Abstract：
Multifactorial chylomicronemia syndrome (MCS) is a complex disease including a genetic component and the presence of lifestyle-related risk factors. We hypothesized that, in subjects with MCS, there would be a greater decrease in plasma triglycerides (TG) with a low-fat (F) diet than with a low-carbohydrate (C) diet. In secondary analyses, we tested the effect of both diets on TG concentration according to the presence or absence of a rare variant in the LPL gene. This randomized crossover dietary intervention included 12 adult subjects with MCS. Subjects followed 2 isocaloric diets, low-C (C, 35%; F, 45%) and low-F (F, 20%; C, 60%), in random order. Each diet lasted 3 weeks, followed by a 6-hour test meal. Diets were separated by a 2-week washout period. TG concentration in fasting subjects decreased by 55% during low-F diet (P = .002) and by 48% during low-C diet (P = .005). The difference between the 2 diets was not significant. However, we observed a more pronounced decrease in TG concentration (65% ± 17%) with the low-F diet compared with the low-C diet (46% ± 31%) (P = .06) in subjects carrying a rare variant in the LPL gene. This is the first study to show that dietary intervention is effective in MCS subjects. In addition, we highlighted the importance of the genetic profile in the choice of treatment by suggesting that subjects with a rare variant of the LPL gene have a greater reduction of TG concentration with a low-F diet than with a low-C diet.
摘要：
多因素乳糜微粒血症综合征（MCS）是一种复杂的疾病，包括遗传成分和生活方式相关的危险因素。我们假设，在MCS科目中，与低碳水化合物(C)饮食相比,低脂(F)饮食的血浆甘油三酯(TG)下降幅度更大.在二级分析中，根据LPL基因中是否存在罕见变异，我们测试了两种饮食对TG浓度的影响。这种随机交叉饮食干预包括12名患有MCS的成年受试者。受试者遵循2种等热量饮食，低C（C，35%；F，45%）和低F（F，20%;C,60%),以随机顺序。每个饮食持续3周，然后是6小时的测试餐。饮食被2周的冲洗期分开。空腹受试者的TG浓度在低F饮食期间降低了55％（P=.002），在低C饮食期间降低了48％（P=.005）。2种饮食之间的差异不显著。然而,我们观察到,在携带LPL基因罕见变异的受试者中,与低C饮食(46%±31%)相比,低F饮食的TG浓度下降(65%±17%)更为显著(P=.06).这是第一项表明饮食干预对MCS受试者有效的研究。此外,我们强调了遗传谱在选择治疗中的重要性,提示具有LPL基因罕见变异的受试者在低F饮食下比在低C饮食下具有更大的TG浓度降低.
