Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA.
Department of Public Health, Shiga University of Medical Science, Otsu, Shiga, Japan.
Eur J Clin Nutr. 2019 May;73(5):783-792. doi: 10.1038/s41430-018-0242-7. Epub 2018 Jul 26.
BACKGROUND/OBJECTIVES: Clinical trials of eicosapentaenoic acid (EPA) among high-risk groups in Japan in which consumption of mairne-omega-3 fatty acids (OM3) is much higher than other countries showed slower progression of coronary atherosclerosis. We aimed to determine the cross-sectional associations of coronary artery calcification (CAC) and calcium density with OM3, EPA, and docosahexaenoic acid (DHA), two principal OM3, in the general population in Japan.
SUBJECTS/METHODS: The Shiga Epidemiological Study of Subclinical Atherosclerosis examined a population-based sample of 1074 men aged 40-79 in 2006-08 for computed tomography-measured CAC score (CCS), a well-established biomarker of coronary atherosclerosis, CAC density score (CDS), a potential marker of plaque stabilization, serum levels of OM3, and risk factors.
Prevalence of CCS > 0, ≥ 100, and ≥ 300 was 65.8%, 25.9%, and 12.9%, respectively; the mean (SD) OM3, EPA, and DHA were 10.1% (3.2), 3.2% (1.7), and 5.9% (1.6), respectively. Odds ratios (95% CI, p-value) of CCS 0, 100, and 300 in ordinal logistic regression associated with 1 SD increase of OM3, EPA, and DHA were 0.91 (0.81-1.03, p = 0.12), 0.99 (0.88-1.11, p = 0.87) and 0.84 (0.74-0.94, p = < 0.01), respectively. The inverse association of DHA with CCS remained significant in multivariate-adjusted model: odds ratio of 0.87 (0.77-0.99, p = 0.03). Blood levels of OM3, EPA, or DHA did not have any significant associations with CDS.
DHA but not EPA had a significant inverse association with coronary atherosclerosis in the general population with high levels of OM3. Future trials are warranted comparing the effect of high-dose DHA and EPA on atherosclerosis and cardiovascular outcomes.
背景/目的：在日本的高危人群中进行的二十碳五烯酸（EPA）临床试验中，由于人们消费的马鲛鱼-ω-3 脂肪酸（OM3）比其他国家高得多，因此冠状动脉粥样硬化的进展速度较慢。我们旨在确定在日本的一般人群中，冠状动脉钙化（CAC）和钙密度与 OM3、EPA 和二十二碳六烯酸（DHA）的横断面相关性，这两种主要的 OM3。
受试者/方法：2006-08 年，Shiga 亚临床动脉粥样硬化研究对 1074 名年龄在 40-79 岁的男性进行了基于人群的样本检查，以评估计算机断层扫描测量的 CAC 评分（CCS），这是冠状动脉粥样硬化的一个很好的生物标志物，CAC 密度评分（CDS），一个潜在的斑块稳定标志物，OM3 的血清水平和危险因素。
CCS>0、≥100 和≥300 的患病率分别为 65.8%、25.9%和 12.9%；OM3、EPA 和 DHA 的平均（SD）值分别为 10.1%（3.2）、3.2%（1.7）和 5.9%（1.6）。在有序逻辑回归中，CCS 0、100 和 300 的比值比（95%置信区间，p 值）与 OM3、EPA 和 DHA 的 1 SD 增加相关，分别为 0.91（0.81-1.03，p=0.12）、0.99（0.88-1.11，p=0.87）和 0.84（0.74-0.94，p<0.01）。在多变量调整模型中，DHA 与 CCS 的负相关仍然显著：比值比为 0.87（0.77-0.99，p=0.03）。OM3、EPA 或 DHA 的血液水平与 CDS 没有任何显著关联。
在 OM3 水平较高的一般人群中，DHA 而非 EPA 与冠状动脉粥样硬化有显著的负相关。有必要进行比较高剂量 DHA 和 EPA 对动脉粥样硬化和心血管结局影响的未来试验。
