Nikkari T
Department of Biomedical Sciences, University of Tampere, Finland.
Prog Lipid Res. 1986;25(1-4):437-50. doi: 10.1016/0163-7827(86)90089-5.
Finland has one of the highest coronary heart disease (CHD) rates in the whole world, and within the country, the rates are higher in men and eastern Finland than in women and western Finland, respectively. The differences are not wholly explained by the 3 classical risk factors. Several cross-sectional and longitudinal studies suggest that the intake of dietary linoleate (18:2), as reflected in the composition of serum and tissue fatty acids, has an inverse association with CHD, although there are also studies with negative results. Our own retrospective study failed to show any differences in the fatty acid composition of serum CE, TG or PL between men who had died of CHD and age- and risk factor-matched controls, but the negative finding may be due to changes in the fatty acids during storage. Among Finnish populations, most serum CE fatty acids had highly significant correlations with those in other serum lipid fractions, adipose tissue and platelets, and they had good "tracking" for up to 4 yr. Serum CE and TG 18:2, and total omega 6 polyunsaturated fatty acids (PUFA) had strong correlations with dietary 18:2 and PUFA, and can thus be used in the evaluation of population differences in the intake of PUFA. CE fatty acids were analyzed in a total of 2820 free-living 1- to 85-yr-old males and females. The percentages of serum fatty acids were age-dependent. West-Finnish populations had higher contents of 18:2 than those in eastern Finland, and middle-aged women had higher proportions of 18:2 than men. The content of 18:2 in adipose tissue and/or serum CE of middle-aged men was comparable to that in Scotland and lower than those in Italy and Sweden. These findings are compatible with the idea that 18:2 is a negative risk factor of CHD, but the evidence is only circumstantial. Possible mechanisms whereby 18:2 could affect CHD have been discussed. The contents of omega 3 fatty acids in CE were opposite to those of omega 6 fatty acids in that eastern Finnish and male populations had higher contents of 18:3 omega 3 and 20:5 omega 3 than western Finns and females, respectively. This finding is apparently due to substitution of vegetable fat for milk fat in the diet, resulting in a relative deficiency of the omega 3 fatty acids at the expense of 18:2. Experimental evidence for such a mechanism was obtained in an intervention study.(ABSTRACT TRUNCATED AT 400 WORDS)
芬兰是全球冠心病（CHD）发病率最高的国家之一，在该国国内，男性和芬兰东部地区的发病率分别高于女性和芬兰西部地区。这些差异并不能完全由3种经典风险因素来解释。多项横断面研究和纵向研究表明，血清和组织脂肪酸组成所反映的膳食亚油酸（18:2）摄入量与冠心病呈负相关，不过也有研究得出了阴性结果。我们自己的回顾性研究未能显示死于冠心病的男性与年龄及风险因素相匹配的对照组在血清胆固醇酯（CE）、甘油三酯（TG）或磷脂（PL）的脂肪酸组成上存在任何差异，但这一阴性结果可能是由于储存过程中脂肪酸发生了变化。在芬兰人群中，大多数血清CE脂肪酸与其他血脂成分、脂肪组织和血小板中的脂肪酸高度显著相关，并且在长达4年的时间里具有良好的“追踪性”。血清CE和TG中的18:2以及总ω-6多不饱和脂肪酸（PUFA）与膳食中的18:2和PUFA密切相关，因此可用于评估人群中PUFA摄入量的差异。对总共2820名年龄在1岁至85岁的自由生活的男性和女性的CE脂肪酸进行了分析。血清脂肪酸的百分比随年龄而变化。芬兰西部人群的18:2含量高于芬兰东部地区，中年女性的18:2比例高于男性。中年男性脂肪组织和/或血清CE中的18:2含量与苏格兰相当，低于意大利和瑞典。这些发现与18:2是冠心病的负性风险因素这一观点相符，但证据只是间接的。文中讨论了18:2可能影响冠心病的机制。CE中ω-3脂肪酸的含量与ω-6脂肪酸的情况相反，即芬兰东部地区和男性人群的18:3ω-3和20:5ω-3含量分别高于芬兰西部和女性。这一发现显然是由于饮食中用植物脂肪替代了乳脂肪，导致以18:2为代价的ω-3脂肪酸相对缺乏。在一项干预研究中获得了这种机制的实验证据。（摘要截取自400字）
