Harris William S, Westra Jason, Tintle Nathan L, Sala-Vila Aleix, Wu Jason Hy, Marklund Matti
Fatty Acid Research Institute, Sioux Falls, SD, United States; Department of Internal Medicine, Sanford School of Medicine, University of South Dakota, Sioux Falls, SD, United States.
Fatty Acid Research Institute, Sioux Falls, SD, United States.
Am J Clin Nutr. 2024 Oct;120(4):936-942. doi: 10.1016/j.ajcnut.2024.08.020. Epub 2024 Aug 22.
The potential role of n-6 PUFAs in major health outcomes remains controversial.
To examine the relationship between the major plasma n6 PUFA, linoleic acid (LA), as well as the non-LA n6 PUFAs, and total and cause-specific mortality.
This was a prospective, observational, biomarker-based study in the UK Biobank. Individuals with complete information on baseline demographic, covariate and plasma PUFA levels (percent ot total fatty acids) and mortality outcomes were included (n=257,925). Multivariable-adjusted, Cox-proportional hazards models were used to predict risk of death from all-causes, and from cardiovascular disease (CVD), cancer, and other causes as a function of plasma LA and non-LA n6 levels, both continuously and by PUFA quintile (Q).
Comparing LA Q5 to Q1, the hazard ratio (HR, 95% CI) for total mortality was 0.80 (0.76, 0.84; p<0.001), and this was similar for all three cause-specific death categories. On the other hand, mortality HR for non-LA n6 was 1.12 (1.08,1.17; p<0.001), and this was primarily due to increased risk for non-CVD, noncancer deaths [HR 1.29 (1.19,1.40; p<0.001)]. Exploratory analyses among the eight next most common other causes of death suggested that both the decreased risk associated with higher LA and the increased risk associated with non-LA n6 were confined to deaths from respiratory and digestive diseases.
These findings highlight the profound differences in mortality risk related to LA and non-LA n6 PUFA levels and underscore the inappropriateness of treating n-6 PUFAs as a homogenous class with respect to health outcomes. They also support recommendations to maintain (if not increase) current LA intakes.
n-6多不饱和脂肪酸（PUFAs）在主要健康结局中的潜在作用仍存在争议。
研究主要血浆n-6多不饱和脂肪酸、亚油酸（LA）以及非LA的n-6多不饱和脂肪酸与全因死亡率和特定病因死亡率之间的关系。
这是一项基于英国生物银行的前瞻性观察性生物标志物研究。纳入了在基线人口统计学、协变量和血浆PUFA水平（占总脂肪酸的百分比）以及死亡率结局方面信息完整的个体（n = 257,925）。使用多变量调整的Cox比例风险模型来预测全因死亡、心血管疾病（CVD）、癌症和其他原因导致的死亡风险，该风险是血浆LA和非LA的n-6水平的函数，包括连续变量和按PUFA五分位数（Q）划分的情况。
将LA的Q5与Q1进行比较，全因死亡率的风险比（HR，95%CI）为0.80（0.76，0.84；p < 0.001），在所有三种特定病因死亡类别中情况类似。另一方面，非LA的n-6的死亡率HR为1.12（1.08，1.17；p < 0.001），这主要是由于非CVD、非癌症死亡风险增加[HR 1.29（1.19，1.40；p < 0.001）]。对接下来八种最常见的其他死因进行的探索性分析表明，与较高LA相关的风险降低和与非LA的n-6相关的风险增加都仅限于呼吸和消化系统疾病导致的死亡。
这些发现突出了与LA和非LA的n-6 PUFA水平相关的死亡风险的巨大差异，并强调了将n-6 PUFAs视为在健康结局方面具有同质性类别是不合适的。它们还支持维持（如果不是增加）当前LA摄入量的建议。
