Nishizaki Yuji, Shimada Kazunori, Tani Shigemasa, Ogawa Takayuki, Ando Jiro, Takahashi Masao, Yamamoto Masato, Shinozaki Tomohiro, Miyazaki Tetsuro, Miyauchi Katsumi, Nagao Ken, Hirayama Atsushi, Yoshimura Michihiro, Komuro Issei, Nagai Ryozo, Daida Hiroyuki
Department of Cardiology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo Bunkyo-ku, Tokyo, 113-8421, Japan.
Department of Cardiology, Nihon University Hospital, 1-6 Kanda Surugadai Chiyoda-ku, Tokyo, 101-8309, Japan.
BMC Cardiovasc Disord. 2016 Jul 7;16(1):143. doi: 10.1186/s12872-016-0299-y.
A low eicosapentaenoic acid (EPA) to arachidonic acid (AA) ratio is a known risk for acute coronary syndrome (ACS). However, the association between the docosahexaenoic acid (DHA) to AA ratio and ACS remains unclear. This study aimed to assess the association between the DHA/AA ratio and ACS by patient characteristics.
We enrolled 1733 patients and evaluated the serum levels of polyunsaturated fatty acids in 5 cardiology departments in a metropolitan area of Japan. We assessed the relationship between the DHA/AA ratio (median cut-off value: 0.903) and ACS according to the following 10 subgroups: sex, age, diabetes mellitus, hypertension, dyslipidemia, smoking history, family history of ischemic heart disease, chronic kidney disease, obesity, and history of coronary revascularization.
Interaction tests in the 10 subgroup analyses revealed a significant difference for adjusted log odds ratios between male and females (p = 0.01), and those with and without hypertension (p = 0.06). Especially in the subgroup based on sex difference, a high DHA/AA ratio was significantly associated with a low risk of ACS among men (adjusted odds ratio = 0.389; 95 % confidence interval: 0.211-0.716). In contrast, a reverse association was found among women, although this was not statistically significant (adjusted odds ratio = 3.820; 95 % confidence interval: 0.718-20.325).
The association between the DHA/AA ratio and ACS differed by clinical characteristic. Notably, patients with a low DHA/AA ratio had a higher risk of ACS than those with a high DHA/AA ratio, and this was significant for men in particular.
二十碳五烯酸（EPA）与花生四烯酸（AA）的比例较低是急性冠状动脉综合征（ACS）的已知风险因素。然而，二十二碳六烯酸（DHA）与AA的比例和ACS之间的关联仍不明确。本研究旨在根据患者特征评估DHA/AA比例与ACS之间的关联。
我们招募了1733名患者，并在日本一个大都市地区的5个心脏病科评估了多不饱和脂肪酸的血清水平。我们根据以下10个亚组评估了DHA/AA比例（中位数临界值：0.903）与ACS之间的关系：性别、年龄、糖尿病、高血压、血脂异常、吸烟史、缺血性心脏病家族史、慢性肾脏病、肥胖症以及冠状动脉血运重建史。
10个亚组分析中的交互检验显示，男性与女性（p = 0.01）以及有高血压和无高血压者（p = 0.06）之间调整后的对数优势比存在显著差异。特别是在基于性别差异的亚组中，高DHA/AA比例与男性患ACS的低风险显著相关（调整后的优势比 = 0.389；95%置信区间：0.211 - 0.716）。相比之下，在女性中发现了相反的关联，尽管这在统计学上不显著（调整后的优势比 = 3.820；95%置信区间：0.718 - 20.325）。
DHA/AA比例与ACS之间的关联因临床特征而异。值得注意的是，DHA/AA比例低的患者患ACS的风险高于DHA/AA比例高的患者，这在男性中尤为显著。
