Background
The prognostic value of circulating polyunsaturated fatty acid (PUFA) levels is 4unclear.
Objectives
To determine the associations between red blood cell (RBC) PUFA levels and risk for death.
Methods
This prospective cohort study included 6501 women aged 65–80 who participated in the Women’s Health Initiative Memory Study (enrolment began 1996). RBC PUFA levels were measured at baseline and expressed as a percent of total RBC PUFAs. PUFAs of primary interest were the n-3 PUFAs eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) and their sum (the Omega-3 Index). PUFA of secondary interest included the two major n-6 PUFAs, linoleic (LA) and arachidonic (ARA), and the PUFA Factor score (a calculated variable including 6 PUFAs that accounts for their inter-correlations). The primary outcome was total mortality through August 2014.
Results
After a median of 14.9 years of follow-up, 1851 (28.5%) women had died. RBC levels of EPA and DHA were higher in the survivors (p<0.002 for each). In the fully adjusted models, the hazard ratios (99% confidence intervals) for mortality associated with a 1-SD PUFA increase for total mortality were 0.92 (0.85, 0.98) for the Omega-3 Index, 0.89 (0.82, 0.96) for EPA, 0.93 (0.87, 1.0) for DHA, and 0.76 (0.64, 0.90) for the PUFA Factor score. There were no significant associations of alpha-linolenic acid or ARA or LA with total mortality.
Conclusions
Higher RBC levels of marine n-3 PUFAs were associated with reduced risk for all-cause mortality. These findings support the beneficial relationship between the Omega-3 Index and health outcomes.
ClinicalTrials.gov Identifier
NCT00000611 (WHIMS).