Mori Kenta, Ishida Tatsuro, Yasuda Tomoyuki, Hasokawa Minoru, Monguchi Tomoko, Sasaki Maki, Kondo Kensuke, Nakajima Hideto, Shinohara Masakazu, Shinke Toshiro, Irino Yasuhiro, Toh Ryuji, Nishimura Kunihiro, Hirata Ken-Ichi
Division of Cardiovascular Medicine, Kobe University Graduate School of Medicine.
Circ J. 2015;79(9):2017-25. doi: 10.1253/circj.CJ-14-0750. Epub 2015 Jul 13.
Adverse effects of dietary intake of trans-fatty acids (TFA) on the incidence of coronary artery disease (CAD) are well recognized in Western countries. The risk of TFA, however, has not been well clarified in Japan. We investigated the association of serum TFA concentration with serum lipid profile, coronary risk factors, and prevalence of CAD.
A total of 902 patients, who were hospitalized at Kobe University Hospital from July 2008 to March 2012 and gave written informed consent, were enrolled in this study. Among them, 463 patients had CAD, and 318 patients had metabolic syndrome (MetS). Serum TFA, elaidic acid (trans-9-C18:1) and linolelaidic acid (trans-9, 12-C18:2), were measured on gas chromatography/mass spectrometry. Serum TFA level had a positive correlation with body mass index, waist circumference, low-density lipoprotein cholesterol, triglycerides, and apolipoprotein B48, and an inverse correlation with age and high-density lipoprotein cholesterol. Fasting serum TFA, by age quartile in the young generation with CAD and/or MetS, was higher than that in patients without CAD and/or MetS. On multivariate logistic regression, TFA was identified as a CAD risk after adjustment for classical risk factors.
Serum TFA concentration was elevated in young patients with CAD and/or MetS. Diet-derived TFA may cause a serious health problem, particularly in the young generation in Japan.
在西方国家，膳食中反式脂肪酸（TFA）的摄入对冠状动脉疾病（CAD）发病率的不良影响已得到充分认识。然而，TFA在日本的风险尚未得到明确阐明。我们研究了血清TFA浓度与血清脂质谱、冠状动脉危险因素及CAD患病率之间的关联。
本研究纳入了2008年7月至2012年3月在神户大学医院住院并签署书面知情同意书的902例患者。其中，463例患有CAD，318例患有代谢综合征（MetS）。采用气相色谱/质谱法测定血清TFA、反油酸（反式-9-十八碳烯酸）和亚油酸（反式-9,12-十八碳二烯酸）。血清TFA水平与体重指数、腰围、低密度脂蛋白胆固醇、甘油三酯和载脂蛋白B48呈正相关，与年龄和高密度脂蛋白胆固醇呈负相关。在患有CAD和/或MetS的年轻一代中，按年龄四分位数分组，空腹血清TFA水平高于无CAD和/或MetS的患者。在多因素逻辑回归分析中，调整经典危险因素后，TFA被确定为CAD的危险因素。
患有CAD和/或MetS的年轻患者血清TFA浓度升高。饮食来源的TFA可能会导致严重的健康问题，尤其是在日本的年轻一代中。
