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Phân tích tổng hợp các tác động của axit béo không bão hòa đa n-3 đối với lipoprotein và các dấu hiệu nguy cơ tim mạch lipid mới nổi ở bệnh nhân tiểu đường típ 2
Tóm tắt
Mục tiêu của nghiên cứu này là xác định tác động của axit béo không bão hòa đa n-3 có nguồn gốc từ biển đối với các dấu hiệu nguy cơ tim mạch liên quan đến lipid và lipoprotein đã được xác lập cũng như mới nổi ở bệnh nhân tiểu đường típ 2. Chúng tôi đã thực hiện một đánh giá hệ thống và phân tích tổng hợp các thử nghiệm ngẫu nhiên có đối chứng so sánh lượng axit béo n-3 từ chế độ ăn uống hoặc bổ sung không từ chế độ ăn uống với giả dược ở bệnh nhân tiểu đường típ 2, bằng cách tìm kiếm cơ sở dữ liệu từ năm 1966 đến tháng 12 năm 2006. Những thay đổi trong các biến số sau được ghi nhận: triacylglycerol; cholesterol toàn phần; HDL, LDL và VLDL cùng với các phân đoạn con của chúng; tỷ lệ lipid; apoprotein; và kích thước hạt cholesterol. Có 23 thử nghiệm về bổ sung không từ chế độ ăn uống, liên quan đến 1.075 người tham gia với thời gian điều trị trung bình là 8.9 tuần, với dữ liệu đầy đủ để cho phép tổng hợp. So với giả dược, axit béo n-3 có tác động đáng kể về mặt thống kê đối với bốn kết quả, làm giảm mức độ (1) triacylglycerol (18 thử nghiệm, 969 người tham gia) giảm 25% (trung bình 0.45 mmol/l; 95% CI −0.58 đến −0.32; p < 0.00001); (2) VLDL-cholesterol (7 thử nghiệm, 238 người tham gia) giảm 36% (0.07 mmol/l; 95% CI −0.13 đến 0.00; p = 0.04); và (3) VLDL-triacylglycerol (6 thử nghiệm, 178 người tham gia) giảm 39.7% (0.44 mmol/l; 95% CI −0.83 đến −0.05; p = 0.03); trong khi làm tăng nhẹ LDL (16 thử nghiệm, 565 người tham gia) tăng 5.7% (0.11 mmol/l; 95% CI 0.00 đến 0.22; p = 0.05). Không có tác động đáng kể nào đối với cholesterol toàn phần, apoprotein, các phân đoạn lipid hay tỷ lệ lipid. Ngoài những tác động đã được công nhận trong việc giảm triacylglycerol, bổ sung axit béo n-3 còn làm giảm VLDL-cholesterol và VLDL-triacylglycerol, nhưng có thể có tác động bất lợi đến LDL-cholesterol. Cần có các thử nghiệm lâm sàng lớn hơn và kéo dài hơn để xác định một cách quyết định tác động của axit béo n-3 đối với các dấu hiệu và kết quả nguy cơ tim mạch ở bệnh nhân tiểu đường típ 2.
Từ khóa
#acid béo không bão hòa đa #n-3 PUFA #triacylglycerol #cholesterol #lipoprotein #bệnh tiểu đường típ 2Tài liệu tham khảo
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