Abstract | CILJ ISTRAŽIVANJA: Ispitati utjecaj konzumacije kokošjih jaja obogaćenih omega-3 masnim kiselinama, luteinom, vitaminom E i selenom na pokazatelje mikrovaskularne funkcije, oksidativnog stresa i razinu upalnih medijatora u bolesnika nakon akutnog koronarnog sindroma (AKS) – randomizirani kontrolirani pokus. ISPITANICI I METODE: Odrasli ispitanici oba spola s AKS-om randomizirani su u kontrolnu skupinu (obična kokošja jaja) i Nutri4 skupinu (funkcionalno obogaćena jaja) i podvrgnuti trotjednom nadziranom dijetetskom protokolu. Prije i nakon provedene dijete, pomoću laser doppler metode mjerenja krvnog protoka u mikrocirkulaciji kože određene su promjene vrijednosti post-okluzivne reaktivne hiperemije (PORH), acetilkolinom inducirane dilatacije (Ach ID) i natrijevim nitroprusidom inducirane dilatacije (SNP ID), što su pokazatelji mikrovaskularne funkcije. Nadalje, utvrđena je aktivnost antioksidativnih enzima CAT, GPx i SOD, promjena biomarkera oksidativnoga stresa i antioksidativnoga kapaciteta, razina pro- i protuupalnih citokina i kemokina, lipidni profil te proteinski izražaj enzima eNOS, iNOS, i nNOS, koji su važni u mehanizmima mikrovaskularne reaktivnosti u bolesnika s AKS-om. REZULTATI: Nakon protokola konzumacije Nutri 4 jaja zabilježene su značajno niže razine LDL kolesterola u krvi i povišene razine triglicerida, dok su razine ukupnog kolesterola ostale unutar referentnih vrijednosti. Dijetetski protokol također je povećao razinu vitamina E u serumu za 12,7 % i razinu selena za 8,6 %, te je imao pozitivan učinak na mikrovaskularnu reaktivnost (endotelnu funkciju), što je prikazano značajno poboljšanom post-okluzivnom reaktivnom hiperemijom i dilatacijom izazvanom acetilkolinom, uz značajno niže razine arterijskog tlaka i pulsa. Dijetetski protokol nije značajno utjecao na aktivnost CAT-a, GPx-a i SOD-a, niti je povećao vrijednosti TBARS-a ili FRAP-a. Također, nije značajno utjecao na razine TNF-α, TGF-1β, C3a, IFN-γ, IL-6, IL-10, IL-17A, IL-23 ili MCP-1. Međutim, konzumacija Nutri 4 jaja dovela je do smanjenja razina nNOS-a i iNOS-a, dok su se razine eNOS-a povećale, iako ne značajno, u bolesnika s AKS-om. ZAKLJUČAK: Prehrambeni protokol koji uključuje konzumaciju Nutri 4 jaja obogaćenih n-3 PUFA, luteinom, vitaminom E i selenom imao je pozitivan učinak na mikrovaskularnu funkciju, bez negativnog utjecaja na oksidativni stres i neznačajno sniženje razine proupalnih medijatora u bolesnika s AKS-om. |
Abstract (english) | OBJECTIVE OF THE RESEARCH: To examine the influence of hen eggs consumption, enriched with omega-3 fatty acids, lutein, vitamin E and selenium on indicators of microvascular function, oxidative stress and the level of inflammatory mediators in patients after acute coronary syndrome (ACS) - a randomized controlled trial. SUBJECTS AND METHODS: Adult subjects of both sexes with ACS were randomized into a control group (regular hen eggs) and a Nutri4 group (functionally enriched eggs) and underwent a three-week supervised dietary protocol. Before and after the diet, changes in the values of post-occlusive reactive hyperemia (PORH), acetylcholine-induced dilation (Ach ID) and sodium nitroprusside-induced dilation (SNP ID) were determined using the laser doppler blood flow measurement method in the skin microcirculation, which are indicators of microvascular functions. Furthermore, the activity of the antioxidant enzymes CAT, GPx and SOD, changes in biomarkers of oxidative stress and antioxidant capacity, levels of pro- and anti-inflammatory cytokines and chemokines, lipid profile and protein expression of the enzymes eNOS, iNOS, and nNOS were assessed, which are important in the mechanisms of microvascular reactivity in patients with ACS. RESULTS: After the Nutri4 consumption protocol, significantly lower blood cholesterol and higher triglyceride levels were recorded, while the levels of total cholesterol remained within the reference values. The dietary protocol also increased serum vitamin E levels by 12.7% and selenium levels by 8.6%, and had a positive effect on microvascular reactivity, as shown by significantly PORH and AcH ID, with significantly lower levels of arterial pressure and heart rate. The dietary protocol did not significantly affect the activity of CAT, GPx and SOD, nor did it increase the values of TBARS or FRAP. Also, it did not significantly affect the levels of TNF-alpha, TGF-1β, C3a, IFN-gamma, IL-6, IL-10, IL-17A, IL-23 or MCP-1. However, Nutri4 eggs consumption led to a decrease in the levels of nNOS and iNOS, while the levels of eNOS increased, although not significantly, in patients with ACS. CONCLUSION: In patients with ACS, consuming Nutri 4 eggs enriched with n-3 PUFA, lutein, vitamin E, and selenium as part of their dietary protocol had a positive impact on microvascular function while not causing any negative effects on oxidative stress. Additionally, there was a non-significant reduction in the level of pro-inflammatory mediators. |