Izumi Tesseki, Nanaura Hitoki, Iguchi Naohiko, Ozaki Maki, Sugie Kazuma
Department of Neurology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8521, Japan.
Department of Neurology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8521, Japan.
J Stroke Cerebrovasc Dis. 2020 Aug;29(8):104892. doi: 10.1016/j.jstrokecerebrovasdis.2020.104892. Epub 2020 May 15.
The increased prevalence of cancer has led to it being considered an important factor in the cause of cryptogenic stroke. In recent years, polyunsaturated fatty acids, particularly omega-3 polyunsaturated fatty acids, have been shown to prevent cancer development and progression. This study aimed to clarify the characteristics of serum polyunsaturated fatty acids in cryptogenic stroke with active cancer.
The serum levels polyunsaturated fatty acid fractions (eicosapentaenoic acid, EPA; docosahexaenoic acid, DHA; dihomo-gamma-linolenic acid, DHLA; and arachidonic acid, AA) in cases of cryptogenic stroke, sampled within 5 days after admission, were measured. Active cancer was defined as a new diagnosis, treatment, progression or recurrence within 6 months before admission, or metastatic cancer. Multivariate logistic regression analyses were performed to explore the relationship between serum polyunsaturated fatty acids and cryptogenic stroke with active cancer.
Among 123 cases classified as cryptogenic stroke, 27 had active cancer. The serum EPA levels (1.26 ± 0.72 versus 1.89 ± 1.27 umol/l; P = 0.02) were significantly lower in cryptogenic stroke with active cancer, whereas the serum DHA, DHLA and AA levels did not significantly differ. Multivariate logistic analysis revealed that the serum EPA levels were associated with cryptogenic stroke with active cancer independently of age and serum D-dimer levels (odds ratio, 0.974; 95% confidence interval, 0.949-0.999; P = 0.04).
In our study, low serum EPA levels were associated with cryptogenic stroke with active cancer. This suggests that low serum EPA levels may have some involvement in the pathogenesis of cryptogenic stroke with active cancer.
癌症患病率的上升使其被视为隐源性卒中病因中的一个重要因素。近年来,多不饱和脂肪酸,尤其是ω-3多不饱和脂肪酸,已被证明可预防癌症的发生和发展。本研究旨在阐明合并活动性癌症的隐源性卒中患者血清多不饱和脂肪酸的特征。
测定入院后5天内采集的隐源性卒中患者血清中多不饱和脂肪酸组分(二十碳五烯酸,EPA;二十二碳六烯酸,DHA;二高-γ-亚麻酸,DHLA;以及花生四烯酸,AA)的水平。活动性癌症定义为入院前6个月内新诊断、治疗、进展或复发的癌症,或转移性癌症。进行多因素逻辑回归分析以探讨血清多不饱和脂肪酸与合并活动性癌症的隐源性卒中之间的关系。
在123例被归类为隐源性卒中的患者中,27例患有活动性癌症。合并活动性癌症的隐源性卒中患者血清EPA水平(1.26±0.72 vs 1.89±1.27 μmol/l;P=0.02)显著较低,而血清DHA、DHLA和AA水平无显著差异。多因素逻辑分析显示,血清EPA水平与合并活动性癌症的隐源性卒中独立相关,不受年龄和血清D-二聚体水平影响(比值比,0.974;95%置信区间,0.949-0.999;P=0.04)。
在我们的研究中,血清EPA水平低与合并活动性癌症的隐源性卒中相关。这表明血清EPA水平低可能在合并活动性癌症的隐源性卒中发病机制中起一定作用。