Fretts Amanda M, Mozaffarian Dariush, Siscovick David S, Djousse Luc, Heckbert Susan R, King Irena B, McKnight Barbara, Sitlani Colleen, Sacks Frank M, Song Xiaoling, Sotoodehnia Nona, Spiegelman Donna, Wallace Erin R, Lemaitre Rozenn N
Department of Epidemiology, University of Washington, Seattle, WA (A.M.F., D.S.S., S.R.H., E.R.W.).
Department of Epidemiology, Harvard School of Public Health, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (D.M., D.S.) Department of Nutrition, Harvard School of Public Health, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (D.M., F.M.S.) Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (D.M., F.M.S.) Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (D.M., F.M.S.) Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA (D.M.).
J Am Heart Assoc. 2014 Jun 26;3(3):e000889. doi: 10.1161/JAHA.114.000889.
Prior studies suggest that circulating fatty acids may influence the risk of atrial fibrillation (AF), but little is known about the associations of circulating saturated fatty acids with risk of AF.
The study population included 2899 participants from the Cardiovascular Health Study, a community-based longitudinal cohort of adults aged 65 years or older in the United States who were free of prevalent coronary heart disease and AF in 1992. Cox regression was used to assess the association of all the long-chain saturated fatty acids-palmitic acid (16:0), stearic acid (18:0), arachidic acid (20:0), behenic acid (22:0), and lignoceric acid (24:0)-with incident AF. During a median of 11.2 years of follow-up, 707 cases of incident AF occurred. After adjustment for other AF risk factors, higher levels of circulating 16:0 were associated with a higher risk of AF (hazard ratio comparing highest and lowest quartiles: 1.48; 95% CI: 1.18, 1.86). In contrast, higher levels of circulating 18:0, 20:0, 22:0, and 24:0 were each associated with a lower risk of AF. The hazard ratios (95% CI) for AF in the top and bottom quartiles were 0.76 (95% CI: 0.61, 0.95) for 18:0; 0.78 (95% CI: 0.63, 0.97) for 20:0; 0.62 (95% CI: 0.50, 0.78) for 22:0; and 0.68 (95% CI: 0.55, 0.85) for 24:0.
Results from this prospective cohort study of older adults demonstrate divergent associations of circulating 16:0 versus longer-chain saturated fatty acids with incident AF, highlighting the need to investigate both determinants of these levels and potential pathways of the observed differential risk.
先前的研究表明，循环脂肪酸可能会影响心房颤动（AF）的风险，但关于循环饱和脂肪酸与AF风险之间的关联知之甚少。
研究人群包括来自心血管健康研究的2899名参与者，该研究是美国一个以社区为基础的65岁及以上成年人纵向队列，这些人在1992年时没有冠心病和AF病史。采用Cox回归分析评估所有长链饱和脂肪酸（棕榈酸（16:0）、硬脂酸（18:0）、花生酸（20:0）、山嵛酸（22:0）和二十四烷酸（24:0））与新发AF之间的关联。在中位随访11.2年期间，发生了707例新发AF病例。在调整其他AF风险因素后，循环中16:0水平较高与AF风险较高相关（最高四分位数与最低四分位数相比的风险比：1.48；95%CI：1.18，1.86）。相比之下，循环中18:0、20:0、22:0和24:0水平较高均与较低的AF风险相关。最高和最低四分位数中AF的风险比（95%CI）分别为：18:0为0.76（95%CI：0.61，0.95）；20:0为0.78（95%CI：0.63，0.97）；22:0为0.62（95%CI：0.50，0.78）；24:0为0.68（95%CI：0.55，0.85）。
这项针对老年人的前瞻性队列研究结果表明，循环中的16:0与较长链饱和脂肪酸与新发AF的关联不同，凸显了研究这些水平的决定因素以及观察到的差异风险的潜在途径的必要性。
