Division of Aging, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School and Boston Veterans Affairs Healthcare System, Boston, MA 02120, USA.
Circ Arrhythm Electrophysiol. 2012 Apr;5(2):273-8. doi: 10.1161/CIRCEP.111.967661. Epub 2012 Jan 26.
Although nonesterified fatty acids (NEFA) have been positively associated with coronary heart disease risk factors, limited and inconsistent data are available on the relation between NEFA and sudden cardiac death.
Using a prospective design, we studied 4657 older men and women (mean age, 75 years) from the Cardiovascular Health Study (1992-2006) to evaluate the association between plasma NEFA and the risk of sudden cardiac death in older adults. Plasma concentrations of NEFA were measured using established enzymatic methods, and sudden death was adjudicated using medical records, death certificates, proxy interview, and autopsy reports. We used Cox proportional hazard models to estimate multivariable-adjusted relative risks. During a median follow-up of 10.0 years, 221 new cases of sudden cardiac death occurred. In a multivariable model adjusting for age, sex, race, clinic site, alcohol intake, smoking, prevalent coronary heart disease and heart failure, and self-reported health status, relative risks (95% confidence interval) for sudden cardiac death were 1.0 (ref), 1.15 (0.81-1.64), 1.06 (0.72-1.55), and 0.91 (0.60-1.38) across consecutive quartiles of NEFA concentration. In secondary analyses restricted to the first 5 years of follow-up, we also did not observe a statistically significant association between plasma NEFA and sudden cardiac death.
Our data do not provide evidence for an association between plasma NEFA measured late in life and the risk of sudden cardiac death in older adults.
尽管非酯化脂肪酸（NEFA）与冠心病危险因素呈正相关，但关于 NEFA 与心源性猝死之间的关系，相关数据有限且不一致。
我们采用前瞻性设计，对心血管健康研究（1992-2006 年）中的 4657 名年龄较大的男性和女性（平均年龄 75 岁）进行了研究，以评估血浆 NEFA 与老年人心源性猝死风险之间的关系。使用既定的酶法测定血浆 NEFA 浓度，通过病历、死亡证明、代理访谈和尸检报告来确定心源性猝死的发生。我们使用 Cox 比例风险模型来估计多变量调整后的相对风险。在中位随访 10.0 年期间，发生了 221 例新的心源性猝死事件。在调整年龄、性别、种族、诊所地点、酒精摄入量、吸烟状况、已确诊的冠心病和心力衰竭以及自我报告的健康状况等因素的多变量模型中，心源性猝死的相对风险（95%置信区间）分别为 1.0（参考值）、1.15（0.81-1.64）、1.06（0.72-1.55）和 0.91（0.60-1.38）。在随访前 5 年的二次分析中，我们也没有观察到血浆 NEFA 与心源性猝死之间存在统计学显著关联。
我们的数据没有提供证据表明，在生命晚期测量的血浆 NEFA 与老年人心源性猝死风险之间存在关联。
