Desaturases

去饱和酶
  • 文章类型: Journal Article
    三阴性乳腺癌(TNBC)的治疗选择有限,是高度转移性的,以早期复发为特征。脂质代谢在TNBC中通常是失调的,并且可能揭示被靶向或用作具有临床价值的生物标志物的脆弱性。铁凋亡是由多不饱和脂肪酸(PUFA)的存在促进的铁依赖性脂质过氧化引起的一种细胞死亡。在这里,我们确定脂肪酸去饱和酶1和2(FADS1/2),它们负责PUFA的生物合成,在预后较差的TNBC亚组中高表达。脂质分析,再加上功能性代谢测定,表明高表达FADS1/2的TNBC对铁凋亡诱导剂敏感,并且通过遗传干扰和药理学方法靶向FADS1/2使这些肿瘤具有铁凋亡抗性,而通过补充外源PUFA使PUFA/MUFA比例失衡使肿瘤对铁凋亡诱导敏感。最后,抑制脂滴(LD)的形成和周转会抑制LD的缓冲能力并增强铁依赖性细胞死亡。这些发现已在小鼠和人类衍生的临床相关模型以及TNBC患者的回顾性队列中在体外和体内得到验证。
    Triple-negative breast cancer (TNBC) has limited therapeutic options, is highly metastatic and characterized by early recurrence. Lipid metabolism is generally deregulated in TNBC and might reveal vulnerabilities to be targeted or used as biomarkers with clinical value. Ferroptosis is a type of cell death caused by iron-dependent lipid peroxidation which is facilitated by the presence of polyunsaturated fatty acids (PUFA). Here we identify fatty acid desaturases 1 and 2 (FADS1/2), which are responsible for PUFA biosynthesis, to be highly expressed in a subset of TNBC with a poorer prognosis. Lipidomic analysis, coupled with functional metabolic assays, showed that FADS1/2 high-expressing TNBC are susceptible to ferroptosis-inducing agents and that targeting FADS1/2 by both genetic interference and pharmacological approach renders those tumors ferroptosis-resistant while unbalancing PUFA/MUFA ratio by the supplementation of exogenous PUFA sensitizes resistant tumors to ferroptosis induction. Last, inhibiting lipid droplet (LD) formation and turnover suppresses the buffering capacity of LD and potentiates iron-dependent cell death. These findings have been validated in vitro and in vivo in mouse- and human-derived clinically relevant models and in a retrospective cohort of TNBC patients.
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  • 文章类型: Journal Article
    信息素在很大程度上用于昆虫。这些信息素中的许多是通过涉及脂肪酸的途径生物合成的。本章将提供详细研究脂肪酸衍生信息素的生物合成途径的示例。这些包括来自鳞翅目的信息素,鞘翅目,和膜翅目.许多鳞翅目物种利用脂肪酸作为具有包括醛在内的官能团的信息素的前体,酒精,和乙酸酯。此外,由于许多昆虫利用碳氢化合物或改性碳氢化合物作为信息素,因此将简要检查碳氢化合物的生物合成。
    Pheromones are utilized to a great extent in insects. Many of these pheromones are biosynthesized through a pathway involving fatty acids. This chapter will provide examples where the biosynthetic pathways of fatty acid-derived pheromones have been studied in detail. These include pheromones from Lepidoptera, Coleoptera, and Hymenoptera. Many species of Lepidoptera utilize fatty acids as precursors to pheromones with a functional group that include aldehydes, alcohols, and acetate esters. In addition, the biosynthesis of hydrocarbons will be briefly examined because many insects utilize hydrocarbons or modified hydrocarbons as pheromones.
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  • 文章类型: Journal Article
    神经性厌食症(AN)的限制性亚型(AN-R)与暴食和清除亚型(AN-BP)之间的饮食行为不同。然而,对于这些差异如何影响AN中的脂肪酸(FA)失调知之甚少。为了解决这个问题,我们分析了96名女性的26个FAs和7个FA脂肪生成酶(4个去饱和酶和3个延伸酶):25个AN-R,25AN-BP,和46名健康对照妇女。我们的目标是评估亚型特异性模式。在禁食时间点,AN-BP中的月桂酸明显高于AN-R中的月桂酸(p=0.038),并且在进食后2小时表现出显着不同的餐后变化。AN-R显示显著较高水平的n-3α-亚麻酸,硬脂酸,二十碳五烯酸(EPA),二十二碳五烯酸,与对照相比,n-6亚油酸和γ-亚麻酸。与对照相比,AN-BP显示升高的EPA和饱和月桂酸。较高的EPA与AN-R的焦虑升高有关(p=0.035),但与AN-BP的焦虑降低有关(p=0.043)。这些发现表明,AN亚型中明显的饮食失调行为会导致脂质失调和饮食失调合并症。个性化饮食干预可以改善脂质失调并增强AN的治疗效果。
    Disordered eating behavior differs between the restricting subtype (AN-R) and the binging and purging subtype (AN-BP) of anorexia nervosa (AN). Yet, little is known about how these differences impact fatty acid (FA) dysregulation in AN. To address this question, we analyzed 26 FAs and 7 FA lipogenic enzymes (4 desaturases and 3 elongases) in 96 women: 25 AN-R, 25 AN-BP, and 46 healthy control women. Our goal was to assess subtype-specific patterns. Lauric acid was significantly higher in AN-BP than in AN-R at the fasting timepoint (p = 0.038) and displayed significantly different postprandial changes 2 h after eating. AN-R displayed significantly higher levels of n-3 alpha-linolenic acid, stearidonic acid, eicosapentaenoic acid (EPA), docosapentaenoic acid, and n-6 linoleic acid and gamma-linolenic acid compared to controls. AN-BP showed elevated EPA and saturated lauric acid compared to controls. Higher EPA was associated with elevated anxiety in AN-R (p = 0.035) but was linked to lower anxiety in AN-BP (p = 0.043). These findings suggest distinct disordered eating behaviors in AN subtypes contribute to lipid dysregulation and eating disorder comorbidities. A personalized dietary intervention may improve lipid dysregulation and enhance treatment effectiveness for AN.
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  • 文章类型: Journal Article
    二酰基甘油酰基转移酶1(DGAT1)是拟南芥种子发育过程中合成三酰基甘油(TAG)的主要酶。突变体dgat1种子除了具有高多不饱和脂肪酸(PUFA)组成外,还具有低油含量。两个编码内质网局部去饱和酶的基因,脂肪酸去饱和酶2(FAD2)和脂肪酸去饱和酶3(FAD3),在dgat1-1和dgat1-2发育中的种子中均上调。dgat1突变体等位基因和fad2-1之间的交叉未能产生dgat1和fad2纯合的植物。与野生型植物的相互杂交表明,雄性和雌性dgat1fad2配子体均可行。来自DGAT1/dgat1-1fad2-1/fad2-1和dgat1-1/dgat1-1FAD2/fad2-1的Siliques拥有外观异常的种子,这些种子在鱼雷生长阶段被捕获。大约25%的种子表现出这种停滞的表型,遗传上与他们具有双纯合dgat1fad2基因型一致。相比之下,双纯合dgat1-1fad3-2突变植物是可行的。这些植物的种子具有较高的18:2水平,而其脂肪酸含量低于dgat1突变体对照。结果与没有DGAT1活性的模型一致,FAD2对脂肪酸的去饱和对于为磷脂:二酰甘油酰基转移酶(PDAT)提供PUFA底物以合成TAG是必不可少的。在dgat1fad2突变体中,种子发育被中止,因为TAG不能被DGAT1或PDAT合成。
    Diacylglycerol acyltransferase1 (DGAT1) is the major enzyme that synthesizes triacylglycerols (TAG) during Arabidopsis seed development. Mutant dgat1 seeds possess low oil content in addition to a high polyunsaturated fatty acid (PUFA) composition. Two genes encoding endoplasmic reticulum localized desaturase enzymes, fatty acid desaturase2 (FAD2) and fatty acid desaturase3 (FAD3), were upregulated in both dgat1-1 and dgat1-2 developing seeds. Crosses between both dgat1 mutant alleles and fad2-1 failed to generate plants homozygous for both dgat1 and fad2. Reciprocal crosses with wild-type plants demonstrated that both male and female dgat1 fad2 gametophytes were viable. Siliques from DGAT1/dgat1-1 fad2-1/fad2-1 and dgat1-1/dgat1-1 FAD2/fad2-1 possessed abnormal looking seeds that were arrested in the torpedo growth stage. Approximately 25% of the seeds exhibited this arrested phenotype, genetically consistent with them possessing the double homozygous dgat1 fad2 genotype. In contrast, double homozygous dgat1-1 fad3-2 mutant plants were viable. Seeds from these plants possessed higher levels of 18:2 while their fatty acid content was lower than dgat1 mutant controls. The results are consistent with a model where in the absence of DGAT1 activity, desaturation of fatty acids by FAD2 becomes essential to provide PUFA substrates for phospholipid:diacylglycerol acyltransferase (PDAT) to synthesize TAG. In a dgat1 fad2 mutant, seed development is aborted because TAG is unable to be synthesized by either DGAT1 or PDAT.
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  • 文章类型: Journal Article
    温度上升和UV-A辐射对生长的影响,脂质损伤,研究了蓝藻铜绿微囊藻脂肪酸(FA)组成和去饱和酶基因desA和desB的表达。虽然UV-A的破坏作用已经有了很好的记录,关于紫外线辐射暴露和变暖对蓝藻的相互作用的报道很少。温度和UV-A剂量基于先前通过本研究中使用的相同铜绿分枝杆菌菌株的研究获得的生理反应来选择。将在26°C预生长的细胞在相同温度或29°C下孵育,并暴露于UV-A+PAR和仅PAR9天。在整个实验过程中,UV-A辐射对生长速率的影响与温度无关。高温产生的脂质损伤在整个实验中明显更高,与26°C相比,在第9天降低。此外,在29°C下在UV-A下生长的细胞显示多不饱和FA(PUFA)水平降低,ω3PUFA在暴露结束时主要受到影响。以前,我们报道了UV-A诱导的脂质损伤对ω3和ω6PUFA的影响不同。我们报告说,UV-A辐射导致desA上调,可能是由于脂质损伤。此外,无论辐射如何,温度升移都会上调desA和desB。UV-A在ω3上缺乏脂质损伤可以解释desB缺乏转录诱导。暴露于UV-A的细胞在26°C时ω6的显着降低可能是由于缺乏desA的上调。
    Temperature up-shift and UV-A radiation effects on growth, lipid damage, fatty acid (FA) composition and expression of desaturase genes desA and desB were investigated in the cyanobacteria Microcystis aeruginosa. Although UV-A damaging effect has been well documented, reports on the interactive effects of UV radiation exposure and warming on cyanobacteria are scarce. Temperature and UV-A doses were selected based on the physiological responses previously obtained by studies with the same M. aeruginosa strain used in this study. Cells pre-grown at 26 °C were incubated at the same temperature or 29 °C and exposed to UV-A + PAR and only PAR for 9 days. Growth rate was significantly affected by UV-A radiation independently of the temperature throughout the experiment. High temperature produced lipid damage significantly higher throughout the experiment, decreasing at day 9 as compared to 26 °C. In addition, the cells grown at 29 °C under UV-A displayed a decrease in polyunsaturated FA (PUFA) levels, with ω3 PUFA being mostly affected at the end of exposure. Previously, we reported that UV-A-induced lipid damage affects differentially ω3 and ω6 PUFAs. We report that UV-A radiation leads to an upregulation of desA, possibly due to lipid damage. In addition, the temperature up-shift upregulates desA and desB regardless of the radiation. The lack of lipid damage for UV-A on ω3 could explain the lack of transcription induction of desB. The significant ω6 decrease at 26 °C in cells exposed to UV-A could be due to the lack of upregulation of desA.
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  • 文章类型: Journal Article
    FAD(脂肪酸去饱和酶)和SAD(硬脂酰ACP去饱和酶)基因在脂肪酸(FA)的合成和亚麻(LinumusitatissimumL.)中油脂成分的测定中起着关键作用。我们在CDC白求恩品种最广泛使用的亚麻基因组中搜索了FAD和SAD基因,以及三个可用的长读组装的亚麻基因组YY5、3896和Atlant。我们鉴定了15个FAD2、6个FAD3和4个SAD基因。在所有确定的基因中,24个存在于重复的对中。在大多数情况下,一对中的两个基因的差异在于大量的基因特异性SNP(单核苷酸多态性)甚至InDels(插入/缺失),除了FAD2a-1和FAD2a-2,其中只有七个SNP区分这些基因。在CDC白求恩基因组组装中的FAD2a-1,FAD2a-2,FAD3c-1和FAD3d-2序列中检测到错误,但在长读基因组组装中未检测到错误。对不同亚麻器官/组织的可用转录组数据的表达分析显示,FAD2a-1,FAD2a-2,FAD3a,FAD3b,SAD3-1和SAD3-2在胚/种子/胶囊中特异性表达,并可能在亚麻种子中FA的合成中起关键作用。相比之下,FAD2b-1,FAD2b-2,SAD2-1和SAD2-2在所有分析的器官/组织中均高表达,并且可能参与整个亚麻植物的FA合成。FAD2c-2,FAD2d-1,FAD3c-1,FAD3c-2,FAD3c-2,FAD3d-1,FAD3d-2,SAD3-1和SAD3-2在胁迫条件下表现出差异表达-尖孢镰刀菌感染和干旱。获得的结果对于研究脂肪酸合成的分子机制至关重要。FAD和SAD编辑,以及标记辅助和基因组选择,用于育种具有确定的油脂脂肪酸组成的亚麻品种。
    FAD (fatty acid desaturase) and SAD (stearoyl-ACP desaturase) genes play key roles in the synthesis of fatty acids (FA) and determination of oil composition in flax (Linum usitatissimum L.). We searched for FAD and SAD genes in the most widely used flax genome of the variety CDC Bethune and three available long-read assembled flax genomes-YY5, 3896, and Atlant. We identified fifteen FAD2, six FAD3, and four SAD genes. Of all the identified genes, 24 were present in duplicated pairs. In most cases, two genes from a pair differed by a significant number of gene-specific SNPs (single nucleotide polymorphisms) or even InDels (insertions/deletions), except for FAD2a-1 and FAD2a-2, where only seven SNPs distinguished these genes. Errors were detected in the FAD2a-1, FAD2a-2, FAD3c-1, and FAD3d-2 sequences in the CDC Bethune genome assembly but not in the long-read genome assemblies. Expression analysis of the available transcriptomic data for different flax organs/tissues revealed that FAD2a-1, FAD2a-2, FAD3a, FAD3b, SAD3-1, and SAD3-2 were specifically expressed in embryos/seeds/capsules and could play a crucial role in the synthesis of FA in flax seeds. In contrast, FAD2b-1, FAD2b-2, SAD2-1, and SAD2-2 were highly expressed in all analyzed organs/tissues and could be involved in FA synthesis in whole flax plants. FAD2c-2, FAD2d-1, FAD3c-1, FAD3c-2, FAD3d-1, FAD3d-2, SAD3-1, and SAD3-2 showed differential expression under stress conditions-Fusarium oxysporum infection and drought. The obtained results are essential for research on molecular mechanisms of fatty acid synthesis, FAD and SAD editing, and marker-assisted and genomic selection for breeding flax varieties with a determined fatty acid composition of oil.
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  • 文章类型: Journal Article
    四碳六烯酸(24:6ω-3)是哺乳动物中18:3ω-3转化为22:6ω-3的中间体。关于细胞是否可以同化和代谢外源24:6ω-3的信息有限。这项研究比较了与24:6ω-3孵育对两种相关细胞类型脂肪酸组成的影响,原发性CD3+T淋巴细胞和JurkatT细胞白血病,多不饱和脂肪酸(PUFA)生物合成途径的完整性不同。当细胞与24:6ω-3孵育时,仅在任一细胞类型中检测到24:6ω-3。与24:6ω-3孵育在两种细胞类型中诱导了22:6ω-3的量的相似增量,并改变了由T淋巴细胞活化诱导的稳态粘性适应脂肪酸组成。在Jurkat细胞中测试了与18:3ω-3相比于24:6ω-3孵育对22:6ω-3增量的影响,因为原代T细胞不能将18:3ω-3转化为22:6ω-3。与24:6ω-3孵育的Jurkat细胞的22:6ω-3含量的增量比与18:3ω-3孵育的细胞高19.5倍。在Jurkat细胞中,酰基辅酶A氧化酶siRNA敲除减少22:6ω-3的量并增加24:6ω-3的量。这些发现表明,外源24:6ω-3可以掺入原代人T淋巴细胞和Jurkat细胞中,并通过涉及过氧化物酶体β-氧化的机制诱导脂肪酸组成的变化与其向22:6ω-3的转化一致,该机制独立于上游PUFA合成途径的完整性。另一个暗示是,消耗24:6ω-3可能是实现归因于20:5ω-3和22:6ω-3的健康益处的有效替代手段。
    Tetracosahexaenoic acid (24:6ω-3) is an intermediate in the conversion of 18:3ω-3 to 22:6ω-3 in mammals. There is limited information about whether cells can assimilate and metabolize exogenous 24:6ω-3. This study compared the effect of incubation with 24:6ω-3 on the fatty acid composition of two related cell types, primary CD3+ T lymphocytes and Jurkat T cell leukemia, which differ in the integrity of the polyunsaturated fatty acid (PUFA) biosynthesis pathway. 24:6ω-3 was only detected in either cell type when cells were incubated with 24:6ω-3. Incubation with 24:6ω-3 induced similar increments in the amount of 22:6ω-3 in both cell types and modified the homeoviscous adaptations fatty acid composition induced by activation of T lymphocytes. The effect of incubation with 18:3ω-3 compared to 24:6ω-3 on the increment in 22:6ω-3 was tested in Jurkat cells because primary T cells cannot convert 18:3ω-3 to 22:6ω-3. The increment in the 22:6ω-3 content of Jurkat cells incubated with 24:6ω-3 was 19.5-fold greater than that of cells incubated with 18:3ω-3. Acyl-coA oxidase siRNA knockdown decreased the amount of 22:6ω-3 and increased the amount of 24:6ω-3 in Jurkat cells. These findings show exogenous 24:6ω-3 can be incorporated into primary human T lymphocytes and Jurkat cells and induces changes in fatty acid composition consistent with its conversion to 22:6ω-3 via a mechanism involving peroxisomal β-oxidation that is regulated independently from the integrity of the upstream PUFA synthesis pathway. One further implication is that consuming 24:6ω-3 may be an effective alternative means of achieving health benefits attributed to 20:5ω-3 and 22:6ω-3.
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  • 文章类型: Journal Article
    锌在人类健康中的作用是在60年前发现的,尽管做出了非凡的研究努力,仍然缺乏足够敏感和特异性的锌状态生物标志物。血浆/血清锌,目前最好的可用和最被接受的人口锌状态指标,对严重锌缺乏反应良好,然而,轻度至中度锌缺乏状态通常仍未被识别。识别早期锌缺乏症需要其他可靠的锌状态标记。本文讨论了灵敏度,特异性,以及血浆锌浓度对锌干预的反应性。它描述了锌和脂肪酸去饱和酶活性之间因果关系的生化和饮食基础。FADS1和FADS2,基于通过在动物和/或人类中进行的研究收集的数据。考虑了潜在的混杂因素和协变量对观察到的关系的影响。讨论了其他潜在的Zn生物标志物,并为该领域的进一步研究提供了建议。
    The role of Zn in human health was discovered 60 years ago, and despite remarkable research efforts, a sufficiently sensitive and specific biomarker of Zn status is still lacking. Plasma/serum Zn, currently the best available and most accepted population Zn status indicator, responds well to severe Zn deficiency, yet, mild to moderate Zn deficiency states usually remain unrecognized. Identifying early-stage Zn deficiency requires additional robust markers of Zn status. This paper discusses the sensitivity, specificity, and responsiveness of plasma Zn concentrations to Zn interventions. It describes the biochemical and dietary basis for the causal association between Zn and fatty acid desaturases activity, FADS1 and FADS2, based on data collected through studies performed in animals and/or humans. The influence of potential confounders and covariates on the observed relationships is considered. Additional potential Zn biomarkers are discussed and suggestions for further research in this area are provided.
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  • 文章类型: Journal Article
    毛霉CircinelloidesWJ11,一种含油丝状真菌,在高C/N比培养基中培养时,产生细胞干重的36%脂质,然而,γ-亚麻酸(GLA)的产量不足以使其与其他植物来源竞争。为了增加CircinelloidesWJ11中的GLA含量,通过过表达其关键基因如Δ6-,Δ12-,和参与GLA生产的Δ9-去饱和酶。首先,我们试图过表达两种Δ6-去饱和酶同工酶,以确定哪一种在GLA合成中起重要作用。其次,Δ6-和Δ12-去饱和酶共同过表达,以检查是否亚油酸(LA),GLA合成的前体,是一个限制因素。此外,我们试图探索同时过表达Δ6-的影响,Δ12-,和Δ9-去饱和酶对GLA生产的影响。我们的结果表明,DES61的过表达(1个基因)促进了更高的GLA含量(占总脂肪酸的21%),而共同过表达(2个基因)DES61和DES12以及同时过表达(3个基因)DES61,DES12和DES91的GLA产量与对照菌株相比增加了1.5倍和1.9倍,分别。这项研究为含油真菌中GLA的生物合成提供了更多的见解,并为进一步增加GLA在真菌中的产量奠定了基础。
    Mucor circinelloides WJ11, an oleaginous filamentous fungus, produces 36% lipid of its cell dry weight when cultured in a high C/N ratio medium, however, the yield of γ-linolenic acid (GLA) is insufficient to make it competitive with other plant sources. To increase the GLA content in M. circinelloides WJ11, this fungus was engineered by overexpression of its key genes such as Δ6-, Δ12-, and Δ9-desaturases involved in GLA production. Firstly, we tried to overexpress two Δ6-desaturase isozymes to determine which one played important role in GLA synthesis. Secondly, Δ6-and Δ12-desaturase were co-overexpressed to check whether linoleic acid (LA), the precursor for GLA synthesis, is a limiting factor or not. Moreover, we tried to explore the effects of simultaneous overexpression of Δ6-, Δ12-, and Δ9-desaturases on GLA production. Our results showed that overexpression (1 gene) of DES61 promoted higher GLA content (21% of total fatty acids) while co-overexpressing (2 genes) DES61 and DES12 and simultaneous overexpressing (3 genes) DES61, DES12, and DES91 increased the GLA production of engineered strains by 1.5 folds and 1.9 folds compared to the control strain, respectively. This study provided more insights into GLA biosynthesis in oleaginous fungi and laid a foundation for further increase in GLA production into fungus such as M. circinelloides.
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  • 文章类型: Journal Article
    去饱和酶活性(DEA)与几种代谢疾病相关。本研究的目的是评估估计的血浆DEA与代谢综合征(MetS)之间的关系,以及它们与MetS各个组成部分的关系。我们对从PREDIMED试验(医院诊所中心)随机招募的148名参与者进行了一项纵向研究。在基线和随访1年后,从单个血浆脂肪酸的产物/前体比率估计DEA。Logistic回归用于评估估计DEAMetS的关系,针对潜在的联合创始人进行了调整。估计的Δ5去饱和酶(D5D)活性与较低的MetS风险相关,而硬脂酰辅酶A(SCD)-16和SCD-18与MetS状态呈负相关。SCD-16、SCD-18和Δ6去饱和酶(D6D)与甘油三酯呈正相关,SCD-18与HDL-胆固醇呈负相关。发现估计的D6D活性与舒张压升高有关。相比之下,D5D与甘油三酯呈负相关,舒张压和腰围。本纵向研究表明,估计的SCD-16,SCD-18和D6D对MetS及其组成部分有负面影响,而D5D可能对代谢健康有益。
    Desaturase enzyme activities (DEA) are associated with several metabolic diseases. The aim of the present study was to assess the relationship between estimated plasma DEA and the metabolic syndrome (MetS), as well as their relationship with individual components of the MetS. We conducted a longitudinal study of 148 participants recruited at random from the PREDIMED trial (Hospital Clinic site). At baseline and after 1 year of follow-up, DEA were estimated from product/precursor ratios of individual plasma fatty acids. Logistic regressions were used to assess the relationship of estimated DEA MetS, adjusted for potential cofounders. Estimated Δ5 desaturase (D5D) activity was associated with lower risk of MetS, whereas stearoyl-CoA (SCD)-16 and SCD-18 were negatively associated with MetS status. SCD-16, SCD-18, and Δ6 desaturase (D6D) were positively associated with triglycerides, SCD-18 was inversely associated with HDL-cholesterol. Estimated D6D activity was found to be associated with increases in diastolic blood pressure. In contrast, D5D was negatively associated with triglycerides, diastolic blood pressure and waist circumference. The present longitudinal study suggests that estimated SCD-16, SCD-18, and D6D have a negative impact in MetS and its components, whereas D5D may have beneficial effects for metabolic health.
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