Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Atherosclerosis. 2013 Dec;231(2):261-7. doi: 10.1016/j.atherosclerosis.2013.09.023. Epub 2013 Oct 5.
We examined the association between the ratio of serum eicosapentaenoic acid to arachidonic acid (EPA/AA) or the docosahexaenoic acid (DHA)/AA and the development of cardiovascular disease in a general Japanese population.
A total of 3103 community-dwelling Japanese individuals aged ≥40 years were followed up for an average of 5.1 years. Serum EPA/AA ratios were categorized into quartiles. The risk estimates were computed using a Cox proportional hazards model.
During the follow-up period, 127 subjects experienced cardiovascular events. Age- and sex-adjusted incidence rates of cardiovascular disease increased with lower serum EPA/AA ratios in individuals with high-sensitivity C-reactive protein (HS-CRP) of ≥1.0 mg/L (p for trend = 0.006), whereas no clear association was observed in those with HS-CRP of <1.0 mg/L (p for trend = 0.27). The multivariable-adjusted risk of cardiovascular disease increased significantly, by 1.52 times (95% confidence interval 1.12-2.04) per 0.20 decrement in serum EPA/AA ratio in subjects with HS-CRP of ≥1.0 mg/L. A lower serum EPA/AA ratio was significantly associated with an increased risk of coronary heart disease, but there was no evidence of an association with stroke. The magnitude of the influence of the serum EPA/AA ratio on the cardiovascular risk increased significantly with elevating HS-CRP levels taken as a continuous variable (p for heterogeneity = 0.007). However, no such association was observed for DHA/AA ratio.
Our findings suggest that a lower serum EPA/AA ratio is associated with a greater risk of cardiovascular disease, especially coronary heart disease, among subjects with higher HS-CRP levels in the general Japanese population.
我们研究了血清二十碳五烯酸与花生四烯酸（EPA/AA）或二十二碳六烯酸（DHA/AA）比值与心血管疾病在日本一般人群中的发展之间的关系。
共随访了 3103 名年龄≥40 岁的社区居民，平均随访时间为 5.1 年。将血清 EPA/AA 比值分为四组。使用 Cox 比例风险模型计算风险估计。
在随访期间，127 名受试者发生了心血管事件。在 hs-CRP≥1.0mg/L 的个体中，随着血清 EPA/AA 比值的降低，年龄和性别调整后的心血管疾病发生率增加（趋势 p 值=0.006），而 hs-CRP<1.0mg/L 的个体中则没有明显的相关性（趋势 p 值=0.27）。在 hs-CRP≥1.0mg/L 的个体中，血清 EPA/AA 比值每降低 0.20，心血管疾病的多变量调整风险显著增加 1.52 倍（95%置信区间为 1.12-2.04）。低血清 EPA/AA 比值与冠心病风险增加显著相关，但与卒中无关。hs-CRP 水平作为连续变量升高时，血清 EPA/AA 比值对心血管风险的影响幅度显著增大（异质性 p 值=0.007）。然而，对于 DHA/AA 比值，没有观察到这种关联。
我们的研究结果表明，在日本一般人群中，hs-CRP 水平较高的个体中，血清 EPA/AA 比值较低与心血管疾病，特别是冠心病的风险增加有关。
