骨关节炎是一种自身免疫病，其特征是膝关节骨骼及软骨组织的自我消化、修复、畸形和疼痛，占关节炎总病例的10%-15%。自身免疫病的病因尚不完全清楚，但通常认为与身体某个部位的慢性炎症有关。这种慢性炎症可能来自肠道菌群失调，也可能来自身体疾病，如癌症患者常伴有骨关节炎。 与其说肥胖是骨关节炎的后遗症，不如说二者都是慢性炎症的并发症。因此，骨关节炎的严重程度并不完全取决于患者的体重是多少，而是也取决于患者所吃的食物是什么。刚刚在《风湿病年报》上发表的一篇文章证实了这个观点。 在小鼠关节炎模型中发现，饲喂饱和脂肪（动物油）的小鼠骨关节炎更严重，饲喂欧米伽6不饱和脂肪酸（植物油）的小鼠骨关节炎有所缓解，而饲喂欧米伽3不饱和脂肪酸（深海鱼油）的小鼠骨关节炎基本康复。 不同种类油脂影响骨关节炎的深层原因在于饱和脂肪酸能促炎，而不饱和脂肪酸能抗炎，其中多不饱和脂肪酸（多个双键）的抗炎能力强于单不饱和脂肪酸（一个双键）。欧米伽6植物油含2-4个双键，欧米伽3深海鱼油含3-6个双键，前者的抗炎活性弱于后者。 因此，从小鼠实验推测，骨关节炎患者吃深海鱼油有助于康复，而吃动物油则会加剧病情，但仍需通过人体试验加以证实。 Omega 3 fatty acids lessen severity of osteoarthritis in mice Date: July 11, 2014 Source: Duke Medicine Summary: Mice consuming a supplement of omega 3 fatty acids had healthier joints than those fed diets high in saturated fats and omega 6 fatty acids, according to researchers. “Our results suggest that dietary factors play a more significant role than mechanical factors in the link between obesity and osteoarthritis,” said the study's senior author. Microcomputed tomography (3D X-ray) images (top) and histology images (bottom) of the knees of mice fed a very high fat diet containing omega 3 fatty acid supplement (left) or only omega 6 fatty acids (right) after a knee injury. The omega 6 diet showed abnormal bone remodeling and calcified tissue formation in the joint (white arrow). The omega 6 diet also showed significant loss of cartilage (red staining, yellow arrowhead) and increased joint inflammation. Credit: Duke Orthopaedic Research Laboratories Mice consuming a supplement of omega 3 fatty acids had healthier joints than those fed diets high in saturated fats and omega 6 fatty acids, according to Duke Medicine researchers. The findings, published in the Annals of the Rheumatic Diseases , suggest that unhealthy dietary fats – not just obesity – may contribute to worsening osteoarthritis. “Our results suggest that dietary factors play a more significant role than mechanical factors in the link between obesity and osteoarthritis,” said Farshid Guilak, Ph.D., Laszlo Ormandy Professor of Orthopaedic Surgery at Duke and the study’s senior author. Obesity is one of the primary risk factors for osteoarthritis, although the mechanisms linking these conditions are not fully understood. It has been assumed that increased weight wears the joints out, but this doesn’t explain why arthritis is also found in hands and other joints that don’t bear weight. Guilak and his colleagues began studying systemic factors other than body weight to determine their effect on arthritis, and in an earlier study in obese mice, found that the lack of appetite hormone leptin predicted whether the mice had arthritis. “This made us think that maybe it’s not how much weight you gain, but what you eat,” Guilak said. In this study, the researchers focused on mice with osteoarthritis of the knee caused by injury to the joint. Arthritis resulting from trauma or injury is thought to account for 10 to 15 percent of all cases of arthritis. The mice were fed one of three high-fat diets: one rich in saturated fat, one rich in omega 6 fatty acids, and one rich in omega 6 fatty acids but supplemented with a small amount of omega 3 fatty acids. Saturated fat, which usually comes from animal sources, is known to raise cholesterol levels. Omega 6 fatty acids, often found in corn oil, soybean oil, nuts and seeds, are thought to be a healthier source of fat. Omega 3 fatty acids, commonly found in fish or fish oil supplements, are often touted as “healthy fat” given their heart-healthy and anti-inflammatory properties. Unfortunately, most Americans eat significantly more saturated fat and omega 6 fatty acids than omega 3 fatty acids. “A healthy diet would include roughly equal ratios of these fats, but we’re way off the scale in the Western diet,” Guilak said. The researchers found that arthritis was significantly associated with the mice’s diets, but not with body weight. The mice that ate diets high in saturated fat or omega 6 fatty acids experienced significant worsening of their arthritis, while mice consuming a small supplement of omega 3 fatty acids had healthier joints. “While omega 3 fatty acids aren’t reversing the injury, they appear to slow the progression of arthritis in this group of mice,” Guilak said. “In fact, omega 3 fatty acids eliminated the detrimental effects of obesity in obese mice.” The researchers also looked at the mice’s ability to heal wounds, which may help them to understand the relationships between arthritis and wound healing. In mice consuming omega 3 fatty acids, a small ear punch typically used to differentiate mice healed much more quickly than it did in animals that did not receive the supplement. “We found that independent of body weight, dietary fatty acids regulate ear wound healing and severity of osteoarthritis following joint injury in obese mice,” said Chia-Lung Wu, a biomedical engineering graduate student in the Duke Orthopaedic Research Laboratories and the study’s lead author. The researchers are working to translate their findings to humans. “A great next step would be to do a clinical study to look at effect of omega 3 fatty acids post-injury,” Guilak said. Story Source: The above story is based on materials provided by Duke Medicine . Note: Materials may be edited for content and length. Journal Reference : Farshid Guilak et al. Dietary fatty acid content regulates wound repair and the pathogenesis of osteoarthritis following joint injury . Annals of the Rheumatic Diseases , July 2014 DOI: 10.1136/annrheumdis-2014-205601
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