Department of Laboratory Medicine & Pathology, University of Minnesota, Minneapolis, MN, USA.
Department of Medicine, University of Minnesota, Minneapolis, MN, USA.
J Clin Lipidol. 2018 Nov-Dec;12(6):1404-1412. doi: 10.1016/j.jacl.2018.08.004. Epub 2018 Aug 16.
Limited evidence has suggested that circulating levels of the omega-9 fatty acid, oleic acid, may be related to greater risks of adverse cardiovascular outcomes.
We aimed to determine whether plasma oleic acid may be independently associated with clinical and subclinical cardiovascular disease (CVD) and all-cause mortality in a large multiethnic cohort.
Plasma fatty acids were measured by gas chromatography-flame ionization in 6568 participants of the Multi-Ethnic Study of Atherosclerosis. The presence of coronary artery calcium (CAC) and aortic valve calcification (AVC) was determined by computed tomography, and carotid plaque was assessed by ultrasound. Incident CVD was defined as myocardial infarction, fatal coronary heart disease, resuscitated cardiac arrest, stroke, or stroke death. Heart failure (HF) was adjudicated from clinical records. Relative risk regression estimated plasma oleic acid-related rate ratios for prevalent CAC, AVC, and carotid plaque. Cox regression estimated hazard ratios (HRs) for CVD, HF, and all-cause mortality over a median 13-year follow-up.
Individuals in top quartiles of oleic acid showed greater rate ratios of CAC, AVC, and carotid plaque (all P < .001), but associations were rendered nonsignificant after adjustment for other risk factors. By contrast, those in top quartiles of plasma oleic acid showed significantly greater risks of incident HF (HR: 2.03; P < .001), CVD (HR: 1.41; P = .008), and all-cause mortality (HR: 1.55; P < .001) than those in referent quartiles independent of typical risk factors as well as plasma omega-3 fatty acid levels.
Plasma oleic acid appears to be a risk factor for CVD events and all-cause mortality independent of typical risk factors and plasma omega-3 fatty acids. Additional studies are warranted for confirmation and to further examine whether plasma oleic acid directly contributes to, or serves as a marker of, disease pathogenesis. These findings should not be extrapolated to dietary oleic acid intake.
有限的证据表明，循环中的 ω-9 脂肪酸油酸含量可能与不良心血管结局风险增加有关。
我们旨在确定在一个大型多民族队列中，血浆油酸水平是否与临床和亚临床心血管疾病（CVD）以及全因死亡率独立相关。
通过气相色谱-火焰离子化法在 6568 名动脉粥样硬化多民族研究参与者的血浆中测量脂肪酸。通过计算机断层扫描确定冠状动脉钙（CAC）和主动脉瓣钙化（AVC）的存在，并通过超声评估颈动脉斑块。CVD 事件定义为心肌梗死、致命性冠心病、复苏性心脏骤停、卒中和卒死。心力衰竭（HF）通过临床记录进行裁决。相对风险回归估计了血浆油酸与 CAC、AVC 和颈动脉斑块的患病率比值比。Cox 回归估计了中位数为 13 年的随访期间 CVD、HF 和全因死亡率的风险比（HR）。
油酸最高四分位数的个体 CAC、AVC 和颈动脉斑块的比率更高（均 P<.001），但在调整其他危险因素后，这些关联变得无统计学意义。相比之下，那些油酸最高四分位数的个体发生 HF（HR：2.03；P<.001）、CVD（HR：1.41；P=.008）和全因死亡率（HR：1.55；P<.001）的风险明显高于参考四分位数的个体，独立于典型危险因素以及血浆 ω-3 脂肪酸水平。
血浆油酸似乎是 CVD 事件和全因死亡率的危险因素，独立于典型危险因素和血浆 ω-3 脂肪酸。需要进一步的研究来证实，并进一步研究血浆油酸是否直接导致疾病发病机制，或者是否作为疾病发病机制的标志物。这些发现不应推断为膳食油酸的摄入量。
