SU.FOL.OM3试验中的基线血浆脂肪酸谱与心血管事件发生率：证据再探讨
Baseline plasma fatty acids profile and incident cardiovascular events in the SU.FOL.OM3 trial: the evidence revisited.
作者信息
Fezeu Léopold K, Laporte François, Kesse-Guyot Emmanuelle, Andreeva Valentina A, Blacher Jacques, Hercberg Serge, Galan Pilar
机构信息
Université Paris 13, Sorbonne Paris Cité - Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre d'Epidémiologie et Biostatistiques (EPIBIOS), Inserm, Inra, Cnam, Université Paris 5, Université Paris 7, Bobigny, France.
Département de Biochimie-Pharmacologie-Toxicologie, Centre Hospitalier Universitaire, Grenoble, France.
出版信息
PLoS One. 2014 Apr 7;9(4):e92548. doi: 10.1371/journal.pone.0092548. eCollection 2014.
OBJECTIVE
We aimed to investigate the association between baseline plasma fatty acids profile and the risk of future major cardiovascular events in patients with a history of ischaemic heart disease or ischemic stroke.
METHODS
Baseline plasma fatty acids as well as established cardiovascular risk factors were measured in 2,263 patients enrolled in the SUpplementation with FOLate, vitamins B-6 and B-12 and/or OMega-3 fatty acids randomized controlled trial. Incident major cardiovascular, cardiac and cerebrovascular events were ascertained during the 4.7 years of follow up. Hazard ratios were obtained from Cox proportional hazards models after adjustment for cardiovascular risk factors.
RESULTS
During the follow-up, 154, 379 and 84 patients had major cardiovascular, cardiac and cerebrovascular events respectively. Upon adjustment for gender, initial event, baseline age and BMI, the risk of developing a major cardiovascular event decreased significantly in successive quartiles of arachidonic acid (P trend<0.002), total omega 3 polyunsaturated fatty acids (P trend<0.03), docosapentaenoic acid (P trend<0.019), docosahexaenoic acid (P trend<0.004), eicosapentaenoic acid + docosahexaenoic acid (P trend<0.03) and eicosapentaenoic acid + docosapentaenoic acid + docosahexaenoic acid (P trend<0.02). This inverse association was borderline significant with increased quartiles of stearidonic acid (P trend<0.06). In the full model, only stearidonic acid remained inversely associated with the risk of developing a major cardiovascular event (P trend<0.035), a cardiac event (P trend<0.016) or a cerebrovascular event (P trend<0.014), while arachidonic acid was inversely associated with the risk a cerebrovascular event (P trend<0.033).
CONCLUSION
The inverse association of long chain omega 3 polyunsaturated fatty acids with recurrence of Cardiovascular diseases was mainly driven by well-known cardiovascular risk factors.
TRIAL REGISTRATION
Controlled-Trials.com ISRCTN41926726.
目的
我们旨在研究缺血性心脏病或缺血性卒中病史患者的基线血浆脂肪酸谱与未来发生主要心血管事件风险之间的关联。
方法
在参与补充叶酸、维生素B-6和B-12及/或ω-3脂肪酸随机对照试验的2263例患者中，测量了基线血浆脂肪酸以及已确定的心血管危险因素。在4.7年的随访期间确定了新发的主要心血管、心脏和脑血管事件。在对心血管危险因素进行调整后，从Cox比例风险模型中获得风险比。
结果
在随访期间，分别有154例、379例和84例患者发生了主要心血管、心脏和脑血管事件。在对性别、初始事件、基线年龄和体重指数进行调整后，在花生四烯酸的连续四分位数中，发生主要心血管事件的风险显著降低（P趋势<0.002），总ω-3多不饱和脂肪酸（P趋势<0.03）、二十二碳五烯酸（P趋势<0.019）、二十二碳六烯酸（P趋势<0.004）、二十碳五烯酸+二十二碳六烯酸（P趋势<0.03）以及二十碳五烯酸+二十二碳五烯酸+二十二碳六烯酸（P趋势<0.02）。随着硬脂酸四分位数的增加，这种负相关接近显著（P趋势<0.06）。在完整模型中，只有硬脂酸仍然与发生主要心血管事件（P趋势<0.035）、心脏事件（P趋势<0.016）或脑血管事件（P趋势<0.014）的风险呈负相关，而花生四烯酸与脑血管事件的风险呈负相关（P趋势<0.033）。
结论
长链ω-3多不饱和脂肪酸与心血管疾病复发的负相关主要由众所周知的心血管危险因素驱动。
试验注册
Controlled-Trials.com ISRCTN41926726。
Zotero 插件