饱和脂肪酸生物标志物与心脏代谢疾病风险：前瞻性研究的荟萃分析
Saturated fatty acid biomarkers and risk of cardiometabolic diseases: A meta-analysis of prospective studies.
作者信息
Li Zhaoqing, Lei Haoyuan, Jiang Hong, Fan Yahui, Shi Jia, Li Chao, Chen Fangyao, Mi Baibing, Ma Mao, Lin Jing, Ma Le
机构信息
School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China.
The First Affiliated Hospital, Xi'an Jiaotong University Health Science Center, Xi'an, China.
出版信息
Front Nutr. 2022 Aug 15;9:963471. doi: 10.3389/fnut.2022.963471. eCollection 2022.
BACKGROUND AND AIMS
Evidence regarding associations of circulating saturated fatty acids (SFAs) with chronic diseases is mixed. The objective of this study was to determine the associations between total or individual SFA biomarkers and the risk of cardiometabolic diseases.
METHODS
Four electronic databases were searched from inception to March 2022. Three investigators independently assessed for inclusion and extracted data. Random-effects or fixed-effects models was used to estimate the pooled relative risks (RRs) and corresponding 95% confidence intervals (CIs) for the association of total or individual SFA biomarkers, including even-chain SFAs (e.g., 14:0, myristic acid; 16:0, palmitic acid; 18:0, stearic acid), odd-chain SFAs (e.g., 15:0, pentadecanoic acid; 17:0, margaric acid) and very-long-chain SFAs (VLCSFAs; e.g., 20:0, arachidic acid; 22:0, behenic acid; 24:0, lignoceric acid), with risk of incident type 2 diabetes (T2D), cardiovascular disease [CVD; coronary heart disease (CHD) inclusive of stroke], CHD and stroke.
RESULTS
A total of 49 prospective studies reported in 45 articles were included. Higher concentration of circulating total SFAs was associated with an increasing risk of cardiometabolic diseases, the risk increased significantly by 50% for CVD (95%CI:1.31-1.71), 63% for CHD (95%CI:1.38-1.94), 38% for stroke (95%CI:1.05-1.82), respectively. Similarly, levels of even-chain SFAs were positively associated with higher risk of chronic diseases, with RRs ranging from 1.15 to 1.43. In contrast, the risk of cardiometabolic diseases was reduced with increasing odd-chain SFA levels, with RRs ranging from 0.62 to 0.91. A higher level of VLCSFAs corresponded to 19% reduction in CVD. Further dose-response analysis indicated that each 50% increment in percentage of total SFAs in circulating was associated with an 8% higher risk of T2D (RR: 1.08, 95%CI: 1.02-1.14) and trends toward higher risk of CVD (RR: 1.15, 95%CI: 0.98-1.34). Inverse linear relationships were observed between 17:0 biomarker and T2D or CVD risk.
CONCLUSION
Our findings support the current recommendations of reducing intake of saturated fat as part of healthy dietary patterns. Further studies are needed to confirm our findings on these SFAs in relation to cardiometabolic outcomes and to elucidate underlying mechanisms.
SYSTEMATIC REVIEW REGISTRATION
[https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022329182], identifier [CRD42022329182].
背景与目的
关于循环饱和脂肪酸（SFA）与慢性病之间关联的证据并不一致。本研究的目的是确定总SFA生物标志物或个体SFA生物标志物与心脏代谢疾病风险之间的关联。
方法
检索了4个电子数据库，检索时间从建库至2022年3月。3名研究人员独立评估纳入情况并提取数据。采用随机效应或固定效应模型，估计总SFA生物标志物或个体SFA生物标志物（包括偶数链SFA，如14:0，肉豆蔻酸；16:0，棕榈酸；18:0，硬脂酸；奇数链SFA，如15:0，十五烷酸；17:0，十七烷酸；以及极长链SFA，如20:0，花生酸；22:0，山嵛酸；24:0，木蜡酸）与2型糖尿病（T2D）、心血管疾病[CVD；包括中风的冠心病（CHD）]、CHD和中风发病风险之间关联的合并相对风险（RR）及相应的95%置信区间（CI）。
结果
共纳入45篇文章中报道的49项前瞻性研究。循环总SFA浓度升高与心脏代谢疾病风险增加相关，CVD风险显著增加50%（95%CI：1.31 - 1.71），CHD风险增加63%（95%CI：1.38 - 1.94），中风风险增加38%（95%CI：1.05 - 1.82）。同样，偶数链SFA水平与慢性病风险升高呈正相关，RR范围为1.15至1.43。相比之下，奇数链SFA水平升高，心脏代谢疾病风险降低RR范围为0.62至0.91。较高水平的极长链SFA使CVD风险降低19%。进一步的剂量反应分析表明，循环中总SFA百分比每增加50%，T2D风险升高8%（RR：1.08，95%CI：1.02 - 1.14），CVD风险有升高趋势（RR：1.15，95%CI：0.98 - 1.34）。观察到17:0生物标志物与T2D或CVD风险之间呈负线性关系。
结论
我们的研究结果支持当前关于减少饱和脂肪摄入量作为健康饮食模式一部分的建议。需要进一步研究来证实我们关于这些SFA与心脏代谢结局关系的发现，并阐明潜在机制。
系统评价注册
[https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022329182]，标识符[CRD42022329182]
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