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Article(id=1241023856463368865, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241023847537897695, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202408267, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1724083200000, receivedDateStr=2024-08-20, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773812744489, onlineDateStr=2026-03-18, pubDate=1737734400000, pubDateStr=2025-01-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773812744489, onlineIssueDateStr=2026-03-18, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773812744489, creator=13701087609, updateTime=1773812744489, updator=13701087609, issue=Issue{id=1241023847537897695, tenantId=1146029695717560320, journalId=1227665162245664772, year='2025', volume='52', issue='2', pageStart='193', pageEnd='384', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773812742361, creator=13701087609, updateTime=1773812823817, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1241024189247845056, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241023847537897695, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1241024189247845057, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241023847537897695, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=246, endPage=252, ext={EN=ArticleExt(id=1241023856815690425, articleId=1241023856463368865, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Circulating monounsaturated fatty acids and cardiovascular-specific death in cardiovascular patients, columnId=1228016572783063333, journalTitle=Modern Preventive Medicine, columnName=Nutrition and Food Hygiene, runingTitle=null, highlight=null, articleAbstract=
Objective

To evaluate the associations between circulating monounsaturated fatty acids(cMUFAs) and cardiovascular-specific death using epidemiological methods.

Methods

This study included 36 254 patients with cardiovascular disease from the UK Biobank. Cox proportional hazards models were employed to examine the associations between cMUFAs and various fatalities, including cardiovascular death, ischaemic heart disease death, stroke death, cancer death, and all-cause death. Moreover, the study examined the dose-response relationship between cMUFAs and outcomes using quartiles, deciles, and restricted cubic splines. A subgroup analysis was conducted to validate the effects of cMUFAs on cardiovascular-specific deaths across different subgroups.

Results

A positive correlation was observed between cMUFAs and all-cause death (HR=1.556, 95% CI: 1.419-1.705), as well as CVD (HR=1.504, 95% CI: 1.261-1.794), IHD (HR=1.572, 95% CI: 1.265-1.953), and cancer death (HR=1.291, 95% CI: 1.109-1.502). However, no significant association was found between cMUFAs and stroke death (P=0.582). The study revealed the existence of non-linear relationships between cMUFAs and cardiovascular-specific death. Subgroup analyses indicated that the association with all-cause death was more pronounced in females and current smokers. Furthermore, individuals aged over 50 years demonstrated a more pronounced correlation with IHD death.

Conclusion

In patients with cardiovascular disease, elevated levels of cMUFAs are associated with an increased risk of CVD death, IHD death, cancer death, and all-cause death. This association demonstrates a non-linear correlation trend.

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目的

采用流行病学方法评估循环单不饱和脂肪酸（circulating monounsaturated fatty acids, cMUFAs）与心血管特异性死亡之间的关系。

方法

研究纳入36 254名来自UK Biobank的心血管疾病患者，采用Cox比例风险模型探究cMUFAs与心血管疾病死亡、缺血性心脏病死亡、卒中死亡、癌症死亡和全因死亡之间的关系。使用四分位数、十分位数和限制性三次样条探索剂量-反应关系，并进行亚组分析和敏感性分析。

结果

cMUFAs与心血管疾病死亡（HR=1.504, 95% CI: 1.261~1.794），缺血性心脏病死亡（HR=1.572, 95% CI: 1.265~1.953），癌症死亡（HR=1.291, 95% CI: 1.109~1.502），全因死亡（HR=1.556, 95% CI: 1.419~1.705）呈正相关，但与卒中死亡无显著关联（P=0.582）。限制性三次样条显示cMUFAs与心血管特异性死亡存在非线性关系（P<0.001）。亚组分析表明在女性和当前吸烟者中，cMUFAs与全因死亡的关联更为明显；在50岁以上的个体中，cMUFAs与缺血性心脏病死亡的关联更为明显。

结论

在心血管疾病患者中，cMUFAs水平升高与心血管疾病死亡、缺血性心脏病死亡、癌症死亡和全因死亡的风险增加相关，并且这种关联表现出非线性趋势。

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梁会营，E-mail：
, copyrightStatement=本刊刊出的所有文章不代表中华预防医学会和本刊编委会的观点，除非特别声明。, copyrightOwner=中华预防医学会和四川大学华西公共卫生学院, extLink=null, articleAbsUrl=null, sourceXml=FY1BtpptxNxb+OJ8vc/wwA==, magXml=w6CQRsoXzfZGVKLrbAX9CQ==, pdfUrl=null, pdf=bg/+JZCk0omp9EviopKQMw==, pdfFileSize=1124831, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=RKB7Z8nkwU04QWDsNQCpwA==, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=dwK1r2FNjimso297yw+rpw==, mapNumber=null, authorCompany=null, fund=null, authors=

陈紫英（1999—），女，硕士在读，研究方向：公共卫生

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陈紫英（1999—），女，硕士在读，研究方向：公共卫生

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陈紫英（1999—），女，硕士在读，研究方向：公共卫生

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Cellular Physiology and Biochemistry, 2014, 34(4): 1101-1108., articleTitle=The relationship between specific Fatty acids of serum lipids and serum high sensitivity C-reactive protein levels in morbidly obese women, refAbstract=null), Reference(id=1241023875077689839, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023856463368865, doi=null, pmid=null, pmcid=null, year=1996, volume=90, issue=4, pageStart=243, pageEnd=253, url=null, language=null, rfNumber=[29], rfOrder=29, authorNames=Frayn KN, Williams CM, Arner P, journalName=Clinical Science, refType=null, unstructuredReference=Frayn KN, Williams CM, Arner P. Are increased plasma non-esterified fatty acid concentrations a risk marker for coronary heart disease and other chronic diseases?[J]. Clinical Science, 1996, 90(4): 243-253., articleTitle=Are increased plasma non-esterified fatty acid concentrations a risk marker for coronary heart disease and other chronic diseases?, refAbstract=null)], funds=[Fund(id=1241023870652699023, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023856463368865, awardId=82204396, language=CN, fundingSource=国家自然科学基金—青年科学基金项目(82204396), fundOrder=null, country=null), Fund(id=1241023872112316820, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023856463368865, awardId=2023YFC3604600, language=CN, fundingSource=老年人整合型慢病管理医防融合技术与应用(2023YFC3604600), fundOrder=null, country=null), Fund(id=1241023872208785815, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023856463368865, awardId=A2023006, language=CN, fundingSource=广东省医学科学技术研究基金项目(A2023006), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1241023861504922599, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023856463368865, xref=1．, ext=[AuthorCompanyExt(id=1241023861555254251, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023856463368865, companyId=1241023861504922599, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=School of Public Health, Southern Medical University, Guangzhou, Guangdong 510515, China), AuthorCompanyExt(id=1241023861572031470, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023856463368865, companyId=1241023861504922599, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1．南方医科大学公共卫生学院，广东　广州　510515)]), AuthorCompany(id=1241023863115535357, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023856463368865, xref=2．, ext=[AuthorCompanyExt(id=1241023863119729662, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023856463368865, companyId=1241023863115535357, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2．中国医科大学公共卫生学院)]), AuthorCompany(id=1241023863245557769, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023856463368865, xref=3．, ext=[AuthorCompanyExt(id=1241023863249752074, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023856463368865, companyId=1241023863245557769, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=3．南方医科大学附属广东省人民医院（广东省医学科学院）大数据中心)])], figs=[ArticleFig(id=1241023868769456434, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023856463368865, language=EN, label=Fig.1, caption=Study design overview, figureFileSmall=gathfKIQO2mOSLvG5SBUmA==, figureFileBig=RKB7Z8nkwU04QWDsNQCpwA==, tableContent=null), ArticleFig(id=1241023868849148215, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023856463368865, language=CN, label=图1, caption=研究设计概述, figureFileSmall=gathfKIQO2mOSLvG5SBUmA==, figureFileBig=RKB7Z8nkwU04QWDsNQCpwA==, tableContent=null), ArticleFig(id=1241023869163721026, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023856463368865, language=EN, label=Fig.2, caption=Forest plot about associations between the deciles levels of circulating MUFAs and cardiovascular-specific deaths in cardiovascular patients, figureFileSmall=teFSPceo994ugiUPOu4RTw==, figureFileBig=PYbqrVkBb5sfCBpzyuaK8w==, tableContent=null), ArticleFig(id=1241023869310521671, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023856463368865, language=CN, label=图2, caption=心血管患者中cMUFAs十分位数水平与心血管特异性死亡的竖状森林图, figureFileSmall=teFSPceo994ugiUPOu4RTw==, figureFileBig=PYbqrVkBb5sfCBpzyuaK8w==, tableContent=null), ArticleFig(id=1241023869415379278, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023856463368865, language=EN, label=Fig.3, caption=Associations between cMUFAs and cardiovascular-specific deathsusing restricted cubic splines, figureFileSmall=gtylh2bS4SGSI16ghHSt2w==, figureFileBig=WjuJ3OW0PpZbQ9gPof82uA==, tableContent=null), ArticleFig(id=1241023869495071059, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023856463368865, language=CN, label=图3, caption=心血管患者中cMUFAs与心血管特异性死亡的限制性三次样条图, figureFileSmall=gtylh2bS4SGSI16ghHSt2w==, figureFileBig=WjuJ3OW0PpZbQ9gPof82uA==, tableContent=null), ArticleFig(id=1241023869574762841, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023856463368865, language=EN, label=Table 1, caption=

Baseline characteristics of the UK Biobank participants according to the quartile of cMUFAs

, figureFileSmall=null, figureFileBig=null, tableContent=
项目全人群Q1Q2Q3Q4P值
n36 2549 0639 0649 0639 064
年龄(岁)（）59.23±7.1859.16±7.5859.54±7.0559.56±6.9658.66±7.07<0.001
性别=男 [n(%)]19 364(53.4)5 244(57.9)4 625(51.0)4 572(50.4)4 923(54.3)<0.001
收缩压（mm Hg）（）144.85±18.56141.87±18.74144.71±18.44146.24±18.33146.56±18.35<0.001
BMI（kg/m2）（）29.12±5.1427.88±4.9728.60±5.0929.49±5.1030.48±5.03<0.001
胆固醇(mmol/L)（）5.40±1.194.67±0.955.28±1.025.60±1.086.03±1.23<0.001
甘油三酯(mmol/L)（）1.89±1.071.08±0.411.46±0.511.96±0.663.07±1.21<0.001
高密度脂蛋白(mmol/L)（）1.38±0.371.42±0.381.44±0.391.37±0.371.28±0.33<0.001
低密度脂蛋白(mmol/L)（）3.35±0.892.81±0.703.26±0.773.52±0.833.79±0.93<0.001
循环单不饱和脂肪酸(mmol/L)（）2.88±0.861.97±0.242.51±0.133.02±0.174.04±0.70<0.001
循环多不饱和脂肪酸(mmol/L)（）4.87±0.824.15±0.544.70±0.555.05±0.625.57±0.79<0.001
吸烟状态[n(%)]<0.001
目前3 642(10.0)781( 8.6)782( 8.6)861( 9.5)1 218(13.4)
从未18 303(50.5)4 844(53.5)4 752(52.4)4537(50.1)4 170(46.0)
先前14 309(39.5)3 437(37.9)3 530(38.9)3 666(40.4)3 676(40.6)
饮酒状态 [n(%)]<0.001
目前32 836(90.6)8 083(89.2)8 209(90.6)8281(91.4)8 263(91.2)
从未1 825( 5.0)514( 5.7)484( 5.3)423( 4.7)404( 4.5)
先前1 593( 4.4)465( 5.1)371( 4.1)360( 4.0)397( 4.4)
糖尿病状况=是 [n(%)]4 135(11.4)1 154(12.7)918(10.1)964(10.6)1 099(12.1)<0.001
种族=白人 [n(%)]34 128(94.1)8 180(90.3)8 520(94.0)8 705(96.0)8 723(96.2)<0.001
学历=大学 [n(%)]26 524(73.2)2 717(30.0)2 511(27.7)2 360(26.0)2 142(23.6)<0.001
IPAQ[n(%)]<0.001
高13 804(38.1)3 720(41.1)3 531(39.0)3 313(36.6)3 240(35.7)
适中14 708(40.6)3 629(40.0)3 736(41.2)3 711(40.9)3 632(40.1)
低7 742(21.4)1 713(18.9)1 797(19.8)2 040(22.5)2 192(24.2)
家庭人年均收入(￥) [n(%)]<0.001
<18 00011 261(31.1)2 721(30.0)2 726(30.1)2 855(31.5)2 959(32.6)
18 000~30 99910 144(28.0)2 472(27.3)2 568(28.3)2 588(28.6)2 516(27.8)
31 000~51 9998 276(22.8)2 055(22.7)2 114(23.3)2 062(22.7)2 045(22.6)
52 000~100 0005 354(14.8)1 450(16.0)1 320(14.6)1 297(14.3)1 287(14.2)
>100 0001 219( 3.4)364( 4.0)364( 4.0)364( 4.0)257( 2.8)
水果摄入(份/天) [n(%)]<0.001
≤112 631(34.8)2 821(31.1)3 006(33.2)3 235(35.7)3 569(39.4)
2~317 425(48.1)4 461(49.2)4 485(49.5)4 393(48.5)4 086(45.1)
≥46 198(17.1)1 780(19.6)1 573(17.4)1 436(15.8)1 409(15.5)
熟蔬菜摄入(勺/天) [n(%)]<0.001
≤16 342(17.5)1 571(17.3)1 561(17.2)1 563(17.2)1 647(18.2)
2~321 592(59.6)5 271(58.2)5 402(59.6)5 519(60.9)5 400(59.6)
≥48 320(22.9)2 220(24.5)2 101(23.2)1 982(21.9)2 017(22.3)
维生素补充=是[n(%)]11 131(30.7)2 755(30.4)2 810(31.0)2 811(31.0)2 755(30.4)0.664
矿物质和其他膳食补充=是[n(%)]16 070(44.3)4 106(45.3)4 083(45.0)4 068(44.9)3 813(42.1)<0.001
抗高血压药物=是[n(%)]21 649(59.7)5 412(59.7)5 386(59.4)5 451(60.1)5 400(59.6)0.783
胰岛素治疗=是[n(%)]863( 2.4)317( 3.5)163( 1.8)183( 2.0)200( 2.2)<0.001
阿司匹林使用=是[n(%)]11 246(31.0)3 529(38.9)2 709(29.9)2 552(28.2)2 456(27.1)<0.001
降胆固醇药物使用=是[n(%)]14 703(40.6)4 529(50.0)3 585(39.6)3 269(36.1)3 320(36.6)<0.001
), ArticleFig(id=1241023869671231838, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023856463368865, language=CN, label=表1, caption=

根据cMUFAs四分位数划分的基线特征表

, figureFileSmall=null, figureFileBig=null, tableContent=
项目全人群Q1Q2Q3Q4P值
n36 2549 0639 0649 0639 064
年龄(岁)（）59.23±7.1859.16±7.5859.54±7.0559.56±6.9658.66±7.07<0.001
性别=男 [n(%)]19 364(53.4)5 244(57.9)4 625(51.0)4 572(50.4)4 923(54.3)<0.001
收缩压（mm Hg）（）144.85±18.56141.87±18.74144.71±18.44146.24±18.33146.56±18.35<0.001
BMI（kg/m2）（）29.12±5.1427.88±4.9728.60±5.0929.49±5.1030.48±5.03<0.001
胆固醇(mmol/L)（）5.40±1.194.67±0.955.28±1.025.60±1.086.03±1.23<0.001
甘油三酯(mmol/L)（）1.89±1.071.08±0.411.46±0.511.96±0.663.07±1.21<0.001
高密度脂蛋白(mmol/L)（）1.38±0.371.42±0.381.44±0.391.37±0.371.28±0.33<0.001
低密度脂蛋白(mmol/L)（）3.35±0.892.81±0.703.26±0.773.52±0.833.79±0.93<0.001
循环单不饱和脂肪酸(mmol/L)（）2.88±0.861.97±0.242.51±0.133.02±0.174.04±0.70<0.001
循环多不饱和脂肪酸(mmol/L)（）4.87±0.824.15±0.544.70±0.555.05±0.625.57±0.79<0.001
吸烟状态[n(%)]<0.001
目前3 642(10.0)781( 8.6)782( 8.6)861( 9.5)1 218(13.4)
从未18 303(50.5)4 844(53.5)4 752(52.4)4537(50.1)4 170(46.0)
先前14 309(39.5)3 437(37.9)3 530(38.9)3 666(40.4)3 676(40.6)
饮酒状态 [n(%)]<0.001
目前32 836(90.6)8 083(89.2)8 209(90.6)8281(91.4)8 263(91.2)
从未1 825( 5.0)514( 5.7)484( 5.3)423( 4.7)404( 4.5)
先前1 593( 4.4)465( 5.1)371( 4.1)360( 4.0)397( 4.4)
糖尿病状况=是 [n(%)]4 135(11.4)1 154(12.7)918(10.1)964(10.6)1 099(12.1)<0.001
种族=白人 [n(%)]34 128(94.1)8 180(90.3)8 520(94.0)8 705(96.0)8 723(96.2)<0.001
学历=大学 [n(%)]26 524(73.2)2 717(30.0)2 511(27.7)2 360(26.0)2 142(23.6)<0.001
IPAQ[n(%)]<0.001
高13 804(38.1)3 720(41.1)3 531(39.0)3 313(36.6)3 240(35.7)
适中14 708(40.6)3 629(40.0)3 736(41.2)3 711(40.9)3 632(40.1)
低7 742(21.4)1 713(18.9)1 797(19.8)2 040(22.5)2 192(24.2)
家庭人年均收入(￥) [n(%)]<0.001
<18 00011 261(31.1)2 721(30.0)2 726(30.1)2 855(31.5)2 959(32.6)
18 000~30 99910 144(28.0)2 472(27.3)2 568(28.3)2 588(28.6)2 516(27.8)
31 000~51 9998 276(22.8)2 055(22.7)2 114(23.3)2 062(22.7)2 045(22.6)
52 000~100 0005 354(14.8)1 450(16.0)1 320(14.6)1 297(14.3)1 287(14.2)
>100 0001 219( 3.4)364( 4.0)364( 4.0)364( 4.0)257( 2.8)
水果摄入(份/天) [n(%)]<0.001
≤112 631(34.8)2 821(31.1)3 006(33.2)3 235(35.7)3 569(39.4)
2~317 425(48.1)4 461(49.2)4 485(49.5)4 393(48.5)4 086(45.1)
≥46 198(17.1)1 780(19.6)1 573(17.4)1 436(15.8)1 409(15.5)
熟蔬菜摄入(勺/天) [n(%)]<0.001
≤16 342(17.5)1 571(17.3)1 561(17.2)1 563(17.2)1 647(18.2)
2~321 592(59.6)5 271(58.2)5 402(59.6)5 519(60.9)5 400(59.6)
≥48 320(22.9)2 220(24.5)2 101(23.2)1 982(21.9)2 017(22.3)
维生素补充=是[n(%)]11 131(30.7)2 755(30.4)2 810(31.0)2 811(31.0)2 755(30.4)0.664
矿物质和其他膳食补充=是[n(%)]16 070(44.3)4 106(45.3)4 083(45.0)4 068(44.9)3 813(42.1)<0.001
抗高血压药物=是[n(%)]21 649(59.7)5 412(59.7)5 386(59.4)5 451(60.1)5 400(59.6)0.783
胰岛素治疗=是[n(%)]863( 2.4)317( 3.5)163( 1.8)183( 2.0)200( 2.2)<0.001
阿司匹林使用=是[n(%)]11 246(31.0)3 529(38.9)2 709(29.9)2 552(28.2)2 456(27.1)<0.001
降胆固醇药物使用=是[n(%)]14 703(40.6)4 529(50.0)3 585(39.6)3 269(36.1)3 320(36.6)<0.001
), ArticleFig(id=1241023869763506530, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023856463368865, language=EN, label=Table 2, caption=

Associations between circulating MUFAs and cardiovascular-specific deathsin cardiovascular patients

, figureFileSmall=null, figureFileBig=null, tableContent=
死亡原因模型1模型2模型3
HR (95% CI)P值HR (95% CI)P值HR (95% CI)P值
心血管疾病1.558(1.423~1.705)<0.0011.267(1.146~1.400)<0.0011.504(1.261~1.794)<0.001
缺血性心脏病1.670(1.497~1.863)<0.0011.347(1.194~1.521)<0.0011.572(1.265~1.953)<0.001
卒中1.188(0.953~1.481)0.1251.086(0.856~1.378)0.4981.121(0.746~1.684)0.582
癌症1.309(1.211~1.415)<0.0011.147(1.052~1.249)0.0021.291(1.109~1.502)0.001
全因1.442(1.376~1.512)<0.0011.215(1.154~1.280)<0.0011.556(1.419~1.705)<0.001
), ArticleFig(id=1241023869839004005, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023856463368865, language=CN, label=表2, caption=

cMUFAs与心血管患者心血管特异性死亡之间的关系

, figureFileSmall=null, figureFileBig=null, tableContent=
死亡原因模型1模型2模型3
HR (95% CI)P值HR (95% CI)P值HR (95% CI)P值
心血管疾病1.558(1.423~1.705)<0.0011.267(1.146~1.400)<0.0011.504(1.261~1.794)<0.001
缺血性心脏病1.670(1.497~1.863)<0.0011.347(1.194~1.521)<0.0011.572(1.265~1.953)<0.001
卒中1.188(0.953~1.481)0.1251.086(0.856~1.378)0.4981.121(0.746~1.684)0.582
癌症1.309(1.211~1.415)<0.0011.147(1.052~1.249)0.0021.291(1.109~1.502)0.001
全因1.442(1.376~1.512)<0.0011.215(1.154~1.280)<0.0011.556(1.419~1.705)<0.001
), ArticleFig(id=1241023869931278696, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023856463368865, language=EN, label=Table 3, caption=

Associations between the quartile levels of circulating MUFAs and cardiovascular-specific deathsin cardiovascular patients

, figureFileSmall=null, figureFileBig=null, tableContent=
cMUFAs四分位数心血管疾病死亡缺血性心脏病死亡卒中死亡
HR(95%CI)P值HR(95%CI)P值HR(95%CI)P值
Q1RefRefRef
Q20.907(0.747~1.102)0.3260.858(0.670~1.098)0.2231.046(0.695~1.574)0.831
Q30.929(0.741~1.165)0.5250.946(0.716~1.250)0.6960.800(0.480~1.333)0.392
Q41.122(0.829~1.519)0.4561.016(0.697~1.480)0.9361.122(0.570~2.207)0.739
cMUFAs四分位数癌症死亡全因死亡
HR(95%CI)P值HR(95%CI)P值
Q1RefRef
Q21.227(1.049~1.434)0.0111.151(1.044~1.268)0.005
Q31.253(1.039~1.511)0.0181.243(1.108~1.396)<0.001
Q41.458(1.127~1.886)0.0041.511(1.290~1.769)<0.001
), ArticleFig(id=1241023870031941996, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023856463368865, language=CN, label=表3, caption=

cMUFAs四分位数水平与心血管患者心血管特异性死亡之间的关系

, figureFileSmall=null, figureFileBig=null, tableContent=
cMUFAs四分位数心血管疾病死亡缺血性心脏病死亡卒中死亡
HR(95%CI)P值HR(95%CI)P值HR(95%CI)P值
Q1RefRefRef
Q20.907(0.747~1.102)0.3260.858(0.670~1.098)0.2231.046(0.695~1.574)0.831
Q30.929(0.741~1.165)0.5250.946(0.716~1.250)0.6960.800(0.480~1.333)0.392
Q41.122(0.829~1.519)0.4561.016(0.697~1.480)0.9361.122(0.570~2.207)0.739
cMUFAs四分位数癌症死亡全因死亡
HR(95%CI)P值HR(95%CI)P值
Q1RefRef
Q21.227(1.049~1.434)0.0111.151(1.044~1.268)0.005
Q31.253(1.039~1.511)0.0181.243(1.108~1.396)<0.001
Q41.458(1.127~1.886)0.0041.511(1.290~1.769)<0.001
), ArticleFig(id=1241023870161965430, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023856463368865, language=EN, label=Table 4, caption=

Associations between cMUFAs and cardiovascular-specific deathsstratified by potential risk factorsin cardiovascular patients

, figureFileSmall=null, figureFileBig=null, tableContent=
潜在危险因素心血管疾病死亡缺血性中风死亡
HR(95%CI)P值P交互HR(95%CI)P值P交互
年龄(岁)
<501.515(1.106~2.076)0.0100.1991.539(1.066~2.224)0.0210.012
≥501.475(1.190~1.828)<0.0011.566(1.193~2.056)0.001
性别
男1.493(1.220~1.826)<0.0010.8031.584(1.245~2.015）<0.0010.225
女1.463(1.004~2.133)0.0481.367(0.819~2.281)0.231
性别
否1.513(1.216~1.884)<0.0010.3901.561(1.185~2.057)0.0020.382
是1.398(1.034~1.892)0.0301.495(1.051~2.127)0.025
肥胖
BMI<301.497(1.150~1.947)0.0030.5041.674(1.211~2.315)0.0020.673
BMI≥301.601(1.263~2.028)<0.0011.545(1.154~2.069)0.003
目前是否吸烟
否1.490(1.217~1.825)<0.0010.3311.570(1.221~2.019)<0.0010.634
是1.457(1.005~2.111)0.0471.437(0.923~2.237)0.108
目前饮酒状态
否1.396(0.905~2.154)0.1310.5631.415(0.849~2.357)0.1830.416
是1.506(1.241~1.827)<0.0011.578(1.243~2.004)<0.001
潜在危险因素卒中死亡癌症死亡
HR(95%CI)P值P交互HR(95%CI)P值P交互
年龄(岁)
<501.207(0.414~3.517)0.7310.0951.484(1.112~1.980)0.0070.111
≥501.117(0.718~1.737)0.6241.194(0.999~1.425)0.050
性别
男0.989(0.589~1.659)0.9660.9611.249(1.040~1.501)0.0170.326
女1.392(0.710~2.727)0.3351.410(1.066~1.864)0.016
性别
否1.168(0.739~1.843)0.5060.0841.348(1.135~1.601)0.0010.172
是0.829(0.332~2.074)0.6891.095(0.793~1.513)0.581
肥胖
BMI<300.840(0.484~1.459)0.5360.2231.441(1.173~1.771)<0.0010.461
BMI≥301.589(0.850~2.970)0.1471.130(0.902~1.416)0.289
目前是否吸烟
否1.009(0.641~1.590)0.9680.4371.213(1.021~1.440)0.0280.056
是2.019(0.773~5.275)0.1521.733(1.244~2.413)0.001
目前饮酒状态
否1.233(0.389~3.899)0.7220.8251.026(0.656~1.604)0.9100.794
是1.102(0.709~1.712)0.6661.326(1.128~1.559)0.001
潜在危险因素全因死亡
HR(95%CI)P值P交互
年龄(岁)
<501.729(1.458~2.051)<0.0010.067
≥501.455(1.305~1.622)<0.001
性别
男1.494(1.339~1.666)<0.0010.029
女1.692(1.421~2.014)<0.001
性别
否1.649(1.479~1.838)<0.0010.064
是1.319(1.107~1.571)0.002
肥胖
BMI<301.703(1.499~1.935)<0.0010.423
BMI≥301.439(1.260~1.643)<0.001
目前是否吸烟
否1.526(1.373~1.696)<0.0010.031
是1.645(1.360~1.989)<0.001
目前饮酒状态
否1.391(1.096~1.766)0.0070.556
是1.573(1.424~1.737)<0.001
), ArticleFig(id=1241023870258434427, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023856463368865, language=CN, label=表4, caption=

按潜在危险因素分层后的cMUFAs与心血管疾病特异性死亡之间的关系

, figureFileSmall=null, figureFileBig=null, tableContent=
潜在危险因素心血管疾病死亡缺血性中风死亡
HR(95%CI)P值P交互HR(95%CI)P值P交互
年龄(岁)
<501.515(1.106~2.076)0.0100.1991.539(1.066~2.224)0.0210.012
≥501.475(1.190~1.828)<0.0011.566(1.193~2.056)0.001
性别
男1.493(1.220~1.826)<0.0010.8031.584(1.245~2.015）<0.0010.225
女1.463(1.004~2.133)0.0481.367(0.819~2.281)0.231
性别
否1.513(1.216~1.884)<0.0010.3901.561(1.185~2.057)0.0020.382
是1.398(1.034~1.892)0.0301.495(1.051~2.127)0.025
肥胖
BMI<301.497(1.150~1.947)0.0030.5041.674(1.211~2.315)0.0020.673
BMI≥301.601(1.263~2.028)<0.0011.545(1.154~2.069)0.003
目前是否吸烟
否1.490(1.217~1.825)<0.0010.3311.570(1.221~2.019)<0.0010.634
是1.457(1.005~2.111)0.0471.437(0.923~2.237)0.108
目前饮酒状态
否1.396(0.905~2.154)0.1310.5631.415(0.849~2.357)0.1830.416
是1.506(1.241~1.827)<0.0011.578(1.243~2.004)<0.001
潜在危险因素卒中死亡癌症死亡
HR(95%CI)P值P交互HR(95%CI)P值P交互
年龄(岁)
<501.207(0.414~3.517)0.7310.0951.484(1.112~1.980)0.0070.111
≥501.117(0.718~1.737)0.6241.194(0.999~1.425)0.050
性别
男0.989(0.589~1.659)0.9660.9611.249(1.040~1.501)0.0170.326
女1.392(0.710~2.727)0.3351.410(1.066~1.864)0.016
性别
否1.168(0.739~1.843)0.5060.0841.348(1.135~1.601)0.0010.172
是0.829(0.332~2.074)0.6891.095(0.793~1.513)0.581
肥胖
BMI<300.840(0.484~1.459)0.5360.2231.441(1.173~1.771)<0.0010.461
BMI≥301.589(0.850~2.970)0.1471.130(0.902~1.416)0.289
目前是否吸烟
否1.009(0.641~1.590)0.9680.4371.213(1.021~1.440)0.0280.056
是2.019(0.773~5.275)0.1521.733(1.244~2.413)0.001
目前饮酒状态
否1.233(0.389~3.899)0.7220.8251.026(0.656~1.604)0.9100.794
是1.102(0.709~1.712)0.6661.326(1.128~1.559)0.001
潜在危险因素全因死亡
HR(95%CI)P值P交互
年龄(岁)
<501.729(1.458~2.051)<0.0010.067
≥501.455(1.305~1.622)<0.001
性别
男1.494(1.339~1.666)<0.0010.029
女1.692(1.421~2.014)<0.001
性别
否1.649(1.479~1.838)<0.0010.064
是1.319(1.107~1.571)0.002
肥胖
BMI<301.703(1.499~1.935)<0.0010.423
BMI≥301.439(1.260~1.643)<0.001
目前是否吸烟
否1.526(1.373~1.696)<0.0010.031
是1.645(1.360~1.989)<0.001
目前饮酒状态
否1.391(1.096~1.766)0.0070.556
是1.573(1.424~1.737)<0.001
), ArticleFig(id=1241023870413623683, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023856463368865, language=EN, label=Table 5, caption=

Sensitivity analyses results

, figureFileSmall=null, figureFileBig=null, tableContent=
死亡原因调整1调整2
HR (95%CI)P值HR (95%CI)P值
心血管疾病1.489(1.239~1.789)<0.0011.297(1.003~1.677)0.047
缺血性心脏病1.566(1.248~1.965)<0.0011.479(1.085~2.017)0.013
卒中1.167(0.763~1.786)0.4760.708(0.384~1.306)0.268
癌症1.314(1.125~1.535)0.0011.291(1.054~1.580)0.014
全因1.538(1.399~1.690)<0.0011.525(1.343~1.731)<0.001
), ArticleFig(id=1241023870522675592, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023856463368865, language=CN, label=表5, caption=

敏感性分析结果

, figureFileSmall=null, figureFileBig=null, tableContent=
死亡原因调整1调整2
HR (95%CI)P值HR (95%CI)P值
心血管疾病1.489(1.239~1.789)<0.0011.297(1.003~1.677)0.047
缺血性心脏病1.566(1.248~1.965)<0.0011.479(1.085~2.017)0.013
卒中1.167(0.763~1.786)0.4760.708(0.384~1.306)0.268
癌症1.314(1.125~1.535)0.0011.291(1.054~1.580)0.014
全因1.538(1.399~1.690)<0.0011.525(1.343~1.731)<0.001
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循环单不饱和脂肪酸与心血管特异性死亡的相关性研究
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陈紫英 1, 3 , 倪明星 2, 3 , 李佳炫 1, 3 , 牛翊霖 1, 3 , 李惠先 3 , 郑海清 3 , 李晴 2, 3 , 李佳美 2, 3 , 梁会营 1, 3
现代预防医学 | 营养与食品卫生 2025,52(2): 246-252
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现代预防医学 | 营养与食品卫生 2025, 52(2): 246-252
循环单不饱和脂肪酸与心血管特异性死亡的相关性研究
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陈紫英1, 3, 倪明星2, 3, 李佳炫1, 3, 牛翊霖1, 3, 李惠先3, 郑海清3, 李晴2, 3, 李佳美2, 3, 梁会营1, 3
作者信息
  • 1．南方医科大学公共卫生学院，广东　广州　510515
  • 2．中国医科大学公共卫生学院
  • 3．南方医科大学附属广东省人民医院（广东省医学科学院）大数据中心

    • 陈紫英（1999—），女，硕士在读，研究方向：公共卫生

通讯作者:

梁会营，E-mail：
Circulating monounsaturated fatty acids and cardiovascular-specific death in cardiovascular patients
Zi-ying CHEN1, 3, Ming-xing NI2, 3, Jia-xuan LI1, 3, Yi-lin NIU1, 3, Hui-xian LI3, Hai-qing ZHENG3, Qing LI2, 3, Jia-mei LI2, 3, Hui-ying LIANG1, 3
Affiliations
  • School of Public Health, Southern Medical University, Guangzhou, Guangdong 510515, China
出版时间: 2025-01-25 doi: 10.20043/j.cnki.MPM.202408267
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摘要
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目的

采用流行病学方法评估循环单不饱和脂肪酸（circulating monounsaturated fatty acids, cMUFAs）与心血管特异性死亡之间的关系。

方法

研究纳入36 254名来自UK Biobank的心血管疾病患者，采用Cox比例风险模型探究cMUFAs与心血管疾病死亡、缺血性心脏病死亡、卒中死亡、癌症死亡和全因死亡之间的关系。使用四分位数、十分位数和限制性三次样条探索剂量-反应关系，并进行亚组分析和敏感性分析。

结果

cMUFAs与心血管疾病死亡（HR=1.504, 95% CI: 1.261~1.794），缺血性心脏病死亡（HR=1.572, 95% CI: 1.265~1.953），癌症死亡（HR=1.291, 95% CI: 1.109~1.502），全因死亡（HR=1.556, 95% CI: 1.419~1.705）呈正相关，但与卒中死亡无显著关联（P=0.582）。限制性三次样条显示cMUFAs与心血管特异性死亡存在非线性关系（P<0.001）。亚组分析表明在女性和当前吸烟者中，cMUFAs与全因死亡的关联更为明显；在50岁以上的个体中，cMUFAs与缺血性心脏病死亡的关联更为明显。

结论

在心血管疾病患者中，cMUFAs水平升高与心血管疾病死亡、缺血性心脏病死亡、癌症死亡和全因死亡的风险增加相关，并且这种关联表现出非线性趋势。

循环单不饱和脂肪酸  /  心血管特异性死亡  /  Cox比例风险模型  /  限制性立方样条
Objective

To evaluate the associations between circulating monounsaturated fatty acids(cMUFAs) and cardiovascular-specific death using epidemiological methods.

Methods

This study included 36 254 patients with cardiovascular disease from the UK Biobank. Cox proportional hazards models were employed to examine the associations between cMUFAs and various fatalities, including cardiovascular death, ischaemic heart disease death, stroke death, cancer death, and all-cause death. Moreover, the study examined the dose-response relationship between cMUFAs and outcomes using quartiles, deciles, and restricted cubic splines. A subgroup analysis was conducted to validate the effects of cMUFAs on cardiovascular-specific deaths across different subgroups.

Results

A positive correlation was observed between cMUFAs and all-cause death (HR=1.556, 95% CI: 1.419-1.705), as well as CVD (HR=1.504, 95% CI: 1.261-1.794), IHD (HR=1.572, 95% CI: 1.265-1.953), and cancer death (HR=1.291, 95% CI: 1.109-1.502). However, no significant association was found between cMUFAs and stroke death (P=0.582). The study revealed the existence of non-linear relationships between cMUFAs and cardiovascular-specific death. Subgroup analyses indicated that the association with all-cause death was more pronounced in females and current smokers. Furthermore, individuals aged over 50 years demonstrated a more pronounced correlation with IHD death.

Conclusion

In patients with cardiovascular disease, elevated levels of cMUFAs are associated with an increased risk of CVD death, IHD death, cancer death, and all-cause death. This association demonstrates a non-linear correlation trend.

Circulating monounsaturated fatty acids  /  Cardiovascular-specific death  /  Cox proportional hazards model  /  Restricted cubic spline
陈紫英, 倪明星, 李佳炫, 牛翊霖, 李惠先, 郑海清, 李晴, 李佳美, 梁会营. 循环单不饱和脂肪酸与心血管特异性死亡的相关性研究. 现代预防医学, 2025 , 52 (2) : 246 -252 . DOI: 10.20043/j.cnki.MPM.202408267
Zi-ying CHEN, Ming-xing NI, Jia-xuan LI, Yi-lin NIU, Hui-xian LI, Hai-qing ZHENG, Qing LI, Jia-mei LI, Hui-ying LIANG. Circulating monounsaturated fatty acids and cardiovascular-specific death in cardiovascular patients[J]. Modern Preventive Medicine, 2025 , 52 (2) : 246 -252 . DOI: 10.20043/j.cnki.MPM.202408267
正文
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2017年全球疾病负担研究显示，心血管疾病仍是全球主要死亡原因，每年导致1 780万死亡[1]。其高发病率、高复发率、高恶化率和高死亡率造成了显著的经济负担[2]。仅在欧洲，每年因心血管疾病死亡超过380万人，包括200多万女性和近176万男性，占女性和男性死亡总数的46%和39%[3]。此外，心肌梗死一年内复发率高达50%，且75%的患者在三年内再次复发[4]。可见，对于心血管患者的危险因素控制仍然不足[5]。然而，临床证据表明，有效的二级预防措施可以显著降低后续事件风险，进而降低死亡率，提高患者生活质量[6]。
单不饱和脂肪酸广泛存在于油类、坚果、种子、水果和肉类等食物中，且几乎所有的MUFAs都能被肠道有效吸收[7]。除了饮食摄取，循环中的单不饱和脂肪酸（circulating monounsaturated fatty acids, cMUFAs）还可以通过内源性途径SCD1生成[8-9]。cMUFAs作为客观生物标志物，能够反映饮食摄入和内源性生成的情况[10]。多数研究表明，MUFAs相关的不良反应主要与血浆中cMUFAs有关[11-12]。cMUFAs与心血管疾病风险之间的相关性已被证实[13-14], 一些研究认为它可能是心血管事件风险的潜在生物标志物[13-14]，在细胞信号传导和基因表达调控中发挥关键作用[15]。尽管如此，目前的研究主要集中在一般人群的初级预防上，对cMUFAs在心血管患者中的作用研究仍较少。为填补这一空白，我们分析了英国生物银行（UK Biobank, UKB）中36 254名心血管患者的数据，以探究cMUFAs与心血管疾病死亡、缺血性心脏病死亡、卒中死亡、癌症死亡及全因死亡之间的关系。本研究得到了UKB的支持（申请号：88365）。
1　材料与方法
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1.1　研究设计
本研究使用了UKB的数据，这是一项覆盖502 387名年龄在37岁至73岁人群的大型队列研究[18]。研究纳入了基线时确诊为心血管疾病的个体，排除了数据不完整、随访期间退出或基线时患有癌症的参与者，最终共36 254名参与者进入分析(图1)。
1.2　cMUFAs与心血管特异性死亡的确定
cMUFAs数据使用了来自UKB参与者的EDTA血浆样本。研究的主要结局为心血管疾病死亡、缺血性心脏病死亡、卒中死亡，次要结局为癌症死亡和全因死亡。参与者的死亡状态和时间依据死亡记录确定，UKB中最后的死亡登记日期为2021年10月31日，因此研究也截止于该日期。随访时间从心血管疾病诊断开始，至死亡或最后一次随访，以先发生者为准。疾病分类基于ICD-10编码确定，心血管疾病为I10-15、I20-25、I26、I42、I48、I50、I60-64、I69、I73、I80和G45；缺血性心脏病为I20-25；卒中为I60-64和I69；癌症为C00-D48。
1.3　协变量的确定
为了准确评估cMUFAs与心血管特异性死亡之间的关系，我们考虑了多个潜在的混杂因素。这些因素包括社会人口学（年龄、性别、种族、家庭收入和学历）、生活方式（吸烟状况、饮酒状况、体重指数（BMI）、国际体育活动问卷（IAPQ））、饮食摄入（水果摄入、熟蔬菜摄入、维生素补充、矿物质和其他膳食补充）、是否糖尿病、药物使用情况（抗高血压药物、胰岛素治疗、阿司匹林以及降胆固醇药物）和血液指标（胆固醇、甘油三酯、高密度脂蛋白、循环多不饱和脂肪酸（circulating polyunsaturated fatty acids, cPUFAs））。
1.4　统计分析
1.4.1　基线特征
通过分类变量的计数（百分比）和连续变量的平均值（标准差）来表示。根据cMUFAs的四分位数水平将参与者分为四组，使用t检验或χ2检验来比较各组间的特征。使用多重插补法填补缺失的变量值。
1.4.2　cMUFAs与结局事件的相关性分析
采用三个Cox比例风险模型进行分析。模型1调整了基线年龄、性别和cPUFAs；模型2在此基础上调整了吸烟状况、饮酒状况、BMI、种族、糖尿病、学历和cPUFAs；模型3为综合模型，在模型2的基础上进一步调整了胆固醇、甘油三酯、高密度脂蛋白、家庭收入、水果摄入、熟蔬菜摄入、IPAQ、维生素补充、矿物质和其他膳食补充和药物使用情况。为进一步评估cMUFAs水平对结局事件的影响，还进行了以下分析：(1) 根据cMUFAs的四分位数水平；(2) 根据cMUFAs的十分位数水平；(3) 使用限制性三次样条进行分析。
1.4.3　亚组分析和敏感性分析
亚组分析基于以下因素进行：年龄（<50岁或≥50岁）、性别、糖尿病状况（是或否）、肥胖（BMI≥30或BMI<30）、当前吸烟状况（是或否）以及当前饮酒状况（是或否）。此外，为增强结果稳健性，进行了两项敏感性分析。首先，排除随访时间少于两年的参与者，以减少反向因果关系的影响；其次，仅分析具有完整协变量数据的参与者，以确保数据的完整性和准确性。
所有数据分析和可视化均使用R 4.3.3完成。
2　结果
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2.1　基线特征描述
本研究纳入了36 254名心血管患者，基线特征见表1。参与者平均年龄为59.23岁（标准差=7.18），男性占53.4%，白种人占94.1%。在平均12.28年的随访期间，记录到心血管疾病死亡967例，缺血性心脏病死亡615例，卒中死亡202例，癌症死亡1 498例，总死亡3 859例。
2.2　cMUFAs与结局事件的相关性
表2显示，cMUFAs与心血管疾病死亡、缺血性心脏病死亡、全因死亡以及癌症死亡正相关（P<0.05），这种关联在三个模型中均一致。在模型3中，风险比（HR）及95%置信区间（CI）为：心血管疾病死亡1.504（1.261~1.794），缺血性心脏病死亡1.572（1.265~1.953），癌症死亡1.291（1.109~1.502），全因死亡1.556（1.419~1.705）。然而，cMUFAs与卒中死亡未发现显著相关性（P=0.582）。此外，与第一个四分位数相比，其他三个四分位数的cMUFAs与全因死亡风险显著增加相关，这一趋势在十分位数分析中得到了验证（见表3和图2）。限制性三次样条分析表明，cMUFAs与心血管特异性死亡之间存在非线性关系（P<0.001），并提示阈值效应为2.743 mmol/L（见图3）。
2.3　亚组分析和敏感性分析
基于潜在危险因素的分层分析结果见表4。cMUFAs与全因死亡的关联在女性（交互作用P=0.029）和当前吸烟者（交互作用P=0.031）中更为显著。50岁以上患者在缺血性心脏病死亡中的关联也更强（交互作用P=0.012）。未见其他交互作用。敏感性分析显示，排除随访时间少于两年的参与者或仅分析无缺失协变量数据的参与者时，结果未发生显著变化（见表5）。
3　讨论
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本研究发现cMUFAs与心血管患者的心血管疾病死亡、缺血性心脏病死亡、癌症死亡以及全因死亡风险升高之间存在正相关，并呈非线性趋势。此外，cMUFAs与性别、当前吸烟状况及年龄之间存在相互作用。有研究指出，在普通人群中，cMUFAs与心血管疾病发病风险增加有关[13-14]。此外，心血管疾病患者的cMUFAs水平高于健康人群[19]。慢性肾病患者的cMUFAs水平升高也与心血管疾病风险增加密切相关[20]。这提示在有基础病的人群中，cMUFAs的水平升高会影响心血管疾病的发生发展。尽管先前有研究发现cMUFAs水平较高的个体在中年时更容易发生卒中[21]。但有研究指出在不考虑其他脂肪酸（如饱和脂肪酸）的影响时，cMUFAs与卒中风险之间并无显著关联[22]。可见，本研究与先前部分研究结果有所不同，这可能与研究中仅调整了cPUFAs的影响有关，提示cMUFAs与卒中之间的关系复杂，需进行进一步探索。
脂肪酸是调节多种细胞通路的动态分子，参与脂质代谢、葡萄糖稳态和炎症反应，促进心血管疾病的发生发展[23-26]。内源性途径SCD1过度表达可能导致高甘油三酯血症，cMUFAs升高与血液甘油三酯升高、异位脂肪沉积和胰岛素抵抗密切相关，所有这些因素都促进了心血管疾病的进展[22，27]。此外，研究表明，肝脏和脂肪组织中的SCD1活性与炎症呈正相关，cMUFAs水平也与血清高敏C反应蛋白正相关，提示较高的SCD1活性和cMUFAs水平可能促进炎症和心血管疾病发展[28]。长期脂肪酸浓度的升高可能部分导致某些激素敏感性癌症的风险增加，而脂肪酸的急性升高会对心肌梗死等应激状态下的心肌功能产生直接的有害影响[29]，强调了脂肪酸在心血管健康和疾病中的多方面作用。
纵观本研究，存在着一定的优势和局限性。首先，这是一项全面的长期前瞻性队列研究，样本量大，能够进行稳健的统计分析。此外，本研究确保了对混杂因素的广泛信息收集，有效降低了反向因果关系和混杂偏倚的可能性。值得一提的是，本研究重点关注心血管疾病患者，填补了以往研究中的空白，为这一特定人群提供了见解。研究中选择的暴露因子为cMUFAs，而非膳食MUFAs，能够更准确地反映影响疾病进展的真实MUFAs水平，从而提高了研究结果的准确性。然而，本研究也存在一定的局限性。首先，该研究依赖于UKB中的欧洲人群，在研究结果外推时需要谨慎考虑。另外，尽管对潜在混杂因素进行了广泛的调整，仍然可能存在未知因素的残留混杂效应，这可能影响结果的解释。
基金
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  • 国家自然科学基金—青年科学基金项目(82204396)
  • 老年人整合型慢病管理医防融合技术与应用(2023YFC3604600)
  • 广东省医学科学技术研究基金项目(A2023006)
文献
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2025年第52卷第2期
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doi: 10.20043/j.cnki.MPM.202408267
  • 接收时间：2024-08-20
  • 首发时间：2026-03-18
  • 出版时间：2025-01-25
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  • 收稿日期：2024-08-20
基金
国家自然科学基金—青年科学基金项目(82204396)
老年人整合型慢病管理医防融合技术与应用(2023YFC3604600)
广东省医学科学技术研究基金项目(A2023006)
作者信息
    1．南方医科大学公共卫生学院，广东　广州　510515
    2．中国医科大学公共卫生学院
    3．南方医科大学附属广东省人民医院（广东省医学科学院）大数据中心

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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
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