Department of Public Health Medicine, Faculty of Medicine, University of Tsukuba, 305-8575, Tsukuba, Japan.
Eur Heart J. 2013 Apr;34(16):1225-32. doi: 10.1093/eurheartj/eht043. Epub 2013 Feb 12.
Aims Although dietary saturated fatty acids (SFA) are considered atherogenic, associations between SFAs intake and stroke and coronary heart disease are still debated. We sought to test the hypothesis that SFA intake is associated inversely with risk of stroke and its subtypes and positively with coronary heart disease among Japanese, whose average SFA intake is lower than that of Westerners. Methods and results The Japan Public Health Center-based prospective Study involves two subcohorts: Cohort I, aged 45-64 in 1995 and followed-up through 2009, and Cohort II, aged 45-74 in 1998 and followed-up through 2007. A total of 38 084 men and 43 847 women were included in this report. Hazards ratios for incident total stroke, ischaemic stroke, intraparhenchymal haemorrhage, subarachnoid haemorrhage, myocardial infarction, and sudden cardiac death across quintiles of dietary SFAs were examined. We found inverse associations between SFA intake and total stroke [multivariable hazard ratio (95% confidence interval) for the highest vs. lowest quintiles = 0.77 (0.65-0.93), trend P = 0.002], intraparenchymal haemorrhage [0.61 (0.43-0.86), P for trend = 0.005], and ischaemic stroke [0.84 (0.67-1.06), trend P = 0.08], primarily for deep intraparenchymal haemorrhage [0.67 (0.45-0.99), P for trend = 0.04] and lacunar infarction [0.75 (0.53, 1.07), trend P = 0.02]. We also observed a positive association between SFAs intake and myocardial infarction [1.39 (0.93-2.08), trend P = 0.046] primarily among men. No associations were observed between SFAs intake and incidence of subarachnoid haemorrhage or sudden cardiac death. Conclusions In this Japanese population, SFAs intake was inversely associated with deep intraparenchymal haemorrhage and lacunar infarction and positively associated with myocardial infarction.
尽管膳食饱和脂肪酸(SFA)被认为具有动脉粥样硬化作用,但 SFA 摄入量与中风和冠心病之间的关系仍存在争议。我们试图验证这样一个假设,即 SFA 的摄入量与日本人中风及其亚型的风险呈负相关,与冠心病的风险呈正相关,因为日本人的 SFA 摄入量低于西方人。
日本公共卫生中心前瞻性研究包括两个子队列:队列 I,1995 年年龄在 45-64 岁,随访至 2009 年;队列 II,1998 年年龄在 45-74 岁,随访至 2007 年。本报告共纳入 38084 名男性和 43847 名女性。通过检查饮食 SFA 摄入量五分位数与总中风、缺血性中风、脑实质内出血、蛛网膜下腔出血、心肌梗死和心源性猝死的发病风险比来评估 SFA 摄入量与各种疾病的关系。
我们发现 SFA 摄入量与总中风呈负相关(最高五分位数与最低五分位数的多变量风险比(95%置信区间)= 0.77(0.65-0.93),趋势 P = 0.002),与脑实质内出血也呈负相关(0.61(0.43-0.86),趋势 P = 0.005),与缺血性中风呈负相关(0.84(0.67-1.06),趋势 P = 0.08),主要与深部脑实质内出血(0.67(0.45-0.99),趋势 P = 0.04)和腔隙性梗死(0.75(0.53-1.07),趋势 P = 0.02)相关。我们还观察到 SFA 摄入量与心肌梗死呈正相关(1.39(0.93-2.08),趋势 P = 0.046),主要发生在男性中。SFA 摄入量与蛛网膜下腔出血或心源性猝死的发生率无关联。
在日本人群中,SFA 的摄入量与深部脑实质内出血和腔隙性梗死呈负相关,与心肌梗死呈正相关。