Department of Food and Nutrition, College of Human Ecology, Hanyang University, Seoul 133-791, South Korea.
Nutr Res. 2009 Dec;29(12):825-30. doi: 10.1016/j.nutres.2009.10.018.
Evidence suggesting an association between n-3 polyunsaturated fatty acids (PUFA) and stroke risk has been inconsistent, possibly because previous studies have not differentiated between different stroke types. The present study investigated the hypothesis that tissue levels of n-3 PUFA are positively associated with hemorrhagic stroke and negatively associated with ischemic stroke. We recruited 120 subjects for this case-control study, with 40 cases each of hemorrhagic stroke, ischemic stroke, and unaffected controls. Patients with a family history of hemorrhagic stroke had a significantly increased risk for hemorrhagic stroke. Omega-3 Index (20:5n3 + 22:6n3 in erythrocytes) and 22:6n3 were negatively (P < .01) associated with the risk of both hemorrhagic and ischemic stroke in multivariate analyses. Saturated fatty acids 16:0 and 18:0 were positively associated, whereas 18:2n6 and 18:3n6 were negatively (P < .05) associated with risk of ischemic stroke. Monounsaturated fatty acid, 18:1n9, increased (P = .03) the odds of hemorrhagic stroke. Omega-3 Index and docosahexaenoic acid were significantly lower in patients with both subtypes of hemorrhagic stroke, subarachnoid and intracerebral hemorrhage, but only in one subtype of ischemic stroke, small-artery occlusion. Saturated fatty acids 16:0 and 18:0 were significantly higher, but 20:4n6 was significantly lower, in patients with small-artery occlusion. Linoleic acid was significantly lower in patients with small-artery occlusion and large-artery atherosclerosis, whereas 18:1n9 was higher in both subgroups of hemorrhagic stroke. In conclusion, the results of our case-control study suggest that erythrocyte n-3 PUFA may protect against hemorrhagic stroke and ischemic stroke, particularly in the case of small-artery occlusion.
有证据表明，n-3 多不饱和脂肪酸（PUFA）与中风风险之间存在关联，但这种关联并不一致，这可能是因为之前的研究并未区分不同类型的中风。本研究旨在验证这样一种假设，即组织中 n-3 PUFA 的水平与出血性中风呈正相关，与缺血性中风呈负相关。我们进行了这项病例对照研究，共招募了 120 名受试者，其中包括 40 例出血性中风、40 例缺血性中风和 40 例无影响对照。有出血性中风家族史的患者患出血性中风的风险显著增加。多元分析显示，ω-3 指数（红细胞中 20:5n3+22:6n3）和 22:6n3 与出血性和缺血性中风的风险呈负相关（P＜0.01）。饱和脂肪酸 16:0 和 18:0 呈正相关，而 18:2n6 和 18:3n6 则呈负相关（P＜0.05），与缺血性中风的风险相关。单不饱和脂肪酸 18:1n9 增加（P=0.03）出血性中风的发病几率。两种类型的出血性中风（蛛网膜下腔出血和脑出血）以及仅一种类型的缺血性中风（小动脉闭塞）患者的ω-3 指数和二十二碳六烯酸显著降低，但在小动脉闭塞患者中，饱和脂肪酸 16:0 和 18:0 显著升高，而 20:4n6 显著降低。亚油酸在小动脉闭塞和大动脉粥样硬化患者中显著降低，而 18:1n9 在两种类型的出血性中风患者中均升高。总之，本病例对照研究的结果表明，红细胞 n-3 PUFA 可能对出血性中风和缺血性中风具有保护作用，尤其是在小动脉闭塞的情况下。
