中国年轻患者血清二十碳五烯酸与花生四烯酸比值与冠状动脉疾病风险的关联
Association between the ratio of serum eicosapentaenoic acid to arachidonic acid and risk of coronary artery disease in young Chinese patients.
作者信息
Liu Xiong, Sun Lichang, Wen Weixing, Qiu Min, Luo Jianjing, Li Weiwen, Hao Shali, He Mingli, Wu Jiandi, Hu Yunzhao, Huang Yuli
机构信息
Department of Cardiology, Shunde Hospital, Southern Medical University, Foshan, China.
Department of Internal Medicine, Zhaoqing Medical College, Zhaoqing, China.
出版信息
Front Nutr. 2022 Nov 3;9:1019058. doi: 10.3389/fnut.2022.1019058. eCollection 2022.
OBJECTIVE
Long-chain (LC) omega-3 PUFAs, including eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), may play an anti-inflammatory effect and decrease the risk of coronary artery disease (CAD). In contrast, omega-6 PUFA, mainly arachidonic acid (AA), has pro-inflammatory and pro-aggregatory effects, which may increase the risk of CAD. This study evaluated the associations between EPA, DHA, AA, and their ratios (EPA/AA and DHA/AA) with the risk of CAD in young Chinese patients.
METHODS
A total of 182 young patients with CAD and 143 age-matched controls were included. Traditional cardiovascular risk factors were recorded. Serum EPA, DHA and AA were measured by ultra-performance liquid chromatography-mass spectrometry.
RESULTS
The level of AA was significantly higher, while the level of EPA was lower in the CAD group than that in the control group. There was no significant difference in DHA level in the two groups. Both the ratios of EPA/AA and DHA/AA were lower in the CAD group than that in the control. Multivariate logistic regression analysis showed that higher serum AA level was associated with the increased risk of CAD, while EPA was a protective factor for CAD. There was no significant association between DHA level and the risk of CAD. Although both higher ratios of EPA/AA [per tertile increment, adjusted odds ratios (ORs) (OR) 0.356, 95% confidence intervals (CI) 0.247-0.513] and DHA/AA (adjusted OR = 0.465, 95%CI = 0.332-0.653) were associated with a lower risk of CAD in young patients. Receiver operating characteristic (ROC) curve analysis showed that compared with AA, the diagnostic value was increased in EPA/AA, but not in DHA/AA.
CONCLUSION
EPA, but not DHA may play a protective role in CAD, while AA may be associated with the increased risk of CAD in young Chinese patients. The ratio of EPA/AA can increase the predictive value for diagnosing CAD than EPA or AA alone.
目的
长链（LC）ω-3多不饱和脂肪酸，包括二十碳五烯酸（EPA）和二十二碳六烯酸（DHA），可能具有抗炎作用并降低冠状动脉疾病（CAD）风险。相比之下，ω-6多不饱和脂肪酸，主要是花生四烯酸（AA），具有促炎和促聚集作用，可能增加CAD风险。本研究评估了中国年轻CAD患者中EPA、DHA、AA及其比值（EPA/AA和DHA/AA）与CAD风险之间的关联。
方法
共纳入182例年轻CAD患者和143例年龄匹配的对照者。记录传统心血管危险因素。采用超高效液相色谱-质谱法测定血清EPA、DHA和AA水平。
结果
CAD组AA水平显著高于对照组，而EPA水平低于对照组。两组DHA水平无显著差异。CAD组EPA/AA和DHA/AA比值均低于对照组。多因素logistic回归分析显示，较高的血清AA水平与CAD风险增加相关，而EPA是CAD的保护因素。DHA水平与CAD风险无显著关联。尽管较高的EPA/AA比值[每三分位数增加，调整后的优势比（OR）为0.356，95%置信区间（CI）为0.247-0.513]和DHA/AA比值（调整后的OR = 0.465，95%CI = 0.332-0.653）均与年轻患者较低的CAD风险相关。受试者工作特征（ROC）曲线分析显示，与AA相比，EPA/AA的诊断价值增加，但DHA/AA未增加。
结论
EPA而非DHA可能在CAD中起保护作用，而AA可能与中国年轻患者CAD风险增加相关。EPA/AA比值比单独的EPA或AA能提高诊断CAD的预测价值。
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