Red blood cell docosahexaenoic acid and eicosapentaenoic acid concentrations are positively associated with socioeconomic status in patients with established coronary artery disease: Data from the heart and soul study
Red blood cell docosahexaenoic acid and eicosapentaenoic acid concentrations are positively associated with socioeconomic status in patients with established coronary artery disease: Data from the heart and soul study
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DOI：
10.1093/jn/138.6.1135
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发表时间：
2008-06-01
影响因子：
4.2
通讯作者：
Whooley, Mary A.
中科院分区：
文献类型：
--
作者：
Cohen, Beth E.;Garg, Sachin K.;Whooley, Mary A.
传统的心脏危险因素只能部分解释社会经济地位较低的人（SES）心血管风险较高的生物学机制。饮食因素导致 (n-3) 脂肪酸循环水平降低，也可能导致低 SES 患者患心血管疾病 (CVD) 的风险增加。我们测试了冠心病患者低 SES 是否与红细胞 (n-3) 脂肪酸水平相关。我们对从旧金山地区门诊诊所招募的 987 名患有稳定性冠状动脉疾病 (CAD) 的成年人进行了横断面分析。通过自我报告评估了四项社会经济地位指标（家庭收入、教育、职业和住房状况）。在禁食受试者的静脉血样本中测量了 2 (n-3) 脂肪酸、二十二碳六烯酸 (DHA) 和二十碳五烯酸 (EPA) 的红细胞脂肪酸水平。家庭收入、教育程度、职业和住房状况较低的参与者的 (n-3) 脂肪酸红细胞水平较低（所有 4 项指标的 P < 0.001）。在多变量模型中，在调整人口因素、BMI、体力活动、他汀类药物使用和肾功能后，家庭收入、教育和职业仍然与 DHA 和 EPA 水平密切相关（所有 3 项指标的 P < 0.001）。多变量调整后，住房状况与 DHA 或 EPA 无关。在 CAD 患者中，家庭收入、教育和职业这 3 个低社会经济地位指标与较低的红细胞 (n-3) 脂肪酸水平密切相关。我们的结果表明，(n-3) 脂肪酸可能是低 SES 与 CVD 之间关联的重要中介因素。
Traditional cardiac risk factors only partially explain the biological mechanisms by which persons of lower socioeconomic status (SES) have higher cardiovascular risk. Dietary factors, resulting in lower circulating levels of (n-3) fatty acids, may also contribute to the increased risk of cardiovascular disease (CVD) in patients with low SES. We tested whether low SES is associated with RBC levels of (n-3) fatty acids in patients with coronary heart disease. We performed a cross-sectional analysis of 987 adults with stable coronary artery disease (CAD) recruited from San Francisco area outpatient clinics. Four SES measures (household income, education, occupation, and housing status) were assessed by self-report. RBC fatty acid levels of 2 (n-3) fatty acids, docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), were measured in venous blood samples from fasting subjects. Participants with lower household income, education, occupation, and housing status had lower RBC levels of (n-3) fatty acids (P < 0.001 for all 4 measures). In multivariable models, household income, education, and occupation remained strongly associated with DHA and EPA levels after adjustment for demographic factors, BMI, physical activity, statin use, and kidney function (P < 0.001 for all 3 measures). Housing status was not associated with DHA or EPA after multivariable adjustment. Among patients with CAD, 3 indicators of low SES, household income, education, and occupation, were strongly associated with lower RBC levels of (n-3) fatty acids. Our results raise the possibility that (n-3) fatty acids may be an important mediating factor in the association between low SES and CVD.