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Sato T, Okumura M, Ishikawa T, Sakuta K, Takahashi J, Tanabe M, Onda A, Komatsu T, Sakai K, Umehara T, Mitsumura H, Iguchi Y. Relationship between ω3 and ω6 polyunsaturated fatty acids and atrial fibrillation in acute ischemic stroke. Clin Nutr 2024; 43:1643-1651. [PMID: 38772071 DOI: 10.1016/j.clnu.2024.05.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2024] [Revised: 05/05/2024] [Accepted: 05/09/2024] [Indexed: 05/23/2024]
Abstract
BACKGROUND & AIMS Some ω3 polyunsaturated fatty acids (PUFAs) are said to demonstrate a dose-related risk of atrial fibrillation (AF), conversely, some ω6 PUFAs might have AF protective potential. However, few investigated the relation among ischemic strokes. Primarily, we aimed to examine a relation between ω3 and ω6 PUFAs and the presence of AF in ischemic strokes. Further, since, some PUFAs are said to affect the cardiac load, we secondarily aimed to investigate the association between ω3 and ω6 PUFAs and brain natriuretic peptide (BNP) and the occurrence of cerebral large vessel occlusion (LVO) in ischemic strokes with AF. METHODS Consecutive patients with ischemic stroke admitted between 2012 and 2022 were retrospectively screened. Plasma levels of PUFAs, including eicosapentaenoic acid (EPA), docosahexaenoic acid, dihomo-γ-linolenic acid (DGLA) and arachidonic acid (AA), were assayed. Data were analyzed using a Poisson regression analysis with a robust variance estimator and a multiple linear regression analysis. RESULTS We screened 2112 consecutive ischemic strokes, including 1574 (1119 [71%] males, median age 69 years). Lower DGLA (prevalence ratio (PR) 0.885, 95% CI 0.811-0.966, p = 0.006), lower AA (PR 0.797, 95% CI 0.649-0.978, p = 0.030), and higher EPA/AA ratio (PR 1.353, 95% CI 1.036-1.767, p = 0.026) were associated with AF. Checking the linearity between AF and PUFAs, negative linear trends were observed between DGLA quartiles (Q1: PR 1.901, Q2: PR 1.550, Q3: PR 1.423, Q4: 1.000, p < 0.001 for trend) and AA quartiles (Q1: PR 1.499, Q2: PR 1.204, Q3: PR 1.125, Q4: 1.000, p = 0.004 for trend), with positive linear trends between EPA/AA ratio quartiles (Q1: 1.000, Q2: PR 1.555, Q3: PR 1.612, Q4: PR 1.797, p = 0.001 for trend). Among patients with AF, a negative association between AA and BNP (unstandardized coefficient -1.316, 95% CI -2.290∼-0.342, p = 0.008) was observed, and lower AA was associated with LVO (PR 0.707, 95% CI 0.527-0.950, p = 0.021). CONCLUSION Lower DGLA and AA and a higher EPA/AA ratio might be related to the development of AF in ischemic strokes. Further, AA might have a cardio-cerebrovascular protective role in ischemic strokes with AF.
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Affiliation(s)
- Takeo Sato
- Department of Neurology, The Jikei University School of Medicine, Tokyo, Japan.
| | - Motohiro Okumura
- Department of Neurology, The Jikei University School of Medicine, Tokyo, Japan
| | - Takahiro Ishikawa
- Department of Neurology, The Jikei University School of Medicine, Tokyo, Japan
| | - Kenichi Sakuta
- Department of Neurology, The Jikei University School of Medicine, Tokyo, Japan
| | - Junichiro Takahashi
- Department of Neurology, The Jikei University School of Medicine, Tokyo, Japan
| | - Maki Tanabe
- Department of Neurology, The Jikei University School of Medicine, Tokyo, Japan
| | - Asako Onda
- Department of Neurology, The Jikei University School of Medicine, Tokyo, Japan
| | - Teppei Komatsu
- Department of Neurology, The Jikei University School of Medicine, Tokyo, Japan
| | - Kenichiro Sakai
- Department of Neurology, The Jikei University School of Medicine, Tokyo, Japan
| | - Tadashi Umehara
- Department of Neurology, The Jikei University School of Medicine, Tokyo, Japan
| | - Hidetaka Mitsumura
- Department of Neurology, The Jikei University School of Medicine, Tokyo, Japan
| | - Yasuyuki Iguchi
- Department of Neurology, The Jikei University School of Medicine, Tokyo, Japan
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Okumura M, Sato T, Takahashi J, Kokubu T, Nakada R, Kitagawa T, Tanabe M, Takatsu H, Onda A, Komatsu T, Sakuta K, Sakai K, Umehara T, Mitsumura H, Iguchi Y. Small ischemic lesions accompanying intracerebral hemorrhage: The underlying influence of old lacunes and polyunsaturated fatty acids. Nutr Metab Cardiovasc Dis 2024; 34:1157-1165. [PMID: 38331645 DOI: 10.1016/j.numecd.2024.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 09/23/2023] [Accepted: 01/03/2024] [Indexed: 02/10/2024]
Abstract
BACKGROUND AND AIMS Small ischemic lesions (SILs) accompanying intracerebral hemorrhage (ICH) might be induced by small-vessel vulnerability and hypercoagulation. Some polyunsaturated fatty acids (PUFAs) have been associated with hypercoagulation in cardiovascular diseases. Our aim here is to determine how pre-existing small-vessel disease (SVD) and PUFAs may affect SILs. METHODS AND RESULTS We screened consecutive ICH patients (October 2012-December 2021) meeting two inclusion criteria: (1) the patients were hospitalized for acute ICH and were undergoing magnetic resonance imaging and (2) the patients' PUFA measurements were available. After excluding patients with isolated intraventricular hemorrhage, we evaluated whether three SVD markers (white matter hyperintensities, old lacunes, cerebral microbleeds) and PUFAs might be associated with the development of SILs. We selected 319 participants from 377 screened consecutive ICH patients (median age = 64, males = 207 [65 %]). Of the 319 patients, 45 patients (14 %) developed SILs. In a multivariable logistic regression analysis, the factors associated with SILs were old lacunes (OR 3.255, 95 % CI 1.101-9.622, p = 0.033) and DHA/AA ratio (OR 0.180, 95 % CI 0.046-0.704, p = 0.013). Furthermore, in our multivariable analysis using DHA/AA ratio tertiles with and without SILs, we observed a linear trend between SILs and the Higher Tertile of the DHA/AA ratio (DHA/AA ratio Mid-Tertile: OR 1.330, 95%CI 0.557-3.177, p = 0.521, and DHA/AA ratio Lower Tertile: OR 2.632, 95%CI 1.124-6.162, p = 0.026). CONCLUSION The presence of old lacunes and lower DHA/AA ratios might be associated with SILs accompanying ICH.
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Affiliation(s)
- Motohiro Okumura
- Department of Neurology, The Jikei University School of Medicine, Tokyo, Japan
| | - Takeo Sato
- Department of Neurology, The Jikei University School of Medicine, Tokyo, Japan.
| | - Junichiro Takahashi
- Department of Neurology, The Jikei University School of Medicine, Tokyo, Japan
| | - Tatsushi Kokubu
- Department of Neurology, The Jikei University School of Medicine, Tokyo, Japan
| | - Ryoji Nakada
- Department of Neurology, The Jikei University School of Medicine, Tokyo, Japan
| | - Tomomichi Kitagawa
- Department of Neurology, The Jikei University School of Medicine, Tokyo, Japan
| | - Maki Tanabe
- Department of Neurology, The Jikei University School of Medicine, Tokyo, Japan
| | - Hiroki Takatsu
- Department of Neurology, The Jikei University School of Medicine, Tokyo, Japan
| | - Asako Onda
- Department of Neurology, The Jikei University School of Medicine, Tokyo, Japan
| | - Teppei Komatsu
- Department of Neurology, The Jikei University School of Medicine, Tokyo, Japan
| | - Kenichi Sakuta
- Department of Neurology, The Jikei University School of Medicine, Tokyo, Japan
| | - Kenichiro Sakai
- Department of Neurology, The Jikei University School of Medicine, Tokyo, Japan
| | - Tadashi Umehara
- Department of Neurology, The Jikei University School of Medicine, Tokyo, Japan
| | - Hidetaka Mitsumura
- Department of Neurology, The Jikei University School of Medicine, Tokyo, Japan
| | - Yasuyuki Iguchi
- Department of Neurology, The Jikei University School of Medicine, Tokyo, Japan
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Sato T, Okumura M, Takahashi J, Kokubu T, Tanabe M, Onda A, Komatsu T, Sakuta K, Sakai K, Umehara T, Mitsumura H, Matsushima M, Iguchi Y. Arachidonic acid level is related to early motor recovery following intracerebral hemorrhage with severe motor paralysis. Prostaglandins Leukot Essent Fatty Acids 2024; 200:102603. [PMID: 38147805 DOI: 10.1016/j.plefa.2023.102603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 12/09/2023] [Accepted: 12/12/2023] [Indexed: 12/28/2023]
Abstract
BACKGROUND Low arachidonic acid (AA) levels are reportedly associated with unfavorable outcomes in intracerebral hemorrhage (ICH). OBJECTIVE We aimed to clarify whether serum AA levels might be associated with a good recovery from severe motor paralysis in the early stage of hospitalization. METHODS From among consecutive ICH patients between October 2012 and December 2021, patients with a sum of upper and lower extremity National Institutes of Health stroke scale (NIHSS) scores of 4-8 at admission (severe motor paralysis) were included. We defined good early recovery from severe motor paralysis as a sum of upper and lower extremity NIHSS scores of 0-3 on day 7 after admission, and that of individual upper and lower extremities as NIHSS scores of 0-1 on day 7 after admission. We aimed to assess whether serum AA levels might be associated with good early recovery from severe motor paralysis. RESULTS We screened 377 consecutive ICH patients, including 140 with severe motor paralysis (88 (63%) males, median age 64 years). Recovery from severe motor paralysis was seen in 48 (34%). Higher AA levels (PR 1.243, 95% CI 1.042 to 1.483, p = 0.016) were independently associated with good overall recovery, and good recovery of upper and lower extremities separately (upper extremity: PR 1.319, 95% CI 1.101 to 1.580, p = 0.003; lower extremity: PR 1.293, 95% CI 1.115 to 1.499, p = 0.001). CONCLUSIONS Higher AA levels may contribute to a good early motor recovery in patients with severe motor paralysis due to ICH.
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Affiliation(s)
- Takeo Sato
- Department of Neurology, The Jikei University School of Medicine, Tokyo, Japan.
| | - Motohiro Okumura
- Department of Neurology, The Jikei University School of Medicine, Tokyo, Japan
| | - Junichiro Takahashi
- Department of Neurology, The Jikei University School of Medicine, Tokyo, Japan
| | - Tatsushi Kokubu
- Department of Neurology, The Jikei University School of Medicine, Tokyo, Japan
| | - Maki Tanabe
- Department of Neurology, The Jikei University School of Medicine, Tokyo, Japan
| | - Asako Onda
- Department of Neurology, The Jikei University School of Medicine, Tokyo, Japan
| | - Teppei Komatsu
- Department of Neurology, The Jikei University School of Medicine, Tokyo, Japan
| | - Kenichi Sakuta
- Department of Neurology, The Jikei University School of Medicine, Tokyo, Japan
| | - Kenichiro Sakai
- Department of Neurology, The Jikei University School of Medicine, Tokyo, Japan
| | - Tadashi Umehara
- Department of Neurology, The Jikei University School of Medicine, Tokyo, Japan
| | - Hidetaka Mitsumura
- Department of Neurology, The Jikei University School of Medicine, Tokyo, Japan
| | - Masato Matsushima
- Division of Clinical Epidemiology, Research Center for Medical Sciences, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo 105-8461, Japan
| | - Yasuyuki Iguchi
- Department of Neurology, The Jikei University School of Medicine, Tokyo, Japan
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Miyoshi T, Naoe S, Wakabayashi H, Yano T, Mori T, Kanda S, Arita M, Ito H. Enhanced Production of EPA-Derived Anti-Inflammatory Metabolites after Oral Administration of a Novel Self-Emulsifying Highly Purified EPA Ethyl Ester Formulation (MND-2119). J Atheroscler Thromb 2023; 30:1927-1949. [PMID: 37532570 DOI: 10.5551/jat.64135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/04/2023] Open
Abstract
AIMS MND-2119 is a novel once-daily dose self-emulsifying formulation of highly purified eicosapentaenoic acid ethyl ester (EPA-E) and is approved as an antihyperlipidemia agent in Japan. It has improved absorption and achieves higher plasma EPA concentrations at Cmax than conventional EPA-E. In the JELIS trial, concomitant use of EPA-E with statin therapy significantly reduced atherosclerotic cardiovascular disease (ASCVD) risks. As a potential mechanism of action of EPA, endogenous formation of EPA-derived anti-inflammatory metabolites is receiving greater attention. This study aims to investigate the endogenous formation of EPA-derived anti-inflammatory metabolites following single and multiple administrations of MND-2119. METHODS Healthy adult male subjects were randomly assigned to a nonintervention (control) group, MND-2119 2-g/day group, MND-2119 4-g/day group, or EPA-E 1.8-g/day group for 7 days (N=8 per group). Plasma fatty acids and EPA-derived metabolites were evaluated. Peripheral blood neutrophils were isolated, and the production of EPA-derived metabolites from in vitro stimulated neutrophils was evaluated. RESULTS After single and multiple administrations of MND-2119 2 g/day, there were significant increases in plasma EPA concentration, 18-hydroxyeicosapentaenoic acid (18-HEPE), and 17,18-epoxyeicosatetraenoic acid compared with those of EPA-E 1.8 g/day. They were further increased with MND-2119 4 g/day administration. In neutrophils, the EPA concentration in the MND-2119 2-g/day group was significantly higher compared with that in the EPA-E 1.8-g/day group after multiple administration, and 18-HEPE production was positively correlated with EPA concentration. No safety issues were noted. CONCLUSIONS These results demonstrate that MND-2119 increases the plasma and cellular concentrations of EPA and EPA-derived metabolites to a greater extent than conventional EPA-E formulations.
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Affiliation(s)
- Toru Miyoshi
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
| | - Satoko Naoe
- Medical Affairs Department, Mochida Pharmaceutical Co., Ltd
| | | | - Takashi Yano
- Medical Affairs Department, Mochida Pharmaceutical Co., Ltd
| | - Takuya Mori
- Clinical Research Department, Mochida Pharmaceutical Co., Ltd
| | - Shingo Kanda
- Clinical Development Planning and Management Department, Mochida Pharmaceutical Co., Ltd
| | - Makoto Arita
- Laboratory for Metabolomics, RIKEN Center for Integrative Medical Sciences
- Graduate School of Medical Life Science, Yokohama City University
- Division of Physiological Chemistry and Metabolism, Graduate School of Pharmaceutical Sciences, Keio University
| | - Hiroshi Ito
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
- Department of General Internal Medicine 3, Kawasaki Medical School
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Ly R, MacIntyre BC, Philips SM, McGlory C, Mutch DM, Britz-McKibbin P. Lipidomic studies reveal two specific circulating phosphatidylcholines as surrogate biomarkers of the omega-3 index. J Lipid Res 2023; 64:100445. [PMID: 37730162 PMCID: PMC10622695 DOI: 10.1016/j.jlr.2023.100445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 09/13/2023] [Accepted: 09/14/2023] [Indexed: 09/22/2023] Open
Abstract
Optimal dietary intake of omega-3 long-chain polyunsaturated fatty acids (n3-LCPUFAs) is critical to human health across the lifespan. However, omega-3 index (O3I) determination is not routinely assessed due to complicated procedures for n3-LCPUFA analysis from the phospholipid (PL) fraction of erythrocytes. Herein, a high-throughput method for lipidomics based on multisegment injection-nonaqueous capillary electrophoresis-mass spectrometry was applied to identify circulating PLs as surrogate biomarkers of O3I in two randomized placebo-controlled trials. An untargeted lipidomic data workflow using a subgroup analysis of serum extracts from sunflower oil versus high-dose fish oil (FO)-supplemented participants revealed that ingested n3-LCPUFAs were primarily distributed as their phosphatidylcholines (PCs) relative to other PL classes. In both high-dose FO (5.0 g/day) and EPA-only trials (3.0 g/day), PC (16:0_20:5) was the most responsive PL, whereas PC (16:0_22:6) was selective to DHA-only supplementation. We also demonstrated that the sum concentration of both these PCs in fasting serum or plasma samples was positively correlated to the O3I following FO (r = 0.708, P = 1.02 × 10-11, n = 69) and EPA- or DHA-only supplementation (r = 0.768, P = 1.01 × 10-33, n = 167). Overall, DHA was more effective in improving the O3I (ΔO3I = 4.90 ± 1.33%) compared to EPA (ΔO3I = 2.99 ± 1.19%) in young Canadian adults who had a poor nutritional status with an O3I (3.50 ± 0.68%) at baseline. Our method enables the rapid assessment of the O3I by directly measuring two circulating PC species in small volumes of blood, which may facilitate screening applications for population and precision health.
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Affiliation(s)
- Ritchie Ly
- Department of Chemistry and Chemical Biology, McMaster University, Hamilton, ON, Canada
| | - Brittany C MacIntyre
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON, Canada
| | - Stuart M Philips
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada
| | - Chris McGlory
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada; School of Kinesiology and Health Studies, Queen's University, Kingston, ON, Canada
| | - David M Mutch
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON, Canada
| | - Philip Britz-McKibbin
- Department of Chemistry and Chemical Biology, McMaster University, Hamilton, ON, Canada.
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Gómez-Vilarrubla A, Mas-Parés B, Carreras-Badosa G, Jové M, Berdún R, Bonmatí-Santané A, de Zegher F, Ibañez L, López-Bermejo A, Bassols J. Placental AA/EPA Ratio Is Associated with Obesity Risk Parameters in the Offspring at 6 Years of Age. Int J Mol Sci 2023; 24:10087. [PMID: 37373236 DOI: 10.3390/ijms241210087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 06/08/2023] [Accepted: 06/10/2023] [Indexed: 06/29/2023] Open
Abstract
During pregnancy, maternal polyunsaturated fatty acids (PUFA) are transferred to the fetus through the placenta by specific FA transporters (FATP). A higher perinatal exposure to n-6 over n-3 PUFA could be linked to excess fat mass and obesity development later in life. In this context, we aimed to assess the associations between long chain PUFAs (LC-PUFAs) (n-6, n-3, and n-6/n-3 ratios) measured in the placenta at term birth with obesity-related parameters in the offspring at 6 years of age and assess whether these associations are dependent on the placental relative expression of fatty acid transporters. As results, the PUFAn-6/PUFAn-3 ratio was 4/1, which scaled up to 15/1 when considering only the arachidonic acid/eicosapentaenoic acid ratio (AA/EPA ratio). Positive associations between the AA/EPA ratio and offspring's obesity risk parameters were found with weight-SDS, BMI-SDS, percent fat mass-SDS, visceral fat, and HOMA-IR (r from 0.204 to 0.375; all p < 0.05). These associations were more noticeable in those subjects with higher expression of fatty acid transporters. Therefore, in conclusion, a higher placental AA/EPA ratio is positively associated with offspring's visceral adiposity and obesity risk parameters, which become more apparent in subjects with higher expressions of placental FATPs. Our results support the potential role of n-6 and n-3 LC-PUFA in the fetal programming of obesity risk in childhood. For the present study, 113 healthy pregnant women were recruited during the first trimester of pregnancy and their offspring were followed up at 6 years of age. The fatty acid profiles and the expression of fatty acid transporters (FATP1 and FATP4) were analyzed from placental samples at birth. Associations between LC-PUFA (n-6, n-3, and n-6/n-3 ratios) and obesity risk parameters (weight, body mass index (BMI), percent fat mass, visceral fat, and homeostatic model assessment of insulin resistance (HOMA-IR)) in the offspring at 6 years of age were examined.
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Affiliation(s)
- Ariadna Gómez-Vilarrubla
- Maternal-Fetal Metabolic Research Group, Girona Institute for Biomedical Research (IDIBGI), 17190 Salt, Spain
| | - Berta Mas-Parés
- Pediatric Endocrinology Research Group, Girona Institute for Biomedical Research (IDIBGI), 17190 Salt, Spain
| | - Gemma Carreras-Badosa
- Pediatric Endocrinology Research Group, Girona Institute for Biomedical Research (IDIBGI), 17190 Salt, Spain
| | - Mariona Jové
- Department of Experimental Medicine, University of Lleida-Biomedical Research Institute of Lleida (UdL-IRBLleida), 25008 Lleida, Spain
| | - Rebeca Berdún
- Department of Experimental Medicine, University of Lleida-Biomedical Research Institute of Lleida (UdL-IRBLleida), 25008 Lleida, Spain
| | | | - Francis de Zegher
- Department of Development & Regeneration, University of Leuven, 3000 Leuven, Belgium
| | - Lourdes Ibañez
- Endocrinology, Pediatric Research Institute, Sant Joan de Déu Children's Hospital, 08950 Esplugues de Llobregat, Spain
- CIBERDEM (Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders), ISCIII, 28029 Madrid, Spain
| | - Abel López-Bermejo
- Pediatric Endocrinology Research Group, Girona Institute for Biomedical Research (IDIBGI), 17190 Salt, Spain
- Department of Pediatrics, Dr. Josep Trueta Hospital, 17007 Girona, Spain
- Department of Medical Sciences, University of Girona, 17003 Girona, Spain
| | - Judit Bassols
- Maternal-Fetal Metabolic Research Group, Girona Institute for Biomedical Research (IDIBGI), 17190 Salt, Spain
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Serum Fatty Acids Are Associated with a Higher Risk of Ischemic Stroke. Nutrients 2023; 15:nu15030585. [PMID: 36771293 PMCID: PMC9921638 DOI: 10.3390/nu15030585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 01/17/2023] [Accepted: 01/18/2023] [Indexed: 01/25/2023] Open
Abstract
Stroke prevention, a significant public-health concern, begins with recognizing and addressing risk factors. Interventions targeted at modifiable risk factors can effectively prevent ischemic stroke, while Omega-3 fatty acids have been shown to improve stroke outcomes. Our study aimed to investigate the relationship between ischemic-stroke risk factors and fatty acids using a prospective observational study with 274 patients. We collected clinical data on risk factors and measured fatty-acid levels using high-performance liquid chromatography coupled with mass spectrometry. We found that several risk factors, including age, sex, smoking, atrial fibrillation, dyslipidemia, and previous stroke history, had a direct relationship with fatty acids. Of these, smoking had the most significant impact, negatively impacting levels of docosahexaenoic and eicosapentaenoic acid. Conversely, dyslipidemia and atrial fibrillation positively correlated with fatty acids, particularly in female patients and those with recurrent strokes. Age was found to directly correlate with other risk factors and variations in fatty-acid ratios. The stroke rate was higher in males than females before the age of 70, but this trend reversed. Our findings suggest that better management of risk factors, particularly modifiable lifestyle factors, could improve fatty-acid profiles and the balance of Omega-3 and Omega-6 in patients with ischemic stroke.
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Liu X, Sun L, Wen W, Qiu M, Luo J, Li W, Hao S, He M, Wu J, Hu Y, Huang Y. Association between the ratio of serum eicosapentaenoic acid to arachidonic acid and risk of coronary artery disease in young Chinese patients. Front Nutr 2022; 9:1019058. [PMID: 36407537 PMCID: PMC9668899 DOI: 10.3389/fnut.2022.1019058] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 10/14/2022] [Indexed: 11/06/2022] Open
Abstract
Objective Long-chain (LC) omega-3 PUFAs, including eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), may play an anti-inflammatory effect and decrease the risk of coronary artery disease (CAD). In contrast, omega-6 PUFA, mainly arachidonic acid (AA), has pro-inflammatory and pro-aggregatory effects, which may increase the risk of CAD. This study evaluated the associations between EPA, DHA, AA, and their ratios (EPA/AA and DHA/AA) with the risk of CAD in young Chinese patients. Methods A total of 182 young patients with CAD and 143 age-matched controls were included. Traditional cardiovascular risk factors were recorded. Serum EPA, DHA and AA were measured by ultra-performance liquid chromatography-mass spectrometry. Results The level of AA was significantly higher, while the level of EPA was lower in the CAD group than that in the control group. There was no significant difference in DHA level in the two groups. Both the ratios of EPA/AA and DHA/AA were lower in the CAD group than that in the control. Multivariate logistic regression analysis showed that higher serum AA level was associated with the increased risk of CAD, while EPA was a protective factor for CAD. There was no significant association between DHA level and the risk of CAD. Although both higher ratios of EPA/AA [per tertile increment, adjusted odds ratios (ORs) (OR) 0.356, 95% confidence intervals (CI) 0.247–0.513] and DHA/AA (adjusted OR = 0.465, 95%CI = 0.332–0.653) were associated with a lower risk of CAD in young patients. Receiver operating characteristic (ROC) curve analysis showed that compared with AA, the diagnostic value was increased in EPA/AA, but not in DHA/AA. Conclusion EPA, but not DHA may play a protective role in CAD, while AA may be associated with the increased risk of CAD in young Chinese patients. The ratio of EPA/AA can increase the predictive value for diagnosing CAD than EPA or AA alone.
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Affiliation(s)
- Xiong Liu
- Department of Cardiology, Shunde Hospital, Southern Medical University, Foshan, China
| | - Lichang Sun
- Department of Cardiology, Shunde Hospital, Southern Medical University, Foshan, China
| | - Weixing Wen
- Department of Cardiology, Shunde Hospital, Southern Medical University, Foshan, China
| | - Min Qiu
- Department of Cardiology, Shunde Hospital, Southern Medical University, Foshan, China
| | - Jianjing Luo
- Department of Cardiology, Shunde Hospital, Southern Medical University, Foshan, China
- Department of Internal Medicine, Zhaoqing Medical College, Zhaoqing, China
| | - Weiwen Li
- Department of Cardiology, Shunde Hospital, Southern Medical University, Foshan, China
| | - Shali Hao
- Department of Cardiology, Shunde Hospital, Southern Medical University, Foshan, China
| | - Mingli He
- Department of Cardiology, Shunde Hospital, Southern Medical University, Foshan, China
| | - Jiandi Wu
- Department of Cardiology, Affiliated Foshan Hospital, Southern Medical University, Foshan, China
| | - Yunzhao Hu
- Department of Cardiology, Shunde Hospital, Southern Medical University, Foshan, China
- Yunzhao Hu,
| | - Yuli Huang
- Department of Cardiology, Shunde Hospital, Southern Medical University, Foshan, China
- Guangdong Provincial Key Laboratory of Cardiac Function and Microcirculation Research, Guangzhou, China
- *Correspondence: Yuli Huang,
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Andone S, Farczádi L, Imre S, Bălașa R. Fatty Acids and Lipid Paradox-Neuroprotective Biomarkers in Ischemic Stroke. Int J Mol Sci 2022; 23:ijms231810810. [PMID: 36142720 PMCID: PMC9505290 DOI: 10.3390/ijms231810810] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 09/10/2022] [Accepted: 09/14/2022] [Indexed: 11/22/2022] Open
Abstract
Stroke is the primary cause of death and disability worldwide, with ischemic stroke up to 80% of the total cases. Lipid profile was established as a major risk factor for stroke, but recent studies show a paradoxical relationship between serum values and the outcome of stroke patients. Our study aims to analyze the impact of the classic extended lipid profile, including fatty acids as potential neuroprotective biomarkers for the outcome of ischemic stroke patients. We included 298 patients and collected clinical, paraclinical, and outcome parameters. We used a method consisting of high-performance liquid chromatography coupled with mass spectrometry to quantify serum fatty acids. We observed a negative correlation between National Institutes of Health Stroke Scale (NIHSS) at admission and total cholesterol (p = 0.040; r = −0.120), respectively triglycerides (p = 0.041; r = −0.122). The eicosapentaenoic to arachidonic acid ratio has a negative correlation, while the docosahexaenoic to eicosapentaenoic acid ratio positively correlates with all the prognostic parameters, showing a potential neuroprotective role for eicosapentaenoic acid in preventing severe ischemic stroke. The impact of the lipid profile paradox and the dependency relationship with the fatty acids represent a significant predictive factor for the functional and disability prognostic of ischemic stroke patients.
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Affiliation(s)
- Sebastian Andone
- Ist Neurology Clinic, Emergency Clinical County Hospital Targu Mures, 540136 Targu Mures, Romania
- Department of Neurology, ‘George Emil Palade’ University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540136 Târgu Mures, Romania
- Doctoral School, ‘George Emil Palade’ University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540142 Targu Mures, Romania
- Correspondence:
| | - Lénárd Farczádi
- Center for Advanced Medical and Pharmaceutical Research, ‘George Emil Palade’ University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540136 Targu Mures, Romania
| | - Silvia Imre
- Center for Advanced Medical and Pharmaceutical Research, ‘George Emil Palade’ University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540136 Targu Mures, Romania
- Department of Analytical Chemistry and Drug Analysis, Faculty of Pharmacy, ‘George Emil Palade’ University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540136 Targu Mures, Romania
| | - Rodica Bălașa
- Ist Neurology Clinic, Emergency Clinical County Hospital Targu Mures, 540136 Targu Mures, Romania
- Department of Neurology, ‘George Emil Palade’ University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540136 Târgu Mures, Romania
- Doctoral School, ‘George Emil Palade’ University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540142 Targu Mures, Romania
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10
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Honda T, Chen S, Hata J, Shibata M, Furuta Y, Oishi E, Sakata S, Kitazono T, Ninomiya T. Changes in the Eicosapentaenoic Acid to Arachidonic Acid Ratio in Serum over 10 Years in a Japanese Community: The Hisayama Study. J Atheroscler Thromb 2022. [PMID: 36089395 DOI: 10.5551/jat.63727] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
AIM Circulating omega-3 and omega-6 polyunsaturated fatty acids may to contribute to cardiovascular health at the population level. Over a decade, we investigated changes in the serum eicosapentaenoic acid (EPA) to arachidonic acid (AA) ratio, and in serum concentrations of the individual fatty acids, in a Japanese community. METHODS Community surveys took place in 2002-2003 and 2012-2013 in a rural area of Japan. The community surveys included 3,194 and 3,220 community dwellers aged ≥ 40 years who did not take EPA medication in 2002-2003 and 2012-2013, respectively. Fatty acid fractionations in serum were measured using a gas chromatography method. Changes in the serum EPA/AA ratio over time were examined using linear mixed models. RESULTS Overall, the average serum EPA/AA ratio decreased over the 10 years. A decreasing trend in the serum EPA/AA ratio occurred in all age groups except participants aged ≥ 80 years, with larger decreases in the younger age groups. A similar decline in serum EPA/AA ratio occurred in participants with and those without lipid-lowering therapy. Serum EPA concentrations were slightly increased in the whole population but remained stable or even decreased in participants aged 40-69. In contrast, the average serum AA concentrations increased in all age groups. CONCLUSION In a Japanese community, the serum EPA/AA ratio decreased over 10 years at the population level, especially in middle-aged participants.
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Affiliation(s)
- Takanori Honda
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University
| | - Sanmei Chen
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University.,Department of Global Health Nursing, Graduate School of Biomedical and Health Sciences, Hiroshima University
| | - Jun Hata
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University.,Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University.,Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University
| | - Mao Shibata
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University.,Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University
| | - Yoshihiko Furuta
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University.,Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University.,Division of Medical Engineering and Healthy Longevity, Graduate School of Medical Sciences, Kyushu University
| | - Emi Oishi
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University.,Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University
| | - Satoko Sakata
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University.,Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University.,Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University
| | - Takanari Kitazono
- Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University.,Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University
| | - Toshiharu Ninomiya
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University.,Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University
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11
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Prediction of Ischemic Stroke Recurrence Based on COX Proportional Risk Regression Model and Evaluation of the Effectiveness of Patient Intensive Care Interventions. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:8392854. [PMID: 35770116 PMCID: PMC9236791 DOI: 10.1155/2022/8392854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 06/01/2022] [Accepted: 06/04/2022] [Indexed: 11/17/2022]
Abstract
With the continuous improvement of medical technology and the aging of the population, the death rate of stroke is gradually decreasing, but the recurrence rate is still high, and the number of recurrences is increasing, resulting in disability and other symptoms, which brings great burden and distress to patients and their families. As the number of strokes increases, neurological impairment becomes more and more severe, affecting patients' ability to live, socialize, and work, and seriously reducing their quality of life. Clustered care is a combination of evidence-based linked interventions and a multidisciplinary team providing the best possible care through evidence-based research and highly operational practice, and it can improve outcomes for ischemic stroke patients more than implementation alone. This paper presents a Cox proportional risk regression-based model, using it to build the most used semi-parametric model for multifactorial survival analysis, due to its advantages of both parametric and nonparametric models, and to analyze the factors influencing survival time in study subjects with incomplete data. The proposed strategy has been found to be useful in predicting ischemic stroke recurrence and cluster care interventions for patients.
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12
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Sato T, Sakai K, Okumura M, Kitagawa T, Takatsu H, Tanabe M, Komatsu T, Sakuta K, Umehara T, Murakami H, Mitsumura H, Matsushima M, Iguchi Y. Low dihomo-γ-linolenic acid is associated with susceptibility vessel sign in cardioembolism. Thromb Res 2022; 213:84-90. [DOI: 10.1016/j.thromres.2022.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 03/02/2022] [Accepted: 03/11/2022] [Indexed: 10/18/2022]
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13
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Takahashi J, Sakai K, Sato T, Takatsu H, Komatsu T, Mitsumura H, Murakami H, Iguchi Y. Serum arachidonic acid levels is a predictor of poor functional outcome in acute intracerebral hemorrhage. Clin Biochem 2021; 98:42-47. [PMID: 34624254 DOI: 10.1016/j.clinbiochem.2021.09.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 08/10/2021] [Accepted: 09/30/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND AND AIMS Correlations between serum levels of polyunsaturated fatty acids (PUFAs) such as eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), arachidonic acid (AA) and dihomogammalinolenic acid (DHLA) and outcomes following cardiovascular disease have been reported. This study aimed to investigate the relationship between serum levels of PUFAs (including AA) and functional outcomes among intracerebral hemorrhage (ICH) patients. METHODS From November 2012 to July 2020, ICH patients within 24 h from onset were enrolled. Patients were divided into a good functional outcome group (modified Rankin Scale [mRS] score at 3 months, 0-3) and a poor functional outcome group (mRS score at 3 months, 4-6). We compared baseline variables between groups. RESULTS Participants comprised 133 patients (mean age, 60 years), with 106 patients (80%) in the good functional outcome group and 27 patients (20%) in the poor functional outcome group. Higher National Institutes of Health Stroke Scale (NIHSS) score and larger hematoma on admission were more frequent in the poor functional outcome group (median NIHSS score 6 vs. 14, p < 0.001; median hematoma volume, 7.5 ml vs. 13.5 ml, p = 0.07). In terms of serum PUFA levels, only median serum AA level was significantly lower in the poor functional outcome group (212 µg/ml vs. 179 µg/ml, p = 0.002). Multivariate logistic regression analysis showed lower serum AA level was independently associated with poor functional outcome (odds ratio 0.986, 95% confidence interval 0.976-0.996, p = 0.009). CONCLUSION Lower serum AA level was associated with poor functional outcome in ICH patients. AA may represent an important biomarker of severity among ICH patients.
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Affiliation(s)
| | - Kenichiro Sakai
- Department of Neurology, The Jikei University School of Medicine, Japan
| | - Takeo Sato
- Department of Neurology, The Jikei University School of Medicine, Japan
| | - Hiroki Takatsu
- Department of Neurology, The Jikei University School of Medicine, Japan
| | - Teppei Komatsu
- Department of Neurology, The Jikei University School of Medicine, Japan
| | | | - Hidetomo Murakami
- Department of Neurology, The Jikei University School of Medicine, Japan
| | - Yasuyuki Iguchi
- Department of Neurology, The Jikei University School of Medicine, Japan
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14
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Changes in Erythrocyte Omega-3 Fatty Acids in German Employees upon Dietary Advice by Corporate Health. Nutrients 2020; 12:nu12113267. [PMID: 33113826 PMCID: PMC7693012 DOI: 10.3390/nu12113267] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 10/19/2020] [Accepted: 10/23/2020] [Indexed: 02/06/2023] Open
Abstract
Background: The erythrocyte ratio of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) over total fatty acids, the omega-3 index (O3I), has been suggested as an overall health marker and to motivate corporate health recommendations. We set out to assess the O3I status in a working population, the differences between normal and rotating shift employees, the consumption of omega-3 rich food and whether recommendations to increase intake of omega-3 rich foods can improve the O3I. Methods: Employees registered for their occupational health check-up were offered to participate in a pre-post study at the Ludwigshafen (Germany) site including an assessment of their O3I at baseline and after 4 months (follow-up) and two subsequent food frequency questionnaires. For those with O3I below 8%, a recommendation was provided to increase the intake of omega-3 fatty acid rich food and to take advantage of the employees’ catering service with its enhanced fatty seafood offer during the study period. Dietary intake of EPA and DHA, erythrocyte fatty acid profiles, clinical and lifestyle parameters were assessed. Results: In 500 employees (26.6% female, 21–64 years, median age: 47 years [IQR: 37–53]), at baseline the overall mean O3I was 4.1 ± 1.1% (99.6% of O3I assessed were below 8%), higher in women, in participants with “normal” body weight, upper employment grade, and non-smokers, but not different between regular and rotating shift workers. The three fifths of the cohort also participating in the follow-up increased their EPA and DHA intake by 0.1 g/d and their O3I by 0.5 percentage points. Conclusion: This study provides essential data on omega-3 erythrocyte concentrations in a clinically healthy German working population and the challenges of increasing the O3I with dietary recommendations even in study participants motivated to follow up on their omega-3 status.
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