFLD subjects were identified,and 400 participants were randomly selected as controls and matched by gender and age(±3 years)Dose-response analysis showed that 1000 mg increment of aromatic amino acids(AAAs)was associated with reduced 16%risk of NAFLD.Dietary increments of 750 mg/d threonine,950 mg/d valine,or 1700 mg/d lysine were associated with a 20%reduction in the NAFLD risk(all P for linearity<0.05).Conclusion:The present study demonstrated that the dietary increases in milk,eggs and deep-sea fish,which are rich in the amino acids,might contribute to protecting against NAFLD in the elderly.

Ursodeoxycholic acid as a means of preventing atherosclerosis,steatosis and liver fibrosis in patients with nonalcoholic fatty liver disease

BACKGROUND Atherosclerotic cardiovascular disease(ASCVD)is the leading cause of mortality in patients with nonalcoholic fatty liver disease(NAFLD).Weight loss is a key factor for successful NAFLD and CVD therapy.Ursodeoxycholic acid(UDCA),which is one of the first-line therapeutic agents for treatment of NAFLD,is reported to have a beneficial effect on dyslipidemia and ASCVD risk because of antioxidant properties.AIM To evaluate the effects of 6 mo of UDCA treatment on hepatic function tests,lipid profile,hepatic steatosis and fibrosis,atherogenesis,and ASCVD risk in men and women with NAFLD,as well as to assess the impact of>5%weight reduction on these parameters.METHODS An open-label,multicenter,international noncomparative trial was carried out at primary health care settings and included 174 patients with ultrasound-diagnosed NAFLD who received 15 mg/kg/d UDCA for 6 mo and were prescribed lifestyle modification with diet and exercise.The efficacy criteria were liver enzymes,lipid profile,fatty liver index(FLI),noninvasive liver fibrosis tests(nonalcoholic fatty liver disease fibrosis score and liver fibrosis index),carotid intima-media thickness(CIMT),and ASCVD risk score.To test statistical hypotheses,the Wilcoxon test,paired t-test,Fisher’s exact test,and Pearson's chi-squared test were used.RESULTS The alanine aminotransferase(ALT)level changed by-14.1 U/L(-31.0;-5.3)from baseline to 3 mo and by-6.5 U/L(-14.0;0.1)from 3 to 6 mo.The magnitude of ALT,aspartate transaminase,and glutamyltransferase decrease was greater during the first 3 mo of treatment compared to the subsequent 3 mo(P<0.001,P<0.01,P<0.001,respectively).At 6 mo,in the total sample,we observed a statistically significant decrease in body weight and levels of FLI:84.9±10.4 vs 72.3±17.6,P<0.001,total cholesterol:6.03±1.36 vs 5.76±1.21,Р<0.001,lowdensity lipoprotein:3.86±1.01 vs 3.66±0.91,Р<0.001,and triglyceride:3.18(2.00;4.29)vs 2.04(1.40;3.16),Р<0.001.No effect on nonalcoholic fatty liver disease fibrosis score or liver fibrosis index was found.The CIMT decreased significantly in the total sample(0.985±0.243 vs 0.968±0.237,P=0.013),whereas the highdensity lipoprotein(Р=0.036)and 10-year ASCVD risk(Р=0.003)improved significantly only in women.Fifty-four patients(31%)achieved>5%weight loss.At the end of the study,the FLI decreased significantly in patients with(88.3±10.2 vs 71.4±19.6,P<0.001)and without>5%weight loss(83.5±10.3 vs 72.8±16.7,P<0.001).The changes in ALT,aspartate transaminase,glutamyltransferase,total cholesterol,and low-density lipoprotein levels were similar between the subgroups.CONCLUSION UDCA normalizes liver enzymes greatly within the first 3 mo of treatment,improves lipid profile and hepatic steatosis independent of weight loss,and has a positive effect on CIMT in the total sample and 10-year ASCVD risk in women after 6 mo of treatment.

Lipid-lowering agents in the management of nonalcoholic fatty liver disease

Nonalcoholic fatty liver disease(NAFLD) is the most common chronic liver disease in developed countries and is associated not only with increased risk for liver disease-related complications but also with higher cardiovascular morbidity. Accordingly, lipid-lowering agents are frequently considered in these patients to reduce cardiovascular risk. However, there have been concerns regarding the safety of these agents in patients with chronic liver diseases. In the present review, we discuss the safety of lipid-lowering agents in patients with NAFLD as well as their effects on both cardiovascular and liver disease in this population. Accumulating data suggest that statins are safe in patients with NAFLD and that they reduce the increased cardiovascular morbidity of this population. However, it is still unclear whether statins are also useful as a treatment for NAFLD per se, since there are very limited and conflicting data on their effects on liver histology. There is also very scarce evidence regarding the safety and efficacy of other lipid-lowering agents in patients with NAFLD. Randomized controlled studies are needed to evaluate the role of lipid-lowering agents and particularly statins for the prevention of both cardiovascular and liver disease-related complications in this high-risk population.

Relationship between high dietary fat intake and Parkinson’s disease risk: a meta-analysis

OBJECTIVE: To assess whether dietary fat intake influences Parkinson’s disease risk. DATA SOURCES: We systematically surveyed the Embase and PubMed databases, reviewing manuscripts published prior to October 2018. The following terms were used:(“Paralysis agitans” OR “Parkinson disease” OR “Parkinson” OR “Parkinson’s” OR “Parkinson’s disease”) AND (“fat” OR “dietary fat” OR “dietary fat intake”). DATA SELECTION: Included studies were those with both dietary fat intake and Parkinson’s disease risk as exposure factors. The Newcastle-Ottawa Scale was adapted to investigate the quality of included studies. Stata V12.0 software was used for statistical analysis. OUTCOME MEASURES: The primary outcomes included the relationship between high total energy intake, high total fat intake, and Parkinson’s disease risk. The secondary outcomes included the relationship between different kinds of fatty acids and Parkinson’s disease risk. RESULTS: Nine articles met the inclusion criteria and were incorporated into this meta-analysis. Four studies scored 7 and the other five studies scored 9 on the Newcastle-Ottawa Scale, meaning that all studies were of high quality. Meta-analysis results showed that high total energy intake was associated with an increased risk of Parkinson’s disease (P = 0.000, odds ratio (OR)= 1.49, 95% confidence interval (CI): 1.26–1.75);in contrast, high total fat intake was not associated with Parkinson’s disease risk (P = 0.123, OR = 1.07, 95% CI: 0.91–1.25). Subgroup analysis revealed that polyunsaturated fatty acid intake (P = 0.010, OR = 1.03, 95% CI: 0.88–1.20) reduced the risk of Parkinson’s disease, while arachidonic acid (P = 0.026, OR = 1.15, 95% CI: 0.97–1.37) and cholesterol (P = 0.002, OR = 1.09, 95% CI: 0.92–1.29) both increased the risk of Parkinson’s disease. Subgroup analysis also demonstrated that, although the results were not significant, consumption of n-3 polyunsaturated fatty acids (P = 0.071, OR = 0.88, 95% CI: 0.73–1.05),α-linolenic acid (P = 0.06, OR = 0.86, 95% CI: 0.72–1.02), and the n-3 to n-6 ratio (P = 0.458, OR = 0.89, 95% CI: 0.75–1.06) were all linked with a trend toward reduced Parkinson’s disease risk. Monounsaturated fatty acid (P = 0.450, OR = 1.06, 95% CI: 0.91–1.23), n-6 polyunsaturated fatty acids (P = 0.100, OR = 1.15, 95% CI: 0.96–1.36) and linoleic acid (P = 0.053, OR = 1.11, 95% CI: 0.94–1.32) intakes were associated with a non-significant trend toward higher PD risk. Saturated fatty acid (P = 0.619, OR = 1.01, 95% CI: 0.87–1.18) intake was not associated with Parkinson’s disease. CONCLUSION: Dietary fat intake affects Parkinson’s disease risk, although this depends on the fatty acid subtype. Higher intake of polyunsaturated fatty acids may reduce the risk of Parkinson’s disease, while higher cholesterol and arachidonic acid intakes may elevate Parkinson’s disease risk. However, further studies and evidence are needed to validate any link between dietary fat intake and Parkinson’s disease.

Pathway-pathway network-based study of the therapeutic mechanisms by which salvianolic acid B regulates cardiovascular diseases

Investigation of the potential therapeutic mechanisms of drug candidates is an essential step in the process of new drug discovery.With the rapid development of systems biology,recent network analyses of proteins,drugs,and diseases have enabled great progress in delineating the molecule mechanisms of drug candidates.However,most analyses perform a direct association between gene/protein and disease levels without considering the intermediate biological pathways regulated by the drugs.Given that a protein performs its biological roles through pathways,we propose using a novel pathway-pathway network analysis to investigate the potential therapeutic functions of the drug candidates.Many studies have demonstrated that salvianolic acid B(SalB) of Salvia miltiorrhiza is an effective therapy for cardiovascular diseases(CVD).Using molecular docking methods to identify direct interacting targets of Sal B,we collected all Sal B-regulated proteins with supporting experimental evidence in PubMed abstracts.FDA-approved CVD drugs and their corresponding targets were also collected.From a traditional drug-protein network analysis,we found that Sal B could affect ACE and REN of the renin-angiotensin-aldosterone system to relax vessels and alleviate hypertension.Subsequent pathway-pathway network analysis was attempted to study the mechanisms of Sal B in treating CVD,and demonstrated that Sal B regulates immunity/inflammation,apoptosis,ion transport and basic metabolism processes in the treatment of CVD.Regulating the immune/inflammation process may be the major mechanism of Sal B.We believe that pathwaypathway network analysis is a novel method for studying the therapeutic mechanisms of herbal ingredients.

Certain sulfonylurea drugs increase serum free fatty acid in diabetic patients:A systematic review and meta-analysis

BACKGROUND Sulfonylurea(SU)is a commonly used antidiabetic drugs effective for type 2diabetes mellitus.Previous studies have reported that the SU treatment could alter the serum free fatty acid(FFA)concentration in diabetic patients;however,their exact effects remain unknown.AIM To assess the impact of SU on the FFA level in diabetic patients.METHODS A systematic literature search was conducted by consulting the PubMed,EMBASE,Cochrane Library,Reference Citation Analysis(https://www.referencecitationanalysis.com/),and Web of Science databases from January 1,1991 to July 30,2021.Either a fixed-effects model or random-effects model was applied to study the association between SU treatment and FFA concentration according to the heterogeneity test.Two investigators independently performed data extraction.The mean difference(MD)and corresponding 95%confidence interval(CI)were used to measure effect size.R3.5.1 software was utilized for conducting statistical analyses.RESULTS A total of 13 studies with 2273 individuals were selected.Results indicated that FFA concentration increased slightly after treatment with SU(MD=0.08,95%CI:0.03-0.12,P<0.01).In addition,we found that SU treatment combined with other antidiabetics could also increase the concentration of serum FFA(MD=0.14,95%CI:0.01-0.28,P<0.01).Regarding the type of SU,there was no significant difference in FFA concentration with glimepiride or glibenclamide.FFA concentration was higher at≥12 wk(MD=0.09,95%CI:0.04-0.13)but not at<12 wk(MD=0.01,95%CI:-0.07-0.09).CONCLUSION SU treatment could increase the serum FFA concentration in diabetic patients.The fundamental underlying mechanism still needs further investigation.

Evaluation of Fourier Transform Infrared Spectroscopy for Diagnosis of Peroxisomal Diseases with Abnormal Very-Long-Chain Fatty Acid Metabolism

Very long chain fatty acids (VLCFAs) are accumulated in cells and blood in patients with peroxisomal diseases, such as adrenoleukodystrophy (ALD) and Zellwger Syndrome (ZS). The purpose of this study is to investigate usefulness of Fourier transform infrared spectroscopy (FTIR) with attenuated total reflection (ATR) analysis method for clinical diagnosis of those diseases, thereby we measured the infrared spectra of the sera of patients and healthy controls. Correlation coefficients between 2nd derivative FTIR spectra of the serum samples and the VLCFA content ratio which is used as a clinical parameter to date were comprehensively calculated to investigate which wavenumber showed high correlation with the VLCFA ratio. Multiple regression analysis using the serum FTIR spectra showed that high correlations were observed with VLCFA ratios (C26:0/C22:0 ratio), and we could construct a suitable regression model (R2 = 0.97, p ﹣19). In addition, the model system using various VLCFAs in newborn bovine serum also showed that several FTIR peaks in 800 ~ 900 cm﹣1 region were found to have good correlation with VLCFA ratios. Our results support that FTIR analysis is useful for diagnosis of peroxisomal diseases.

The role of lipotoxicity in cardiovascular disease

Fatty acids are the primary fuel for cardiac muscle.The physiological equilibrium of lipid uptake and oxidation may aid in the prevention of excessive lipid accumulation.Several pathological states,such as myocardial ischemia,obesity,and insulin resistance,are routinely associated with disorders of lipid metabolism.There is growing evidence that certain types of lipids trigger cardiac lipotoxicity and ultimately heart failure.This review focuses on recent advances in the pathogenesis of lipotoxic cardiomyopathy and the treatment prospects for the repair of cardiac damage caused by lipotoxicity.

Targeted metabolomics study of fatty-acid metabolism in lean metabolic-associated fatty liver disease patients

BACKGROUND The annual incidence of metabolic-associated fatty liver disease(MAFLD)in China has been increasing and is often overlooked owing to its insidious charac-teristics.Approximately 50%of the patients have a normal weight or are not obese.They are said to have lean-type MAFLD,and few studies of such patients are available.Because MAFLD is associated with abnormal lipid metabolism,lipid-targeted metabolomics was used in this study to provide experimental evidence for early diagnosis and pathogenesis.MAFLD and analyze metabolic pathways.UPLC-Q-Orbitrap/MS content determination was used to determine serum palmitic acid(PA),oleic acid(OA),linoleic acid(LA),and arachidonic acid(AA)levels in lean-type MAFLD patients.RESULTS Urea nitrogen and uric acid levels were higher in lean-type MAFLD patients than in healthy individuals(P<0.05).Alanine transaminase and cholinesterase levels were higher in lean-type MAFLD patients than in healthy indi-viduals(P<0.01).The expression of high-density lipoprotein and apolipoprotein A-1 were lower in lean-type MAFLD patients than in healthy individuals(P<0.05)and the expression of triglycerides and fasting blood glucose were increased(P<0.01).A total of 65 biomarkers that affected the synthesis and metabolism of fatty acids were found with P<0.05 and variable importance in projection>1.The levels of PA,OA,LA,and AA were significantly increased compared with healthy individuals.CONCLUSION The metabolic profiles of lean-type MAFLD patients and healthy participants differed significantly,yielding 65 identified biomarkers.PA,OA,LA,and AA exhibited the most significant changes,offering valuable clinical guidance for prevention and treatment of lean-type MAFLD.

不同市售坚果的脂肪酸组成比较及营养评价

为探究不同坚果品质的差异,采用气相色谱法测定8种市售坚果中脂肪酸组成,并结合主成分分析、皮尔逊相关性分析进行样品之间差异性比较,通过致动脉粥样硬化指数、血栓形成指数等指标评价其营养价值。结果表明,共鉴定出17种脂肪酸,在所有样品中,以油酸和亚油酸为主的不饱和脂肪酸含量明显高于饱和脂肪酸含量,表现出较高的营养价值。基于脂肪酸组分的主成分分析,实现了不同坚果样品区分,为坚果资源的品质提升和加工利用提供了理论支撑。

血尿酸/肌酐比值与代谢相关脂肪性肝病的相关性研究

背景 代谢相关脂肪性肝病(MAFLD)的检出率高于非酒精性脂肪性肝病(NAFLD),可以识别出更多代谢复杂的脂肪肝疾病。血尿酸/肌酐比值(SUA/Cr)是经肾功能标准化血尿酸(SUA)后的新型生物标志物,目前,SUA/Cr与MAFLD的关系研究较少。目的 探讨SUA/Cr与MAFLD的相关性及其预测价值。方法 选取2023年2—6月在内蒙古医科大学附属医院体检中心参加健康体检的2 288例体检人群为研究对象,采集其空腹静脉血进行实验室检查,采用腹部超声检查肝脏情况。根据腹部超声检查结果及MAFLD诊断标准,将受试者分为MAFLD组(n=945)和非MAFLD组(n=1 343)。根据SUA/Cr四分位数将研究对象分为Q1组(SUA/Cr≤4.13,n=574)、Q2组(4.13<SUA/Cr≤4.84,n=573)、Q3组(4.84<SUA/Cr≤5.72,n=570)、Q4组(SUA/Cr>5.72,n=571)。采用Spearman秩相关分析探究SUA/Cr与临床资料的相关性。采用二元Logistic回归分析逐步探究MAFLD的影响因素。绘制受试者工作特征曲线(ROC),计算ROC曲线下面积(AUC)以评估SUA/Cr对MAFLD的预测价值。结果 MAFLD组患者男性占比、年龄、腰围(WC)、BMI、收缩压(SBP)、舒张压(DBP)、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、碱性磷酸酶(ALP)、γ-谷氨酰基转肽酶(GGT)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、空腹血糖(FBG)、糖化血红蛋白(HbA_(1c))、同型半胱氨酸(Hcy)、SUA、血肌酐(Scr)及SUA/Cr均高于非MAFLD组,高密度脂蛋白胆固醇(HDL-C)低于非MAFLD组(P<0.001)。Q4组WC、BMI、ALT、GGT、SUA、TC、TG高于Q1、Q2、Q3组,AST高于Q1、Q2组,DBP、ALP、HbA_(1c)高于Q1组,Scr、HDL-C低于Q1、Q2、Q3组,年龄低于Q1、Q2组(P<0.05);Q3组ALT、AST、GGT、SUA、TC、TG均高于Q1、Q2组,WC、BMI高于Q1组,Scr低于Q1、Q2组,年龄、HDL-C低于Q1组(P<0.05);Q2组WC、BMI、ALT、GGT、SUA、TG均高于Q1组,年龄、HDL-C低于Q1组(P<0.05)。多因素Logistic回归分析结果显示,高WC(OR=1.034,95%CI=1.016~1.053)、BMI(OR=1.340,95%CI=1.266~1.418)、GGT(OR=1.006,95%CI=1.003~1.010)、SUA(OR=1.002,95%CI=1.000~1.003)、TG(OR=1.319,95%CI=1.181~1.474)、HbA_(1c)(OR=1.348,95%CI=1.184~1.536)为MAFLD患病的危险因素,高HDL-C(OR=0.334,95%CI=0.205~0.543)为MAFLD患病的保护因素(P<0.05)。以SUA/Cr四分位数分组为自变量,调整混杂因素后,与Q1组相比,Q4组MAFLD的发生风险为1.734(95%CI=1.220~2.465,P=0.002)。SUA/Cr预测MAFLD的AUC为0.607(95%CI=0.584~0.630),最佳临界值为4.538。结论 MAFLD组患者SUA/Cr高于非MAFLD组,随着SUA/Cr升高,MAFLD的检出率越高,SUA/Cr是MAFLD的危险因素。SUA/Cr可以作为评估MAFLD发生风险的预测指标。

Differential effects of adulterated versus unadulterated forms of linoleic acid on cardiovascular health

According to the classic ＂diet-heart＂ hypothesis, high dietary intake of saturated fats and cholesterol combined with low intake of polyunsaturated fats can increase levels of serum cholesterol and lead to the development of atherogenic plaques and ultimately cardio- vascular diseases. Recently, the beneficial health effects of omega-6 polyunsaturated fatty acids, particularly linoleic acid （LA）, on cardiovascular health have been called into question with some scientists suggesting that consumption of LA should be reduced in Western countries. The focus of this critical review is on the controversy surrounding the effects of dietary intake of LA on cardiovascular health. Specifically, we critically examined the effects of both unadulterated and adulterated forms of LA on cardiovascular health outcomes based on findings from epidemiological studies and randomized controlled trials. Additionally, we address common concems surrounding dietary intake of LA regarding its relationship with arachidonic acid, the ratio of omega-6 to omega-3 fatty acids, and its relationship with inflammation. Our critical review indicates that unadulterated forms of LA are cardioprotective and should be consumed as part of a healthy diet. In contrast, abundant evidence now indicates that adulterated forms of LA, predominantly hydrogenated vegetable oils, are atherogenic and should not be considered part of a healthy diet. The ability to adulterate the natural omega-6 fatty acid, LA, has contributed to mixed findings regarding the effects of this fatty acid on cardiovascular health. Thus, it is critical that the source of LA be taken into account when drawing conclusions about the physiological effects of this fatty acid. The findings of the present review are in line with current dietary recommendations of the American Heart Association.

体脂成分及代谢指标与非肥胖人群代谢相关脂肪性肝病的相关性研究

背景近年来,代谢相关脂肪性肝病(MAFLD)患病率增长迅速,非肥胖MAFLD患者体脂成分和代谢指标的特点及各指标对该病预测价值的研究结论尚不一致。目的分析非肥胖MAFLD患者的体脂成分及关键代谢指标的变化特点,明确非肥胖MAFLD的危险因素,探讨以上指标与非肥胖MAFLD相关性及对该病的预测价值。方法选取2018年1月至2019年1月南京大学医学院附属鼓楼医院健康管理中心体检人员为研究对象,根据肝脏B超结果分为脂肪肝患者和非脂肪肝者,排除脂肪肝患者中的非MAFLD患者后,再根据体质指数(BMI)将两组体检者分为非肥胖非脂肪肝组(n=129)、肥胖MAFLD组(n=129)、肥胖非脂肪肝组(n=129)、非肥胖MAFLD组(n=129),比较非肥胖MAFLD组与其他3组间体脂成分及代谢指标,分析各指标与非肥胖MAFLD的相关性,采用Logistic回归分析明确非肥胖MAFLD的独立危险因素,采用受试者工作特征(ROC)曲线分析各指标对非肥胖MAFLD的预测价值。结果(1)体脂成分及代谢指标比较:非肥胖MAFLD组BMI、体脂肪(BF)、体脂率(BFR)、内脏脂肪面积(VFA)、腰围(WC)、腰臀比(WHR)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、尿酸(UA)、丙氨酸氨基转移酶(ALT)及谷酰转肽酶(GGT)高于非肥胖非脂肪肝组,高密度脂蛋白胆固醇(HDL-C)低于非肥胖非脂肪肝组(P<0.05);非肥胖MAFLD组BMI、BF、VFA、WC、WHR、空腹血糖(FPG)、糖化血红蛋白(HbA1c)低于肥胖MAFLD组(P<0.05);非肥胖MAFLD组BMI、BF、WC低于肥胖非脂肪肝组,TG、UA、ALT、GGT高于肥胖非脂肪肝组(P<0.05);非肥胖MAFLD组中女性年龄、BF、BFR、VFA高于男性,WC、UA、GGT低于男性(P<0.05)。(2)Kendall's相关分析结果显示,BFR、VFA、WHR、TC、TG、LDL-C、UA、ALT、GGT与非肥胖MAFLD呈正相关(r=0.099、0.092、0.136、0.095、0.176、0.092、0.114、0.125、0.142,P<0.05),HDL-C与非肥胖MAFLD呈负相关(r=-0.112,P<0.05)。(3)多因素Logistic回归分析结果显示,TG、ALT、UA、BFR和VFA为非肥胖MAFLD的影响因素(P<0.05)。(4)BFR、VFA、TG、UA、ALT预测非肥胖MAFLD的ROC曲线下面积(AUC)分别为0.853〔95%CI(0.807,0.898)〕、0.938〔95%CI(0.906,0.970)〕、0.807〔95%CI(0.754,0.860)〕、0.665〔95%CI(0.599,0.731)〕、0.752〔95%CI(0.692,0.812)〕,灵敏度分别为0.789、0.852、0.822、0.605、0.814,特异度分别为0.770、0.904、0.713、0.682、0.770,最佳临界值分别为22.30%、61.45 cm2、1.02 mmol/L、356.00μmol/L、18.35 U/L。结论非肥胖MAFLD患者与非肥胖非脂肪肝人群相比,BF及内脏脂肪增多,脂质代谢异常,UA水平升高,转氨酶上升;TG、ALT、UA、BFR和VFA为非肥胖MAFLD的影响因素;BFR、VFA、TG、UA、ALT对非肥胖MAFLD具有一定诊断价值,可用于预测非肥胖MAFLD的发生,以便尽早进行干预。

High Cholesterol Disorders, Myocardial Infarction and Its Therapeutics

The current review article discusses several conditions linked to high cholesterol, including their causes, diagnoses, and treatments. Cardiovascular disease is one of the leading causes of death worldwide, and hypercholesterolemia is a standalone risk factor for the condition. Numerous cardiovascular illnesses (CVDs) and disorders, including myocardial infarction, hypertension, peripheral vascular diseases, and coronary heart diseases, were highlighted in this article. Low density lipoprotein (LDL) is the key factor in the majority of CVDs. It adheres to fatty deposits and forms plaques inside artery lumen, preventing the heart and other body organs from receiving enough blood and oxygen. Cardiomyopathies and dyslipidemias are the most common causes of morbidity and mortality in men and place a considerable health cost on society. Age, hypertension, obesity-induced blood pressure, and a rise in plasma cholesterol are all factors that raise the risk of coronary heart disease (CHD). Calorie intake must be controlled, meal composition must be changed, a natural cycle must be established, and circadian timeliness must be maintained in order to live a healthy life. To lower the risks of metabolic and cardiovascular diseases, try to go vegetarian and always consume traditional plant-based diets and herbal remedies. Exercise yoga and aerobics every day to stay physically healthy, and have your blood pressure, blood sugar, and cholesterol levels checked on a regular basis. Follow your family doctor’s recommendations for managing high cholesterol risks and diagnosing CVD, obtain a lipid profile, take the recommended medications, maintain composure, and adopt a positive outlook for a long and healthy life.

Omega-3脂肪酸在心血管疾病防治中的作用中国专家共识

众所周知,降低密度脂蛋白胆固醇(LDL-C)治疗可带来显著的心血管获益,但仍存在心血管剩余风险。有证据提示甘油三酯(TG)或富含TG的脂蛋白(TRL)胆固醇(TRL-C)水平升高是剩余风险发生的原因之一。Omega-3脂肪酸虽能有效降低TG,但临床随机对照研究显示其在降低动脉粥样硬化性心血管疾病风险的获益结果不一,同时,其在心力衰竭、心律失常、心肌病、高血压、心脏性猝死等心血管疾病防治中的价值仍存困惑。据此,本专业委员会综合有关Omega-3脂肪酸的现有认知,从诸多方面对Omega-3脂肪酸进行全面而科学的阐述,以期为中国人群Omega-3脂肪酸的临床应用提供参考。

反刍动物源和工业源反式脂肪酸的摄入对心脏代谢风险标志物的影响

反式脂肪酸(TFA)主要来源于氢化植物油和反刍动物(瘤胃中通过生物氢化途径合成)源食品。人类膳食中总反式脂肪酸的摄入量与心血管代谢疾病危害因子的升高和心血管疾病的发展紧密相关。但有关工业源反式脂肪酸(iTFA)与反刍动物源反式脂肪酸(rTFA)对心血管代谢疾病危害因子影响的差异仍存争议。鉴于此,本研究查阅国内外有关反式脂肪酸对心血管代谢疾病影响的最新研究成果,在综合考虑研究对象性别、年龄、反式脂肪酸摄入量以及食物营养构成等因素的基础上,系统分析工业源和反刍动物源反式脂肪酸的摄入量对成人心血管代谢疾病危害因子的影响。结果表明:两种来源的反式脂肪酸都会增加心血管疾病代谢风险因子,反刍动物源反式脂肪酸对心血管疾病代谢风险的影响要高于工业源反式脂肪酸,并且对女性的影响要高于对男性的影响。此外,引起风险的大小除了与TFA来源有关外,还与性别、摄入量以及膳食结构存在紧密的关系。建议加大对不同人群、不同膳食模型条件下反式脂肪酸对心血管疾病风险影响的研究,为指导并制定我国居民膳食中反式脂肪酸的允许安全摄入量提供科学依据。

不饱和脂肪酸与炎症性肠病因果关系的孟德尔随机化分析

背景:炎症性肠病(IBD)是一种慢性复发性胃肠道炎症性疾病,包括溃疡性结肠炎(UC)和克罗恩病(CD)。目前尚不清楚不饱和脂肪酸与IBD之间是否存在因果关系。目的:采用两样本孟德尔随机化分析探究不饱和脂肪酸与IBD之间的因果关系。方法:不饱和脂肪酸和IBD的全基因组关联研究(GWAS)数据均来源于网络公开数据库。采用逆方差加权分析法进行两样本孟德尔随机化分析,使用加权中位数法和MR⁃Egger回归分析验证因果效应,以OR及其95%CI评价不饱和脂肪酸与IBD风险的因果关系。结果:ω⁃6脂肪酸与CD无直接因果关系,与UC有直接因果关系,逆方差加权分析结果显示ω⁃6脂肪酸基因水平每增加一个标准差,UC风险增加16%(OR=1.16,95%CI:1.00~1.36,P=0.04)。而ω⁃3脂肪酸、单不饱和脂肪酸与IBD之间均未发现因果关系。结论:ω⁃6脂肪酸可能仅与UC存在因果关系,ω⁃3脂肪酸、单不饱和脂肪酸与IBD之间均未发现因果关系。

晚睡影响心血管疾病风险因素的相关性研究进展

心血管疾病(cardiovascular disease,CVD)是导致全球死亡率升高的最大单一因素,被列为全球重大健康问题。其中载脂蛋白A-I(apolipoprotein A-I,Apo A-I)、载脂蛋白B(apolipoprotein B,Apo B)以及Apo B/Apo A-I是CVD的有效预测指标。在引起CVD的众多原因中,就寝时间是不容忽视的风险因素,长期晚睡易引发失眠、昼夜节律紊乱等一系列睡眠问题,进而通过影响神经递质水平,引发全身慢性炎症反应,影响脂肪酸代谢和血压调节等机制,最终导致CVD的发生和发展。因此养成规律、健康的就寝时间对预防CVD至关重要。

Food for Thought: Have We Been Giving the Wrong Dietary Advice?

Background: Since 1984 UK citizens have been advised to reduce total dietary fat intake to 30% of total energy and saturated fat intake to 10%. The National Institute of Clinical Excellence [NICE] suggests a further benefit for Coronary Heart Disease [CHD] prevention by reducing saturated fat [SFA] intake to 6% - 7% of total energy and that 30,000 lives could be saved by replacing SFAs with Polyunsaturated fats [PUFAs]. Methods: 20 volumes of the Seven Countries Study, the seminal work behind the 1984 nutritional guidelines, were assessed. The evidence upon which the NICE guidance was based was reviewed. Nutritional facts about fat and the UK intake of fat are presented and the impact of macronutrient confusion on public health dietary advice is discussed. Findings: The Seven Countries study classified processed foods, primarily carbohydrates, as saturated fats. The UK government and NICE do the same, listing biscuits, cakes, pastries and savoury snacks as saturated fats. Processed foods should be the target of public health advice but not natural fats, in which the UK diet is deficient. With reference to the macro and micro nutrient composition of meat, fish, eggs, and dairy foods the article demonstrates that dietary trials cannot change one type of fat for another in a controlled study. Interpretation: The evidence suggests that processed food is strongly associated with the increase in obesity, diabetes, CHD, and other modern illness in our society. The macro and micro nutrients found in meat, fish, eggs and dairy products, are vital for human health and consumption of these nutritious foods should be encouraged.

槟榔果仁油提取及其脂肪酸分析

槟榔果仁含有约14%左右的油脂,为探讨槟榔脂肪酸的主要种类,用不同的溶剂对槟榔种子中的脂肪酸进行提取,确定了乙酸乙酯为较好的提取溶剂,考察了提取温度、提取时间和料液比三个因素对提取槟榔种子油的影响,确定了最佳工艺参数为:提取温度为60℃,提取时间是2 h,料液比为1∶8。将提取油脂甲酯化后,利用气相色谱质谱联用法鉴定出了11种成分及各种成分的相对含量。结果表明:槟榔果仁中含量较高的脂肪酸是亚油酸32.12%,油酸29.50%,棕榈酸27.70%,表明槟榔的脂肪酸中既含高含量的饱和脂肪酸棕榈酸,有含高含量的多不饱和脂肪酸(亚油酸)。