Plasma free fatty acids and risk of heart failure: the Cardiovascular Health Study.
Plasma free fatty acids and risk of heart failure: the Cardiovascular Health Study.
复制标题
DOI：
10.1161/circheartfailure.113.000521
复制
发表时间：
2013-09-01
期刊：
影响因子：
--
通讯作者：
Ix JH
中科院分区：
文献类型：
--
作者：
Djoussé L;Benkeser D;Arnold A;Kizer JR;Zieman SJ;Lemaitre RN;Tracy RP;Gottdiener JS;Mozaffarian D;Siscovick DS;Mukamal KJ;Ix JH
尽管血浆游离脂肪酸 (FFA) 浓度与脂毒性、细胞凋亡以及糖尿病和冠心病风险相关，但尚不清楚 FFA 水平是否与心力衰竭 (HF) 相关。为了检验 FFA 血浆浓度与心力衰竭呈正相关这一假设，我们前瞻性地分析了心血管健康研究中 4248 名基线时无心力衰竭且年龄在 65 岁以上的男性和女性的数据。 FFA浓度通过Wako酶法测量两次。 HF 事件由集中事件委员会验证。我们使用 Cox 比例风险来估计 HF 与 FFA 标准差 (SD) 的风险比。在中位随访 10.5 年期间，发生了 1,286 例新的心力衰竭病例。在调整临床地点、合并症、人口统计学、人体测量和生活方式因素的多变量模型中，血浆 FFA 每升高一个 SD (0.2 mEq/L)，心力衰竭风险就会升高 12%（95% CI：6% 至 19%）。控制随时间变化的糖尿病和冠心病并没有改变结果[HR per SD: 1.16 (95% CI: 1.09–1.23)]。晚年获得的血浆 FFA 的单一测量结果与老年人患心力衰竭的较高风险相关。需要进行更多研究来探索 FFA 影响心力衰竭风险的生物学机制，并确定 FFA 是否可以作为预防心力衰竭的新药理学靶点。
Although plasma free fatty acid (FFA) concentrations have been associated with lipotoxicity, apoptosis, and risk of diabetes and coronary heart disease, it is unclear whether FFA levels are associated with heart failure (HF). To test the hypothesis that plasma concentration of FFA is positively associated with incident HF, we prospectively analyzed data on 4248 men and women free of HF at baseline and aged 65+ years from the Cardiovascular Health Study. FFA concentration was measured in duplicate by the Wako enzymatic method. Incident HF was validated by a centralized Events Committee. We used Cox proportional hazards to estimate the hazard ratio of HF per standard deviation (SD) of FFA. During a median follow up of 10.5 y, 1,286 new cases of HF occurred. In a multivariable model adjusting for clinic site, comorbidity, demographic, anthropometric, and lifestyle factors, each SD (0.2 mEq/L) higher plasma FFA was associated with 12% (95% CI: 6% to 19%) higher risk of HF. Controlling for time-varying diabetes and coronary heart disease did not change the results [HR per SD: 1.16 (95% CI: 1.09–1.23)]. A single measure of plasma FFA obtained later in life is associated with a higher risk of HF in older adults. Additional studies are needed to explore biologic mechanisms by which FFA may influence the risk of HF and determine whether FFA could serve as a novel pharmacological target for HF prevention.