Department of Cardiology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
Medicine (Baltimore). 2021 Jan 22;100(3):e24359. doi: 10.1097/MD.0000000000024359.
High polyunsaturated fatty acids (PUFAs) intake is recommended for primary and secondary prevention of cardiovascular disease (CVD). However, the association of PUFAs with blood pressure (BP) is still controversial. In the present study, two-sample Mendelian randomization (MR) analysis was performed to investigate the causal relationship of PUFAs with BP, including systolic blood pressure (SBP), diastolic blood pressure (DBP), and pulse pressure (PP).Genetic instruments and summary statistics for two-sample MR analysis were obtained from 3 large-scale genome-wide association studies (GWASs). Eight single nucleotide polymorphisms (SNPs) significantly (P < 5 × 10-8) related to 6 PUFAs were used as instrumental variables. Conventional inverse-variance weighted method was adopted to evaluate the causality of PUFAs with BP; the Weighted Median, MR-egger, and Leave-one-out method were used for sensitivity analyses.As a result, there was no evidence of a causal association between all PUFAs and SBP. In addition, arachidonic acid (AA, β = -0.04, P < .001) and eicosapentaenoic acid (EPA, β = -0.47, P = .02) were negatively associated with DBP, while linoleic acid (LA, β = 0.03, P = .005) and α-linolenic acid (ALA, β = 3.83, P < .001) were positively associated with DBP. There was no evidence of a causal relationship between either docosapentaenoic acid (DPA) or docosahexaenoic acid (DHA) with DBP.In conclusion, a genetic predisposition to plasma polyunsaturated fatty acid (PUFA) had a divergent effect on DBP, independent of SBP. It suggested that it is helpful for lower DBP level to supplemental intake of AA and EPA or promote the conversion of LA and ALA to AA and EPA respectively, which need to be further validated with randomized controlled studies.
高多不饱和脂肪酸 (PUFA) 的摄入被推荐用于心血管疾病 (CVD) 的一级和二级预防。然而,PUFA 与血压 (BP) 的关系仍存在争议。在本研究中,进行了两样本 Mendelian 随机化 (MR) 分析,以研究 PUFAs 与 BP(包括收缩压 (SBP)、舒张压 (DBP) 和脉压 (PP))之间的因果关系。两样本 MR 分析的遗传工具和汇总统计数据来自 3 项大型全基因组关联研究 (GWAS)。使用 8 个与 6 种 PUFAs 显著相关的单核苷酸多态性 (SNP) 作为工具变量。采用常规逆方差加权法评估 PUFAs 与 BP 的因果关系;采用加权中位数、MR-egger 和逐一剔除法进行敏感性分析。结果表明,所有 PUFAs 与 SBP 之间没有因果关系的证据。此外,花生四烯酸 (AA,β=-0.04,P<0.001) 和二十碳五烯酸 (EPA,β=-0.47,P=0.02) 与 DBP 呈负相关,而亚油酸 (LA,β=0.03,P=0.005) 和 α-亚麻酸 (ALA,β=3.83,P<0.001) 与 DBP 呈正相关。二十二碳五烯酸 (DPA) 或二十二碳六烯酸 (DHA) 与 DBP 之间没有因果关系的证据。总之,血浆多不饱和脂肪酸 (PUFA) 的遗传倾向对 DBP 有不同的影响,独立于 SBP。这表明补充 AA 和 EPA 或促进 LA 和 ALA 分别向 AA 和 EPA 转化有助于降低 DBP 水平,这需要进一步通过随机对照研究来验证。