Objective: To determine the effects of ω-3 polyunsaturated fatty acids from different sources on glucolipid metabolism in type 2 diabetic patients with dyslipidemia. Methods: We recruited participants from the diabetes specialist clinic at the Guanlin hospital in Yixing city, Jiangsu Province from February 2017 to March 2017. A total of 180 subjects were randomly assigned to 3 g/day fish oil (FO), perilla oil (PO), or fish oil mixed with linseed oil (FLO) for 6 months. The basic conditions and fasting venous blood sample were obtained from each study subject at baseline, after 6 months of intervention. Serum glucose and lipid metabolism were investigated. Results: A total of 156 subjects aged (62.6±8.6) years completed the final follow-up after 6 months (FO,54 subjects; PO,52 subjects; FLO,50 subjects). Among them,59 patients (37.8%) were male. Serum glucose, glycated hemoglobin, C peptide, insulin and homeostasis model assessment-insulin resistance were not significantly different among the three groups after 6 months. Serum triglyceride decreased, whereas high-density lipoprotein cholesterol increased in FO [1.33 (1.05,1.93) mmol/L, (1.36±0.29) mmol/L, respectively] compared with PO [1.71 (1.23, 2.17) mmol/L, (1.23±0.22) mmol/L, respectively] and FLO [1.51 (1.12, 2.22) mmol/L, (1.29±0.30) mmol/L, respectively] (P<0.05). Serum low-density lipoprotein cholesterol and apolipoprotein B decreased in PO [(2.60±0.57) mmol/L,(0.96±0.23) g/L, respectively] compared with FO [(2.89±0.76) mmol/L, (1.07±0.30) g/L, respectively] (P<0.05). Serum lipoprotein(a) decreased in FLO [130.7 (63.3,270.6) mg/L] compared with FO [137.4 (58.7,333.2) mg/L] (P<0.05). Serum free fatty acid decreased in FLO [(0.43±0.15) mmol/L] compared with PO [(0.53±0.22) mmol/L] (P<0.05). Conclusion: The effects of ω-3 PUFA from different sources on glucose metabolism in type 2 diabetic patients with dyslipidemia are similar. Each of them has a good application prospect in improving lipid metabolism.
目的： 探讨不同来源ω-3多不饱和脂肪酸（PUFA）对2型糖尿病合并血脂异常人群糖脂代谢的影响。 方法： 于2017年2—3月在江苏省宜兴市官林医院糖尿病专科门诊招募180例2型糖尿病合并血脂异常患者，采用随机数字法分为鱼油组、紫苏油组和鱼油+亚麻油组，每组60例，每日分别给予3 g鱼油、紫苏油和鱼油+亚麻油胶囊，持续时间6个月。在基线和干预6个月时收集研究对象的基本情况等，并采集空腹血，测定糖、脂代谢指标，比较不同干预组间差异。 结果： 共有156例对象完成6个月的干预研究，年龄为（62.6±8.6）岁，男性占37.8%（59例），其中鱼油组54例，紫苏油组52例，鱼油+亚麻油组50例。糖代谢与基线相比，3组C肽、胰岛素、稳固模型评估胰岛素抵抗指数（HOMA-IR）均降低（P值均<0.05），紫苏油组和鱼油+亚麻油组血糖、糖化血红蛋白（HbA1c）降低（P值均<0.05）。脂代谢与基线相比，3组总胆固醇、非高密度蛋白胆固醇（HDL-C）、载脂蛋白A1均降低（P值均<0.05），鱼油组和紫苏油组甘油三酯（TG）降低（P<0.05），紫苏油组和鱼油+亚麻油组载脂蛋白B（Apo B）、脂蛋白（a）降低（P值均<0.05）。干预6个月后，3组间血糖、糖化血红蛋白、C肽、胰岛素、HOMA-IR差异无统计学意义（P>0.05）；鱼油组TG低于紫苏油组和鱼油+亚麻油组（P<0.05），HDL-C高于紫苏油组和鱼油+亚麻油组（P<0.05）；紫苏油组低密度脂蛋白胆固醇、Apo B均低于鱼油组（P值均<0.05）；鱼油+亚麻油组脂蛋白（a）低于鱼油组（P<0.05），游离脂肪酸低于紫苏油组（P<0.05）。 结论： 动物性来源、植物性来源和动植物性来源兼有的ω-3 PUFA对2型糖尿病合并血脂异常人群糖代谢方面的影响相似，对脂代谢方面的影响各有优势。.
Keywords: Diabetes mellitus, type 2; Dyslipidemias; Glucolipid metabolism; ω-3 polyunsaturated fatty acid.