Biomarkers of oxidation, inflammation and intestinal permeability in persons with diabetes mellitus with parenteral nutrition: A multicenter randomized trial.
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Soria-Utrilla Virginia, Sasso Corina Verónica, Romero-Zerbo Silvana Yanina, Adarve-Castro Antonio, López-Urdiales Rafael, Herranz-Antolín Sandra, García-Almeida José Manuel, García-Malpartida Katherine, Ferrer-Gómez Mercedes, Moreno-Borreguero Alicia, Luengo-Pérez Luis Miguel, Álvarez-Hernández Julia, Aragón-Valera Carmen, Ocón-Bretón María Julia, García-Manzanares Álvaro, Bretón-Lesmes Irene, Serrano-Aguayo Pilar, Pérez-Ferre Natalia, López-Gómez Juan José, Olivares-Alcolea Josefina, Moreno-Martínez Macarena, Tejera-Pérez Cristina, García-Arias Sara, Abad-González Ángel Luis, Alhambra-Expósito María Rosa, Zugasti-Murillo Ana, Parra-Barona Juan, Torrejón-Jaramillo Sara, Abuin José, Fernández-García José Carlos, Olveira Gabriel, Nutrition Area of the Spanish Society of Endocrinology and Nutrition (SEEN)
Аннотация
METHODS: This was a prospective study, including 94 patients with T2DM who received omega (n)-3 polyunsaturated fatty acids (PUFA)-enriched PN, a mixture of medium and long chain triglycerides (MCT/LCT) PN, or an olive oil-based PN. Serum levels of biomarkers of oxidative status, intestinal permeability and inflammation biomarkers were determined at day 1 and day 5 after PN initiation. Registered under ClinicalTrials.gov Identifier no. NCT02706119.
RESULTS: At day 5 after the onset of PN, the MCT/LCT group had a significant reduction of 2 proinflammatory cytokines [interleukin (IL)-15, IL-17A], elevation of the anti-inflammatory cytokine IL-13 and increase of zonulin and indoxylsulfate. The olive oil group showed a statistically significant reduction of 5 proinflammatory cytokines [IL-1β, IL-17A, IL-6, cytokine-leukemia inhibitory factor (LIF) and tumor necrosis factor alpha (TNF-α)] and reduced concentrations of the anti-inflammatory cytokine IL-1RA, while the n-3 PUFA-enriched group presented a statistically significant reduction of 8 proinflammatory cytokines (interferon-gamma, IL-1β, IL-15, IL-17A, IL-6, LIF, monocyte chemoattractant protein 1, and TNF-α). In the between-group comparisons, indoxylsulfate significantly increased in the MCT/LCT group compared to the n-3 PUFA-enriched group, while 8-isoprostane and indoxylsulfate significantly increased in the MCT/LCT group compared to the other groups and superoxide dismutase significantly decreased in the MCT/LCT group compared to the other groups.
CONCLUSION: In patients with T2DM, PN lipid composition exerts a profound impact on proinflammatory, prooxidative and intestinal permeability biomarkers.