Block Robert C, Harris William S, Reid Kimberly J, Spertus John A
Division of Epidemiology, Department of Community and Preventive Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642, USA.
Am Heart J. 2008 Dec;156(6):1117-23. doi: 10.1016/j.ahj.2008.07.014. Epub 2008 Oct 14.
Although fatty acid intake has been associated with risk of coronary disease events, the association between blood omega-6 and trans fatty acids (FAs) at the time of an acute coronary syndrome (ACS) is unknown.
The relationship of blood FA composition to ACS was analyzed in 768 incident cases and 768 controls (matched on age, sex, and race).
Compared to controls, ACS cases' blood cell membrane content of linoleic acid was 13% lower (P < .0001); arachidonic acid was 3.6% higher (P < .001); the trans isomer of oleic acid was 13.3% higher (P < .0001); and the trans-trans isomer of linoleic acid was 13.3% higher (P = .003). In multivariable analyses, a 1-SD decrease in linoleic acid was associated with >3 times the odds for being a case (odds ratio [OR] 3.23, 95% confidence interval [CI] 2.63-4.17). The relationship of arachidonic acid to ACS was U shaped; compared to the first quartile of arachidonic acid, the ORs for case status in the second, third, and fourth quartiles were 0.73 (95% CI 0.47-1.13), 0.65 (95% CI 0.41-1.04), and 2.32 (95% CI 1.39-3.90), respectively. The OR for a 1-SD increase in trans oleic acid was 1.24 (95% CI 1.06-1.45), and for trans-trans linoleic acid, 1.1 (95% CI 0.93-1.30). All associations were independent of membrane omega-3 FA content.
High blood levels of linoleic acid but low levels of trans oleic acid are inversely associated with ACS. The relationship of arachidonic acid to ACS appears more complex.
尽管脂肪酸摄入与冠心病事件风险相关，但急性冠状动脉综合征（ACS）发生时血液中ω-6和反式脂肪酸（FAs）之间的关联尚不清楚。
分析了768例新发病例和768例对照（按年龄、性别和种族匹配）的血液脂肪酸组成与ACS的关系。
与对照组相比，ACS病例的细胞膜亚油酸含量低13%（P<.0001）；花生四烯酸含量高3.6%（P<.001）；油酸的反式异构体含量高13.3%（P<.0001）；亚油酸的反-反式异构体含量高13.3%（P=.003）。在多变量分析中，亚油酸降低1个标准差与成为病例的几率增加3倍以上相关（优势比[OR]3.23，95%置信区间[CI]2.63-4.17）。花生四烯酸与ACS的关系呈U形；与花生四烯酸的第一个四分位数相比，第二、第三和第四个四分位数中病例状态的OR分别为0.73（95%CI 0.47-1.13）、0.65（95%CI 0.41-1.04）和2.32（95%CI 1.39-3.90）。反式油酸增加1个标准差的OR为1.24（95%CI 1.06-1.45），反-反式亚油酸的OR为1.1（95%CI 0.93-1.30）。所有关联均独立于膜ω-3脂肪酸含量。
血液中亚油酸水平高但反式油酸水平低与ACS呈负相关。花生四烯酸与ACS的关系似乎更为复杂。
