Ge Sun, Harriett Fuller, Hayley Fenton, Amanda D Race, Amy Downing, Colin J Rees, Louise C Brown, Paul M Loadman, Elizabeth A Williams, Mark A Hull
{"title":"膳食和补充 n-3 HUFA 摄入量、血液和组织中的 n-3 HUFA 水平与结直肠息肉复发之间的关系：seAFOod息肉预防试验的二次分析。","authors":"Ge Sun, Harriett Fuller, Hayley Fenton, Amanda D Race, Amy Downing, Colin J Rees, Louise C Brown, Paul M Loadman, Elizabeth A Williams, Mark A Hull","doi":"10.1016/j.tjnut.2024.12.004","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The seAFOod randomised controlled trial tested colorectal polyp prevention by the omega-3 highly unsaturated fatty acid (HUFA) eicosapentaenoic acid (EPA) and aspirin. Variable dietary intake of omega-3 HUFAs (also including docosahexaenoic acid [DHA]) and differential EPA capsule compliance could confound analysis of trial outcomes.</p><p><strong>Objective: </strong>To investigate the relationship between total (diet and capsule) daily omega-3 HUFA intake, red blood cell (RBC) and rectal mucosa omega-3 HUFA levels, and colorectal polyp outcomes in a secondary analysis of the seAFOod trial.</p><p><strong>Methods: </strong>Individual-participant dietary omega-3 HUFA intake (mg/d) was derived from food frequency questionnaires using the EPIC-Norfolk fatty acid nutrient database. Capsule EPA intake (mg/d) was adjusted for compliance (capsule counting). Fatty acids were analysed by liquid chromatography-tandem mass spectrometry (as % of total fatty acids). HUFA oxidation was measured as the HUFA/saturated fatty acid (SAT) ratio. The colorectal polyp detection rate [PDR; % with one or more polyps] and polyp number per participant were analysed according to the change in RBC EPA level during the trial (ΔEPA), irrespective of treatment allocation.</p><p><strong>Results: </strong>There was a small degree of HUFA degradation over time in RBC samples stored at higher than minus 80<sup>o</sup>C at research sites (r=-0.36, P<0.001 for HUFA/SAT ratio over time), which did not affect analysis of omega-3 HUFA levels. Low baseline EPA level, as well as allocation to EPA and % compliance, were associated with a high ΔEPA. Individuals with a ΔEPA value >+0.5% points (ΔEPA<sub>high</sub>), irrespective of allocation to EPA or placebo, had a lower PDR than ΔEPA<sub>low</sub> individuals (odds ratio 0.63 (95% confidence interval [CI] 0.40,1.01) and reduced colorectal polyp number (incidence rate ratio 0.74 [95%CI 0.54,1.02]).</p><p><strong>Conclusions: </strong>Analysis of the seAFOod trial according to the change in EPA level, instead of treatment allocation, revealed a protective effect of EPA treatment on colorectal polyp recurrence (ISRCTN05926847).</p>","PeriodicalId":16620,"journal":{"name":"Journal of Nutrition","volume":" ","pages":""},"PeriodicalIF":3.7000,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The relationship between dietary and supplemental n-3 HUFA intake, blood and tissue n-3 HUFA levels, and colorectal polyp recurrence: A secondary analysis of the seAFOod polyp prevention trial.\",\"authors\":\"Ge Sun, Harriett Fuller, Hayley Fenton, Amanda D Race, Amy Downing, Colin J Rees, Louise C Brown, Paul M Loadman, Elizabeth A Williams, Mark A Hull\",\"doi\":\"10.1016/j.tjnut.2024.12.004\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The seAFOod randomised controlled trial tested colorectal polyp prevention by the omega-3 highly unsaturated fatty acid (HUFA) eicosapentaenoic acid (EPA) and aspirin. Variable dietary intake of omega-3 HUFAs (also including docosahexaenoic acid [DHA]) and differential EPA capsule compliance could confound analysis of trial outcomes.</p><p><strong>Objective: </strong>To investigate the relationship between total (diet and capsule) daily omega-3 HUFA intake, red blood cell (RBC) and rectal mucosa omega-3 HUFA levels, and colorectal polyp outcomes in a secondary analysis of the seAFOod trial.</p><p><strong>Methods: </strong>Individual-participant dietary omega-3 HUFA intake (mg/d) was derived from food frequency questionnaires using the EPIC-Norfolk fatty acid nutrient database. Capsule EPA intake (mg/d) was adjusted for compliance (capsule counting). Fatty acids were analysed by liquid chromatography-tandem mass spectrometry (as % of total fatty acids). HUFA oxidation was measured as the HUFA/saturated fatty acid (SAT) ratio. The colorectal polyp detection rate [PDR; % with one or more polyps] and polyp number per participant were analysed according to the change in RBC EPA level during the trial (ΔEPA), irrespective of treatment allocation.</p><p><strong>Results: </strong>There was a small degree of HUFA degradation over time in RBC samples stored at higher than minus 80<sup>o</sup>C at research sites (r=-0.36, P<0.001 for HUFA/SAT ratio over time), which did not affect analysis of omega-3 HUFA levels. Low baseline EPA level, as well as allocation to EPA and % compliance, were associated with a high ΔEPA. Individuals with a ΔEPA value >+0.5% points (ΔEPA<sub>high</sub>), irrespective of allocation to EPA or placebo, had a lower PDR than ΔEPA<sub>low</sub> individuals (odds ratio 0.63 (95% confidence interval [CI] 0.40,1.01) and reduced colorectal polyp number (incidence rate ratio 0.74 [95%CI 0.54,1.02]).</p><p><strong>Conclusions: </strong>Analysis of the seAFOod trial according to the change in EPA level, instead of treatment allocation, revealed a protective effect of EPA treatment on colorectal polyp recurrence (ISRCTN05926847).</p>\",\"PeriodicalId\":16620,\"journal\":{\"name\":\"Journal of Nutrition\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.7000,\"publicationDate\":\"2024-12-13\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Nutrition\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.tjnut.2024.12.004\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"NUTRITION & DIETETICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Nutrition","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.tjnut.2024.12.004","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"NUTRITION & DIETETICS","Score":null,"Total":0}
The relationship between dietary and supplemental n-3 HUFA intake, blood and tissue n-3 HUFA levels, and colorectal polyp recurrence: A secondary analysis of the seAFOod polyp prevention trial.
Background: The seAFOod randomised controlled trial tested colorectal polyp prevention by the omega-3 highly unsaturated fatty acid (HUFA) eicosapentaenoic acid (EPA) and aspirin. Variable dietary intake of omega-3 HUFAs (also including docosahexaenoic acid [DHA]) and differential EPA capsule compliance could confound analysis of trial outcomes.
Objective: To investigate the relationship between total (diet and capsule) daily omega-3 HUFA intake, red blood cell (RBC) and rectal mucosa omega-3 HUFA levels, and colorectal polyp outcomes in a secondary analysis of the seAFOod trial.
Methods: Individual-participant dietary omega-3 HUFA intake (mg/d) was derived from food frequency questionnaires using the EPIC-Norfolk fatty acid nutrient database. Capsule EPA intake (mg/d) was adjusted for compliance (capsule counting). Fatty acids were analysed by liquid chromatography-tandem mass spectrometry (as % of total fatty acids). HUFA oxidation was measured as the HUFA/saturated fatty acid (SAT) ratio. The colorectal polyp detection rate [PDR; % with one or more polyps] and polyp number per participant were analysed according to the change in RBC EPA level during the trial (ΔEPA), irrespective of treatment allocation.
Results: There was a small degree of HUFA degradation over time in RBC samples stored at higher than minus 80oC at research sites (r=-0.36, P<0.001 for HUFA/SAT ratio over time), which did not affect analysis of omega-3 HUFA levels. Low baseline EPA level, as well as allocation to EPA and % compliance, were associated with a high ΔEPA. Individuals with a ΔEPA value >+0.5% points (ΔEPAhigh), irrespective of allocation to EPA or placebo, had a lower PDR than ΔEPAlow individuals (odds ratio 0.63 (95% confidence interval [CI] 0.40,1.01) and reduced colorectal polyp number (incidence rate ratio 0.74 [95%CI 0.54,1.02]).
Conclusions: Analysis of the seAFOod trial according to the change in EPA level, instead of treatment allocation, revealed a protective effect of EPA treatment on colorectal polyp recurrence (ISRCTN05926847).
期刊介绍：
The Journal of Nutrition (JN/J Nutr) publishes peer-reviewed original research papers covering all aspects of experimental nutrition in humans and other animal species; special articles such as reviews and biographies of prominent nutrition scientists; and issues, opinions, and commentaries on controversial issues in nutrition. Supplements are frequently published to provide extended discussion of topics of special interest.
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