Sugiura Tsuyoshi, Yoshikawa Daiji, Ishii Hideki, Suzuki Susumu, Kumagai Soichiro, Inoue Yosuke, Okumura Satoshi, Isobe Satoshi, Hayashi Mutsuharu, Ando Hirohiko, Amano Tetsuya, Murohara Toyoaki
Department of Cardiology, Ichinomiya Municipal Hospital, Ichinomiya, Japan.
Heart Vessels. 2014 Jul;29(4):449-55. doi: 10.1007/s00380-013-0384-4. Epub 2013 Jun 26.
Eicosapentaenoic acid (EPA), a member of the omega-3 polyunsaturated fatty acid family, prevents cardiovascular disease. C-reactive protein (CRP) is a marker of inflammation, which promotes atherosclerosis. The aim of this study was to investigate the relationship among EPA, CRP, and the prevalence of peripheral artery disease (PAD), which is a manifestation of systemic atherosclerosis. A cross-sectional study was performed on 238 patients with coronary artery disease (CAD). Blood EPA and CRP levels and ankle-brachial pressure indices were measured. Cut-off values for plasma EPA levels and serum CRP levels were determined using receiver operating characteristic (ROC) analysis. Patients with ABIs ≤0.9 were defined as having PAD. EPA levels were significantly lower and CRP levels were significantly higher in patients with PAD than in those without [48 (26-77) vs. 58 (41-83) μg/ml, p = 0.026 and 3.3 (0.64-14.0) vs. 0.70 (0.32, 2.4) mg/l, p = 0.004]. Multivariate analysis for PAD revealed that high CRP levels and low EPA levels were significant and independent predictors of PAD [odds ratio 3.1 (95 % CI 1.4-6.9), p = 0.006 and odds ratio 4.9 (95 % CI 1.5-9.7), p = 0.004]. Furthermore, to predict PAD, adding high CRP levels and low EPA levels to the established risk factors significantly improved the area under the ROC curves, from 0.66 to 0.78, of the PAD prediction model (p = 0.004). A significant relationship among EPA, CRP, and PAD was confirmed in patients with CAD.
二十碳五烯酸（EPA）是ω-3多不饱和脂肪酸家族的一员，可预防心血管疾病。C反应蛋白（CRP）是炎症标志物，会促进动脉粥样硬化。本研究旨在探讨EPA、CRP与外周动脉疾病（PAD）患病率之间的关系，PAD是全身性动脉粥样硬化的一种表现。对238例冠心病（CAD）患者进行了横断面研究。测量了血液中的EPA和CRP水平以及踝臂压力指数。使用受试者工作特征（ROC）分析确定血浆EPA水平和血清CRP水平的临界值。踝臂指数（ABI）≤0.9的患者被定义为患有PAD。与未患PAD的患者相比，患PAD的患者EPA水平显著降低，CRP水平显著升高[48（26 - 77）vs. 58（41 - 83）μg/ml，p = 0.026；3.3（0.64 - 14.0）vs. 0.70（0.32，2.4）mg/l，p = 0.004]。对PAD的多变量分析显示，高CRP水平和低EPA水平是PAD的显著且独立预测因素[比值比3.1（95%可信区间1.4 - 6.9），p = 0.006；比值比4.9（95%可信区间1.5 - 9.7），p = 0.004]。此外，为了预测PAD，将高CRP水平和低EPA水平添加到已有的危险因素中，显著提高了PAD预测模型的ROC曲线下面积，从0.66提高到0.78（p = 0.004）。在CAD患者中证实了EPA、CRP和PAD之间存在显著关系。
