Yunoki Kei, Matsumi Hiroaki, Miyoshi Toru, Kubo Motoki, Hata Yoshiki, Yuasa Shinsuke
Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Okayama 700-8558, Japan.
Department of Cardiology, Tsuyama Chuo Hospital, Tsuyama 708-0841, Japan.
J Cardiovasc Dev Dis. 2025 Feb 5;12(2):60. doi: 10.3390/jcdd12020060.
Vascular endothelial function plays an important role in the pathogenesis of atherosclerosis. The reduction in low-density lipoprotein cholesterol (LDL-C) is a key therapy for preventing coronary artery disease (CAD), but the role of omega-3 fatty acids as residual risk factors of CAD remains controversial. We studied the correlation between serum omega-3 fatty acid levels and endothelial function in patients with CAD receiving statin therapy and examined the effect of eicosapentaenoic acid (EPA) therapy on endothelial function.
A total of 150 consecutive patients with CAD receiving statin therapy (LDL-C levels < 100 mg/dL) were enrolled. Serum omega-3 fatty acid levels were measured, and endothelial function was assessed by flow-mediated dilation (FMD) of the brachial artery. Subsequently, 65 patients with impaired FMD (<6%) and low EPA/arachidonic acid (AA) (<0.3) were administered EPA, and FMD was reassessed after 3 months.
A multivariate linear regression analysis demonstrated that serum docosahexaenoic acid (DHA) and EPA plus DHA levels were independent determinants of %FMD (β = 0.214 and 0.163, < 0.05, respectively). The EPA therapy significantly improved %FMD (from 3.7 ± 1.0% to 4.1 ± 1.0%, < 0.05) in patients with low EPA/AA, and especially in patients with low EPA/AA and high triglyceride levels (from 3.4 ± 1.0% to 4.0 ± 1.1%, < 0.01).
Serum omega-3 fatty acid levels were associated with endothelial dysfunction in patients with CAD receiving statin therapy. EPA therapy improves endothelial function in patients with low EPA/AA, especially those with low EPA/AA and high triglycerides.
血管内皮功能在动脉粥样硬化的发病机制中起重要作用。降低低密度脂蛋白胆固醇（LDL-C）是预防冠心病（CAD）的关键疗法，但ω-3脂肪酸作为CAD残余危险因素的作用仍存在争议。我们研究了接受他汀类药物治疗的CAD患者血清ω-3脂肪酸水平与内皮功能之间的相关性，并探讨了二十碳五烯酸（EPA）治疗对内皮功能的影响。
共纳入150例连续接受他汀类药物治疗（LDL-C水平<100mg/dL）的CAD患者。检测血清ω-3脂肪酸水平，并通过肱动脉血流介导的舒张功能（FMD）评估内皮功能。随后，对65例FMD受损（<6%）且EPA/花生四烯酸（AA）较低（<0.3）的患者给予EPA治疗，并在3个月后重新评估FMD。
多因素线性回归分析表明，血清二十二碳六烯酸（DHA）以及EPA加DHA水平是FMD百分比的独立决定因素（β分别为0.214和0.163，P均<0.05）。EPA治疗显著改善了EPA/AA较低患者的FMD百分比（从3.7±1.0%提高到4.1±1.0%，P<0.05），尤其是EPA/AA较低且甘油三酯水平较高的患者（从3.4±1.0%提高到4.0±1.1%，P<0.01）。
接受他汀类药物治疗的CAD患者血清ω-3脂肪酸水平与内皮功能障碍有关。EPA治疗可改善EPA/AA较低患者的内皮功能，尤其是那些EPA/AA较低且甘油三酯水平较高的患者。
