Plasma phospholipid fatty acids and CHD in older men: Whitehall study of London civil servants

Plasma phospholipid fatty acids and CHD in older men: Whitehall study of London civil servants
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DOI:
10.1017/s0007114508143562
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发表时间:
2009-07-28
影响因子:
3.6
通讯作者:
Harris, William
Harris, William
中科院分区:
医学3区
文献类型:
--
作者:
Clarke, Robert;Shipley, Martin;Harris, William

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膳食脂肪酸(FA)是血脂的主要决定因素,血浆磷脂FA(PL-FA)组成的测量,反映了FA的膳食摄入量可能会提供洞察饮食和CHD之间的关系。我们评估了CHD死亡率与PL-FA(SFA,PUFA和MUFA)水平的关系,该研究在116例CHD死亡病例和239例年龄和就业等级频率匹配的对照组中进行了巢式病例对照研究。记录参与者的血浆总胆固醇、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇、载脂蛋白B和载脂蛋白A(1)、C反应蛋白(CRP)和纤维蛋白原水平。SFA水平与总胆固醇、LDL-C、apo B、CRP蛋白、纤维蛋白原呈显著正相关。相反,磷脂-PUFA与CRP呈负相关,但与任何脂质无关。较高的SFA含量(上四分之一与下四分之一)与CHD风险增加2倍相关(OR和95% CI:OR 2.12; 95% CI:1.13,3.99),PUFA的同等差异与CHD风险减半相关(OR 0.49; 95% CI:0.26,0.94),但MUFA与CHD风险无关。在对脂质和炎症标志物进行额外调整后,这些相关性大大减弱。较高水平的饱和脂肪和较低水平的多不饱和脂肪分别与老年男性冠心病的较高风险相关,这些相关性部分解释为它们对血脂和炎症生物标志物的影响。
Dietary fatty acids (FA) are the major determinants of blood lipids, and measurements of plasma phospholipid FA (PL-FA) composition that reflect the dietary intake of FA may provide insights into the relationships between diet and CHD. We assessed CHD mortality associations with PL-FA (SFA, PUFA and MUFA) levels measured in a nested case-control study of 116 cases of CHD death and 239 controls that were frequency-matched for age and employment grade. The participants had plasma levels of total cholesterol, LDL-cholesterol (LDL-C), HDL-cholesterol, apo B and apo A(1), C-reactive protein (CRP) and fibrinogen recorded. SFA levels were significantly positively correlated with total cholesterol, LDL-C, apo B, CRP protein and fibrinogen. By contrast, phospholipid-PUFA were inversely associated with CRP, but not with any of the lipids. A higher SFA content (top v. bottom quarter) was associated with a 2-fold higher risk of CHD (OR and 95% CI: OR 2.12; 95% CI: 1.13, 3.99), and an equivalent difference in PUFA was associated with a halving in CHD risk (OR 0.49; 95% CI: 0.26, 0.94), but MUFA was unrelated to CHD risk. These associations were substantially attenuated, after additional adjustment for lipids and inflammatory markers. Higher levels of saturated fat and lower levels of polyunsaturated fats were each associated with a higher risk of CHD in elderly men, and these associations were partly explained by their effects on blood lipids and biomarkers of inflammation.