Department of Digestive and Life-style Related Diseases, Human Environmental Sciences, Health Research Studies, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
Department of Digestive and Life-style Related Diseases, Human Environmental Sciences, Health Research Studies, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
J Cardiol. 2014 Mar;63(3):211-7. doi: 10.1016/j.jjcc.2013.08.005. Epub 2013 Sep 27.
Brachial-ankle pulse wave velocity (baPWV) and ratio of plasma eicosapentaenoic acid to arachidonic acid (EPA/AA ratio) are surrogate markers for coronary artery disease (CAD). We aimed to evaluate the effects of a fish-based diet and administration of EPA on baPWV and plasma EPA/AA ratio.
The changes in baPWV and plasma EPA/AA ratio were compared before and after a 6-month fish-based diet in 191 patients with cardiovascular risk factors. A fish-based diet resulted in significant increment of plasma EPA/AA ratio (0.40±0.18 vs. 0.49±0.27, p<0.001), with baPWV remaining unchanged. Multivariate analysis revealed that systolic blood pressure (SBP) (6-month SBP-baseline SBP) and CAD were positively associated with increased baPWV (CAD: odds ratio=2.040, p=0.0436, SPB: odds ratio=1.056, p=0.0003). When the patients were divided into three groups: CAD, low-risk, and high-risk with no prior history of CAD according to the number of risk factors at baseline, comparison among the three groups disclosed an inter-group difference in the magnitude of change in baPWV (low-risk: -35±164cm/s, high-risk: -14±190cm/s, CAD: 39±164cm/s, p=0.0071 for trend). In 191 patients who had received a 6-month fish-based diet, 21 patients (primarily CAD patients) sequentially received high purity EPA (1800mg/day) for 6 months. It resulted in marked increment of plasma EPA/AA ratio (0.65±0.57 vs. 1.19±0.46, p<0.001), accompanied by significant reduction in baPWV (1968±344cm/s vs. 1829±344cm/s, p=0.0061). There was a significant negative correlation between changes in baPWV and changes in plasma EPA/AA ratio in patients with a fish-based diet and sequential administration of EPA (r=-0.446, p=0.017).
A fish-based diet was effective against increased baPWV only in low-risk patients, with slight increment of plasma EPA/AA. In high-risk patients and CAD patients, administration of EPA for preventing progression of baPWV endorsed the validity of high purity EPA administration recommended in the current guidelines.
肱踝脉搏波速度（baPWV）和血浆二十碳五烯酸与花生四烯酸的比值（EPA/AA 比值）是冠心病（CAD）的替代标志物。我们旨在评估富含鱼类的饮食和 EPA 给药对 baPWV 和血浆 EPA/AA 比值的影响。
191 例心血管危险因素患者在进行为期 6 个月的富含鱼类饮食后，比较了 baPWV 和血浆 EPA/AA 比值的变化。富含鱼类的饮食导致血浆 EPA/AA 比值显著升高（0.40±0.18 比 0.49±0.27，p<0.001），而 baPWV 保持不变。多变量分析显示，收缩压（SBP）（6 个月 SBP-基线 SBP）和 CAD 与 baPWV 的升高呈正相关（CAD：比值比=2.040，p=0.0436，SBP：比值比=1.056，p=0.0003）。当根据基线时的危险因素数量将患者分为 CAD、低危和高危无 CAD 既往史三组时，三组之间的 baPWV 变化幅度存在组间差异（低危：-35±164cm/s，高危：-14±190cm/s，CAD：39±164cm/s，p=0.0071 趋势）。在 191 例接受 6 个月富含鱼类饮食的患者中，21 例（主要为 CAD 患者）随后连续 6 个月接受高纯度 EPA（1800mg/天）。这导致血浆 EPA/AA 比值显著升高（0.65±0.57 比 1.19±0.46，p<0.001），同时 baPWV 显著降低（1968±344cm/s 比 1829±344cm/s，p=0.0061）。富含鱼类饮食和连续 EPA 给药的患者 baPWV 和血浆 EPA/AA 比值的变化之间存在显著负相关（r=-0.446，p=0.017）。
富含鱼类的饮食仅在低危患者中有效对抗 baPWV 的升高，血浆 EPA/AA 稍有增加。在高危患者和 CAD 患者中，EPA 的给药预防 baPWV 的进展支持当前指南中推荐的高纯度 EPA 给药的有效性。
