Department of Physiology, Tokai University School of Medicine, Shimokasuya, Isehara, Kanagawa, Japan.
Nutrition. 2013 Jan;29(1):127-31. doi: 10.1016/j.nut.2012.05.003. Epub 2012 Sep 23.
ω-3 fatty acids, including eicosapentaenoic acid (EPA), prevent ischemic stroke. However, the clinical importance of EPA for ischemic stroke and its subtype has not been fully elucidated.
In a cross-sectional study, we determined whether ω-3 fatty acids were predictive factors for ischemic stroke. We compared common clinical parameters among 65 patients with ischemic stroke and 65 control subjects. The parameters included blood chemistry data; concentrations of EPA, docosahexaenoic acid, and arachidonic acid (AA); EPA/AA ratio; smoking; alcohol intake; fish consumption more than four times per week; and the incidence of underlying diseases. The comparisons were performed using the Mann-Whitney U test, and multiple logistic regression analysis was applied to the significant factors in the non-parametric test. We also applied the same approach to the ischemic stroke subtypes, cardioembolism and large-artery atherosclerosis.
In the multiple logistic regression analysis after the Mann-Whitney U test, a lower EPA concentration was one of the significant risk factors for ischemic stroke, as were a lower body mass index, lower high-density lipoprotein cholesterol, and smoking (sensitivity 0.846, specificity 0.831, positive predictive value 0.833). In the analysis of subtypes, a lower EPA/AA ratio and a lower body mass index were the significant risk factors for cardioembolism (sensitivity 0.800, specificity 0.733, positive predictive value 0.750). However, large-artery atherosclerosis was not related to the EPA concentration or the EPA/AA ratio.
In this study, the plasma EPA concentration and the EPA/AA ratio were potential predictive risk factors for ischemic stroke, especially for cardioembolism. Further prospective studies are necessary.
ω-3 脂肪酸，包括二十碳五烯酸（EPA），可预防缺血性脑卒中。然而，EPA 对缺血性脑卒中及其亚型的临床重要性尚未完全阐明。
在一项横断面研究中，我们确定 ω-3 脂肪酸是否是缺血性脑卒中的预测因素。我们比较了 65 例缺血性脑卒中患者和 65 例对照者的常见临床参数。这些参数包括血液化学数据、EPA、二十二碳六烯酸和花生四烯酸（AA）浓度、EPA/AA 比值、吸烟、饮酒、每周食用鱼类超过 4 次，以及基础疾病的发生率。使用 Mann-Whitney U 检验比较参数，对非参数检验中的显著因素进行多元逻辑回归分析。我们还将相同的方法应用于缺血性脑卒中亚型，即心源性栓塞和大动脉粥样硬化。
在 Mann-Whitney U 检验后的多元逻辑回归分析中，EPA 浓度较低是缺血性脑卒中的显著危险因素之一，此外还有体重指数较低、高密度脂蛋白胆固醇较低和吸烟（敏感性 0.846、特异性 0.831、阳性预测值 0.833）。在亚型分析中，EPA/AA 比值较低和体重指数较低是心源性栓塞的显著危险因素（敏感性 0.800、特异性 0.733、阳性预测值 0.750）。然而，大动脉粥样硬化与 EPA 浓度或 EPA/AA 比值无关。
在这项研究中，血浆 EPA 浓度和 EPA/AA 比值是缺血性脑卒中，特别是心源性栓塞的潜在预测风险因素。需要进一步的前瞻性研究。
