Department of Epidemiology, Harvard School of Public Health, Division of Cardiovascular Medicine and Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Building 2-315, Boston, MA 02115, USA.
Curr Atheroscler Rep. 2009 Nov;11(6):423-33. doi: 10.1007/s11883-009-0064-0.
Consumption of industrially produced trans-fatty acids (TFA) is associated with substantial risk of coronary heart disease (CHD). The magnitude of this relationship, as well as emerging associations with end points such as diabetes and sudden cardiac death, cannot be fully explained by the well-established adverse effects of TFA on serum lipids. We review the evidence for effects of TFA intake on nonlipid risk factors. Based on evidence from randomized controlled trials, observational studies, animal experiments, and in vitro studies, these include effects on systemic inflammation, endothelial dysfunction, visceral adiposity, insulin resistance, and arrhythmic risk. The types and strength of evidence for each of these nonlipid effects varies, but the overall constellation of findings is qualitatively and quantitatively unique among dietary fats. The multiple adverse effects and implicated pathways are consistent with the observed strong associations of TFA consumption with CHD risk. These nonlipid effects also explain why TFA consumption may adversely impact other non-CHD diseases and end points.
工业生产的反式脂肪酸（TFA）的消耗与冠心病（CHD）的风险显著相关。这种关系的重要性，以及与糖尿病和心源性猝死等终点的新关联，不能完全用 TFA 对血清脂质的既定不良影响来解释。我们回顾了 TFA 摄入对非脂类危险因素的影响的证据。基于随机对照试验、观察性研究、动物实验和体外研究的证据，这些影响包括对全身炎症、内皮功能障碍、内脏肥胖、胰岛素抵抗和心律失常风险的影响。这些非脂类影响的证据类型和强度各不相同，但总体发现在膳食脂肪中具有独特的定性和定量特征。这些多种不良影响和涉及的途径与 TFA 消耗与 CHD 风险的强相关性一致。这些非脂类影响也解释了为什么 TFA 消耗可能对其他非 CHD 疾病和终点产生不利影响。
