Department of Cardiology, Second Affiliated Hospital of Harbin Medical University, Harbin, China; The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, 246 Xuefu Road, Nangang District, 150086, Harbin, China.
Department of Epidemiology and Biostatistics, School of Public Health, Harbin Medical University, Harbin, China.
Clin Nutr. 2021 Mar;40(3):1095-1101. doi: 10.1016/j.clnu.2020.07.010. Epub 2020 Jul 21.
BACKGROUND & AIMS: There has been controversial evidence regarding the relationship between isomers of circulating trans-fatty acids (TFAs) and mortality. This study aimed to ascertain the relationships between plasma TFAs and overall or cause-specific mortality of the general population in two independent subsets from the US National Health and Nutrition Examination Survey (1999-2000 and 2009-2010 cycles).
Plasma TFA isomers (C16:1n-7t, C18:1n-7t, C18:1n-9t and C18:2n-6,9t) in 3439 adults free of cancer or severe cardiovascular disease were analyzed by gas chromatography/mass spectrometry. Overall, 259 died among 1376 individuals over a median follow-up of 15.6 years in the 1999-2000 cycle, and 105 died in the latter subset of 2063 subjects during a median of 5.9 years. Cox proportional hazards regression was conducted to estimate the hazard ratios of mortality. The main isomer of industrially derived TFAs, elaidic acid (C18:1n-9t) was considerably associated with long-term total mortality in the 1999-2000 cycle after adjusting for confounders, with a 54% increase in the top tertile compared with the bottom one. However, the association disappeared with halving C18:1n-9t by 2009-2010. In contrast, neither of the ruminant-derived TFAs (C16:1n-7t and C18:1n-7t) suggested any inverse correlations with all-cause death, mortality due to heart disease, cancer or other causes.
The major isomer of industrial TFAs, the higher circulating C18:1n-9t might be associated with increased long-term mortality. The associations with death risk turned slight with the reduction of TFAs consumption by half. However, dietary guidelines should rigorously identify the healthy effect of animal TFAs consumption.
关于循环反式脂肪酸（TFAs）异构体与死亡率之间的关系，存在争议。本研究旨在确定美国国家健康与营养检查调查（1999-2000 年和 2009-2010 年周期）两个独立子集中，血浆 TFAs 异构体与普通人群的总死亡率或死因特异性死亡率之间的关系。
通过气相色谱/质谱法分析了 3439 名无癌症或严重心血管疾病的成年人的血浆 TFA 异构体（C16:1n-7t、C18:1n-7t、C18:1n-9t 和 C18:2n-6、9t）。在 1999-2000 年周期中，中位随访 15.6 年期间，1376 人中共有 259 人死亡，在后一组 2063 名受试者中，中位随访 5.9 年期间有 105 人死亡。采用 Cox 比例风险回归估计死亡率的危险比。在调整混杂因素后，工业衍生 TFAs 的主要异构体（油酸 C18:1n-9t）与长期总死亡率密切相关，与最低三分位相比，最高三分位的死亡率增加了 54%。然而，到 2009-2010 年，C18:1n-9t 减少一半后，这种关联就消失了。相比之下，反刍动物衍生 TFAs（C16:1n-7t 和 C18:1n-7t）均与全因死亡、心脏病死亡、癌症或其他原因死亡无关。
工业 TFAs 的主要异构体，即循环 C18:1n-9t 水平较高，可能与长期死亡率升高有关。随着 TFAs 摄入量减少一半，与死亡风险的关联变得轻微。然而，饮食指南应严格确定动物 TFAs 摄入的健康效应。
