Department of Public Health and Primary Care, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom.
PLoS Med. 2012;9(7):e1001255. doi: 10.1371/journal.pmed.1001255. Epub 2012 Jul 3.
The lack of association found in several cohort studies between dietary saturated fat and coronary heart disease (CHD) risk has renewed debate over the link between dietary fats and CHD.
We assessed the relationship between plasma phospholipid fatty acid (PFA) concentration and incident CHD using a nested case control design within a prospective study (EPIC-Norfolk) of 25,639 individuals aged 40-79 years examined in 1993-1997 and followed up to 2009. Plasma PFA concentrations were measured by gas chromatography in baseline samples retrieved from frozen storage. In 2,424 men and women with incident CHD compared with 4,930 controls alive and free of cardiovascular disease, mean follow-up 13 years, saturated PFA (14:0, 16:0,18:0) plasma concentrations were significantly associated with increased CHD risk (odds ratio [OR] 1.75, 95% CI 1.27-2.41, p<0.0001), in top compared to bottom quartiles (Q), and omega-6 polyunsaturated PFA concentrations were inversely related (OR 0.77, 0.60-0.99, p<0.05) after adjusting for age, sex, body mass index, blood pressure, smoking, alcohol intake, plasma vitamin C, social class, education, and other PFAs. Monounsaturated PFA, omega-3 PFA, and trans PFA concentrations were not significantly associated with CHD. Odd chain PFA (15:0, 17:0) concentrations were significantly inversely associated with CHD (OR 0.73, 0.59-0.91, p<0.001, Q4 versus Q1). Within families of saturated PFA or polyunsaturated PFA, significantly heterogeneous relationships with CHD were observed for individual fatty acids.
In this study, plasma concentrations of even chain saturated PFA were found to be positively and omega-6 polyunsaturated PFA inversely related to subsequent coronary heart disease risk. These findings are consistent with accumulating evidence suggesting a protective role of omega-6 fats substituting for saturated fats for CHD prevention.
几项队列研究发现，饮食中的饱和脂肪与冠心病（CHD）风险之间并无关联，这重新引发了关于饮食脂肪与 CHD 之间关联的争论。
我们采用前瞻性研究（EPIC-Norfolk）中的嵌套病例对照设计，评估了血浆磷脂脂肪酸（PFA）浓度与 CHD 发病之间的关系，该研究纳入了 1993-1997 年接受检查且年龄在 40-79 岁的 25639 名个体，并随访至 2009 年。通过气相色谱法在基线样本中测量血浆 PFA 浓度，这些样本来自于冷冻储存。在 2424 名发生 CHD 的男性和女性与 4930 名存活且无心血管疾病的对照者（中位随访 13 年）相比，饱和 PFA（14:0、16:0、18:0）的血浆浓度与 CHD 风险增加显著相关（比值比[OR]1.75，95%置信区间[CI]1.27-2.41，p<0.0001），在最高四分位数（Q）与最低四分位数相比。调整年龄、性别、体重指数、血压、吸烟、饮酒、血浆维生素 C、社会阶层、教育和其他 PFA 后，ω-6 多不饱和 PFA 浓度呈负相关（OR 0.77，0.60-0.99，p<0.05）。单不饱和 PFA、ω-3 PFA 和反式 PFA 浓度与 CHD 无显著相关性。奇数链 PFA（15:0、17:0）浓度与 CHD 呈显著负相关（OR 0.73，0.59-0.91，p<0.001，Q4 与 Q1 相比）。在饱和 PFA 或多不饱和 PFA 的家族内，观察到个别脂肪酸与 CHD 存在显著异质性关系。
在这项研究中，发现血浆中偶数链饱和 PFA 浓度与随后的冠心病风险呈正相关，而 ω-6 多不饱和 PFA 呈负相关。这些发现与越来越多的证据一致，这些证据表明 ω-6 脂肪替代饱和脂肪可预防 CHD。
