多不饱和脂肪酸对动脉粥样硬化疾病的疗效

H. Bando, M. Bando
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引用次数: 0

摘要

在抗衰老医学和健康科学领域,关于脂质与健康的观点众说纷纭。大量临床和流行病学研究表明,摄入长链n-3多不饱和脂肪酸(PUFA)与动脉粥样硬化的发展呈显著负相关[1,2]。这些研究包括二十二碳六烯酸(DHA)和二十碳五烯酸(EPA),以及冠状动脉疾病的死亡率。日本EPA脂质干预研究(JELIS)也显示了降低主要冠状动脉事件的疗效。研究显示,与对照组相比,EPA组在主要终点的主要冠状动脉事件减少了19%。关于n-3 PUFA对动脉硬化疾病的影响一直存在争议。以前,人们普遍知道n-3 PUFA具有预防动脉硬化的作用。然而,最近的论文显示了相反的结果。这个问题不仅关系到医疗健康问题,而且关系到我们日常生活中的饮食问题。本文将介绍n-3 PUFA的效果问题。ASCEND (A Study of Cardiovascular Events iN Diabetes)试验的结果于2018年公布并被注意到。采用随机对照试验(RCT)研究n-3 PUFA对动脉硬化的预防作用。结果为阴性,这与先前报道的临床效果相反。以前,有一项研究表明,吃鱼可以减少心脏病的发病率。后来,对血脂与心脏病等动脉硬化性疾病的关系进行了临床研究。在这种情况下,2019年最高医学杂志《新英格兰医学杂志》发表了两篇报道。这两个结果是矛盾的,其中一个在REDUCE-IT[7]中显示预防作用,而另一个没有显示预防作用(VITAL)[7]。这些报告的细节将在下面描述。有一个研究减少心血管事件的Icosapent乙基干预试验(REDUCE-IT)。REDUCE-IT是一项来自11个国家473个中心的随机对照研究[6,8]。研究对象包括患有心血管疾病或糖尿病及其他危险因素的患者,这些患者在甘油三酯和/或低密度脂蛋白胆固醇水平升高的情况下一直在接受他汀类药物治疗。换句话说,目的是检查预防动脉硬化事件的复发。将8179名受试者分为两组
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The efficacy of polyunsaturated fatty acids for atherosclerotic diseases
In the field of anti-aging medicine and health science, various opinions about lipid and health are found. Among lots of clinical and epidemiological research, there has been a significant inverse association between intake of long-chain n-3 polyunsaturated fatty acids (PUFA) and atherosclerosis development [1,2]. These studies included docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), and mortality rate with coronary artery diseases. There was also the Japan EPA Lipid Intervention Study (JELIS), which showed the efficacy of reduction of major coronary events [3]. It showed a 19% reduction in major coronary events by a primary endpoint in the EPA group compared with the control group. Regarding n-3 PUFA, there have been controversies concerning the effect of arteriosclerotic diseases. Formerly, it was rather widely known that the preventive arteriosclerotic effect was present in n-3 PUFA. However, recent papers showed opposite results. This problem is related to not only medical and health matter, but also our meals in our usual lives. In this article, the problem of the effect of n-3 PUFA will be described. The results of the ASCEND (A Study of Cardiovascular Events iN Diabetes) trial were announced and noted in 2018 [4]. The prevention effect of n-3 PUFA on arteriosclerosis was investigated by Randomized Comparison Test (RCT). The result was negative, which was contrary to the clinical effects previously reported. Formerly, there was a study suggested that fish intake could reduce heart diseases [5]. Later, clinical research has been developed concerning the relationship between lipids and arteriosclerotic diseases such as heart diseases. Under these circumstances, there are two reports in 2019 from the supreme medical journal, New England Journal of Medicine. Both results were contradictory, in which one showed a preventive effect in REDUCE-IT [6], and another did not show a preventive effect (VITAL) [7]. Details of these reports will be described in the following. There is a study of the Reduction of Cardiovascular Events with Icosapent Ethyl-Intervention Trial (REDUCE-IT). REDUCE-IT was an RCT study from 473 centers in 11 countries [6,8]. The subjects included patients with established cardiovascular diseases or with diabetes and other risk factors, who had been receiving statin therapy with elevated triglyceride and/or LDL-cholesterol level. In other words, the purpose was the check for the prevention of recurrence of arteriosclerotic events. Subjects (n=8,179) were divided into two groups, which
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