Nutritional Support Reduces Circulating Cytokines in Patients with Heart Failure

• Published in: Nutrients Vol. 16; no. 11; p. 1637
• Main Authors: Herrera-Martínez, Aura D, Jiménez, Concepción Muñoz, Romo, Ana Navas, Aguilera, José López, Crespin, Manuel Crespin, Baena, Bárbara Torrecillas, Casado-Díaz, Antonio, Moreno, María Ángeles Gálvez, Puerta, María José Molina, Roger, Aurora Jurado
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 27.05.2024; MDPI
• Subjects: Abdomen; Aged; B cells; Body composition; Body fat; Cardiac patients; Chemokine CCL2 - blood; Cholesterol; Chronic kidney failure; Clinical outcomes; Clinical trials; Comorbidity; Cytokines; Cytokines - blood; Diabetes; Diet therapy; Diet, Mediterranean; Dietary Supplements; Ejection fraction; Fatty acids; Fatty Acids, Omega-3 - administration & dosage; Female; Heart failure; Heart Failure - blood; Heart Failure - diet therapy; Heart Failure - therapy; Hemoglobin; Humans; Inflammation; Inflammation - blood; Interleukin-6 - blood; Interleukin-8 - blood; Intervention; Male; Malnutrition; Medical prognosis; Middle Aged; Mortality; Nutritional Support - methods; oral supplements; outcomes; Sarcopenia; Ultrasonic imaging; Vitamin D; mortality; heart failure; cytokines; oral supplements; outcomes
• ISSN: 2072-6643; 2072-6643
• DOI: 10.3390/nu16111637

Increased inflammation is associated with the pathogenesis of heart failure (HF). Increased circulating levels of cytokines have been previously reported and generally associated with worse clinical outcomes. In this context, the modulation of inflammation-related parameters seems to be a reasonable therapeutic option for improving the clinical course of the disease. Based on this, we aimed to compare changes in circulating cytokines when Mediterranean diet alone or in combination with hypercaloric, hyperproteic oral nutritional supplements (ONS), enriched with omega-3 (n-3) polyunsaturated fatty acids were administered to patients with HF. Briefly, patients were randomly assigned to receive Mediterranean Diet (control group) vs. Mediterranean Diet plus ONS (intervention group). We observed increased circulating levels of IL-6, IL-8, MCP-1 and IP-10. MCP-1 and IL-6 were associated with overweight and obesity ( = 0.01-0.01-0.04, respectively); IL-6 and IL-8 were positively correlated with fat mass and CRP serum levels ( = 0.02-0.04, respectively). Circulating levels of IL-8 significantly decreased in all patients treated with the Mediterranean diet, while IL-6 and IP-10 only significantly decreased in patients that received plus ONS. In the univariate analysis, MCP-1 and its combination with IL-6 were associated with increased mortality ( = 0.02), while the multivariate analysis confirmed that MCP-1 was an independent factor for mortality (OR 1.01, 95%ci 1.01-1.02). In conclusion, nutritional support using hypercaloric, hyperproteic, n-3 enriched ONS in combination with Mediterranean Diet was associated with decreased circulating levels of some cytokines and could represent an interesting step for improving heart functionality of patients with HF.