Fifth Department of Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Fifth Department of Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University Graz, Graz, Austria; Synlab Academy, Synlab Holding Deutschland GmbH, Mannheim, Germany.
J Clin Lipidol. 2017 Jul-Aug;11(4):1082-1090.e14. doi: 10.1016/j.jacl.2017.05.003. Epub 2017 Jun 1.
Omega-6 polyunsaturated fatty acids (omega-6 PUFA) are recommended in European cardiovascular prevention guidelines. However, individual fatty acids have distinct biological functions, and there have been conflicting reports about the association of omega-6 PUFA with cardiovascular risk.
The aim of our study was to investigate the association of individual omega-6 fatty acids with mortality in a cohort of patients referred for coronary angiography.
Omega-6 PUFA proportions were measured in erythrocytes at baseline in a total of 3259 patients participating in the Ludwigshafen Risk and Cardiovascular Health Study using the HS-Omega-3 Index method. Associations of omega-6 PUFA with mortality were analyzed by Cox regression with adjustment for conventional risk factors.
During a median follow-up of 10.0 years, 975 patients (29.9%) died, 614 patients (18.8%) from cardiovascular causes. γ-Linolenic acid was inversely associated with all-cause and cardiovascular mortalities in models adjusted for cardiovascular risk factors with hazard ratios of 0.88 (0.82-0.95) and 0.86 (0.79-0.95) per 1-standard deviation increase, respectively. Adrenic acid and docosapentaenoic acid ω-6 were both directly associated with risk with hazard ratio of 1.10 (1.30-1.18) and 1.12 (1.05-1.19) for all-cause mortality, respectively. No association was found for arachidonic acid.
We observed opposing associations of individual omega-6 PUFA with mortality risk. While LA and γ-linolenic acid were associated with reduced risk, there was a direct association for adrenic acid and docosapentaenoic acid. These differences do not support the use of omega-6 PUFA concentrations as a single combined metric, and the prognostic value of each individual member should be examined separately.
欧米伽-6 多不饱和脂肪酸（omega-6 PUFA）被推荐用于欧洲心血管预防指南。然而，不同的脂肪酸具有不同的生物学功能，关于 omega-6 PUFA 与心血管风险的关系存在相互矛盾的报告。
我们的研究旨在调查在接受冠状动脉造影检查的患者队列中，个体 omega-6 脂肪酸与死亡率的关系。
共纳入 3259 例参与路德维希港风险与心血管健康研究的患者，在基线时采用 HS-Omega-3 Index 方法检测红细胞中的 omega-6 PUFA 比例。使用 Cox 回归分析 omega-6 PUFA 与死亡率的关系，调整传统危险因素。
在中位随访 10.0 年期间，975 例患者（29.9%）死亡，614 例患者（18.8%）死于心血管原因。在调整心血管危险因素的模型中，γ-亚麻酸与全因死亡率和心血管死亡率呈负相关，危险比分别为 0.88（0.82-0.95）和 0.86（0.79-0.95）。花生四烯酸和二十二碳五烯酸ω-6 与风险呈正相关，全因死亡率的危险比分别为 1.10（1.30-1.18）和 1.12（1.05-1.19）。未发现花生四烯酸与风险之间存在关联。
我们观察到个体 omega-6 PUFA 与死亡率风险之间存在相反的关联。虽然 LA 和 γ-亚麻酸与降低风险相关，但花生四烯酸和二十二碳五烯酸ω-6 与风险呈正相关。这些差异不支持将 omega-6 PUFA 浓度作为单一综合指标使用，应该分别检查每个个体成员的预后价值。
