Long-chain n-3 fatty acids and mortality in elderly patients
Long-chain n-3 fatty acids and mortality in elderly patients
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DOI：
10.1093/ajcn/88.3.722
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发表时间：
2008-09-01
影响因子：
7.1
通讯作者：
Bjerve, Kristian S.
中科院分区：
文献类型：
--
作者：
Lindberg, Morten;Saltvedt, Ingvild;Bjerve, Kristian S.
背景：长链n-3脂肪酸可能对许多疾病具有良好的调节作用。冠心病的证据是确凿的，中风的证据不太确定，其他疾病的证据只是推测。这些脂肪酸对急性病老年患者死亡率的影响尚不清楚。目的：探讨长链n-3脂肪酸与老年急性病患者总死亡率的关系。设计：虚弱，老年患者（n = 254）急性圣奥拉夫斯医院在挪威中部进行了检查。二十碳五烯酸（EPA）的血浆磷脂浓度被用作膳食摄入海洋脂肪酸的替代标志物。随访3年后评价死亡率。采用考克斯比例风险分析计算校正重要生化和临床协变量的风险比。结果如下：EPA浓度处于最低四分位数的患者的总体死亡率风险比显着高于处于上3个四分位数的患者（调整后的风险比：0.52; 95%CI：0.35，0.77）。上3个四分位数彼此之间无显著差异（P = 0.94）。结论：体弱、老年、重病患者的总体死亡率与EPA浓度呈负相关且非线性相关。大约25%的人口EPA浓度低于最大保护的指示阈值，这表明只有这部分人口可能受益于额外的EPA摄入量。
Background: Long-chain n-3 fatty acids may favorably modulate many diseases. The evidence is firm for coronary heart disease, less certain for stroke, and only speculative for other diseases. The impact of these fatty acids on mortality among acutely sick elderly patients is unknown. Objective: The objective was to investigate the relation between long-chain n-3 fatty acids and overall mortality in acutely sick elderly patients. Design: Frail, elderly patients (n = 254) acutely admitted to St Olavs Hospital in central Norway were examined. The plasma phospholipid concentration of eicosapentaenoic acid (EPA) was used as a surrogate marker for dietary intake of marine fatty acids. Mortality rates were evaluated after 3 y of follow-up. Cox proportional hazard analysis was used to calculate hazard ratios adjusted for important biochemical and clinical covariates. Results: The hazard ratio of overall mortality was significantly higher in patients with EPA concentrations in the lowest quartile than in patients in the upper 3 quartiles (adjusted hazard ratio: 0.52; 95% CI: 0.35, 0.77). The upper 3 quartiles were not significantly different from one another (P = 0.94). Conclusions: Overall mortality in frail, elderly, acutely sick patients was inversely and nonlinearly associated with EPA concentrations. Approximately 25% of the population had EPA concentrations below the indicated threshold for maximal protection, suggesting that only this part of the population might have benefited from additional EPA intake.