Division of Aging, Department of Medicine.
Circ Heart Fail. 2013 Sep 1;6(5):964-9. doi: 10.1161/CIRCHEARTFAILURE.113.000521. Epub 2013 Aug 7.
Although plasma free fatty acid (FFA) concentrations have been associated with lipotoxicity, apoptosis, and risk of diabetes mellitus and coronary heart disease, it is unclear whether FFA levels are associated with heart failure (HF).
To test the hypothesis that plasma concentration of FFAs is positively associated with incident HF, we prospectively analyzed data on 4248 men and women free of HF at baseline and >65 years old from the Cardiovascular Health Study. FFA concentration was measured in duplicate by the Wako enzymatic method. Incident HF was validated by a centralized Events Committee. We used Cox proportional hazards to estimate the hazard ratio of HF per SD of FFAs. During a median follow-up of 10.5 years, a total of 1286 new cases of HF occurred. In a multivariable model adjusting for clinic site, comorbidity, demographic, anthropometric, and lifestyle factors, each SD (0.2 mEq/L) higher plasma FFA was associated with 12% (95% confidence interval, 6%-19%) higher risk of HF. Controlling for time-varying diabetes mellitus and coronary heart disease did not change the results (hazard ratio per SD, 1.16 [95% confidence interval, 1.09-1.23]).
A single measure of plasma FFA obtained later in life is associated with a higher risk of HF in older adults. Additional studies are needed to explore biological mechanisms by which FFAs may influence the risk of HF and determine whether FFAs could serve as a novel pharmacological target for HF prevention.
尽管血浆游离脂肪酸（FFA）浓度与脂肪毒性、细胞凋亡以及糖尿病和冠心病的发病风险相关，但 FFA 水平与心力衰竭（HF）之间的关系尚不清楚。
为了检验血浆游离脂肪酸浓度与 HF 发病呈正相关的假设，我们前瞻性地分析了心血管健康研究中基线时无 HF 且年龄>65 岁的 4248 名男性和女性的数据。FFA 浓度采用 Wako 酶法重复测量。HF 事件通过集中的事件委员会进行验证。我们采用 Cox 比例风险模型来估计每个 FFA 标准差（SD）与 HF 发病风险的比值比。中位随访 10.5 年后，共发生 1286 例新发 HF。在调整了临床站点、合并症、人口统计学、人体测量学和生活方式因素的多变量模型中，每个 FFA 浓度 SD（0.2mEq/L）的升高与 HF 发病风险增加 12%（95%置信区间，6%-19%）相关。在控制时变的糖尿病和冠心病后，结果并未改变（SD 时的比值比，1.16[95%置信区间，1.09-1.23]）。
在老年人中，单次测量的血浆 FFA 水平与 HF 风险增加相关。需要进一步的研究来探索 FFA 可能影响 HF 发病风险的生物学机制，并确定 FFA 是否可以作为 HF 预防的新的药物靶点。
