Yang Bo, Ding Fang, Wang Feng-Lei, Yu Wei, Li Duo
From the Department of Food Science and Nutrition, Zhejiang University, Hangzhou, China (BY, F-LW, DL); and The Province Center for Cardio-Cerebral-Vascular Disease, Zhejiang Hospital, Hangzhou, China (FD, WY).
Medicine (Baltimore). 2016 Feb;95(5):e2329. doi: 10.1097/MD.0000000000002329.
Observational studies on circulating fatty acid (FA) and primary prevention of hypertension have yielded inconsistent results, and the association among the Chinese population is not fully clear. The aim of the study was to discern important FAs that can discriminate hypertensive patients from normotensive persons, and investigate associations between the important FAs and risk of hypertension.We conducted a case-control study nested within a community-based cohort of 2447 Chinese participants aged 35 to 79 years who completed a baseline assessment between October 2012 and April 2013. In all, 480 patients with newly diagnosed hypertension were identified at baseline and 480 normotensive individuals were randomly selected as matched normotensive controls. Controls were individually matched to cases by age (±2 y), sex, and recruitment center, with a 1:1 case-to-control ratio. Serum FA profile was compared between cases and controls by orthogonal partial least squares-discriminant analyses. Odds ratio (OR) with 95% confidence interval (CI) for newly diagnosed hypertension was estimated by a conditional logistical analysis.After adjustment for body mass index, education, profession, family history of hypertension, salt intake, heart rate, blood lipids, and fasting glucose levels, serum FA profile in hypertensive patients was typically characterized by higher 16:0 and 16:1n-7, and lower 18:2n-6 and 22:6n-3, compared with normotensive controls. Docosahexaenoic acid (22:6n-3) and palmitoleic acid (16:1n-7) were identified as the important FA contributing most to the intergroup separations. When comparing the highest and lowest quartile of FA composition, newly diagnosed hypertension was negatively associated with 22:6n-3 (OR 0.65; 95% CI, 0.45-0.93; P for trend = 0.02), but positively associated with 16:1n-7 (OR 2.14; 95% CI, 1.46-3.12; P for trend < 0.001). The associations remained pronounced after multiple adjustments and in further stratified analyses.In distinguishing hypertensive patients and normotensive persons, 22:6n-3 was considered as an important n-3 FA. Increased serum proportion of 22:6n-3 was associated with decreased odds of newly diagnosed hypertension, which suggests that high levels of 22:6n-3 in serum or perhaps in diet may be beneficial for prevention of hypertension in the Chinese population.
关于循环脂肪酸（FA）与高血压一级预防的观察性研究结果并不一致，中国人群中的这种关联也尚未完全明确。本研究的目的是识别能够区分高血压患者和血压正常者的重要脂肪酸，并调查这些重要脂肪酸与高血压风险之间的关联。我们进行了一项病例对照研究，该研究嵌套于一个基于社区的队列中，该队列有2447名年龄在35至79岁之间的中国参与者，他们在2012年10月至2013年4月期间完成了基线评估。总共在基线时确定了480例新诊断的高血压患者，并随机选择480名血压正常个体作为匹配的血压正常对照。对照按年龄（±2岁）、性别和招募中心与病例进行个体匹配，病例与对照的比例为1:1。通过正交偏最小二乘法判别分析比较病例组和对照组的血清脂肪酸谱。通过条件逻辑分析估计新诊断高血压的比值比（OR）及其95%置信区间（CI）。在调整了体重指数、教育程度、职业、高血压家族史、盐摄入量、心率、血脂和空腹血糖水平后，与血压正常对照相比，高血压患者的血清脂肪酸谱通常表现为16:0和16:1n - 7含量较高，而18:2n - 6和22:6n - 3含量较低。二十二碳六烯酸（22:6n - 3）和棕榈油酸（16:1n - 7）被确定为对组间分离贡献最大的重要脂肪酸。比较脂肪酸组成的最高和最低四分位数时，新诊断高血压与22:6n - 3呈负相关（OR 0.65；95% CI，0.45 - 0.93；趋势P = 0.02），但与16:1n - 7呈正相关（OR 2.14；95% CI，1.46 - 3.12；趋势P < 0.001）。在多次调整和进一步分层分析后，这些关联仍然显著。在区分高血压患者和血压正常者时，22:6n - 3被认为是一种重要的n - 3脂肪酸。血清中22:6n - 3比例的增加与新诊断高血压的几率降低相关，这表明血清中或可能饮食中高水平的22:6n - 3可能对中国人群预防高血压有益。
