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. 2018 Jul 1;25(7):593-605.
doi: 10.5551/jat.40691. Epub 2017 Dec 2.

Age Stratification and Impact of Eicosapentaenoic Acid and Docosahexaenoic Acid to Arachidonic Acid Ratios in Ischemic Stroke Patients

Yuji Ueno  1 , Ryota Tanaka  1 , Kazuo Yamashiro  1 , Nobukazu Miyamoto  1 , Kenichiro Hira  1 , Naohide Kurita  1 , Mayu Sakurai  1 , Takao Urabe  2 , Kazunori Shimada  3 , Tetsuro Miyazaki  3 , Hiroyuki Daida  3 , Nobutaka Hattori  1
Affiliations

Age Stratification and Impact of Eicosapentaenoic Acid and Docosahexaenoic Acid to Arachidonic Acid Ratios in Ischemic Stroke Patients

Yuji Ueno et al. J Atheroscler Thromb. .

Abstract

Aim: We focused on the ratios of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) to arachidonic acid (AA) and explored the significance of these ratios relative to clinical characteristics by age in ischemic stroke patients.

Methods: We enrolled patients with acute ischemic stroke who underwent radiological investigations and laboratory examinations, including measurement of serum EPA, DHA, and AA levels, and controls. Patients were classified according to age (＜65, 65-74, and ≥ 75 years) and the tertile of EPA/AA and DHA/AA ratios, and clinical aspects were compared with these factors.

Results: We analyzed 373 patients (age 70.2±13.4 years; 245 males) and 105 controls. Among stroke patients, patients aged ＜65 years had the lowest EPA/AA (0.35±0.23, p=0.006) and DHA/AA (0.73±0.27, p＜0.001) ratios. Compared with controls, patients aged ＜65 years showed lower EPA/AA (vs. 0.49±0.25, p＜0.001) and DHA/AA (vs. 0.82±0.26, p=0.009) ratios. From logistic regression analysis, the EPA/AA (odds ratio 0.18, 95% confidence interval 0.04-0.81, p=0.026) and DHA/AA (odds ratio 0.09, 95% confidence interval 0.02-0.33, p＜0.001) ratios were inversely related to patients aged ＜65 years. According to age-stratified analyses, we found an association of aortic arch calcification with a lower EPA/AA ratio for patients aged ≥ 75 years and an association of multiple infarctions and cerebral white matter lesions with a lower EPA/AA ratio for patients aged 65-74 years (p＜0.05).

Conclusions: The ratios of EPA/AA and DHA/AA could be specific markers for younger stroke patients. The EPA/AA ratio may be related to aortic arch calcification for elderly stroke patients and to multiple infarctions and cerebral white matter disease for middle-aged stroke patients.

Keywords: Aortic arch calcification; Docosahexaenoic acid; Eicosapentaenoic acid; Ischemic stroke; White matter lesions.

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Conflict of interest statement

R.T. received research funds from Bayer Pharmaceutical Co., Ltd., Pfizer Japan Inc., Takeda Pharmaceutical Co., Ltd.

T.U. received lecture fees from Boehringer Ingelheim, Bristol-Myers Squibb, AstraZeneca K.K., Bayer Pharmaceutical Co., Ltd., Otsuka Pharmaceutical Co., Ltd., Takeda Pharmaceutical Co., Ltd., Mitsubishi-Tanabe Pharma Co., Ltd., Sanofi K.K., Shionogi & Co., Ltd., Novartis Pharmaceuticals, UCB Japan Co., Ltd., Kowa Shinyaku Co., Ltd., Sumitomo Dainippon Pharma Co., Ltd., ONO Pharmaceutical Co., Ltd., Pfizer Japan Inc., Merck Sharp and Dohme (MSD) K.K., Astellas Pharma Inc., GlaxoSmithkline K.K., and research funds from Pfizer Japan Inc., Boehringer Ingelheim, AstraZeneca K.K., Otsuka Pharmaceutical Co., Ltd., Astellas Pharma Inc., Eisai Co., Ltd.

K.S. received lecture fees from Mochida Pharmaceutical Company Ltd. and Takeda Pharmaceutical Company Ltd.

H.D. received scholarship funds and lecture fees from Mochida Pharmaceutical Company Ltd. and Takeda Pharmaceutical Company Ltd.

N.H. was an advisory member of Hisamitsu Pharmaceutical, Dai-Nippon Sumitomo Pharma, Otsuka Pharmaceutical, Novartis Pharma, Takeda Pharmaceutical, Abbie, received lecture fees from GSK, Nippon Boehringer Ingelheim, FP Pharmaceutical, Dai-Nippon Sumitomo Pharma, Eisai, Kissei Pharmaceutical, Nihon Medi-physics, Kyowa Hakko-Kirin, Novartis Pharma, Biogen, Otsuka Pharmaceutical, Medtronic, Abbie, research funds from Kyowa Hakko-Kirin, Nihon Medi-physics, FP Pharmaceutical, Takeda Pharmaceutical, and scholarship funds from Astellas Pharma, Daiichi-Sankyo, Pfizer Japan Inc.

The remaining authors report no conflicts of interest.

Figures

Fig. 1.
Fig. 1.
Comparison of the ratios of EPA/AA (A) and DHA/AA (B) serum levels among ischemic stroke patients and control subjects. #p = 0.006; *p < 0.001 vs. ischemic stroke patients aged < 65 years; ##p < 0.001; **p = 0.009 vs. ischemic stroke patients aged < 65 years.
See this image and copyright information in PMC

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