PDF(Pubmed)
Abstract：
Increased inflammation is associated with the pathogenesis of heart failure (HF). Increased circulating levels of cytokines have been previously reported and generally associated with worse clinical outcomes. In this context, the modulation of inflammation-related parameters seems to be a reasonable therapeutic option for improving the clinical course of the disease. Based on this, we aimed to compare changes in circulating cytokines when Mediterranean diet alone or in combination with hypercaloric, hyperproteic oral nutritional supplements (ONS), enriched with omega-3 (n-3) polyunsaturated fatty acids were administered to patients with HF. Briefly, patients were randomly assigned to receive Mediterranean Diet (control group) vs. Mediterranean Diet plus ONS (intervention group). We observed increased circulating levels of IL-6, IL-8, MCP-1 and IP-10. MCP-1 and IL-6 were associated with overweight and obesity (p = 0.01-0.01-0.04, respectively); IL-6 and IL-8 were positively correlated with fat mass and CRP serum levels (p = 0.02-0.04, respectively). Circulating levels of IL-8 significantly decreased in all patients treated with the Mediterranean diet, while IL-6 and IP-10 only significantly decreased in patients that received plus ONS. In the univariate analysis, MCP-1 and its combination with IL-6 were associated with increased mortality (p = 0.02), while the multivariate analysis confirmed that MCP-1 was an independent factor for mortality (OR 1.01, 95%ci 1.01-1.02). In conclusion, nutritional support using hypercaloric, hyperproteic, n-3 enriched ONS in combination with Mediterranean Diet was associated with decreased circulating levels of some cytokines and could represent an interesting step for improving heart functionality of patients with HF.
摘要：
炎症增加与心力衰竭（HF）的发病机理有关。先前已经报道了细胞因子的循环水平增加,并且通常与更差的临床结果相关。在这种情况下，调节炎症相关参数似乎是改善疾病临床病程的合理治疗选择.基于此,我们的目的是比较单独使用地中海饮食或与高热量饮食联合使用时循环细胞因子的变化，高蛋白口服营养补充剂（ONS），我们对HF患者给予富含omega-3(n-3)多不饱和脂肪酸的治疗.简而言之，患者被随机分配接受地中海饮食（对照组）与地中海饮食加ONS（干预组）。我们观察到IL-6、IL-8、MCP-1和IP-10的循环水平升高。MCP-1和IL-6与超重和肥胖相关(p分别为0.01～0.01～0.04);IL-6和IL-8与脂肪量和血清CRP水平呈正相关(p分别为0.02～0.04)。在所有接受地中海饮食治疗的患者中，IL-8的循环水平显着降低，而IL-6和IP-10仅在接受+ONS的患者中显著降低。在单变量分析中，MCP-1及其与IL-6的组合与死亡率增加相关（p=0.02），而多变量分析证实MCP-1是死亡率的独立因素(OR1.01,95%CI1.01-1.02).总之,使用高热量的营养支持，高蛋白，n-3富集的ONS与地中海饮食的组合与一些细胞因子的循环水平降低相关,并且可以代表改善患有HF的患者的心脏功能的令人感兴趣的步骤。
