颈动脉粥样硬化斑块中不同种类脂肪酸含量分析

Analysis of contents of different kinds of fatty acids in carotid atherosclerotic plaques

目的定量分析颈动脉粥样硬化斑块中不同种类脂肪酸的含量。方法回顾性纳入2021年10月至2022年9月因颈动脉中重度狭窄于海军军医大学第二附属医院行颈动脉内膜剥脱术的24例患者,其中男20例,女4例,年龄[M(Q_(1),Q_(3))]为68.5(63.5,72.3)岁。(1)症状学分组:根据有无脑缺血症状将患者分为有症状组(12例)和无症状组(12例);(2)病理学分组:根据颈动脉斑块病理学评分将患者分为稳定组(14例)和易损组(10例)。通过基于超高效液相色谱-电喷雾电离质谱分析(UPLC-ESI-MS/MS)的靶向脂肪酸代谢组学技术,分析不同类型脂肪酸在颈动脉斑块中的表达差异。结果24份标本中,脂肪酸总量[M(Q_(1),Q_(3))]为1113(330,5897)ng/g。共检测到13种中长链脂肪酸,包括饱和脂肪酸、单不饱和脂肪酸、多聚不饱和脂肪酸;其中饱和脂肪酸含量最高,为584(290,9888)ng/g,占51.8%;多聚不饱和脂肪酸含量次之,为1444(393,4264)ng/g,占44.4%;单不饱和脂肪酸含量最低,为2793(1558,3247)ng/g,占3.8%。有症状组的颈动脉斑块中亚油酸、α-亚麻酸、油酸含量分别为1760(581,3006)、682(527,886)、2081(1358,2907)ng/g,低于无症状组的3149(2226,4683)、1423(964,2270)、3178(2352,3993)ng/g(均P<0.05);易损组颈动脉斑块中亚油酸、α-亚麻酸和油酸含量分别为1537(588,2921)、649(477,850)、2081(1129,2831)ng/g,低于稳定组的3149(2047,4416)、1423(940,2184)、3091(2201,3973)ng/g(均P<0.05);而11,14-二十碳二烯酸、γ-亚麻酸、二十碳五烯酸、花生四烯酸、芥酸、十七酸、十五烷酸、硬脂酸、月桂酸、棕榈酸含量差异均无统计学意义(均P>0.05)。结论在颈动脉斑块中,饱和脂肪酸是主要的脂肪酸类型。油酸、α-亚麻酸和亚油酸在易损斑块内含量下降。

Objective To analyze the contents of different kinds of fatty acids in carotid atherosclerotic plaques.Methods A total of 24 patients who underwent carotid endarterectomy at the Second Affiliated Hospital of Naval Medical University from October 2021 to September 2022 due to moderate and severe carotid artery stenosis were retrospectively enrolled,including 20 males and 4 females,with a median age[M(Q_(1),Q_(3))]of 68.5(63.5,72.3)years.According to the symptoms of cerebral ischemia,the patients were divided into a symptomatic group(12 cases)and an asymptomatic group(12 cases).Regarding the pathological characteristics,the patients were divided into a stable group(14 cases)and a vulnerable group(10 cases)according to carotid plaque pathology scores.The expression differences of different types of fatty acids in carotid plaques were analyzed by targeted fatty acid metabolomics technology based on ultra-performance liquid chromatography-mass spectrometry(UPLC-ESI-MS/MS)analysis.Results In the 24 samples,the median amount of fatty acids[M(Q_(1),Q_(3))]was 1113(330,5897)ng/g.A total of 13 medium and long-chain fatty acids were detected,including saturated fatty acids,monounsaturated fatty acids and polyunsaturated fatty acids.The content of saturated fatty acids was 584(290,9888)ng/g,accounting for the highest proportion of 51.8%.The content of polyunsaturated fatty acids was 1444(393,4264)ng/g,accounting for 44.4%.The content of monounsaturated fatty acids was 2793(1558,3247)ng/g,accounting for 3.8%.The contents of linoleic acid,α-linolenic acid and oleic acid in carotid plaques in the symptomatic group were 1760(581,3006),682(527,886)and 2081(1358,2907)ng/g,respectively,which were lower than those in the asymptomatic group 3149(2226,4683),1423(964,2270)and 3178(2352,3993)ng/g(all P<0.05).The contents of linoleic acid,α-linolenic acid and oleic acid in carotid plaques in the vulnerable group were 1537(588,2921),649(477,850)and 2081(1129,2831)ng/g,respectively,which were lower than those in the stable group 3149(2047,4416),1423(940,2184)and 3091(2201,3973)ng/g(all P<0.05).There were no significant differences in the contents of 11,14-eicosadienoic acid,γ-linolenic acid,eicosapentaenoic acid,arachidonic acid,erucic acid,margaric acid,pentadecanoic acid,stearic acid,dodecanoic acid and palmitic acid(all P>0.05).Conclusions Saturated fatty acids are the main type in carotid plaques.The contents of oleic acid,α-linolenic acid and linoleic acid decrease in vulnerable plaques.