Comparison of predictive performance of various fatty acids for the risk of cardiovascular disease events and all-cause deaths in a community-based cohort
Comparison of predictive performance of various fatty acids for the risk of cardiovascular disease events and all-cause deaths in a community-based cohort
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DOI：
10.1016/j.atherosclerosis.2013.06.015
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发表时间：
2013-09-01
期刊：
影响因子：
5.3
通讯作者：
Lee, Yuan-Teh
中科院分区：
文献类型：
--
作者：
Chien, Kuo-Liong;Lin, Hung-Ju;Lee, Yuan-Teh
背景资料：饱和脂肪和反式脂肪是否比n-3多不饱和脂肪酸（如二十碳五烯酸（EPA）和二十二碳六烯酸（DHA））上级预测全因死亡和心血管疾病，这一问题仍然存在争议。此外，很少有研究探讨亚洲人群中脂肪酸与心血管疾病（CVD）结局之间的关系。本研究的目的是比较各种血浆脂肪酸作为全因死亡和心血管疾病事件的预测因子在中国少数民族population.Methods的有效性：本研究组装了一个以社区为基础的前瞻性队列，包括1833名参与者（60.6 +/- 10.5岁，44.5%的妇女）谁进行了全面的评估，血液中的脂肪酸使用气相色谱法。没有受试者在招募时有CVD的历史。结果：共有568人死亡，275人在随访期间（中位数为9.6年，四分位数范围为8.9-10.5年）发展为CVD。在调整既定的心血管危险因素后，饱和脂肪的最高四分位数与最低四分位数的全因死亡相对风险为1.33（95%置信区间[CI]，1.01-1.75，趋势检验，P = 0.015），反式脂肪为1.71（95% CI，1.27-2.31，趋势检验，P = 0.0003），EPA为0.77（95% CI，0.59 - 1.00，趋势检验，P = 0.048），DHA为0.89（95% CI，0.68-1.18，趋势检验，P = 0.354）。CVD事件也观察到类似模式。反式脂肪在预测全因死亡的受试者工作特征曲线下面积最大（0.740，95%CI，0.716-0.766）。一个相互调整的双标记模型表明，饱和脂肪和反式脂肪是全因死亡和心血管疾病的重要预测因子;然而，其他脂肪酸不是。此外，反式脂肪在全因死亡的净重新分类中表现出最大的改善（7.7%，P = 0.003），其次是EPA（3.8%，P = 0.033）。饱和脂肪在CVD事件的净重新分类中表现出最大的改善（5.6%，P = 0.039）。结论：我们的数据提供了强有力的证据支持血浆饱和脂肪和反式脂肪可以比其他脂肪酸标志物更有效地预测全因死亡和CVD。(C)2013爱思唯尔爱尔兰有限公司保留所有权利。
Background: The issue of whether saturated fats and trans fats are superior predictors of all-cause death and cardiovascular disease than n-3 polyunsaturated fatty acids, such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), remains a matter of contention. Furthermore, few studies have examined the relationship between fatty acids and the outcomes of cardiovascular disease (CVD) in Asian populations. The aim of this study was to compare the effectiveness of various plasma fatty acids as predictors for all-cause death and CVD events in an ethnic Chinese population.Methods: This study assembled a community-based prospective cohort, comprising 1833 participants (60.6 +/- 10.5 yrs, 44.5% women) who underwent a comprehensive evaluation of fatty acids in blood using gas chromatography. None of the subjects had a history of CVD at the time of recruitment.Results: A total of 568 individuals died and 275 individuals developed CVD during the follow-up period (median of 9.6 years; interquartile range of 8.9-10.5 years). Following adjustment for established cardiovascular risk factors, the relative risk of all-cause death in the highest quartile, compared with the lowest quartile, was 1.33 for saturated fats (95% confidence interval [CI], 1.01-1.75, test for trend, P = 0.015), 1.71 for trans fats (95% CI, 1.27-2.31, test for trend, P = 0.0003), 0.77 for EPA (95% CI, 0.59 -1.00, test for trend, P = 0.048), and 0.89 for DHA (95% CI, 0.68-1.18, test for trend, P = 0.354). Similar patterns were observed for CVD events. Trans fats presented the largest area under the receiver operator characteristic curve (0.740, 95% CI, 0.716-0.766) for the prediction of all-cause death. A mutually adjusted two-marker model indicated that saturated fats and trans fats were significant predictors of all-cause death and CVD; however, the other fatty acids were not. In addition, trans fats presented the greatest improvement in net reclassification for all-cause death (7.7%, P = 0.003), followed by EPA (3.8%, P = 0.033). Saturated fats presented the greatest improvement in net reclassification for CVD events (5.6%, P = 0.039).Conclusions: Our data provides strong evidence to support that plasma saturated fats and trans fats can predict all-cause death and CVD more effectively than other fatty acid markers. (C) 2013 Elsevier Ireland Ltd. All rights reserved.