Discussion
obesity, TNF-α, inflammation, cancer, AIP, ALL, hypertriglyceridemia
OBESITY, DYSLIPIDEMIA, CANCER, EVENT, INFLAMMATION, SECONDARY, HYPERTRIGLYCERIDEMIA, ATHEROGENIC DYSLIPIDEMIA
In this secondary analysis, we confirmed the effect of ω3-LCPUFA supplementation at a rate of 0.100 g/kg/day on the lipid profile, specifically on the TGs and VLDL-C concentrations during the first 3 months of ALL treatment. We observed a significantly lower concentration of TGs and VLDL-C in the ω3-LCPUFA group than in the placebo group. We found that 82.4% (28/34) of the children had hypertriglyceridemia and low levels of HDL at the time of ALL diagnoses. These results are consistent with previous findings from ALL studies (There is considerable evidence that EPA and DHA have independent effects on multiple cardiometabolic risk factors, including blood pressure and cardiac function and lipids, as well as anti-platelet, anti-inflammatory, pro-resolving, and antioxidative actions (On the other hand, in a retrospective study, Salvador et al. (In contrast, we found differences in the total cholesterol between the groups at 3 months of supplementation; however, unexpectedly, the ω3-LCPUFA group presented a higher total cholesterol concentration (On the other hand, we did not find significant differences in HDL-C and LDL-C levels between the groups. In our study, we probably did not find differences since the shake provided in both groups contained 4.3 g of saturated fatty acids which might have influenced the result.The AIP is a biomarker of atherogenic dyslipidemia that, through non-HDL-C and/or the TG/HDL-C ratio, can predict the risk of a future atherogenic cardiometabolic event from an early age (Data on the potential effects of ω3-LCPUFAs on anti-inflammatory actions and cardiometabolic factors in children with ALL are scarce. Nevertheless, there is evidence that ω3-LCPUFAs, reduce inflammatory markers in adult oncology patients (Based on these results, we should discuss the strengths and limitations of our work. A strength of the study was the use of a prospective cohort, which improved the accuracy of data collection. Another added benefit was the use of controls. In addition, supplementation at a rate of 0.100 g/kg/d (like Bayram et al.) (Although ω3-LCPUFAs have a positive effect on cancer patients, in ALL pediatric patients there is no sufficient data for recommendations. As we stated above, available studies from randomized placebo-controlled trials the supplements evaluated have varied in dose, source, time of intervention and kind of supplements used in these of ω3-LCPUFAs (Dyslipidemia and inflammation have some common pathological links, such as obesity and cancer. Recent literature mentions that lipids have a fundamental role in the activation of inflammatory pathways, thus increasing the production of inflammatory cytokines (TNF-α, IL-6 and IL-1), which can promote the interruption of lipid metabolism, especially the reverse transport of cholesterol; this is related to a decrease in HDL-C, which could stimulate compensatory changes, such as the synthesis and accumulation of VLDL-C and hypertriglyceridemia, and ultimately increase cardiometabolic risk (