| Literature DB >> 24834104 |
Veronika Tillander1, Bodil Bjørndal2, Lena Burri3, Pavol Bohov2, Jon Skorve2, Rolf K Berge4, Stefan Eh Alexson1.
Abstract
BACKGROUND: Marine derived oils are rich in long-chain polyunsaturated omega-3 fatty acids, in particular eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), which have long been associated with health promoting effects such as reduced plasma lipid levels and anti-inflammatory effects. Krill oil (KO) is a novel marine oil on the market and is also rich in EPA and DHA, but the fatty acids are incorporated mainly into phospholipids (PLs) rather than triacylglycerols (TAG). This study compares the effects of fish oil (FO) and KO on gene regulation that influences plasma and liver lipids in a high fat diet mouse model.Entities:
Keywords: Gene regulation; High-fat diet; Krill oil; Omega-3 fatty acids; Plasma lipids
Year: 2014 PMID: 24834104 PMCID: PMC4021563 DOI: 10.1186/1743-7075-11-20
Source DB: PubMed Journal: Nutr Metab (Lond) ISSN: 1743-7075 Impact factor: 4.169
Diet composition
| | | | |
| Protein | 20.7 | 20.6 | 20.7 |
| Fat | 46.0 | 46.2 | 45.9 |
| Carbohydrate | 33.3 | 33.2 | 33.3 |
| Lard 21.3% | Lard 15.7% | Lard 15.6% | |
| Soy oil 2.3% | Soy oil 2.3% | Soy oil 2.3% | |
| Fish oil 5.8% | Krill oil 5.7% | ||
| | | | |
| Total SFA | 42.9 | 34.1 | 39.7 |
| Total MUFA | 38.7 | 32.1 | 35.4 |
| Total ω-6 PUFA | 16.4 | 14.5 | 14.6 |
| Total ω-3 PUFA | 1.9 | 19.1 | 10.1 |
| EPA | 0.03 | 8.97 | 5.23 |
| DHA | 0.05 | 6.40 | 2.28 |
FO; fish oil, KO; Krill oil, SFA; saturated fatty acids, MUFA; monounsaturated fatty acids, PUFA; polyunsaturated fatty acids.
Figure 1Body weight gain. The mice were weighed weekly and the figure shows body weights as median ± range of the animals in the three groups from day 0 to the endpoint at 6 weeks of feeding the different diets. Filled squares; HF (n = 9), open triangles; FO (n = 5), filled triangles; KO (n = 6). K-W* = significance by Kruskal-Wallis, a = HF vs. FO, c = FO vs. KO, * = p < 0.05 in Dunn post hoc test.
Final body and liver weights
| | ||||
|---|---|---|---|---|
| Final body weight (g) | 33.7 (31.0–41.9) | 32.1 (31.2–35.7) | 36.2 (28.3–40.6) | 0.097 |
| Liver weight (g) | 1.65 (1.43–1.84) | 1.74 (1.52–1.76) | 1.66 (1.24–1.99) | 0.851 |
| Liver weight/body weight (%) | 4.5% (4.3–5.7) | 5.1% (4.7–5.5) | 4.5% (3.9–5.0) | 0.074 |
Values are shown as median with the range in brackets. High fat (n = 9), FO (n = 5) and KO (n = 6). K-W, p indicates the p-value with the Kruskal-Wallace test. FO; fish oil, KO; Krill oil.
Plasma lipids
| Total cholesterol | 3.08 (2.82–3.28) | 2.05 (2.00–2.46) | 2.59 (2.07–3.42) | 0.007 |
| Cholesterol esters | 2.11 (1.88–2.32) | 1.50 (1.36–1.80) | 1.86 (1.27–2.44) | 0.004 |
| Free cholesterol | 0.96 (0.92–0.99) | 0.65 (0.50–0.66) | 0.82 (0.68–0.98) | 0.035 |
| Triacylglycerol | 1.12 (0.78–1.48) | 0.49 (0.26–0.68) | 0.77 (0.46–1.00) | 0.008 |
| Phospholipids | 3.56 (2.87–3.95) | 2.42 (2.17–2.52) | 2.73 (2.27–3.26) | 0.007 |
| Nonesterified fatty acids | 0.19 (0.14–0.29) | 0.11 (0.02–0.14) | 0.05 (0.00–0.18) | 0.016 |
Data is shown as median and range. High fat (n = 5), FO (n = 5) and KO (n = 6). a = HF vs. FO, b = HF vs. KO, *= p < 0.05, **= p <0.01 by Dunn’s test. K-W, p indicates the p-value with the Kruskal-Wallace test. FO; fish oil, KO; Krill oil.
Cholesterol and TAG content of the lipoprotein fractions in plasma
| VLDL | 0.11 (0.06–0.12) | 0.04 (0.04–0.06) | 0.10 (0.07–0.12) | 0.009 |
| LDL | 0.17 (0.14–0.61) | 0.32 (0.27–0.37) | 0.34 (0.17–0.51) | 0.468 |
| HDL | 3.10 (2.42–3.36) | 1.92 (1.71–2.21) | 2.46 (1.85–3.15) | 0.018 |
| | | | | |
| VLDL | 0.79 (0.42–0.92) | 0.20 (0.11–0.30) | 0.37 (0.32–0.50) | 0.004 |
| LDL | 0.27 (0.23–0.39) | 0.23 (0.09–0.32) | 0.20 (0.08–0.25) | 0.063 |
| HDL | 0.08 (0.04–0.19) | 0.06 (0.03–0.13) | 0.08 (0.07–0.22) | 0.133 |
Data is shown as median and range. High fat (n = 5), FO (n = 5) and KO (n = 5). a = HF vs. FO, c = FO vs. KO, *= p <0.05 by Dunn’s test. K-W, p indicates the p-value with the Kruskal-Wallace test. FO; fish oil, KO; Krill oil, VLDL; very low density lipoprotein, LDL; low density lipoprotein, HDL; high density lipoprotein.
Total fatty acid composition of plasma lipids
| SFA | 1255 (889–1928) | 715 (570–731)a** | 735 (611–925) | 0.001 |
| C10:0 | 0.9 (0.4–3.2) | 1.0 (0.7–1.4) | 1.8 (1.2–2.1) | 0.126 |
| C12:0 | 1.5 (0.6–2.9) | 0.4 (0.3–0.6)a** | 0.7 (0.5–1.0) | 0.001 |
| C14:0 | 15.3 (7.4–24.3) | 5.8 (4.1–6.7)a** | 11.4 (9.2–20.5) | 0.003 |
| C16:0 | 781 (524–1170) | 422 (359–436)a** | 482 (379–596) | 0.002 |
| C18:0 | 402 (311–637) | 242 (181–271)a** | 228 (187–274)b** | 0.001 |
| C20:0 | 11.0 (7.6–19.5) | 4.6 (3.7–5.4)a*** | 6.4 (5.1–8.1) | 0.003 |
| C22:0 | 16.2 (10.6–26.6) | 9.7 (7.7–10.3) | 13.1 (10.7–17.3) | 0.199 |
| C24:0 | 5.0 (2.8–8.4) | 3.9 (3.0–4.2)a** | 3.8 (3.8–4.8) | 0.001 |
| MUFA | 679 (493–1115) | 277 (217–292)a*** | 351 (331–527) | 0.001 |
| C16:1n–9 | 11.7 (7.5–17.4) | 4.4 (4.0–4.9)a** | 5.7 (4.7–8.2) | 0.001 |
| C16:1n–7 | 45.2 (23.9–51.8) | 18.9 (14.6–24.5)a**, c* | 35.0 (24.7–53.0) | 0.007 |
| C18:1n–9 | 543 (397–919) | 218 (170–232)a*** | 254 (241–390) | 0.000 |
| C18:1n–7 | 42.5 (33.0–70.5) | 20.1 (14.3–22.7)a** | 36.9 (30.6–45.1) | 0.004 |
| C20:1n–9 | 12.9 (8.7–24.8) | 3.7 (2.9–4.8)a*** | 5.9 (4.6–7.6) | 0.001 |
| C20:1n–7 | 2.6 (1.7–4.2) | 1.1 (0.8–1.4)a** | 2.0 (1.8–2.5) | 0.002 |
| C22:1n–9 | 2.0 (1.3–4.1) | 0.5 (0.4–0.6)a*, c** | 3.0 (2.3–3.5) | 0.004 |
| C22:1n–7 | 1.4 (0.9–1.7) | 0.6 (0.5–0.7)c*** | 2.1 (1.8–2.6) | 0.000 |
| C24:1n–9 | 9.6 (6.5–14.3) | 7.2 (6.3–7.8)a* | 7.5 (6.0–10.2) | 0.040 |
| ω-6 PUFA | 1490 (1080–2176) | 468 (419–527)a*** | 744 (513–815) | 0.001 |
| C18:2n–6 | 969 (677–1461) | 283 (214–293)a*** | 562 (351–615) | 0.000 |
| C18:3n–6 | 14.1 (8.2–22.8) | 2.6 (2.3–3.0)a*** | 4.8 (3.0–5.2) | 0.001 |
| C20:3n–6 | 48.4 (30.2–69.2) | 12.8 (12.0–15.5)a** | 15.0 (10.8–21.0)b* | 0.001 |
| C20:4n–6 | 455 (338–588) | 189 (167–219) | 136 (123–166)b*** | 0.000 |
| C22:4n–6 | 5.8 (4.2–10.3) | 1.1 (0.8–1.1)a** | 1.2 (1.0–1.4)b* | 0.001 |
| C22:5n–6 | 7.7 (4.3–12.0) | 3.1 (2.5–3.8) | 1.3 (1.1–1.6)b*** | 0.000 |
| ω | 272 (187–415) | 773 (639–898)a** | 696 (588–877)b** | 0.001 |
| C18:3n–3 | 18.3 (10.4–29.3) | 3.8 (2.3–6.4)a** | 11.3 (5.6–16.9) | 0.002 |
| C20:5n–3 | 21.4 (13.1–28.3) | 420 (351–512)a** | 400 (316–486)b* | 0.001 |
| C22:6n–3 | 212 (147–328) | 261 (248–331)a* | 268 (231–334)b* | 0.013 |
| C22:5n–3 | 14.1 (9.6–19.9) | 31.2 (24.1–35.0)a** | 26.0 (19.1–33.4)b* | 0.002 |
| ω | 0.2 (0.2–0.2) | 1.6 (1.5–1.7)a*** | 1.1 (0.8–1.4) | 0.000 |
| Total FA | 3712 (2679–5648) | 2282 (1849–2427)a** | 2406 (2175–3079) | 0.002 |
Quantitative fatty acid composition of selected fatty acids in plasma. SFA; saturated fatty acids, MUFA; monounsaturated fatty acids, PUFA; polyunsaturated fatty acids. Data are shown as median and range. High fat (n = 9), FO (n = 5), KO (=6). a = HF vs. FO, p <0.05, b = HF vs. KO, p <0.05, c = FO vs. KO, *= p <0.05, **= p <0.01 and ***= p <0.001. K-W, p indicates the p-value with the Kruskal-Wallace test. FO; fish oil, KO; Krill oil.
Liver lipids
| Total Cholesterol | 5.6 (4.8–6.7) | 6.9 (6.0–10.4) | 7.0 (5.9–9.7) | 0.005 |
| Triacylglycerol | 12.2 (8.0–50.8) | 42.2 (22.7–55.4) | 17.0 (6.7–32.7) | 0.045 |
| Phospholipids | 18.5 (16.3–20.8) | 21.7 (21.5–23.5) | 20.7 (19.2–22.6) | 0.002 |
Data is shown as median and range. High fat n = 9, FO n = 5, KO n = 6. a = HF vs. FO, b = HF vs. KO, *= p <0.05, **= p <0.01 for Dunn’s test. K-W, p indicates the p-value with the Kruskal-Wallace test. FO; fish oil, KO; Krill oil.
Fatty acid composition of the PL fraction in liver
| SFA | 7174 (6094–8626) | 9118 (8693–9471)a** | 8918 (7882–9276)b* | 0.001 |
| C10:0 | 1.7 (0.9–3.8) | 2.4 (1.3–2.7) | 1.6 (0.6–3.0) | 0.878 |
| C12:0 | 1.8 (0.6–5.6) | 4.7 (3.5–6.1)a* | 2.5 (1.9–3.9) | 0.022 |
| C14:0 | 15.2 (10.1–17.4) | 21.5 (19.5–23.3)a** | 19.6 (17.4–27.4)b** | 0.001 |
| C16:0 | 3732 (3082–4211) | 4990 (4560–5257)a* | 5078 (4433–5170)b** | 0.001 |
| C18:0 | 2886 (2635–3975) | 3816 (3682–4001)a** | 3462 (3003–3650) | 0.007 |
| C20:0 | 72.3 (56.8–78.2) | 72.4 (52.3–80.6) | 85.8 (79.2–102)b** | 0.005 |
| C22:0 | 151 (130–169) | 141 (98.4–142)c*** | 188 (155–225) | 0.001 |
| C24:0 | 52.8 (34.4–75.1) | 69.5 (61.4–77.5) | 66.2 (55.7–74.3) | 0.179 |
| MUFA | 1732 (1473–2232) | 2008 (1722–2546) | 2168 (1996–2915)b* | 0.012 |
| C16:1n–9 | 25.6 (20.3–33.5) | 28.6 (22.9–36.9) | 31.0 (27.2–40.2) | 0.063 |
| C16:1n–7 | 94.7 (67.3–131) | 141 (118–165)a* | 169 (103–249)b** | 0.003 |
| C18:1n–9 | 1257 (1095–1638) | 1506 (1231–1998) | 1614 (1472–2162)b* | 0.015 |
| C18:1n–7 | 220 (174–295) | 225 (211–260) | 249 (217–276) | 0.198 |
| C20:1n–9 | 31.9 (27.0–50.6) | 32.4 (32.2–37.6) | 32.0 (30.8–45.2) | 0.600 |
| C20:1n–7 | 7.2 (5.6–10.5) | 8.2 (6.7–9.3) | 8.2 (7.2–13.3) | 0.410 |
| C22:1n–9 | 7.0 (5.5–8.5) | 4.9 (4.8–6.6)a* | 6.5 (5.4–7.0) | 0.020 |
| C22:1n–7 | 5.1 (3.8–6.5) | 4.7 (3.4–4.9)c** | 6.5 (5.5–9.2) | 0.006 |
| C24:1n–9 | 51.3 (40.6–77.3) | 61.9 (57.1–63.9) | 50.5 (44.4–78.0) | 0.172 |
| ω–6 PUFA | 6206 (5254–7494) | 3874 (3697–4144)a*** | 4768 (4056–5520) | 0.001 |
| C18:2n–6 | 2881 (2305–3231) | 1935 (1677–2052)a*, c** | 2865 (2449–3607) | 0.004 |
| C18:3n–6 | 45.4 (24.0–56.9) | 16.6 (13.7–19.6)a*** | 24.6 (18.8–30.8) | 0.001 |
| C20:3n–6 | 286 (210–344) | 163 (153–210)a** | 174 (155–248)b* | 0.001 |
| C20:4n–6 | 2984 (2470–3728) | 1808 (1576–1818)a* | 1629 (1324–1723)b*** | 0.001 |
| C22:4n–6 | 40.0 (31.8–60.4) | 11.4 (9.3–12.0)a** | 12.1 (10.1;13.7)b* | 0.001 |
| C22:5n–6 | 35.8 (27.2–67.8) | 29.7 (27.1–35.2) | 10.4 (9.6–11.6)b*** | 0.001 |
| ω-3 PUFA | 1931 (1824–2155) | 6189 (5560–6985)a*** | 5660 (4417–6124)b* | 0.001 |
| C18:3n–3 | 18.4 (14.0–22.8) | 19.2 (14.9–25.8)c | 33.0 (27.6–39.8)b** | 0.002 |
| C20:5n–3 | 77.9 (52.0–83.8) | 2057 (1621–2186)a*** | 1435 (1211–2261)b* | 0.001 |
| C22:6n–3 | 1774 (1666–1970) | 3615 (3308–4480)a** | 3612 (2614–3964)b** | 0.001 |
| C22:5n–3 | 74.7 (59.3–95.7) | 321 (296–371)a*** | 276 (203–323)b* | 0.001 |
| ω–3/ω–6 PUFA | 0.3 (0.3–0.4) | 1.7 (1.3–1.7)a*** | 1.1 (0.9–1.3)b* | 0.001 |
| Total FA | 17281 (15088–20534) | 21171 (20619–22608)a* | 21626 (18584–22927)b** | 0.001 |
Quantitative fatty acid analysis of the most abundant fatty acids in the PL fraction from liver. SFA; saturated fatty acids, MUFA; monounsaturated fatty acids, PUFA; polyunsaturated fatty acids. Data are shown as median and range. High fat (n = 9), FO (n = 5), KO (n = 6). a = HF vs. FO, b = HF vs. KO, c = FO vs KO. *= p <0.05, **= p <0.01 and ***= p <0.001. K-W, p indicates the p-value with the Kruskal-Wallace test. FO; fish oil, KO; Krill oil.
Fatty acid composition of the TAG fraction in liver
| SFA | 2567 (1678–12724) | 9625 (5443–13484) | 3741 (1279–7260) | 0.036 |
| C10:0 | 1.9 (1.3–7.3) | 8.0 (4.9–11.0)a* | 3.1 (1.4–8.1) | 0.019 |
| C12:0 | 7.9 (2.0–59.8) | 37.2 (28.2–43.0)a* | 14.0 (7.2–26.3) | 0.016 |
| C14:0 | 41.3 (27.3–240) | 161.1 (122–270) | 82.6 (21.9–167) | 0.063 |
| C16:0 | 2067 (1367–11132) | 8642 (4733–12151)a* | 3196 (1041–6389) | 0.029 |
| C18:0 | 294 (182–823) | 610 (360–815) | 251 (136–372)b* | 0.026 |
| C20:0 | 89.3 (32.1–166) | 115.0 (60.7–132) | 58.7 (31.3–97.0) | 0.158 |
| C22:0 | 17.8 (5.9–30.6) | 18.5 (11.8–21.1) | 13.0 (7.2–21.6) | 0.567 |
| C24:0 | 3.9 (1.5–5.6) | 6.9 (4.4–8.0)c** | 3.0 (1.7–3.7) | 0.006 |
| MUFA | 3659 (2367–19647) | 12583 (5295–18215) | 4388 (1458–11092) | 0.095 |
| C16:1n–9 | 69.8 (42.6–487) | 264.0 (116–442) | 94.3 (24.5–303) | 0.145 |
| C16:1n–7 | 113 (77–1190) | 771 (475–1202) | 360 (48.4–1058) | 0.075 |
| C18:1n–9 | 3088 (2016–16228) | 10246 (4347–15384) | 3595 (1252–8971) | 0.095 |
| C18:1n–7 | 171 (108–1160) | 540 (221–694) | 200 (72.3–459) | 0.148 |
| C20:1n–9 | 135 (64.9–362) | 181 (75.9–319) | 68.9 (31.2–158) | 0.080 |
| C20:1n–7 | 26.7 (12.8–98.0) | 49.3 (20.2–72.4) | 20.3 (8.3–44.4) | 0.116 |
| C22:1n–9 | 26.9 (12.2–48.6) | 24.1 (12.6–40.6) | 17.2 (7.2–29.6) | 0.160 |
| C22:1n–7 | 5.7 (2.3–12.5) | 6.7 (3.7–8.9) | 5.3 (2.1–9.2) | 0.621 |
| C24:1n–9 | 2.8 (1.3–3.2) | 3.6 (2.5–5.3)c* | 2.0 (1.1–2.2) | 0.020 |
| ω–6 PUFA | 1751 (1290–7085) | 2611 (1684–3193) | 1851 (822–2969) | 0.507 |
| C18:2n–6 | 1418 (1029–5911) | 2262 (1442–2781) | 1677 (744–2724) | 0.516 |
| C18:3n–6 | 35.7 (28.5–105) | 29.2 (16.2–40.0) | 24.2 (10.5–36.7) | 0.053 |
| C20:3n–6 | 77.2 (42.0–222) | 61.0 (32.9–83.2) | 30.0 (15.0–51.9)b** | 0.006 |
| C20:4n–6 | 121 (99.2–542) | 133 (111–165)c* | 60.9 (28.4–88.5)b** | 0.002 |
| C22:4n–6 | 37.7 (27.4–137) | 39.7 (24.8–48.3)c* | 13.6 (7.8–19.0)b** | 0.002 |
| C22:5n–6 | 23.8 (15.6–56.4) | 47.1 (35.4–56.3)c*** | 11.8 (6.2–17.0)b* | 0.026 |
| ω–3 PUFA | 278 (210–1393) | 6355 (4656–7148)a*** | 2192 (831–3543) | 0.000 |
| C18:3n–3 | 55.9 (34.6–291) | 190 (129–197) | 146 (41.2–265) | 0.135 |
| C20:5n–3 | 11.9 (9.8–113) | 1329 (1170–2156)a*** | 594 (143–1048)b* | 0.000 |
| C22:6n–3 | 158 (127–688) | 3097 (2200–3535)a*** | 1004 (496–1542) | 0.000 |
| C22:5n–3 | 41.0 (25.9–217) | 1275 (814–1486)a*** | 330 (117–463) | 0.001 |
| ω–3/ω–6 PUFA | 0.2 (0.2–0.2) | 2.6 (2.0–2.8)a*** | 1.2 (0.9–1.5)b* | 0.000 |
| Total FA | 8274 (5559–40955) | 30744 (17101–41288)a* | 12380 (4398–24899) | 0.029 |
Quantitative fatty acid analysis of the most abundant fatty acids in the TAG fraction from liver. SFA; saturated fatty acids, MUFA; monounsaturated fatty acids, PUFA; polyunsaturated fatty acids. Data are shown as median and range. High fat (n = 9), FO (n = 5), KO (=6). a = HF vs. FO, b = HF vs. KO, c = FO vs. KO. *= p <0.05, **= p <0.01 and ***= p <0.001. K-W, p indicates the p-value with the Kruskal-Wallace test. FO; fish oil, KO; Krill oil.
Figure 2Gene expression in liver. The graphs showing the relative mRNA expression of genes coding for selected proteins in “Peroxisomal pathways”, “Mitochondrial pathways”, “Mevalonate pathway” and “Nuclear transcription factors” are generated from the TLDA array described in Materials and Methods. The bars show the median and range of the relative expression in the control group (HF, dark grey bars), the FO group (FO, light grey bars) and the KO group (KO, medium gray bars). Values are shown in relation to the expression of respective gene in one individual of the HF group (n = 4 per group). The graph showing “Additional metabolic pathways” was generated by real time PCR on selected genes as described in Material and Methods with the bars showing the median and the range of the relative mRNA expression in relation to one individual (set to 1) in the HF group. HF; dark grey bars (n = 6), FO; light grey bars (n = 5) KO; medium grey bars (n = 6). Significance by the Kruskal-Wallis test is shown to the right in each graph (K-W), and a star close to the bars show significance by the Dunn post hoc analysis (* = p < 0.05, # = p < 0.01 for the post hoc test).
Liver enzyme activities
| | nmol/mg/min - 15μM Malonyl-CoA | nmol/mg/min + 15μM Malonyl-CoA | nmol/mg/min | nmol/mg/min |
| 2.35 (1.83–3.74) | 1.24 (1.05–4.41) | 16.8 (14.4–30.6) | 0.31 (0.24–0.38) | |
| 3.42 (2.22–3.73) | 2.10 (1.61–2.20) | 43.8 (33.3–54.7)a** | 0.57 (0.36–0.63)c*** | |
| 2.50 (1.84–3.08) | 1.49 (1.28–2.15) | 22.4 (16.8–39.4) | 0.20 (0.12–0.22) | |
| 0.337 | 0.120 | 0.005 | 0.001 |
Acyl-CoA oxidase (ACOX), fatty acid synthase (FAS) and carnitine palmitoyltransferase 1 (CPT1) activities were measured as described in Materials and Methods. CPT1 activity was measured with and without the addition of 15 μM malonyl-CoA. Data shown as median and range. High fat (n = 6), FO (n = 5) and KO (n = 6). a = HF vs FO, c = FO vs KO. **= p <0.01 and ***= p <0.001. K-W, p indicates the p -value with the Kruskal-Wallace test. FO; fish oil, KO; Krill oil.
Figure 3Gene expression in small intestine. mRNA expression of genes coding for proteins in fatty acid uptake and lipid synthesis in the intestinal epithelium of the four segments relative to the expression in segment 1 (S1) of one individual in the HF group. Graphs show the median expression value and range of each group. HF; dark grey bars (n = 6), FO; light grey bars (n = 5) KO; medium grey bars (n = 6). a(segment) = HF vs. FO, p < 0.05; b(segment) = HF vs. KO, p < 0.05; c(segment) = FO vs. KO, **p < 0.01 for Dunn post hoc analysis after significant differences with the Kruskal-Wallis test, marked as K-W over respective segment in the HF group.