Association of plasma phospholipid long-chain ω-3 fatty acids with incident atrial fibrillation in older adults: the cardiovascular health study.
Association of plasma phospholipid long-chain ω-3 fatty acids with incident atrial fibrillation in older adults: the cardiovascular health study.
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DOI：
10.1161/circulationaha.111.062653
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发表时间：
2012-03-06
期刊：
影响因子：
37.8
通讯作者：
Mozaffarian D
中科院分区：
文献类型：
--
作者：
Wu JH;Lemaitre RN;King IB;Song X;Sacks FM;Rimm EB;Heckbert SR;Siscovick DS;Mozaffarian D
实验研究表明，长链n-3多不饱和脂肪酸（n-3 PUFA）可以降低心房颤动（AF）的风险。先前的研究通过膳食调查问卷评估鱼类或n-3 PUFA的摄入量和AF事件之间的矛盾。n-3 PUFA的循环水平提供了暴露的客观测量。在3326名年龄≥65岁且基线时无房颤或心力衰竭的美国男性和女性中，采用标准化方法测量了基线时血浆二十碳五烯酸（EPA）、二十二碳五烯酸（DPA）和二十二碳六烯酸（DHA）的磷脂水平。在31,169人-年的随访期间（1992-2006），从出院记录和研究访视心电图中前瞻性地确定了AF事件（789例）。在校正了其他危险因素的多变量Cox模型中，总n-3 PUFA （EPA+DPA+DHA）水平最高与最低四分位数的RR为0.71 (95%CI=0.57-0.89, P-trend=0.004)；DHA水平为0.77 （95%CI=0.62 ~ 0.96, P-trend=0.01）。EPA和DPA水平与房颤发生率无显著相关性。非参数评估显示，总n-3 PUFA和DHA均与房颤发生率呈分级和线性负相关。在随访期间调整干预事件（如心力衰竭或心肌梗死）并没有明显改变结果。在老年人中，较高的循环总长链n-3 PUFA和DHA水平与房颤发生的风险较低相关。这些结果强调需要评估增加这些脂肪酸的饮食摄入是否对房颤的一级预防有效。
Experimental studies suggest long-chain n-3 polyunsaturated fatty acids (n-3 PUFA) may reduce risk of atrial fibrillation (AF). Prior studies evaluating fish or n-3 PUFA consumption from dietary questionnaires and incident AF have been conflicting. Circulating levels of n-3 PUFA provide an objective measurement of exposure. Among 3,326 US men and women age≥65y and free of AF or heart failure at baseline, plasma phospholipid levels of eicosapentaenoic acid (EPA), docosapentaenoic acid (DPA), and docosahexaenoic acid (DHA) were measured at baseline using standardized methods. Incident AF (789 cases) was prospectively identified from hospital discharge records and study visit electrocardiograms during 31,169 person-years of follow-up (1992-2006). In multivariable Cox models adjusted for other risk factors, the RR in the top versus lowest quartile of total n-3 PUFA (EPA+DPA+DHA) levels was 0.71 (95%CI=0.57-0.89, P-trend=0.004); and of DHA levels, 0.77 (95%CI=0.62-0.96, P-trend=0.01). EPA and DPA levels were not significantly associated with incident AF. Evaluated non-parametrically, both total n-3 PUFA and DHA showed graded and linear inverse associations with incidence of AF. Adjustment for intervening events such as heart failure or myocardial infarction during follow-up did not appreciably alter results. In older adults, higher circulating total long-chain n-3 PUFA and DHA levels were associated with lower risk of incident AF. These results highlight the need to evaluate whether increased dietary intake of these fatty acids could be effective for primary prevention of AF.