ω-3 Polyunsaturated Fatty Acid Biomarkers and Coronary Heart Disease

Abstract

IMPORTANCEThe role of ω-3 polyunsaturated fatty acids for primary prevention of coronary heart disease (CHD) remains controversial. Most prior longitudinal studies evaluated self-reported consumption rather than biomarkers.OBJECTIVE To evaluate biomarkers of seafood-derived eicosapentaenoic acid (EPA; 20:5ω-3), docosapentaenoic acid (DPA; 22:5ω-3), and docosahexaenoic acid (DHA; 22:6ω-3) and plant-derived α-linolenic acid (ALA; 18:3ω-3) for incident CHD.DATA SOURCES A global consortium of 19 studies identified by November 2014.STUDY SELECTION Available prospective (cohort, nested case-control) or retrospective studies with circulating or tissue ω-3 biomarkers and ascertained CHD. DATA EXTRACTION AND SYNTHESISEach study conducted standardized, individual-level analysis using harmonized models, exposures, outcomes, and covariates. Findings were centrally pooled using random-effects meta-analysis. Heterogeneity was examined by age, sex, race, diabetes, statins, aspirin, ω-6 levels, and FADS desaturase genes.MAIN OUTCOMES AND MEASURES Incident total CHD, fatal CHD, and nonfatal myocardial infarction (MI). RESULTSThe 19 studies comprised 16 countries, 45 637 unique individuals, and 7973 total CHD, 2781 fatal CHD, and 7157 nonfatal MI events, with ω-3 measures in total plasma, phospholipids, cholesterol esters, and adipose tissue. Median age at baseline was 59 years (range, 18-97 years), and 28 660 (62.8%) were male. In continuous (per 1-SD increase) multivariable-adjusted analyses, the ω-3 biomarkers ALA, DPA, and DHA were associated with a lower risk of fatal CHD, with relative risks (RRs) of 0.91 (95% CI, 0.84-0.98) for ALA, 0.90 (95% CI, 0.85-0.96) for DPA, and 0.90 (95% CI, 0.84-0.96) for DHA. Although DPA was associated with a lower risk of total CHD (RR, 0.94; 95% CI, 0.90-0.99), ALA (RR, 1.00; 95% CI, 0.95-1.05), EPA (RR, 0.94; 95% CI, 0.87-1.02), and DHA (RR, 0.95; 95% CI, 0.91-1.00) were not. Significant associations with nonfatal MI were not evident. Associations appeared generally stronger in phospholipids and total plasma. Restricted cubic splines did not identify evidence of nonlinearity in dose responses.CONCLUSIONS AND RELEVANCE On the basis of available studies of free-living populations globally, biomarker concentrations of seafood and plant-derived ω-3 fatty acids are associated with a modestly lower incidence of fatal CHD.

New evidence that omega-3 fatty acids have a role in primary prevention of coronary heart disease

“…Del Gobbo et al (1) demonstrate that a one standard deviation increase in the relative concentration of any of the omega-3 fatty acids in an accessible body compartment is associated with a roughly 10% reduction in risk of fatal CHD. Browning et al (7) report mean (+ standard deviation) concentrations of EPA and DHA in plasma phosphatidylcholine, the major plasma phospholipid, to be 1.1 + 0.5 and 3.2 + 1.2 % of total fatty acids, respectively.…”

“…A recently published study (1) provides new evidence that omega-3 fatty acids have a role in the primary prevention of coronary heart disease (CHD). This new publication included pooled data from 19 cohort studies conducted in 16 countries and including over 45,000 individuals with a median follow-up time of 10 years.…”

Influence of Statins on LDL- and HDL-Cholesterol and Plasma Fatty Acids in Elderly Japanese Ischemic Stroke Patients

“…Fatty acids have relation to cardiovascular risks [3,[5][6][7]. Subanalysis of previous studies reported that administration of highly purified eicosapentaenoic acid (EPA) appeared to reduce the risk of recurrent stroke in a Japanese population of hypercholesterolemic patients receiving low-dose statin therapy [3,4].…”

Misvisende om kosthold i ny nasjonal retningslinje for forebygging av hjerte- og karsykdommer

“…Nyere biomarkør-studier støtter at et høyere inntak av flerumettet fett er forbundet med lavere risiko for koronar hjertesykdom [244][245][246][247] . Slike funn er imidlertid vanskelig å tolke og kan ikke «oversettes» til kvantitative råd om inntak ettersom studiene måler andeler av fettsyrer i vev.…”