DHA

DHA
  • 文章类型: Journal Article
    暴露于砷(As)是与癌症(皮肤和结肠)相关的公共卫生问题,据报道,表观遗传变化可能是As致癌的潜在机制。在与癌症相关的基因中评估这一过程是相关的,例如ADAMTS9和C18ORF8。妊娠和分娩数据来自POSGRAD研究。在怀孕期间测量尿液中的As暴露。通过亚硫酸氢钠测序进行基因甲基化;分析了C18ORF8基因的26个CpG位点和ADAMTS9的21个CpG位点。这些位点位于转录开始附近的CpG岛上。社会人口统计学特征是通过问卷调查获得的。使用校正潜在混杂因素的多元线性回归模型进行统计分析。As暴露高于49.4μgg-1的新生儿显示C18ORF8基因位点CpG15,CpG19和CpG21的甲基化率降低0.21%(调整的β=-0.21,p值=0.02)。在产前暴露于As和ADAMTS9基因甲基化之间没有发现统计学上的显着关联。产前暴露于As与C18ORF8基因的CpG15,CpG19和CpG21位点的DNA甲基化减少有关。这些位点可以提供信息来阐明与产前暴露于As和癌症相关的表观遗传机制。
    Exposure to arsenic (As) is a public health problem associated with cancer (skin and colon) and it has been reported that epigenetic changes may be a potential mechanism of As carcinogenesis. It is pertinent to evaluate this process in genes that have been associated with cancer, such as ADAMTS9 and C18ORF8. Gestation and delivery data were obtained from the POSGRAD study. Exposure to As was measured in urine during pregnancy. Gene methylation was performed by sodium bisulfite sequencing; 26 CpG sites for the C18ORF8 gene and 21 for ADAMTS9 were analyzed. These sites are located on the CpG islands near the start of transcription. Sociodemographic characteristics were obtained by a questionnaire. The statistical analysis was performed using multiple linear regression models adjusted for potential confounders. Newborns with an As exposure above 49.4 μg g-1 showed a decrease of 0.21% on the methylation rate in the sites CpG15, CpG19, and CpG21 of the C18ORF8 gene (adjusted ß = -0.21, p-value = 0.02). No statistically significant association was found between prenatal exposure to As and methylation of the ADAMTS9 gene. Prenatal exposure to As was associated with decreased DNA methylation at the CpG15, CpG19, and CpG21 sites of the C18ORF8 gene. These sites can provide information to elucidate epigenetic mechanisms associated with prenatal exposure to As and cancer.
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  • 文章类型: Journal Article
    早产儿视网膜病变(ROP)是早产儿失明的主要原因。该病症与二十二碳六烯酸(DHA)缺乏有关。本研究旨在探讨补充DHA对口服滴油剂婴幼儿ROP发生的影响。它是JoinvilleDHA研究(JoiDHA研究)的一部分,2020年3月至2023年1月在巴西一家公立妇产医院进行的非平行组队列研究.招募在胎龄33周之前出生或出生体重≤1,500g的婴儿。在155名婴儿中,81未接受,74接受DHA补充,直到周边视网膜完全血管化。与DHA组(41·4%)相比,未补充组(58·6%)的ROP婴儿发生率更高,但差异不显著(P=0·22)。非校正logistic回归分析显示,两组动脉导管未闭和新生儿糖皮质激素均与ROP显著相关(P<0·05)。在DHA组中,表面活性剂的使用也与ROP相关(P=0·003)。在调整了重要的协变量后,在未补充组中,动脉导管未闭和新生儿皮质类固醇对婴儿的影响仍然显著(分别为OR=3·99;P=0·022和OR=5·64;P=0·019).在DHA组中,仅表面活性剂的使用继续与ROP相关(OR=4·84;P=0·015)。总之,DHA补充与ROP无关。进一步的研究是必要的,以更好地了解DHA补充之间的关系。拖放,和相关的合并症。
    Retinopathy of prematurity (ROP) is a leading cause of blindness in premature infants. The condition is associated with DHA deficiency. This study aimed to investigate the effect of DHA supplementation on the occurrence of ROP in infants receiving oral oil drops. It is part of the Joinville DHA study, a non-parallel-group cohort study conducted from March 2020 to January 2023 at a public maternity hospital in Brazil. Infants born before 33 weeks of gestational age or with a birth weight ≤ 1500 g were recruited. Among 155 infants, 81 did not receive and 74 received DHA supplementation until complete vascularisation of the peripheral retina. There was a higher incidence of infants with ROP in the unsupplemented group (58·6 %) compared with the DHA group (41·4 %), but this difference was NS (P = 0·22). Unadjusted logistic regression analysis showed that patent ductus arteriosus and neonatal corticosteroids were significantly (P < 0·05) associated with ROP in both groups. In the DHA group, surfactant use was also associated with ROP (P = 0·003). After adjusting for important covariates, patent ductus arteriosus and neonatal corticosteroids continued to be significant for infants in the unsupplemented group (OR = 3·99; P = 0·022 and OR = 5·64; P = 0·019, respectively). In the DHA group, only surfactant use continued to be associated with ROP (OR = 4·84; P = 0·015). In summary, DHA supplementation was not associated with ROP. Further studies are necessary to better understand the relationship between DHA supplementation, ROP and associated comorbidities.
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  • 文章类型: Journal Article
    一个随机的,对65名受试者进行了双盲试验,以比较由二十碳五烯酸和二十二碳六烯酸(EPADHA)以及自乳化药物递送系统(SEDDS)组成的PhytoMarineCelle(PM)之间的药代动力学。和不含SEDDS的标准EPA+DHA乙酯(SEE)。在300mg时,PM显示出血浆曲线下面积(AUC)比SEE大1.6倍,虽然没有观察到显著差异。在500mg和1000mg时,PM显示分别比SEE高3.1和3.2倍(p<0.05)的血浆AUC。EPA+DHA的浓度max(Cmax)在300mg时在PM和SEE之间没有变化。PM的Cmax分别为500mg和1000mg,比SEE大两倍。EPA+DHA的Cmax仅在500mg剂量下达到显著差异(p<0.05)。与500和1000mg的SEE相比,PM制剂使EPA+DHA的生物利用度增加了三倍。
    A randomized, double-blinded trial with 65 subjects was conducted to compare the pharmacokinetics between PhytoMarineCelle (PM) that consists of eicosapentaenoic acid and docosahexaenoic acid (EPA + DHA) plus a self-emulsifying drug delivery system (SEDDS), and a standard EPA + DHA ethyl ester (SEE) that does not contain SEDDS. PM showed 1.6-fold greater plasma area under the curve (AUC) than SEE at 300 mg, although no significant difference was observed. PM showed a 3.1 and 3.2-fold (p < 0.05) greater plasma AUC than SEE at 500 mg and 1000 mg respectively. The concentration max (Cmax) of EPA + DHA did not change between PM and SEE at 300 mg. Cmax of PM was twofold greater than SEE at 500 mg and 1000 mg respectively. The Cmax of EPA + DHA achieved significant difference (p < 0.05) only with the 500 mg dose. The PM formulation increased the bioavailability of EPA + DHA by threefold compared to SEE at 500 and 1000 mg.
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  • 文章类型: Journal Article
    经常食用加工和即食(RTE)食品被认为是不健康的,但是缺乏与循环代谢参数关系的证据。日本大都市的居民,20到50岁,在人体测量和生化参数方面进行了研究,包括循环反式脂肪和血清磷脂脂肪酸水平。加工食品,除了饮料和乳制品,根据食用前额外配料和烹饪的要求进行分类。加工和RTE食品根据脂肪和/或油含量分为非脂肪或脂肪食品。根据来自脂肪RTE食物的能量百分比(En%),将参与者分为三元组。Fatty-RTEEn%与鱼类呈负相关,大豆和大豆产品,乳制品,鸡蛋,蔬菜,海藻/蘑菇/魔芋,水果和非油性调味料反映较低的膳食纤维,二十碳五烯酸(EPA)和二十二碳六烯酸(DHA),矿物质和维生素的摄入量,而与脂肪/油的联系,糖果,和甜饮料是积极的。脂肪RTEEn%消耗与碱性磷酸酶呈正相关,亮氨酸氨基肽酶,直接胆红素,反油酸,和C18:2,但与HDL胆固醇呈负相关,C15:0,C17:0,EPA,和DHA。建议较高的脂肪RTE食物摄入量导致营养摄入量不平衡,反映在脂质代谢参数上。需要进一步的大规模研究来评估RTE食品的质量和影响。
    Frequently consuming processed and ready-to-eat (RTE) foods is regarded as unhealthy, but evidence on the relationships with circulating metabolic parameters is lacking. Japanese residents of a metropolitan area, 20 to 50 years of age, were studied in terms of anthropometric and biochemical parameters, including circulating trans fat and serum phospholipid fatty acid levels. Processed foods, except drinks and dairy items, were categorized according to requirements for additional ingredients and cooking before eating. Processed and RTE foods were divided according to fat and/or oil content into non-fatty or fatty foods. The participants were grouped into tertiles based on the energy percent (En%) derived from fatty-RTE foods. Fatty-RTE En% showed negative associations with fish, soybean and soybean products, dairy, eggs, vegetables, seaweed/mushrooms/konjac, fruit and non-oily seasonings reflecting lower dietary fiber, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), and mineral and vitamin intakes, while the associations with fat/oil, confectionaries, and sweet beverages were positive. Fatty-RTE En% consumption was positively associated with alkaline phosphatase, leucine aminopeptidase, direct bilirubin, elaidic acid, and C18:2 but inversely associated with HDL cholesterol, C15:0, C17:0, EPA, and DHA. A higher fatty-RTE food intake was suggested to contribute to unbalanced nutrient intakes, as reflected in lipid metabolic parameters. Further large-scale studies are needed to evaluate the quality and impacts of RTE foods.
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  • 文章类型: Journal Article
    目的:我们评估了补充omega(n)-3脂肪酸和饮食鱼摄入对成人炎症的全身脂质介质的联合影响。
    方法:在VITAL中,一项双盲随机对照试验,成人随机接受ω-3脂肪酸(460mgEPA+380mgDHA/d)或安慰剂治疗.我们选择了报告低(<1份/月)基线饮食鱼摄入量的参与者,并按年龄与他们相匹配。性别,种族,并对自我报告鱼类摄入量最高(≥3.9份/周)的参与者进行试验。测试基线和1-y血浆样品的9种ω-3脂肪酸衍生的脂质介质。多变量线性模型评估了脂质介质的变化以及ω-3脂肪酸补充和膳食鱼类摄入量的联合影响。
    结果:48名基线鱼类摄入量低的参与者与48名鱼类摄入量高的参与者相匹配。平均年龄为64.6(±7.26),50%是女性,85%的非西班牙裔白人.与安慰剂相比,在接受ω-3脂肪酸的患者中观察到预期方向的一年脂质介质变化:促炎介质减少,PGD2,5-HETE,和12-HETE;促分辨介体的增加,EPA和DHA。较大的1-y脂质生物标志物变化在那些低基线鱼摄入量随机服用DHA活性ω-3脂肪酸,EPA,观察到PGD2,ResolvinD1和ResolvinD4,尽管没有检测到显著的乘法相互作用。
    结论:所有参与者补充1-yω-3脂肪酸与安慰剂相比,发现循环促分解和促炎介质的有益变化,在基线鱼类摄入量低的人群中,有更大的影响趋势,虽然相互作用并不显著。
    OBJECTIVE: We assessed the joint effects of omega (n)-3 fatty acid supplementation and dietary fish intake on systemic lipid mediators of inflammation among adults.
    METHODS: Within VITAL, a double-blind randomized controlled trial, adults were randomized to ω-3 fatty acids (460 mg EPA + 380 mg DHA/d) or placebo. We selected participants who reported low (<1 serving/mo) baseline dietary fish intake and matched them by age, sex, race, and trial arm to participants with self-reported highest fish intake (≥3.9 servings/wk). Baseline and 1-y plasma samples were tested for 9 ω-3 fatty acid-derived lipid mediators. Multivariable linear models assessed lipid mediator changes and joint effects of ω-3 fatty acid supplementation and dietary fish intake.
    RESULTS: Forty-eight participants with low baseline fish intake were matched to 48 with high fish intake. Mean age was 64.6 (±7.26), 50% were female, and 85% non-Hispanic white. One-year lipid mediator changes in expected directions were observed in those receiving ω-3 fatty acids versus placebo: reductions in proinflammatory mediators, PGD2, 5-HETE, and 12-HETE; increases in proresolving mediators, EPA and DHA. Larger 1-y lipid biomarker changes were seen in those with low baseline fish intake randomized to active ω-3 fatty acids for DHA, EPA, PGD2, Resolvin D1, and Resolvin D4 were observed, although no significant multiplicative interactions were detected.
    CONCLUSIONS: Beneficial changes in circulating proresolving and proinflammatory mediators were found with 1-y of ω-3 fatty acid supplementation versus placebo for all participants, with a trend toward larger effects among those with low baseline fish intake, although interactions were not significant.
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  • 文章类型: Journal Article
    Omega-3长链多不饱和脂肪酸(n-3LCPUFAs)在早期神经发育中起关键作用,但是来自观察性和临床研究的证据仍然不一致.本研究调查了母体n-3LCPUFA,二十二碳六烯酸(DHA),和二十碳五烯酸(EPA)浓度在怀孕期间和婴儿发育功能在40天。这项研究包括348对母婴。产妇血清浓度在第一和第三三个月与社会人口统计学评估,临床,营养,心理,和产科数据。在40天,贝利婴儿和幼儿发展量表,施用第三版(BSID-III)。调整后的分析显示,较低的孕早期n-3LCPUFA和DHA浓度与更好的婴儿运动发育有关。这些结果强调了妊娠早期母体n-3LCPUFA状态对影响胎儿神经发育的潜在意义。然而,这些关联的复杂性需要进一步调查,强调迫切需要更多的研究,以全面阐明母体n-3LCPUFA状态和婴儿神经发育之间的细微差别的相互作用。
    Omega-3 Long-Chain Polyunsaturated Fatty Acids (n-3 LCPUFAs) play a key role in early neurodevelopment, but evidence from observational and clinical studies remains inconsistent. This study investigates the association between maternal n-3 LCPUFA, Docosahexaenoic Acid (DHA), and eicosapentaenoic acid (EPA) concentrations during pregnancy and infant development functioning at 40 days. This study includes 348 mother-infant pairs. Maternal serum concentrations were assessed in the first and third trimesters alongside sociodemographic, clinical, nutritional, psychological, and obstetrical data. At 40 days, the Bayley Scales of Infant and Toddler Development, Third Edition (BSID-III) was administered. An adjusted analysis revealed that lower first-trimester n-3 LCPUFA and DHA concentrations are associated with better infant motor development. These results underscore the potential significance of the maternal n-3 LCPUFA status in early pregnancy for influencing fetal neurodevelopment. However, the complexity of these associations necessitates further investigation, emphasizing the urgent need for additional studies to comprehensively elucidate the nuanced interplay between the maternal n-3 LCPUFA status and infant neurodevelopment.
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  • 文章类型: Journal Article
    目的:患有肥胖症的中年女性铁过载的风险增加,已知铁紊乱会破坏n-3多不饱和脂肪酸的稳态。我们评估了治疗前血红蛋白和n-3多不饱和脂肪酸水平之间的关系,并测试了治疗前血红蛋白是否有助于体重减轻的个体差异,特别关注体重的变化,铁和n-3多不饱和脂肪酸谱。
    方法:117名患有肥胖和两种以上代谢异常的中老年妇女被随机分为12周低热量饮食,不补充或补充鱼油。评估血铁生物标志物和红细胞膜磷脂谱。
    结果:根据治疗前血红蛋白和鱼油补充剂,血清铁和红细胞n-3多不饱和脂肪酸水平从基线到第12周的绝对变化。
    结果:Pearson相关分析表明,治疗前的血红蛋白水平与亚油酸呈负相关(r=-0.231),α-亚油酸(r=-0.279),和n-3多不饱和脂肪酸(r=-0.217)(所有p<0.05)。饮食减肥显着增强了亚油酸的红细胞膜脂质,α-亚油酸,n-6和n-3多不饱和脂肪酸仅在那些治疗前血红蛋白水平最高的女性中(三元组3)(所有p<0.05)。补充鱼油可增加女性的生物可利用铁与中等预处理血红蛋白水平(tertile2)(p<0.05)和,在较小程度上,防止了那些血红蛋白水平最低的人的循环铁减少(三分1)。
    结论:饮食减肥是治疗肥胖相关铁和n-3多不饱和脂肪酸疾病的有效治疗方案,特别是对于肥胖和铁过载的中年女性。
    OBJECTIVE: Middle-aged women with obesity are at increased risk of iron overload and iron disorder is known to disrupt n-3 polyunsaturated fatty acid homeostasis. We evaluated relationships between pretreatment hemoglobin and n-3 polyunsaturated fatty acid levels, and tested whether pretreatment hemoglobin contributed to inter-individual variability in weight loss with special focus on changes in body weight, iron and n-3 polyunsaturated fatty acid profiles.
    METHODS: 117 middle and older aged women with obesity and more than two metabolic abnormalities were randomized to a 12-week hypocaloric diet without or with fish oil supplementation. Blood iron biomarker and erythrocyte membrane phospholipid profiles were evaluated.
    RESULTS: The absolute change from baseline to week 12 in serum iron and erythrocyte n-3 polyunsaturated fatty acid levels according to pretreatment hemoglobin tertiles and fish oil supplementation.
    RESULTS: A Pearson correlation analysis showed that pretreatment hemoglobin levels were negatively correlated with linoleic acid (r = -0.231), α-linoleic acid (r = -0.279), and n-3 polyunsaturated fatty acid (r = -0.217) (all p < 0.05). Dietary weight loss markedly enhanced erythrocyte membrane lipids of linoleic acid, α-linoleic acid, and n-6 and n-3 polyunsaturated fatty acid only in those women with the highest pretreatment hemoglobin levels (tertile 3) (all p < 0.05). Fish oil supplementation increased bioavailable iron in women with moderate pretreatment hemoglobin levels (tertile 2) (p < 0.05) and, to a lesser extent, prevented a reduction in circulating iron in those with the lowest hemoglobin levels (tertile 1).
    CONCLUSIONS: Dietary weight loss is an effective treatment program to manage obesity-related iron and n-3 polyunsaturated fatty acid disorders, particularly for middle-aged women with obesity and iron overload.
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  • 文章类型: Journal Article
    目的:妊娠恶心和呕吐(NVP)是一种常见的疾病,会对工作和家庭生活产生负面影响,从而降低生活质量。身心健康,和经济福祉。然而,其风险因素尚不清楚。本研究旨在探讨NVP与言语评定量表测量的痛经之间的关系,并探讨潜在的保护因素。
    方法:本回顾性队列研究于2018年6月至2020年12月在武汉市同济医院进行。关于基线特征的信息,妊娠相关病史,周围的微量营养素补充,收集产科结局。使用言语评定量表(VRS)评估痛经的严重程度。
    结果:共招募443名孕妇,分为NVP组(n=76)和对照组(n=367)。在NVP和VRS测量的痛经之间观察到显着关联(χ2=10.038,P=0.007)。在调整协变量后,中度/重度痛经与NVP之间的相关性仍然显着(OR2.384,95%CI1.104-5.148,P=0.004)。早期补充DHA(OR0.443,95%CI0.205-0.960,P=0.039)可能有助于降低NVP的风险。
    结论:患有中度至重度痛经的女性在孕早期经历NVP的风险更高。感知DHA补充可能起到保护作用。
    OBJECTIVE: Nausea and vomiting in pregnancy (NVP) is a common condition that reduces the quality of life by negatively affecting work and family life, physical and mental health, and economic well-being. However, its risk factors remain unclear. This study aimed to explore the association between NVP and verbal rating scale (VRS)-measured dysmenorrhea and to explore potential protective factors.
    METHODS: This retrospective cohort study was conducted from June 2018 to December 2020 at Tongji Hospital in Wuhan. Information on baseline characteristics, pregnancy-related history, periconceptional micronutrient supplementation, and obstetric outcomes were collected. The severity of dysmenorrhea was assessed using VRS.
    RESULTS: A total of 443 pregnant women were recruited and divided into the NVP group (n = 76) and the control group (n = 367). A significant association was observed between NVP and VRS-measured dysmenorrhea (c2=10.038, P = 0.007). After adjusting for covariates, the association between moderate/severe dysmenorrhea and NVP remained significant (OR 2.384; 95% CI 1.104-5.148, P = 0.004). First-trimester docosahexaenoic acid supplement (OR 0.443; 95% CI 0.205-0.960, P = 0.039) may be beneficial in reducing the risk of NVP.
    CONCLUSIONS: Women with moderate to severe dysmenorrhea have a higher risk of experiencing NVP during the first trimester. Periconceptional docosahexaenoic acid supplementation may play a protective role.
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  • 文章类型: Journal Article
    本研究旨在评估肝保护,富含omega-3的鱼油对高胆固醇血症BALB/c小鼠的降血脂和主动脉形态学作用。这是一个实验模型,包括16只雄性BALB/c小鼠(Musmusculus),分为三组(G1(标准商业食品和0.9%盐溶液),G2(高胆固醇血症饮食和0.9%盐溶液)和G3(高胆固醇血症饮食和鱼油)8周。用富含ω-3的鱼油处理的血脂谱没有显著差异(p>0.05)。在组织学分析中,G2组检测到肝炎和肝组织坏死的存在,但G3组未观察到这种情况.至于血管明亮区域的形态测量,G1组的评分(2.62±0.36mm2)高于G2(2.10±0.16mm2)和G3(2.26±0.25mm2)(p<0.05).各组间血管壁厚度无差异(p>0.05)。结论本研究补充富含ω-3的鱼油可能对肝脏组织有保护作用,但它还没有改善脂质和形态特征。尽管这项研究是初步的,这是一项具有未来前景的相关研究,可以改善EPA和DHA的剂量,以更好地阐明鱼油在血脂异常模型中的益处。
    This study aims to evaluate the hepatoprotective, hypolipidemic and aortic morphometric effects of fish oil rich in omega-3 in hypercholesterolemic BALB/c mice. This is an experimental model that included 16 male BALB/c mice (Mus musculus) divided into three groups (G1 (standard commercial chow and 0.9% saline solution), G2 (hypercholesterolemic diet and 0.9% saline solution) and G3 (hypercholesterolemic diet and fish oil)) for 8 weeks. There was no significant difference in the treatment with omega-3-rich fish oil in the lipid profile (p > 0.05). In the histological analysis, group G2 detected the presence of hepatitis and liver tissue necrosis, but this was not observed in group G3. As for the morphometry in the light area of the vessel, the G1 group had a higher score (2.62 ± 0.36 mm2) when compared to G2 (2.10 ± 0.16 mm2) and G3 (2.26 ± 0.25 mm2) (p < 0.05). The vessel wall thickness did not differ between the groups (p > 0.05). It is concluded that supplementation with fish oil rich in omega-3 carried out in this study may have a protective effect on liver tissue, but it has not yet improved the lipid and morphometric profile. Despite this research being preliminary, it is a relevant study with future prospects for improving the doses of EPA and DHA in order to better elucidate the benefits of fish oil in models of dyslipidemia.
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  • 文章类型: Journal Article
    目的:二十二碳六烯酸(DHA)通常被推荐用于妊娠期间充分的胎儿发育。因为它是一种具有强烈抗炎作用的物质,其对胎儿心脏和循环的影响尚不清楚,在妊娠期间给药的安全性尚未确定。这项随机临床试验旨在研究孕妇补充DHA后是否会改变孕妇的前列腺素水平和胎儿动脉导管血流动力学。在怀孕的最后三个月。
    方法:双盲,安慰剂对照,设计了平行组的随机临床试验.该研究是在2018年至2021年期间开发的。18岁以上的孕妇,在27或28周时,胎儿超声心动图没有心脏改变被纳入试验,排除那些服用已知前列腺素抑制作用的物质,如非甾体抗炎药和富含多酚的食物。干预组口服补充ω-3和450毫克/天的DHA,安慰剂组接受大豆卵磷脂胶囊。两组均补充8周。在随访开始和结束时获得以下数据:人体测量学,评估多酚和omega-3的消耗,胎儿形态学超声,胎儿多普勒超声心动图检查和抽血评估前列腺素水平。参与者被认为是合格的,没有心脏或心外异常,当两名观察者排除导管狭窄的诊断时。评估组间和组内数据。
    结果:该研究以每组24名参与者结束。8周后,两组的导管流量和血清前列腺素水平的多普勒超声心动图参数均未显示明显的组间差异。存在导致胎龄增加的预期组内差异。
    结论:尽管尚未测试DHA的完全安全性,这项随机临床试验表明,孕晚期孕妇补充DHA,在使用的剂量和时期,不会导致PGE2的抑制,也不会引起动脉导管收缩,为更多的上市后监督研究提供基础,让最好的临床保证。本文受版权保护。保留所有权利。
    OBJECTIVE: Docosahexaenoic acid (DHA) is recommended routinely in pregnancy to promote fetal development. DHA has anti-inflammatory activity, but its effects on the fetal heart and circulation are unknown. This study aimed to investigate whether maternal DHA supplementation in the third trimester affects maternal prostaglandin levels and fetal ductus arteriosus flow dynamics.
    METHODS: This was a double-blind randomized controlled trial with parallel groups conducted between 2018 and 2021. Pregnant women aged over 18 years with a normal fetus at 27-28 weeks\' gestation showing no cardiac/extracardiac anomalies or ductal constriction were eligible for the trial. Women consuming substances with a known inhibitory effect on prostaglandin metabolism, such as non-steroidal anti-inflammatory drugs and polyphenol-rich foods, were excluded. The intervention group received oral supplementation of omega-3 with 450 mg/day of DHA for 8 weeks and the placebo group received capsules of soy lecithin for 8 weeks. Anthropometric measurements, assessment of polyphenol and omega-3 consumption, fetal morphological ultrasound examination, fetal Doppler echocardiographic examination and blood sample collection were performed at the start of the study and the latter two were repeated at follow-up. Prostaglandin E2 (PGE2) level and echocardiographic parameters were compared between the intervention and placebo groups and between baseline and follow-up.
    RESULTS: A total of 24 participants were included in each group. After 8 weeks, there were no significant differences between the intervention and placebo groups in maternal serum PGE2 level or Doppler echocardiographic parameters of ductal flow. No case of ductus arteriosus constriction was observed. The expected intragroup changes in cardiac morphology, as a result of advancing gestation, were present.
    CONCLUSIONS: Maternal DHA supplementation in the third trimester at a clinically recommended dose did not result in inhibition of PGE2 or constriction of the ductus arteriosus. These findings should be confirmed in postmarket surveillance studies with larger patient numbers in order to test the full safety profile of DHA and provide robust clinical reassurance. © 2024 International Society of Ultrasound in Obstetrics and Gynecology.
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