社区动脉粥样硬化风险（ARIC）研究中老年人的n-3脂肪酸、高血压与认知衰退风险
n-3 Fatty acids, hypertension and risk of cognitive decline among older adults in the Atherosclerosis Risk in Communities (ARIC) study.
作者信息
Beydoun May A, Kaufman Jay S, Sloane Philip D, Heiss Gerardo, Ibrahim Joseph
机构信息
Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street E2610, Baltimore, MD 21205, USA.
出版信息
Public Health Nutr. 2008 Jan;11(1):17-29. doi: 10.1017/S1368980007000080. Epub 2007 Jul 12.
OBJECTIVE
Recent research indicates that n-3 fatty acids can inhibit cognitive decline, perhaps differentially by hypertensive status.
DESIGN
We tested these hypotheses in a prospective cohort study (the Atherosclerosis Risk in Communities). Dietary assessment using a food-frequency questionnaire and plasma fatty acid exposure by gas chromatography were completed in 1987-1989 (visit 1), while cognitive assessment with three screening tools--the Delayed Word Recall Test, the Digit Symbol Substitution Test of the Wechsler Adult Intelligence Scale-Revised and the Word Fluency Test (WFT)--was completed in 1990-1992 (visit 2) and 1996-1998 (visit 4). Regression calibration and simulation extrapolation were used to control for measurement error in dietary exposures.
SETTING
Four US communities--Forsyth County (North Carolina), Jackson (Mississippi), suburbs of Minneapolis (Minnesota) and Washington County (Maryland).
SUBJECTS
Men and women aged 50-65 years at visit 1 with complete dietary data (n = 7814); white men and women in same age group in the Minnesota field centre with complete plasma fatty acid data (n = 2251).
RESULTS
Findings indicated that an increase of one standard deviation in dietary long-chain n-3 fatty acids (% of energy intake) and balancing long-chain n-3/n-6 decreased the risk of 6-year cognitive decline in verbal fluency with an odds ratio (95% confidence interval) of 0.79 (0.66-0.95) and 0.81 (0.68-0.96), respectively, among hypertensives. An interaction with hypertensive status was found for dietary long-chain n-3 fatty acids (g day-1) and WFT decline (likelihood ratio test, P = 0.06). This exposure in plasma cholesteryl esters was also protective against WFT decline, particularly among hypertensives (OR = 0.51, P < 0.05).
CONCLUSION
One implication from our study is that diets rich in fatty acids of marine origin should be considered for middle-aged hypertensive subjects. To this end, randomised clinical trials are needed.
目的
近期研究表明，n-3脂肪酸可抑制认知能力下降，可能因高血压状态而异。
设计
我们在一项前瞻性队列研究（社区动脉粥样硬化风险研究）中检验了这些假设。1987 - 1989年（访视1）完成了使用食物频率问卷进行的饮食评估以及通过气相色谱法进行的血浆脂肪酸暴露评估，而在1990 - 1992年（访视2）和1996 - 1998年（访视4）使用三种筛查工具——延迟单词回忆测试、修订版韦氏成人智力量表数字符号替换测试和单词流畅性测试（WFT）完成了认知评估。采用回归校准和模拟外推法来控制饮食暴露中的测量误差。
地点
美国四个社区——福赛斯县（北卡罗来纳州）、杰克逊（密西西比州）、明尼阿波利斯郊区（明尼苏达州）和华盛顿县（马里兰州）。
研究对象
访视1时年龄在50 - 65岁且有完整饮食数据的男性和女性（n = 7814）；明尼苏达现场中心同年龄组有完整血浆脂肪酸数据的白人男性和女性（n = 2251）。
结果
研究结果表明，饮食中长链n-3脂肪酸（占能量摄入的百分比）增加一个标准差以及长链n-3/n-6达到平衡，可使高血压患者6年言语流畅性认知能力下降的风险降低，优势比（95%置信区间）分别为0.79（0.66 - 0.95）和0.81（0.68 - 0.96）。发现饮食中长链n-3脂肪酸（克/天）与WFT下降之间存在与高血压状态的交互作用（似然比检验，P = 0.06）。血浆胆固醇酯中的这种暴露也可预防WFT下降，尤其是在高血压患者中（OR = 0.51，P < 0.05）。
结论
我们研究的一个启示是，对于中年高血压患者应考虑食用富含海洋来源脂肪酸的饮食。为此，需要进行随机临床试验。
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