Dietary Fat Intake Is Differentially Associated with Risk of Paroxysmal Compared with Sustained Atrial Fibrillation in Women
Dietary Fat Intake Is Differentially Associated with Risk of Paroxysmal Compared with Sustained Atrial Fibrillation in Women
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DOI：
10.3945/jn.115.212860
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发表时间：
2015-09-01
影响因子：
4.2
通讯作者：
Albert, Christine M.
中科院分区：
文献类型：
--
作者：
Chiuve, Stephanie E.;Sandhu, Roopinder K.;Albert, Christine M.
背景：膳食脂肪对可能影响房颤（AF）发展和维持的生物学途径有影响。然而，n-3（omega-3）多不饱和脂肪酸和AF之间的关联是不一致的，关于其他膳食脂肪和AF风险的数据也很稀少。目的：我们研究了膳食脂肪酸（FA）亚类和AF发生风险之间的关联，并探讨这些关联是否在持续性和阵发性AF中存在差异。我们在1993年对33，665名年龄≥ 45岁且基线时无心血管疾病（CVD）和AF的女性进行了一项前瞻性队列研究。在基线和2004年，通过食物频率问卷估计脂肪摄入量。2013年10月之前的病历证实了AF事件。根据诊断后2年内最持续的房颤形式对房颤模式进行分类。考克斯比例风险模型与使用竞争风险模型的方法估计的RR.Results：超过19.2年，1441例事件AF（929阵发性和467持续/慢性）被证实。总脂肪和FA亚类的摄入量与AF的风险无关。饱和脂肪酸（SFA）和单不饱和脂肪酸（MUFA）与AF模式有差异。对于持续性/慢性房颤，SFA能量增加5%的RR为1.47（95% CI：1.04，2.09），阵发性房颤为0.85（95% CI：0.66，1.08）（P差异= 0.01）。对于MUFA，5%增量的RR为0.67（95% CI：0.46，0.98）持续性/慢性和1.03（95% CI：0.78，1.34）阵发性房颤，尽管模式之间的差异不显著（P-差异= 0.07）。在没有心血管疾病或房颤的女性中，膳食脂肪与房颤发生风险无关。持续性或慢性房颤的风险更大，但不是阵发性房颤。改善膳食脂肪质量可能在预防持续性房颤中发挥作用。妇女健康研究在www.example.com注册clinicaltrials.gov为NCT 00000479。
Background: Dietary fats have effects on biological pathways that may influence the development and maintenance of atrial fibrillation (AF). However, associations between n-3 (omega-3) polyunsaturated fatty acids and AF are inconsistent, and data on other dietary fats and AF risk are sparse.Objectives: We examined the association between dietary fatty acid (FA) subclasses and risk of incident AF and explored whether these associations differed for sustained and paroxysmal AF.Methods: We conducted a prospective cohort study in 33,665 women >= 45 y old without cardiovascular disease (CVD) and AF at baseline in 1993. Fat intake was estimated from food frequency questionnaires at baseline and in 2004. Incident AF was confirmed by medical records through October 2013. AF patterns were classified according to the most sustained form of AF within 2 y of diagnosis. Cox proportional hazards models with the use of a competing risk model approach estimated the RR.Results: Over 19.2 y, 1441 cases of incident AF (929 paroxysmal and 467 persistent/chronic) were confirmed. Intakes of total fat and FA subclasses were not associated with risk of AF. Saturated fatty acids (SFAs) and monounsaturated fatty acids (MUFAs) were differentially associated with AF patterns. The RR for a 5% increment of energy from SFAs was 1.47 (95% CI: 1.04, 2.09) for persistent/chronic and 0.85 (95% CI: 0.66, 1.08) for paroxysmal AF (P-difference = 0.01). For MUFAs, the RR for a 5% increment was 0.67 (95% CI: 0.46, 0.98) for persistent/chronic and 1.03 (95% CI: 0.78, 1.34) for paroxysmal AF, although the difference between patterns was not significant (P-difference = 0.07).Conclusions: Dietary fat was not associated with risk of incident AF in women without established CVD or AF. High SFA and low MUFA intakes were associated with greater risk of persistent or chronic, but not paroxysmal, AF. Improving dietary fat quality may play a role in the prevention of sustained forms of AF. The Women's Health Study was registered at clinicaltrials.gov as NCT00000479.