Omega-6多不饱和脂肪酸与外周动脉疾病：9项国际前瞻性研究的个体参与者水平分析。
完整摘要 · 中文译文
背景：ω-6多不饱和脂肪酸（PUFA）此前已被认为与多个外周动脉疾病（PAD）危险因素相关。我们在一项多队列分析中研究了单个ω-6多不饱和脂肪酸与外周动脉疾病发生之间的关联。 方法：本研究纳入来自FORCE（脂肪酸与结局研究联盟）中9个队列（N=137 704；外周动脉疾病病例=2014）的参与者，这些参与者在基线时无临床外周动脉疾病。在基线时测量ω-6多不饱和脂肪酸，中位随访时间为14年。在单个队列中进行Cox比例风险回归分析，以评估ω-6多不饱和脂肪酸（连续队列标准化区间五分位数间距[第10和第90个ω-6多不饱和脂肪酸百分位数中位数之间的差值]和队列特异性五分位数）与临床外周动脉疾病发生的关联，并调整预设协变量。使用逆方差加权荟萃分析计算合并风险比（HR）和95%置信区间（CI）。 结果：在所有9个队列中测量了亚油酸（LA），在8个队列中测量了花生四烯酸（N=33 541；外周动脉疾病病例=1766），在7个队列中测量了二高-γ-亚油酸和γ-亚油酸（N=29 861；外周动脉疾病病例=1686），在6个队列中测量了二十碳二烯酸（N=27 538；外周动脉疾病病例=1435）。仅亚油酸与外周动脉疾病发生风险降低相关（第5五分位数对比第1五分位数：HR，0.75 [95% CI，0.64-0.89]；P=0.0009）。按年龄、性别、糖尿病状态或吸烟状态分层，结果无统计学显著性差异。 结论：结果表明，ω-6多不饱和脂肪酸亚油酸可能对外周动脉疾病具有保护作用，而其他ω-6多不饱和脂肪酸与外周动脉疾病发生无关。 这进一步证明，ω-6多不饱和脂肪酸与疾病的关系应分别按单个脂肪酸进行评估，而非将总ω-6多不饱和脂肪酸归为一组。
完整摘要 · 英文原文
BACKGROUND: Omega-6 polyunsaturated fatty acids (PUFAs) have previously been associated with several peripheral artery disease (PAD) risk factors. We studied the association between individual omega-6 PUFAs and incident PAD in a multicohort analysis. METHODS: This study was conducted among participants from 9 cohorts (N=137 704; PAD cases=2014) in the FORCE (Fatty Acids and Outcomes Research Consortium) who were free of clinical PAD at baseline. Omega-6 PUFAs were measured at baseline and with a median follow-up of 14 years. Cox proportional hazards regression analyses were conducted in individual cohorts to evaluate associations of omega-6 PUFAs (continuous cohort-standardized interquintile ranges [difference between the medians of the 10th and 90th omega-6 PUFAs percentiles] and cohort-specific quintiles) with incident clinical PAD adjusting for prespecified covariates. Inverse-variance weighted meta-analysis was used to calculate the combined hazard ratios (HRs) and 95% CIs. RESULTS: Linoleic acid (LA) was measured in all 9 cohorts, arachidonic acid in 8 (N=33 541; PAD cases=1766), dihomo-γ-LA and γ-LA in 7 (N=29 861; PAD cases=1686), and eicosadienoic acid in 6 (N=27 538; PAD cases=1435). Only LA was associated with a lower risk of incident PAD (quintile 5 versus quintile 1: HR, 0.75 [95% CI, 0.64-0.89]; P=0.0009). Results did not differ in a statistically significant manner by age, sex, diabetes status, or smoking status. CONCLUSIONS: Results suggest that the omega-6 PUFA LA may be protective against PAD, and other omega-6 PUFAs are not associated with PAD incidence. This is further evidence that omega-6 PUFA-disease relationships should be evaluated by individual fatty acids rather than grouped as total omega-6 PUFAs.