Circulating Long-Chain ω-3 Fatty Acids and Incidence of Congestive Heart Failure in Older Adults: The Cardiovascular Health Study A Cohort Study
Circulating Long-Chain ω-3 Fatty Acids and Incidence of Congestive Heart Failure in Older Adults: The Cardiovascular Health Study A Cohort Study
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DOI：
10.7326/0003-4819-155-3-201108020-00006
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发表时间：
2011-08-02
影响因子：
39.2
通讯作者：
Siscovick, David S.
中科院分区：
文献类型：
--
作者：
Mozaffarian, Dariush;Lemaitre, Rozenn N.;Siscovick, David S.
背景资料：以前很少有研究评估长链omega-3脂肪酸与充血性心力衰竭（CHF）发生率之间的关联，并且那些通常基于饮食问卷并产生相互矛盾的结果。循环脂肪酸浓度提供了暴露的客观生物标志物。目的：确定长链ω-3脂肪酸（包括二十碳五烯酸（EPA）、二十二碳五烯酸（DPA）和二十二碳六烯酸（DHA））的血浆磷脂浓度是否与CHF事件相关。设计：前瞻性队列研究。S.患者：2735 U. S. 1992年至2006年参加心血管健康研究的无心脏病的成年人。测量：1992年采用标准化方法测量血浆磷脂脂肪酸浓度和其他心血管危险因素。与CHF事件的关系结果：经多因素校正后，血浆磷脂EPA浓度与CHF发生率呈负相关;最高四分位数与最低四分位数相比，风险降低约50%（风险比[HR]，0.52 [95%CI，0.38 - 0.72];趋势P = 0.001）。在类似的分析中，观察到DPA的风险降低趋势（HR，0.76 [CI，0.56 - 1.04];趋势P = 0.057）和总长链ω-3脂肪酸（HR，0.70 [CI，0.49至0.99];趋势P = 0.062），但DHA没有（HR，0.84 [CI，0.58至1.21];趋势P = 0.38）。在分析中，删失至随访中期（7年），以尽量减少随时间的暴露错误分类，EPA的多变量调整HR为0.48（CI，0.32 - 0.71;趋势P = 0.005），DPA为0.61（CI，0.39 - 0.95;趋势P = 0.033），DHA为0.64（CI，0.40 - 1.04;趋势P = 0.057），总ω-3脂肪酸为0.51（CI，0.32至0.80;趋势P = 0.003）。局限性：脂肪酸浓度随时间的时间变化可能导致低估了相关性。未测量或测量不完全的协变量可能会造成残留confounding.Conclusion：循环中的个人和总的omega-3脂肪酸浓度与老年人CHF的发病率较低。
Background: Few previous studies have evaluated associations between long-chain omega-3 fatty acids and incidence of congestive heart failure (CHF), and those that have are typically based on diet questionnaires and yield conflicting results. Circulating fatty acid concentrations provide objective biomarkers of exposure.Objective: To determine whether plasma phospholipid concentrations of long-chain omega-3 fatty acids, including eicosapentaenoic acid (EPA), docosapentaenoic acid (DPA), and docosahexaenoic acid (DHA), were associated with incident CHF.Design: Prospective cohort study.Setting: 4 U. S. communities.Patients: 2735 U. S. adults without prevalent heart disease who were enrolled in the Cardiovascular Health Study from 1992 to 2006.Measurements: Plasma phospholipid fatty acid concentrations and other cardiovascular risk factors were measured in 1992 by using standardized methods. Relationships with incident CHF (555 cases during 26 490 person-years, adjudicated by using medical records) were assessed by using Cox proportional hazards models.Results: After multivariate adjustment, plasma phospholipid EPA concentration was inversely associated with incident CHF; risk was approximately 50% lower in the highest versus the lowest quartile (hazard ratio [HR], 0.52 [95% CI, 0.38 to 0.72]; P for trend = 0.001). In similar analyses, trends toward lower risk were seen for DPA (HR, 0.76 [CI, 0.56 to 1.04]; P for trend = 0.057) and total long-chain omega-3 fatty acids (HR, 0.70 [CI, 0.49 to 0.99]; P for trend = 0.062) but not for DHA (HR, 0.84 [CI, 0.58 to 1.21]; P for trend = 0.38). In analyses censored to the middle of follow-up (7 years) to minimize exposure misclassification over time, multivariate-adjusted HRs were 0.48 for EPA (CI, 0.32 to 0.71; P for trend = 0.005), 0.61 for DPA (CI, 0.39 to 0.95; P for trend = 0.033), 0.64 for DHA (CI, 0.40 to 1.04; P for trend = 0.057), and 0.51 for total omega-3 fatty acids (CI, 0.32 to 0.80; P for trend = 0.003).Limitations: Temporal changes in fatty acid concentrations over time may have caused underestimation of associations. Unmeasured or imperfectly measured covariates may have caused residual confounding.Conclusion: Circulating individual and total omega-3 fatty acid concentrations are associated with lower incidence of CHF in older adults.