Peripheral Artery Disease Is Associated with a Deficiency of Erythrocyte Membrane n‐3 Polyunsaturated Fatty Acids

Abstract

Population‐based data suggest that individuals who consume large dietary amounts of n‐3 polyunsaturated fatty acids (PUFA) have lower odds of peripheral artery disease (PAD); however, clinical studies examining n‐3 PUFA levels in patients with PAD are sparse. The objective of this study is to compare erythrocyte membrane fatty acid (FA) content between patients with PAD and controls. We conducted a cross‐sectional study of 179 vascular surgery outpatients (controls, 34; PAD, 145). A blood sample was drawn and the erythrocyte FA content was assayed using capillary gas chromatography. We calculated the ratio of the n‐3 PUFA eicosapentaenoic acid (EPA) to the n‐6 PUFA arachidonic acid (ARA) as well as the omega‐3 index (O3I), a measure of erythrocyte content of the n‐3 PUFA, EPA, and docosahexaenoic acid (DHA), expressed as a percentage of total erythrocyte FA. Compared with controls, patients with PAD smoked more and were more likely to have hypertension and hyperlipidemia (p < 0.05). Patients with PAD had a lower mean O3I (5.0 ± 1.7% vs 6.0 ± 1.6%, p < 0.001) and EPA:ARA ratio (0.04 ± 0.02 vs 0.05 ± 0.05, p < 0.001), but greater mean total saturated fats (39.5 ± 2.5% vs 38.5 ± 2.6%, p = 0.01). After adjusting for several patient characteristics, comorbidities, and medications, an absolute decrease of 1% in the O3I was associated with 39% greater odds of PAD (odds ratio [OR] 1.39, 95% confidence interval [CI] 1.03–1.86, and p = 0.03). PAD was associated with a deficiency of erythrocyte n‐3 PUFA, a lower EPA:ARA ratio, and greater mean total saturated fats. These alterations in FA content may be involved in the pathogenesis or development of poor outcomes in PAD.

The effect of omega-3 polyunsaturated fatty acid intake on blood levels of omega-3s in people with chronic atherosclerotic disease: a systematic review

“…When comparing baseline levels of omega-3s in PAD participants with those in studies conducted in the healthy population, omega-3 levels were consistently higher in the healthy population. 59 , 62 , 63 This is consistent with published literature concluding that people with chronic atherosclerotic disease have lower baseline levels of omega-3s when compared with the healthy population. 59 Given that omega-3s are proposed to reduce the progression of atherosclerosis, support optimal mental health and functioning, 64 and promote wound healing, 65 consideration of making omega-3 supplementation routine practice in patients with chronic atherosclerotic disease is justified.…”

Omega-3 index in 2018/19

“…Interestingly, simultaneously measured cholesterol levels were no risk for any of the events mentioned (3) . The risk for peripheral artery disease was also substantially lower with a higher omega-3 index than with a lower omega-3 index (23) . When dietary intake was assessed, associations with the health issues mentioned were substantially smaller (24,25,26) .…”

Fatty acid composition in erythrocytes and coronary artery disease risk: a case–control study in China

“…31,39 These favorable effects may contribute to CAD risk reduction observed in individuals with higher C18:1n-9 intake or blood levels. However, there is conflicting evidence regarding the association between blood C18:1n-9 levels and CVD risk; some studies suggest no association, 14 while others indicate a positive association. 25,40 These discrepancies may be attributed to variations in blood samples, study design, dietary background, or uncontrolled confounding factors.…”

“…Additionally, several researchers have reported erythrocyte FAs as potential biomarkers for multiple CVDs, such as myocardial infarction, heart failure, stroke, and peripheral artery disease, with interesting differences in various levels of erythrocyte FAs. 9,10,14,15 Among these studies, Harris et al 16 confirmed a strong association between eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) levels in erythrocytes with the risk of CAD. However, most research has been conducted on Western populations with limited data available from Chinese and other Asian people.…”