Association between the docosahexaenoic acid to arachidonic acid ratio and acute coronary syndrome: a multicenter observational study.
Association between the docosahexaenoic acid to arachidonic acid ratio and acute coronary syndrome: a multicenter observational study.
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DOI：
10.1186/s12872-016-0299-y
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发表时间：
2016-07-07
影响因子：
2.1
通讯作者：
Daida H
中科院分区：
文献类型：
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作者：
Nishizaki Y;Shimada K;Tani S;Ogawa T;Ando J;Takahashi M;Yamamoto M;Shinozaki T;Miyazaki T;Miyauchi K;Nagao K;Hirayama A;Yoshimura M;Komuro I;Nagai R;Daida H
二十碳五烯酸(EPA)与花生四烯酸(AA)比值低是急性冠脉综合征(ACS)的已知危险因素。然而，二十二碳六烯酸(DHA)与AA比率与急性冠脉综合征之间的关联仍不清楚。本研究旨在通过患者特征评估DHA/AA比率与急性冠脉综合征之间的关系。我们招募了1733名患者，并评估了日本大都市5个心内科的多不饱和脂肪酸水平。我们根据以下10个亚组：性别、年龄、糖尿病、高血压、血脂异常、吸烟史、缺血性心脏病家族史、慢性肾病、肥胖和冠状动脉血运重建史来评估DHA/AA比率(中位数截断值：0.903)与急性冠脉综合征的关系。10个亚组分析中的交互作用检验显示，调整后的对数优势比在男性和女性之间有显著差异(p = 0.0 1)，在有和没有高血压的人之间有显著差异(p = 0.0 6)。特别是在基于性别差异的亚组中，高DHA/AA比率与男性急性冠脉综合征的低风险显著相关(调整后的优势比 = 为0.389；95%可信区间：0.211-0.716)。相比之下，在女性中发现了相反的关联，尽管这在统计学上没有显著意义(调整后的优势比 = 为3.820；95%可信区间：0.718-20.325)。DHA/AA比值与急性冠脉综合征的相关性因临床特征而异。值得注意的是，DHA/AA比率低的患者比DHA/AA比率高的患者患急性冠脉综合征的风险更高，这对男性尤其显著。
A low eicosapentaenoic acid (EPA) to arachidonic acid (AA) ratio is a known risk for acute coronary syndrome (ACS). However, the association between the docosahexaenoic acid (DHA) to AA ratio and ACS remains unclear. This study aimed to assess the association between the DHA/AA ratio and ACS by patient characteristics. We enrolled 1733 patients and evaluated the serum levels of polyunsaturated fatty acids in 5 cardiology departments in a metropolitan area of Japan. We assessed the relationship between the DHA/AA ratio (median cut-off value: 0.903) and ACS according to the following 10 subgroups: sex, age, diabetes mellitus, hypertension, dyslipidemia, smoking history, family history of ischemic heart disease, chronic kidney disease, obesity, and history of coronary revascularization. Interaction tests in the 10 subgroup analyses revealed a significant difference for adjusted log odds ratios between male and females (p = 0.01), and those with and without hypertension (p = 0.06). Especially in the subgroup based on sex difference, a high DHA/AA ratio was significantly associated with a low risk of ACS among men (adjusted odds ratio = 0.389; 95 % confidence interval: 0.211–0.716). In contrast, a reverse association was found among women, although this was not statistically significant (adjusted odds ratio = 3.820; 95 % confidence interval: 0.718–20.325). The association between the DHA/AA ratio and ACS differed by clinical characteristic. Notably, patients with a low DHA/AA ratio had a higher risk of ACS than those with a high DHA/AA ratio, and this was significant for men in particular.