Einfluss von Ernährungsparametern auf die Hämostase

A. Michalsen; G. J. Dobos

doi:10.1055/s-0037-1619647

Hämostaseologie, Table of Contents

Hamostaseologie 2005; 25(01): 13-17
DOI: 10.1055/s-0037-1619647

Original Article

Schattauer GmbH

Einfluss von Ernährungsparametern auf die Hämostase

Effects of nutritional factors on haemostasis

Authors

A. Michalsen

¹Abteilung Innere Medizin V (Leiter: Prof. Dr. G. J. Dobos), Integrative Medizin, Kliniken Essen-Mitte Lehrstuhl Naturheilkunde der Universitätsklinik Duisburg-Essen
G. J. Dobos

¹Abteilung Innere Medizin V (Leiter: Prof. Dr. G. J. Dobos), Integrative Medizin, Kliniken Essen-Mitte Lehrstuhl Naturheilkunde der Universitätsklinik Duisburg-Essen

Abstract

Zusammenfassung

Die Ernährung ist der wichtigste exogener Risikofaktor für die Prävention kardiovaskulärer Ereignisse und der Atherothrombose. Überernährung und Adipositas sind hierbei von Fehlernährung bzw. der protektiven Wirkung einzelner Nahrungsmittel zu differenzieren. Während Überernährung mit nachteiligen Veränderungen fast aller Parameter der Hämostase, Fibrinolyse und Thrombozytenaggregation assoziiert ist, führt Lebensstilmodifikation mit Gewichtsreduktion und geringer Zufuhr gesättigter Fette zu entsprechenden Normalisierungen. Epidemiologische und klinische Studien belegen andererseits den ausgeprägten Nutzen der mediterranen Kost auf kardiovaskuläre Ereignisse, der unabhängig von der Nahrungsenergiezufuhr und Cholesterinprofilen besteht. Sowohl für einfach ungesättigte Fettsäuren aus Olivenöl, aber vor allem für die Gruppe der Omega-3-Fettsäuren aus Fischöl und speziellen Pflanzenölen, Gemüse und Nüssen belegen zahlreiche Studien günstige Wirkungen auf die Hämostase. Zudem sind möglicherweise eine Vielzahl weiterer sekundärer Pflanzeninhaltsstoffe sowie moderater Alkohol-und Weinkonsum an der günstigen Wirkung der mediterranen Kost auf thrombotische Erkrankungen beteiligt. Synergistische Effekte dieser Nahrungsmittel auf Hämostase, Endothelfunktion und vaskuläre Inflammation können so die ausgeprägte Gesamtwirkung der mediterranen Kost induzieren.

Summary

Among all exogenic factors nutrition has a most relevant impact on the haemostatic system and related cardiovascular and thrombotic disease. Whereas obesity and high-caloric diet are associated with negative changes of mostly all parameters of haemostasis, fibrinolysis and platelet reactivity, weight reduction and lifestyle modification induce respective beneficial effects. Recent studies demonstrate large evidence for the beneficial effects of a mediterranean diet in thrombotic diseases not mediated by cholesterol or weight reduction. The principal sources of fat within this diet, olive oil and omega-3 polyunsaturated fatty acids from fatty fish, nuts, seeds, and vegetables show a variety of beneficial effects on the haemostatic system in experimental and observational studies. Furthermore, for an increasing number of substances such as plant-based polyphenols and for moderate alcohol consumption attenuation of coagulation and platelet reactivity have been demonstrated. In the clinical context, mediterranean diet may exert its beneficial effects through synergistic action on haemostasis, endothelial function and vascular inflammation.

Schlüsselwörter

Hämostase - Ernährung - mediterrane Kost

Keywords

Haemostasis - nutrition - mediterranean diet

Full Text

References

Literatur
1 De Pergola G, Pannacciulli N. Coagulation and fibrinolysis abnormalities in obesity. J Endocrinol Invest 2002; 25: 899-904.
2 Yarnell JW, Sweetnam PM, Rumley A. et al. Lifestyle and hemostatic risk factors for ischemic heart disease : the Caerphilly Study. Arterioscler Thromb Vasc Biol 2000; 20: 271-9.
3 Landin K, Stigendal L, Eriksson E. et al. Abdominal obesity is associated with an impaired fibrinolytic activity and elevated plasminogen activator inhibitor-1. Metabolism 1990; 39: 1044-8.
4 Van Gaal LF, Wauters MA, De Leeuw IH. The beneficial effects of modest weight loss on cardiovascular risk factors. Int J Obes Relat Metab Disord 1997; 21 (Suppl. 01) S5-9.
5 Charles MA, Morange P, Eschwege E. et al. Effect of weight change and metformin on fibrinolysis and the von Willebrand factor in obese nondiabetic subjects: the BIGPRO1 Study. Biguanides and the Prevention of the Risk of Obesity. Diabetes Care 1998; 21: 1967-72.
6 Juhan-Vague I, Alessi MC, Vague P. Thrombogenic and fibrinolytic factors and cardiovascular risk in non-insulin-dependent diabetes mellitus. Ann Med 1996; 28: 371-80.
7 Loskutoff DJ, Samad F. The adipocyte and hemostatic balance in obesity: studies of PAI-1. Arterioscler Thromb Vasc Biol 1998; 18: 1-6.
8 Berntorp E, Berntorp K, Brorson H. et al. Liposuction in Dercum’s disease: impact on haemostatic factors associated with cardiovascular disease and insulin sensitivity. J Intern Med 1998; 243: 197-201.
9 Mehta J, Mehta P, Lawson D. et al. Plasma tissue plasminogen activator inhibitor levels in coronary artery disease: correlation with age and serum triglyceride concentrations. J Am Coll Cardiol 1987; 9: 263-8.
10 Elkeles RS, Chakrabarti R, Vickers M. et al. Effect of treatment of hyperlipidaemia on haemostatic variables. Br Med J 1980; 281 (6246): 973-4.
11 Ijiri Y, Miura M, Hashimoto M. et al. A new model to evaluate the diet-induced prothrombotic state, using He-Ne laser-induced thrombogenesis in the carotid artery of apolipoprotein E-deficient and low-density lipoprotein receptor-deficient mice. Blood Coagul Fibrinol 2002; 13: 497-504.
12 Aravanis C, Corcondilas A, Dontas AS. et al. Coronary heart disease in seven countries. IX. The Greek islands of Crete and Corfu. Circulation 1970; 41 (Suppl. 04) I88-100.
13 de Lorgeril M, Renaud S, Mamelle N. et al. Mediterranean alpha-linolenic acid-rich diet in secondary prevention of coronary heart disease. Lancet 1994; 343: 1454-9.
14 Trichopoulou A, Costacou T, Bamia C. et al. Adherence to a Mediterranean diet and survival in a Greek population. N Engl J Med 2003; 348: 2599-608.
15 Singh RB, Dubnov G, Niaz MA. et al. Effect of an Indo-Mediterranean diet on progression of coronary artery disease in high risk patients: a randomised single-blind trial. Lancet 2002; 360: 1455-61.
16 GISSI Investigators. Dietary supplementation with n-3 polyunsaturated fatty acids and vitamin E after myocardial infarction: results of the GISSIPrevenzione trial. Lancet 1999; 354: 447-55.
17 Burr ML, Gilbert JF, Holliday RM. al. e. Effect of changes in fat, fish, and fibre intakes on death and myocardial infarction: Diet and Reinfarction Trial (DART). Lancet 1989; II: 757-61.
18 Kris-Etherton PM, Harris WS. et al. Fish consumption, fish oil, omega-3 fatty acids, and cardiovascular disease. Arterioscler Thromb Vasc Biol 2003; 23: e20-30.
19 Kris-Etherton P, Daniels SR, Eckel RH. et al. AHA scientific statement: summary of the Scientific Conference on Dietary Fatty Acids and Cardiovascular Health. Conference summary from the Nutrition Committee of the American Heart Association. J Nutr 2001; 131: 1322-6.
20 Archer SL, Green D, Chamberlain M. et al. Association of dietary fish and n-3 fatty acid intake with hemostatic factors in the coronary artery risk development in young adults (CARDIA) study. Arterioscler Thromb Vasc Biol 1998; 18: 1119-23.
21 Shahar E, Folsom AR, Wu KK. et al. Associations of fish intake and dietary n-3 polyunsaturated fatty acids with a hypocoagulable profile. The Atherosclerosis Risk in Communities (ARIC) Study. Arterioscler Thromb 1993; 13: 1205-12.
22 Solomon SA, Cartwright I, Pockley G. et al. A placebo-controlled, double-blind study of eicosapentaenoic acid-rich fish oil in patients with stable angina pectoris. Curr Med Res Opin 1990; 12: 1-11.
23 Conquer JA, Cheryk LA, Chan E. et al. Effect of supplementation with dietary seal oil on selected cardiovascular risk factors and hemostatic variables in healthy male subjects. Thromb Res 1999; 96: 239-50.
24 Tremoli E, Eligini S, Colli S. et al. n-3 fatty acid ethyl ester administration to healthy subjects and to hypertriglyceridemic patients reduces tissue factor activity in adherent monocytes. Arterioscler Thromb 1994; 14: 1600-8.
25 Barcelli U, Glas-Greenwalt P, Pollak VE. Enhancing effect of dietary supplementation with omega-3 fatty acids on plasma fibrinolysis in normal subjects. Thromb Res 1985; 39: 307-12.
26 Scarabin PY, Aillaud MF, Luc G. et al. Haemostasis in relation to dietary fat as estimated by erythrocyte fatty acid composition: the prime study. Thromb Res 2001; 102: 285-93.
27 Dunstan DW, Mori TA, Puddey IB. et al. A randomised, controlled study of the effects of aerobic exercise and dietary fish on coagulation and fibrinolytic factors in type 2 diabetics. Thromb Haemost 1999; 81: 367-72.
28 Armstrong RA, Chardigny JM, Beaufrere B. et al. No effect of dietary trans isomers of alpha-linolenic acid on platelet aggregation and haemostatic factors in european healthy men. The TRANSLinE study. Thromb Res 2000; 100: 133-41.
29 Hansen J, Grimsgaard S, Nordoy A. et al. Dietary supplementation with highly purified eicosapentaenoic acid and docosahexaenoic acid does not influence PAI-1 activity. Thromb Res 2000; 98: 123-32.
30 Kristensen SD, Schmidt EB, Dyerberg J. Dietary supplementation with n-3 polyunsaturated fatty acids and human platelet function: a review with particular emphasis on implications for cardiovascular disease. J Intern Med Suppl 1989; 225: 141-50.
31 Lee KW, Lip GY. Effects of lifestyle on hemostasis, fibrinolysis, and platelet reactivity: a systematic review. Arch Intern Med 2003; 163: 2368-92.
32 Yamamoto J, Taka T, Yamada K. et al. Tomatoes have natural anti-thrombotic effects. Br J Nutr 2003; 90: 1031-8.
33 Legnani C, Frascaro M, Guazzaloca G. et al. Effects of a dried garlic preparation on fibrinolysis and platelet aggregation in healthy subjects. Arzneimittelforschung 1993; 43: 119-22.
34 Kelly CM, Smith RD, Williams CM. Dietary monounsaturated fatty acids and haemostasis. Proc Nutr Soc 2001; 60: 161-70.
35 Bayindir O, Ozmen D, Mutaf I. et al. Comparison of the effects of dietary saturated, mono-, and n-6 polyunsaturated fatty acids on blood lipid profile, oxidant stress, prostanoid synthesis and aortic histology in rabbits. Ann Nutr Metab 2002; 46: 222-8.
36 Brzosko S, De Curtis A, Murzilli S, de Gaetano G, Donati MB, Iacoviello L. Effect of extra virgin olive oil on experimental thrombosis and primary hemostasis in rats. Nutr Metab Cardiovasc Dis 2002; 12 (06) 337-42.
37 Rimm EB, Williams P, Fosher K, Criqui M, Stampfer MJ. Moderate alcohol intake and lower risk of coronary heart disease: meta-analysis of effects on lipids and haemostatic factors. Br Med J 1999; 319: 1523-8.
38 Pellegrini N, Pareti FI, Stabile F. et al. Effects of moderate consumption of red wine on platelet aggregation and haemostatic variables in healthy volunteers. Eur J Clin Nutr 1996; 50: 209-13.
39 Demrow HS, Slane PR, Folts JD. Administration of wine and grape juice inhibits in vivo platelet activity and thrombosis in stenosed canine coronary arteries. Circulation 1995; 91: 1182-8.
40 Fukao H, Ijiri Y, Miura M. et al. Effect of trans-resveratrol on the thrombogenicity and atherogenicity in apolipoprotein E-deficient and low-density lipoprotein receptor-deficient mice. Blood Coagul Fibrinolysis 2004; 15: 441-6.
41 Lacoste L, Hung J, Lam JY. Acute and delayed antithrombotic effects of alcohol in humans. Am J Cardiol 2001; 87: 82-5.
42 Esposito K, Marfella R, Ciotola M. et al. Effect of a mediterranean-style diet on endothelial dysfunction and markers of vascular inflammation in the metabolic syndrome: a randomized trial. JAMA 2004; 292: 1440-6.
43 Chrysohoou C, Panagiotakos DB, Pitsavos C. et al. Adherence to the Mediterranean diet attenuates inflammation and coagulation process in healthy adults: The ATTICA Study. J Am Coll Cardiol 2004; 44: 152-8.