From the Department of Cardiology (S.K.V., C.S.B., K.O., E.B.S.), Aalborg University Hospital, Denmark.
Department of Clinical Medicine, Aalborg University, Denmark (S.K.V., E.B.S.).
Stroke. 2019 Feb;50(2):274-282. doi: 10.1161/STROKEAHA.118.023384.
Background and Purpose- We hypothesized that total marine n-3 polyunsaturated fatty acids (PUFA), in particular eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) in the diet and in adipose tissue (biomarkers of long-term intake and endogenous exposure) were inversely associated with the risk of ischemic stroke and its subtypes. Methods- The Diet, Cancer and Health cohort consisted of 57 053 participants aged 50 to 65 years at enrolment. All participants filled in a food frequency questionnaire and had an adipose tissue biopsy taken at baseline. Information on ischemic stroke during follow-up was obtained from The Danish National Patient Register, and all cases were validated. Cases and a random sample of 3203 subjects from the whole cohort had their fatty acid composition of adipose tissue determined by gas chromatography. Results- During 13.5 years of follow-up 1879 participants developed an ischemic stroke. Adipose tissue content of EPA was inversely associated with total ischemic stroke (hazard ratio [HR], 0.74; 95% CI, 0.62-0.88) when comparing the highest with the lowest quartile. Also, lower rates of large artery atherosclerosis were seen with higher intakes of total marine n-3 PUFA (HR, 0.69; 95% CI, 0.50-0.95), EPA (HR, 0.66; 95% CI, 0.48-0.91) and DHA (HR, 0.72; 95% CI, 0.53-0.99), and higher adipose tissue content of EPA (HR, 0.52; 95% CI, 0.36-0.76). Higher rates of cardioembolism were seen with higher intakes of total marine n-3 PUFA (HR, 2.50; 95% CI, 1.38-4.53) and DHA (HR, 2.12; 95% CI, 1.21-3.69) as well as with higher adipose tissue content of total marine n-3 PUFA (HR, 2.63; 95% CI, 1.33-5.19) and DHA (HR, 2.00; 95% CI, 1.04-3.84). The EPA content in adipose tissue was inversely associated with small-vessel occlusion (HR, 0.69; 95% CI, 0.55-0.88). Conclusions- EPA was associated with lower risks of most types of ischemic stroke, apart from cardioembolism, while inconsistent findings were observed for total marine n-3 PUFA and DHA.
背景与目的-我们假设总海洋 n-3 多不饱和脂肪酸（PUFA），特别是饮食和脂肪组织中的二十碳五烯酸（EPA）和二十二碳六烯酸（DHA）（长期摄入和内源性暴露的生物标志物）与缺血性中风及其亚型的风险呈负相关。方法-饮食、癌症和健康队列由 57053 名年龄在 50 至 65 岁的参与者组成。所有参与者都填写了一份食物频率问卷，并在基线时进行了脂肪组织活检。通过丹麦国家患者登记处获得随访期间的缺血性中风信息，所有病例均经过验证。病例和整个队列中的 3203 名随机样本的脂肪组织脂肪酸组成通过气相色谱法确定。结果-在 13.5 年的随访中，1879 名参与者发生了缺血性中风。与最低四分位数相比，脂肪组织中 EPA 含量与总缺血性中风呈负相关（危险比 [HR]，0.74；95%置信区间，0.62-0.88）。较高的总海洋 n-3 PUFA（HR，0.69；95%置信区间，0.50-0.95）、EPA（HR，0.66；95%置信区间，0.48-0.91）和 DHA（HR，0.72；95%置信区间，0.53-0.99）摄入量与较大的动脉粥样硬化发生率较低，而 EPA（HR，0.52；95%置信区间，0.36-0.76）和脂肪组织中 EPA 含量较高。较高的总海洋 n-3 PUFA（HR，2.50；95%置信区间，1.38-4.53）和 DHA（HR，2.12；95%置信区间，1.21-3.69）以及总海洋 n-3 PUFA（HR，2.63；95%置信区间，1.33-5.19）和 DHA（HR，2.00；95%置信区间，1.04-3.84）的摄入量与心源性栓塞的发生率较高有关。脂肪组织中 EPA 含量与小血管闭塞呈负相关（HR，0.69；95%置信区间，0.55-0.88）。结论-EPA 与大多数类型的缺血性中风风险降低有关，除了心源性栓塞，而总海洋 n-3 PUFA 和 DHA 的结果不一致。
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