Zhao Huimin, Guo Meirong, Yang Changlin, Xing Fangkai
Department of General Medicine, No. 970 Hospital of the People's Liberation Army Joint Logistics Support Force, Yantai, Shandong, China.
Department of General Medicine, No. 970 Hospital of the People's Liberation Army Joint Logistics Support Force, Yantai, Shandong, China.
Clin Nutr ESPEN. 2025 Apr;66:372-380. doi: 10.1016/j.clnesp.2025.01.053. Epub 2025 Jan 31.
BACKGROUND & AIMS: The impact of serum Omega-6 fatty acids on cardiovascular health is debated, with evidence supporting both protective and harmful effects. To investigate the association between serum Omega-6 fatty acid and mortality from all causes and cardiovascular disease (CVD), utilizing advanced statistical methodologies including competing risk models and multivariate Mendelian randomization.
Data of 5070 participants from National Health and Nutrition Examination Survey (NHANES) in 2011-2014 wave were analyzed, with follow-up data on mortality sourced from the National Death Index. Serum Omega-6 fatty acids level was measured at baseline. Cox proportional hazards regression and competing risks models was used to estimate hazard ratios (HRs) and 95 % confidence intervals (CIs) for all-cause and CVD mortality by baseline Omega-6 fatty acids level. Restricted cubic splines were used to explore the nonlinearity. Mendelian randomization to assess the causal relationships between Omega-6 levels and mortality.
438 all-cause deaths and 137 CVD deaths were observed during an 83 months median follow-up. Restricted cubic spline analysis demonstrated a U-shaped correlation between baseline serum Omega-6 fatty acid levels with all-cause and CVD mortality risks. Subgroup analysis indicated that for the low-level Omega-6 fatty acid participants, the hazard ratios were 0.68 (95 % CI, 0.55-0.85) for all-cause mortality and 0.62 (95 % CI, 0.40-0.95) for CVD mortality. Conversely, for the high-level participants, the hazard ratios were 1.14 (95 % CI, 1.01-1.28) for all-cause mortality and 1.23 (95 % CI, 1.05-1.44) for CVD mortality. Both univariate and multivariate Mendelian randomization analyses confirmed a positive causal relationship between higher serum Omega-6 fatty acid levels and increased CVD mortality risk.
The findings suggest a U-shaped relationship between serum Omega-6 fatty acid levels and mortality risks, with elevated levels linked causally to increased CVD mortality. These results underscore the need for balanced dietary Omega-6 fatty acid intake to optimize cardiovascular health.
血清ω-6脂肪酸对心血管健康的影响存在争议，有证据支持其具有保护作用和有害作用。为了利用包括竞争风险模型和多变量孟德尔随机化在内的先进统计方法，研究血清ω-6脂肪酸与全因死亡率和心血管疾病（CVD）之间的关联。
分析了2011 - 2014年美国国家健康与营养检查调查（NHANES）中5070名参与者的数据，死亡随访数据来自国家死亡指数。在基线时测量血清ω-6脂肪酸水平。使用Cox比例风险回归和竞争风险模型，根据基线ω-6脂肪酸水平估计全因死亡率和CVD死亡率的风险比（HRs）及95%置信区间（CIs）。使用受限立方样条来探究非线性关系。采用孟德尔随机化评估ω-6水平与死亡率之间的因果关系。
在83个月的中位随访期内，观察到438例全因死亡和137例CVD死亡。受限立方样条分析表明，基线血清ω-6脂肪酸水平与全因死亡率和CVD死亡风险之间呈U形关联。亚组分析表明，对于低水平ω-6脂肪酸参与者，全因死亡率的风险比为0.68（95%CI，0.55 - 0.85），CVD死亡率的风险比为0.62（95%CI，0.40 - 0.95）。相反，对于高水平参与者，全因死亡率的风险比为1.14（95%CI，1.01 - 1.28），CVD死亡率的风险比为1.23（95%CI，1.05 - 1.44）。单变量和多变量孟德尔随机化分析均证实，较高的血清ω-6脂肪酸水平与CVD死亡风险增加之间存在正因果关系。
研究结果表明血清ω-6脂肪酸水平与死亡风险之间呈U形关系，水平升高与CVD死亡风险增加存在因果关联。这些结果强调了均衡饮食中ω-6脂肪酸摄入量以优化心血管健康的必要性。
