老年人血浆磷脂脂肪酸和鱼油摄入量与骨质疏松性骨折风险的关系：年龄、基因/环境易感性研究
Plasma phospholipid fatty acids and fish-oil consumption in relation to osteoporotic fracture risk in older adults: the Age, Gene/Environment Susceptibility Study.
作者信息
Harris Tamara B, Song Xiaoling, Reinders Ilse, Lang Thomas F, Garcia Melissa E, Siggeirsdottir Kristin, Sigurdsson Sigurdur, Gudnason Vilmundur, Eiriksdottir Gudny, Sigurdsson Gunnar, Steingrimsdottir Laufey, Aspelund Thor, Brouwer Ingeborg A, Murphy Rachel A
机构信息
From the Laboratory of Epidemiology, and Population Sciences, National Institute on Aging, Bethesda, MD (TBH, IR, MEG, and RAM); the Biomarker Laboratory, Fred Hutchinson Cancer Research Center, Seattle, WA (XS); the Department of Health Sciences and the EMGO+ Institute for Health and Care Research, VU University, Amsterdam, The Netherlands (IR and IAB); the Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA (TFL); the Icelandic Heart Association, Kopavogur, Iceland (KS, SS, VG, GE, GS, and TA); and the University of Iceland, Reykjavik, Iceland (VG, GS, and LS).
出版信息
Am J Clin Nutr. 2015 May;101(5):947-55. doi: 10.3945/ajcn.114.087502. Epub 2015 Mar 18.
BACKGROUND
Polyunsaturated fatty acids (PUFAs) may play a role in fracture, but studies have been largely confined to estimates of dietary intake.
OBJECTIVE
We aimed to examine associations between fatty acids measured in late life and fish-oil consumption in early life, midlife, and late life with osteoporotic fracture risk.
DESIGN
Osteoporotic fractures were determined from medical records over 5-9 y of follow-up in men and women aged 66-96 y. Data were analyzed from 1438 participants including 898 participants who were randomly selected from the Age, Gene/Environment Susceptibility Study, which is an observational study, and 540 participants with incident fracture. Plasma phospholipid fatty acids were assessed by using gas chromatography. Fish-oil consumption was assessed by using validated questionnaires as never (referent), less than daily, or daily. HRs and 95% CIs adjusted for age, education, height, weight, diabetes, physical activity, and medications were estimated by using Cox regression.
RESULTS
In men, the highest tertile of PUFAs, n-3 (ω-3), and eicosapentaenoic acid were associated with decreased fracture risk [HRs (95% CIs): 0.60 (95% CI: 0.41, 0.89), 0.66 (0.45, 0.95), and 0.59 (0.41, 0.86), respectively]. In women, PUFAs tended to be inversely associated with fracture risk (P-trend = 0.06), but tertiles 2 and 3 were not independently associated with risk. Tertile 2 of n-6 and arachidonic acid was associated with fracture risk in women [HRs (95% CIs): 1.43 (1.10, 1.85) and 1.42 (1.09, 1.85), respectively]. Daily fish-oil consumption in late life was associated with lower fracture risk in men (HR: 0.64; 95% CI: 0.45, 0.91). Daily fish-oil consumption in midlife was associated with lower fracture risk in women (HR: 0.75; 95% CI: 0.58, 0.98).
CONCLUSIONS
Greater PUFA concentrations may be associated with lower osteoporotic fracture risk in older adults, particularly in men. Critical time periods for n-3 fatty acid consumption may differ by sex.
背景
多不饱和脂肪酸（PUFAs）可能在骨折中发挥作用，但研究大多局限于膳食摄入量的估计。
目的
我们旨在研究晚年测量的脂肪酸与早年、中年和晚年鱼油摄入量与骨质疏松性骨折风险之间的关联。
设计
通过对66 - 96岁男性和女性5 - 9年随访期的医疗记录确定骨质疏松性骨折情况。对1438名参与者的数据进行分析，其中包括从年龄、基因/环境易感性研究（一项观察性研究）中随机选取的898名参与者以及540名新发骨折参与者。采用气相色谱法评估血浆磷脂脂肪酸。通过使用经过验证的问卷评估鱼油摄入量，分为从不（参照组）、少于每日或每日摄入。采用Cox回归估计校正年龄、教育程度、身高、体重、糖尿病、身体活动和药物治疗后的风险比（HRs）及95%可信区间（CIs）。
结果
在男性中，PUFAs、n - 3（ω - 3）和二十碳五烯酸最高三分位数与骨折风险降低相关[HRs（95% CIs）分别为：0.60（95% CI：0.41，0.89）、0.66（0.45，0.95）和0.59（0.41，0.86）]。在女性中，PUFAs倾向于与骨折风险呈负相关（P趋势 = 0.06），但第二和第三三分位数与风险无独立关联。n - 6和花生四烯酸的第二三分位数与女性骨折风险相关[HRs（95% CIs）分别为：1.43（1.10，1.85）和1.42（1.09，1.85）]。晚年每日摄入鱼油与男性较低的骨折风险相关（HR：0.64；95% CI：0.45，0.91）。中年每日摄入鱼油与女性较低的骨折风险相关（HR：0.75；95% CI：0.58，0.98）。
结论
较高的PUFA浓度可能与老年人尤其是男性较低的骨质疏松性骨折风险相关。n - 3脂肪酸摄入的关键时期可能因性别而异。
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