Department of Cardiology, Juntendo University Graduate School of Medicine, Tokyo, Japan.
Department of Cardiology, Surugadai Nihon University Hospital, Tokyo, Japan.
Am J Cardiol. 2014 Feb 1;113(3):441-5. doi: 10.1016/j.amjcard.2013.10.011. Epub 2013 Nov 7.
This study aimed to assess the balance of serum n-3 to n-6 polyunsaturated fatty acids (PUFAs) in patients with acute coronary syndrome (ACS). We enrolled 1,119 patients who were treated and in whom serum PUFA level was evaluated in 5 divisions of cardiology in a metropolitan area in Japan. Serum levels of PUFAs, including eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and arachidonic acid (AA), were compared between patients with and without ACS. We also evaluated the balance of serum n-3 to n-6 PUFAs, including EPA/AA and DHA/AA ratios. EPA/AA values were 0.46 ± 0.32 and 0.50 ± 0.32 in the ACS and non-ACS groups, respectively. DHA/AA values were 0.95 ± 0.37 and 0.96 ± 0.41 in the ACS and non-ACS groups, respectively. Next, we divided the patients into 3 groups based on the tertiles of EPA/AA or tertiles of DHA/AA to determine the independent risk factors for ACS. According to multivariate logistic regression analysis, the group with the lowest EPA/AA (≤0.33) had a greater probability of ACS (odds ratio 3.14, 95% confidence interval 1.16 to 8.49), but this was not true for DHA/AA. In conclusion, an imbalance in the ratio of serum EPA to AA, but not in the ratio of DHA to AA, was significantly associated with ACS.
本研究旨在评估急性冠状动脉综合征（ACS）患者血清 n-3 与 n-6 多不饱和脂肪酸（PUFAs）的平衡。我们纳入了日本一个大都市区的 5 个心脏病学部门治疗的 1119 名患者，并评估了他们的血清 PUFAs 水平。比较了 ACS 患者与非 ACS 患者的血清 PUFAs 水平，包括二十碳五烯酸（EPA）、二十二碳六烯酸（DHA）和花生四烯酸（AA）。我们还评估了血清 n-3 与 n-6 PUFAs 的平衡，包括 EPA/AA 和 DHA/AA 比值。ACS 组和非 ACS 组的 EPA/AA 值分别为 0.46±0.32 和 0.50±0.32。DHA/AA 值分别为 0.95±0.37 和 0.96±0.41。接下来，我们根据 EPA/AA 的三分位数或 DHA/AA 的三分位数将患者分为 3 组，以确定 ACS 的独立危险因素。根据多变量逻辑回归分析，EPA/AA 最低（≤0.33）的组发生 ACS 的可能性更大（比值比 3.14，95%置信区间 1.16 至 8.49），但 DHA/AA 则不然。总之，血清 EPA 与 AA 比值的不平衡，而不是 DHA 与 AA 的比值，与 ACS 显著相关。
