Honda Tomoko, Kishi Satoru, Furukawa Emi, Ambe Hiroko, Kurata Yu, Ichikawa Masahiro, Aoe Mari, Ohara Ken, Furuse Satoshi, Saito Katsunori, Nishio Kyosuke, Masaki Kazunobu, Kano Tatsuya, Mise Naobumi
Division of Internal Medicine, Mitsui Memorial Hospital, Tokyo, Japan.
Shinkoiwa Clinic, Tokyo, Japan.
Ther Apher Dial. 2018 Oct;22(5):514-518. doi: 10.1111/1744-9987.12677. Epub 2018 Jul 10.
Eicosapentaenoic acid (EPA)/arachidonic acid (AA) ratio showed inverse associations with cardiovascular disease (CVD) in general population. However, this has not been examined enough in dialysis patients. We cross-sectionally investigated the relationship between EPA/AA ratio and prevalence of CVD in 321 chronic hemodialysis patients (64 ± 11 years old; 110 women; dialysis vintage 10 ± 8 years) in an urban area of Tokyo. CVD was defined as a composite of ischemic heart disease, ischemic stroke and hemorrhagic stroke. The frequency of dietary fish intake was also examined. Logistic regression was used to quantify the association of EPA/AA ratio with CVD. EPA/AA ratio was 0.31 ± 0.19 and 154 patients (48%) consumed fish once or less weekly. One hundred and thirty patients (41%) had CVD, including 65 with ischemic heart disease, 70 with ischemic stroke, and 20 with hemorrhagic stroke. Age (odds ratio [OR], 1.04; P = 0.01), hypertension (OR, 2.25; P = 0.002), and dialysis vintage (OR, 1.04; P = 0.02) were associated with CVD; however, EPA/AA was not after adjustment for other risk factors. A similar relationship was observed between fish intake and CVD prevalence. We did not find any significant association between EPA/AA ratio and prevalence of CVD, although traditional risk factors such as age, hypertension and dialysis vintage were associated with CVD. These results might have been influenced by the fact that only a small proportion of our patients showed a high EPA/AA ratio.
在普通人群中，二十碳五烯酸（EPA）/花生四烯酸（AA）比值与心血管疾病（CVD）呈负相关。然而，在透析患者中对此研究尚不充分。我们对东京市区321例慢性血液透析患者（64±11岁；女性110例；透析龄10±8年）进行了横断面研究，以调查EPA/AA比值与CVD患病率之间的关系。CVD定义为缺血性心脏病、缺血性卒中和出血性卒中的综合。同时还调查了鱼类摄入频率。采用逻辑回归分析来量化EPA/AA比值与CVD之间的关联。EPA/AA比值为0.31±0.19，154例患者（48%）每周食用鱼类一次或更少。130例患者（41%）患有CVD，其中65例患有缺血性心脏病，70例患有缺血性卒中，20例患有出血性卒中。年龄（比值比[OR]，1.04；P=0.01）、高血压（OR，2.25；P=0.002）和透析龄（OR，1.04；P=0.02）与CVD相关；然而，在对其他危险因素进行校正后，EPA/AA与CVD无关。在鱼类摄入与CVD患病率之间也观察到类似关系。尽管年龄、高血压和透析龄等传统危险因素与CVD相关，但我们未发现EPA/AA比值与CVD患病率之间存在任何显著关联。这些结果可能受到以下事实的影响：我们的患者中只有一小部分EPA/AA比值较高。
