Wang L, Folsom A R, Eckfeldt J H
Division of Epidemiology, School of Public Health, University of Minnesota, 1300 South Second Street, Suite 300, Minneapolis, MN 55454, USA.
Nutr Metab Cardiovasc Dis. 2003 Oct;13(5):256-66. doi: 10.1016/s0939-4753(03)80029-7.
To prospectively investigate the relation of plasma cholesterol ester (CE) and phospholipid (PL) fatty acid (FA) composition with incidence of coronary heart disease (CHD).
3,591 white participants in the Minneapolis field center of the Atherosclerosis Risk in Communities Study, aged 45-64 years, were studied. Plasma FA composition of CEs and PLs was quantified using gas-liquid chromatography and expressed as percentage of total FAs. Incident CHD was identified during 10.7 years of follow-up. In both CE and PL fractions, the proportions of stearic (18:0) acid, dihomo-gamma-linolenic (20:3n6) acid and total saturated fatty acids (SFAs) were significantly higher while arachidonic (20:4n6) acid and total polyunsaturated fatty acids (PUFAs) were significantly lower among participants who developed incident CHD (n = 282). After adjusting for age, gender, smoking, alcohol drinking, sports activity, and non-FA dietary factors, the incidence of CHD was significantly and positively associated with the proportion of dihomo-gamma-linolenic acid but inversely associated with arachiadonic acid. The multiply-adjusted rate ratios (RRs) of CHD incidence for the highest versus the lowest quintile were 1.31 in CE and 1.44 in PL for dihomo-gamma-linolenic acid (p for trend: 0.05 and 0.017, respectively), 0.59 in CE and 0.65 in PL for arachidonic acid (p: 0.016 and 0.024, respectively). Also significantly and positively associated with incident CHD were PL stearic acid and CE linolenic (18:3n3) acid. Only a borderline significant positive association was observed for total SFAs in CE (multivariate RRs across quintiles: 1.00, 1.15, 1.40, 1.62, 1.32; p = 0.07). Total PUFAs or monounsaturated FA were not independently associated with CHD.
Our study found a weak positive association of SFAs with incident CHD. Our findings also confirm that FA metabolism in the body, such as the activity of delta-5 desaturase, which converts dihomo-gamma-linolenic acid to arachidonic acid, may affect the development of CHD.
前瞻性研究血浆胆固醇酯（CE）和磷脂（PL）脂肪酸（FA）组成与冠心病（CHD）发病率之间的关系。
对社区动脉粥样硬化风险研究明尼阿波利斯现场中心的3591名45 - 64岁白人参与者进行了研究。采用气液色谱法对CE和PL的血浆FA组成进行定量，并以总FA的百分比表示。在10.7年的随访期间确定了冠心病发病情况。在发生冠心病的参与者（n = 282）中，CE和PL组分中硬脂酸（18:0）、二高-γ-亚麻酸（20:3n6）和总饱和脂肪酸（SFA）的比例显著更高，而花生四烯酸（20:4n6）和总多不饱和脂肪酸（PUFA）的比例显著更低。在调整年龄、性别、吸烟、饮酒、体育活动和非FA饮食因素后，冠心病发病率与二高-γ-亚麻酸比例显著正相关，但与花生四烯酸呈负相关。二高-γ-亚麻酸最高五分位数与最低五分位数相比，冠心病发病的多重调整率比（RR）在CE中为1.31，在PL中为1.44（趋势p值：分别为0.05和0.017），花生四烯酸在CE中为0.59，在PL中为0.65（p值：分别为0.016和0.024）。PL硬脂酸和CE亚麻酸（18:3n3）也与冠心病发病显著正相关。仅观察到CE中总SFA有边缘显著的正相关（跨五分位数的多变量RR：1.00、1.15、1.40、1.62、1.32；p = 0.07）。总PUFA或单不饱和脂肪酸与冠心病无独立关联。
我们的研究发现SFA与冠心病发病存在弱正相关。我们的研究结果还证实，体内的FA代谢，如将二高-γ-亚麻酸转化为花生四烯酸的δ-5去饱和酶活性，可能影响冠心病的发生发展。
