Omega-3 Fatty Acids in Adipose Tissue and Risk of Myocardial Infarction : The EURAMIC Study (original) (raw)
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Omega-3 Fatty Acids in Adipose Tissue and Risk of Myocardial Infarction
Arteriosclerosis, Thrombosis, and Vascular Biology, 1999
Omega-3 fatty acids have potential antiatherogenic, antithrombotic, and antiarrhythmic properties, but their role in coronary heart disease remains controversial. To evaluate the association of omega-3 fatty acids in adipose tissue with the risk of myocardial infarction in men, a case-control study was conducted in eight European countries and Israel. Cases (nϭ639) included patients with a first myocardial infarction admitted to coronary care units within 24 hours from the onset of symptoms. Controls (nϭ700) were selected to represent the populations originating the cases. Adipose tissue levels of fatty acids were determined by capillary gas chromatography. The mean (ϮSD) proportion of ␣-linolenic acid was 0.77% (Ϯ0.19) of fatty acids in cases and 0.80% (Ϯ0.19) of fatty acids in controls (Pϭ0.01). The relative risk for the highest quintile of ␣-linolenic acid compared with the lowest was 0.42 (95% confidence interval [CI] 0.22 to 0.81, P-trendϭ0.02). After adjusting for classical risk factors, the relative risk for the highest quintile was 0.68 (95% CI 0.31 to 1.49, P-trendϭ0.38). The mean proportion of docosahexaenoic acid was 0.24% (Ϯ0.13) of fatty acids in cases and 0.25% (Ϯ0.13) of fatty acids in controls (Pϭ0.14), with no evidence of association with risk of myocardial infarction. In this large case-control study we could not detect a protective effect of docosahexaenoic acid on the risk of myocardial infarction. The protective effect of ␣-linolenic acid was attenuated after adjusting for classical risk factors (mainly smoking), but it deserves further research.
Adipose tissue fatty acids and risk of myocardial infarction—a case-control study
European Journal of Clinical Nutrition, 2000
Objectives: To study the association between content in adipose tissue of very long-chain n-3 fatty acids, trans fatty acids, linoleic acid and a-linolenic acid and risk of a ®rst myocardial infarction. Design and subjects: A case-control design among 100 patients and 98 population controls both men and postmenopausal women, age 45 ± 75 y. Adipose tissue fatty acids were determined by gas ± liquid chromatography. Intake data were obtained through interview using a validated food frequency questionnaire. Results: Dietary intake and adipose tissue content of the fatty acids studied correlated signi®cantly. Adipose tissue contents of eicosapentaenoic acid (20:5n-3), docosapentaenoic acid (22:5n-3) and docosahexaenoic acid (22:6n-3) were signi®cantly lower while those of trans fatty acids, linoleic and a-linolenic acid were signi®cantly higher in patients than in controls. Age and sex adjusted odds ratios (OR) were signi®cantly reduced with increasing quintiles of very long-chain n-3 fatty acids, thus the OR in the ®fth compared to the ®rst quintile was 0.23 (95% CI 0.08 ± 0.70). After further adjustment for waist-to-hip ratio, smoking, family history of CHD and content of trans fatty acids, the OR in the highest quintile was 0.17 (95% CI 0.04 ± 0.76) and the P for trend 0.016. Age and sex adjusted OR was increased in the ®fth compared to the ®rst quintile of trans fatty acids (OR 2.81, 95% CI 1.16 ± 6.84), linoleic acid (OR 2.10, 95% CI 0.87 ± 5.07) and a-linolenic acid (OR 1.96, 95% CI 0.83 ± 4.61), and P for trend was 0.002, 0.005 and 0.020, respectively. The trends remained signi®cant after adjustment for waist-to-hip ratio, smoking, and family history of coronary heart disease. Trans fatty acids, linoleic acid and a-linolenic acid in adipose tissue were strongly correlated, indicating a common source, most likely margarine. When each of these fatty acid species were adjusted for the two others the trends were no longer signi®cant. Conclusion: Intake of very long-chain n-3 fatty acids as re¯ected in adipose tissue content is inversely associated with risk of myocardial infarction. Trans fatty acids, linoleic and a-linolenic acid were intercorrelated and associated with increased risk. It is suggested that the increased risk may be connected to trans fatty acids or to some other factor associated with margarine consumption.
… American journal of …, 2003
Background: The Jewish population of Israel consumes a diet rich in nϪ6 polyunsaturated fatty acids (PUFAs), principally linoleic acid. The consequences of this diet for ischemic heart disease (IHD) remain unclear. Objective: We assessed the association of adipose tissue nϪ6 fatty acids, which are derived entirely from the diet, with acute myocardial infarction (AMI). Design: A total of 180 cases and 492 IHD-free controls aged 25-64 were included in a population-based case-control study of Jerusalem residents hospitalized with a first AMI. Diet was assessed by the use of a food-frequency questionnaire and adipose tissue fatty acids by gas chromatography of biopsy samples taken from subcutaneous gluteal tissue. The data were analyzed by multivariate logistic regression. Results: Dietary PUFAs (x -: 10.1% of energy) correlated (r = 0.43, P < 0.001) with adipose tissue linoleic acid, which constituted 25.6% of storage fatty acids. High intakes of linoleic acid were not associated with excess risk of AMI (age-and sex-adjusted odds ratio for the third versus the first tertile: 0.96; 95% CI: 0.62, 1.48; NS). In contrast, arachidonic acid, the long chain nϪ6 derivative of linoleic acid, was positively associated with AMI (ageand sex-adjusted odds ratio: 2.12; 95% CI: 1.33, 3.36; P = 0.004). With multivariate adjustment, there was no evidence for an adverse association of linoleic acid with AMI, whereas the risk associated with arachidonic acid persisted, albeit attenuated. Conclusions: A very high linoleic acid intake does not appear to confer increased risk of nonfatal AMI. Nonetheless, the increased risk associated with arachidonic acid, a finding that requires confirmation, tempers an inference that diets rich in nϪ6 fatty acids are safe vis-à-vis coronary health.
Omega-3 Fatty Acids and Cardiovascular Diseases
Since the expeditions to Greenland by Bang and Dyerberg starting in the late 1960s, a diet rich of omega-3 fatty acids was suggested as the main responsible for the very low incidence of myocardial infarction in the Inuit population when compared to Danish controls. A few decades after, omega-3 fatty acids have been reported as associated with an antiatherogenic blood lipid pattern, reduced platelet reactivity, and fewer cardiovascular events. Proposed mechanisms for the protective role of omega 3 fats against cardiovascular diseases include blood pressure lowering; altered lipid profile, especially reduced serum triglyceride concentration; reduced thrombotic tendency; antiinflammatory effects; anti-arrhythmic effects including heart rate reduction; improved vascular endothelial function; increased plaque stability; increased paraoxonase levels and improved insulin sensitivity. Unfortunately, while previous randomized clinical trials presented some enthusiastic results regarding a strong positive role of omega-3 fatty acids in preventing death, myocardial infarction, stroke and ventricular arrhythmias, recent ones failed to confirm such benefits on broader populations. Moreover, different dosages of either eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA) or both, administered either through dietary counseling or tablet supplement, were used while collecting evidences. Systematic reviews and meta-analyses added further confusion to the existing controversy as they often reported conflicting findings.
Journal of The American Dietetic Association, 2007
Objective To evaluate the relation between intake and adipose tissue composition of fatty acids and acute myocardial infarction in Portuguese men. Design Case-control study. Diet was assessed using a semiquantitative food frequency questionnaire. In 49 case and 49 control subjects, adipose tissue composition was assessed by gas-liquid chromatography. Subjects/setting Population-based; subjects were 297 consecutively admitted cases of first acute myocardial infarction in a tertiary care hospital who were aged Ն40 years. Three hundred ten community controls were selected by random-digit dialing. Main outcome measure Odds ratio (OR). Statistical analysis performed Logistic regression, adjusting for age, education, family history of acute myocardial infarction, smoking, physical activity, body mass index, and energy intake. Results Total fat intake (OR 0.45, fourth quartile, Pϭ0.02), lauric acid (OR 0.44, fourth quartile, Pϭ0.02), palmitic acid (OR 0.58, fourth quartile, Pϭ0.03), and oleic acid (OR 0.42, fourth quartile, Pϭ0.03) were inversely associated with acute myocardial infarction. No significant ef-fects were found for the remaining fatty acids. In the adipose tissue composition data, the adjusted risk estimates of acute myocardial infarction for the highest vs the lowest tertile were 0.16, 0.14, and 0.04 for lauric, oleic, and trans-fatty acids, respectively. A significant direct association was found for palmitic and linoleic acids (adjusted ORs for the highest tertile were 9.02 and 3.63, respectively). Conclusions Low intake of total fat and lauric acid from dairy products was associated with acute myocardial infarction. The association of polyunsaturated fatty acids with risk of acute myocardial infarction was nonsignificant after adjustment for energy intake and confounders.
Fatty Acids and Associated Cardiovascular Risk
Food and Nutrition Sciences, 2013
A fatty acid (FA) is a carboxylic acid with a long aliphatic chain, which is either saturated or unsaturated. Recently, the role of FA and particularly omega-3 and -6 has emerged as cardiovascular risk factor in the literature. The aim of our study was to establish reference values for these FA and to compare them with data obtained in a population of acute myocardial infarction (AMI) patients. Materials and methods: Hundred thirty five healthy subjects (59.38 ± 27.12 yo, 75 men) were selected as reference population. We also evaluated FA in thirty three patients (55 ± 9 yo, 23 men) admitted in the Emergency Department of our Institution for AMI. The fasting whole blood was drawn in vacutainer containing EDTA. Before analysis, samples were washed and transmethylated. We performed the quantification of different FA by gas chromatography associated with flame ionization detector (GCFID). Results: We obtained results in control healthy patients to be used as reference values. In the AMI group, levels of omega-6 were significantly higher (p < 0.05) for C18:2n6 and C18:3n6 than the reference population and omega-3 values were significantly lower (p < 0.01) compared to reference value for C22:6n3. The omega-3 index was lower and the ratio omega-6/omega-3 was higher in AMI group compared to reference values. Conclusions: We have established reference value for FA and have compared these values with the results obtained in AMI population. FA determination is a new tool we are able to use and to process in our laboratory which can help the clinician to screen patients with the highest cardiovascular risks because of the implication of FA in the etiopathogeny of atherosclerosis.
2013
Background: A high intake of omega-3 (n-3) long-chain polyunsaturated fatty acids (LCPUFAs), which are potential peroxisome proliferator-activated receptor (PPAR) agonists, has been associated with proposed favourable effects related to prevention and treatment of coronary heart disease. The n-3 LCPUFAs eicosapentaenoic (EPA) and docosahexaenoic (DHA) acids are poorly oxidizable and resemble the effects of the modified fatty acid and pan-PPAR agonist tetradecylthioacetic acid (TTA) mainly through PPAR activation. Aims: Aims were to investigate the dietary intake of n-3 LCPUFAs and risk of future coronary events in patients with coronary artery disease (CAD) and also to try and elucidate the mechanistic effects of PPAR activation using a rodent model. Subjects and Methods: The human studies were sub-studies of participants from the Western Norway B-Vitamin Intervention Trial, who completed a food frequency questionnaire at baseline, from which daily intake of n-3 LCPUFAs [EPA, docosa...
Atherosclerosis, 2016
There is an ongoing debate whether omega-3-fatty acids protect from cardiovascular disease mortality. We examined the associations of erythrocyte omega-3 fatty acids with mortality in patients referred for coronary angiography. Erythrocyte omega-3 fatty acid proportions were measured at baseline in 3259 participants of the Ludwigshafen Risk and Cardiovascular Health Study (LURIC) using the HS-Omega-3 Index method. Associations of omega-3 fatty acid proportions with mortality were investigated using Cox proportional hazards regression. During a median follow-up of 9.9 years, 975 patients (29.9%) died, 614 patients (18.8%) from cardiovascular causes. Proportions of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) were inversely associated with all-cause and cardiovascular mortality in models adjusted for conventional cardiovascular risk factors. The strongest association was observed for EPA with a hazard ratio (HR) of 0.89 (0.83-0.96) per increase of one standard deviation....