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Red blood cell polyunsaturated fatty acids and mortality in the Women's Health Initiative Memory Study.

ABSTRACT: BACKGROUND:The prognostic value of circulating polyunsaturated fatty acid (PUFA) levels is unclear. 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 to 80 years 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). PUFAs of secondary interest included the 2 major n-6 PUFAs, linoleic acid and arachidonic acid, and the PUFA factor score (a calculated variable including 6 PUFAs that accounts for their intercorrelations). The primary outcome was total mortality through August 2014. RESULTS:After a median of 14.9 years of follow-up, 1851 women (28.5%) had died. RBC levels of EPA and DHA were higher in the survivors (P < .002 for each). In the fully adjusted models, the hazard ratios (99% confidence intervals) for mortality associated with a 1 standard deviation 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, arachidonic acid or linoleic acid 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.

SUBMITTER: Harris WS

PROVIDER: S-EPMC5563382 | biostudies-literature | 2017 Jan - Feb

REPOSITORIES: biostudies-literature

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Red blood cell polyunsaturated fatty acids and mortality in the Women's Health Initiative Memory Study.

Harris William S WS Luo Juhua J Pottala James V JV Espeland Mark A MA Margolis Karen L KL Manson Joann E JE Wang Lu L Brasky Theodore M TM Robinson Jennifer G JG

Journal of clinical lipidology 20170112 1

<h4>Background</h4>The prognostic value of circulating polyunsaturated fatty acid (PUFA) levels is unclear.<h4>Objectives</h4>To determine the associations between red blood cell (RBC) PUFA levels and risk for death.<h4>Methods</h4>This prospective cohort study included 6501 women aged 65 to 80 years 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 inter ...[more]

PMID: 28391893

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Project description:BackgroundAlthough omega-6 polyunsaturated fatty acids (n-6 PUFA) have been recommended to reduce coronary heart disease (CHD), controversy remains about benefits versus harms, including concerns over theorized proinflammatory effects of n-6 PUFA. We investigated associations of circulating n-6 PUFA including linoleic acid (the major dietary PUFA), γ-linolenic acid, dihomo-γ-linolenic acid, and arachidonic acid, with total and cause-specific mortality in the Cardiovascular Health Study, a community-based U.S. cohort.Methods and resultsAmong 2792 participants(aged ≥65 years) free of cardiovascular disease at baseline, plasma phospholipid n-6 PUFA were measured at baseline using standardized methods. All-cause and cause-specific mortality, and total incident CHD and stroke, were assessed and adjudicated centrally. Associations of PUFA with risk were assessed by Cox regression. During 34 291 person-years of follow-up (1992-2010), 1994 deaths occurred (678 cardiovascular deaths), with 427 fatal and 418 nonfatal CHD, and 154 fatal and 399 nonfatal strokes. In multivariable models, higher linoleic acid was associated with lower total mortality, with extreme-quintile hazard ratio =0.87 (P trend=0.005). Lower death was largely attributable to cardiovascular disease causes, especially nonarrhythmic CHD mortality (hazard ratio, 0.51; 95% confidence interval, 0.32-0.82; P trend=0.001). Circulating γ-linolenic acid, dihomo-γ-linolenic acid, and arachidonic acid were not significantly associated with total or cause-specific mortality (eg, for arachidonic acid and CHD death, the extreme-quintile hazard ratio was 0.97; 95% confidence interval, 0.70-1.34; P trend=0.87). Evaluated semiparametrically, linoleic acid showed graded inverse associations with total mortality (P=0.005). There was little evidence that associations of n-6 PUFA with total mortality varied by age, sex, race, or plasma n-3 PUFA. Evaluating both n-6 and n-3 PUFA, lowest risk was evident with highest levels of both.ConclusionsHigh circulating linoleic acid, but not other n-6 PUFA, was inversely associated with total and CHD mortality in older adults.

Dataset Information

Red blood cell polyunsaturated fatty acids and mortality in the Women's Health Initiative Memory Study.

Publications

Red blood cell polyunsaturated fatty acids and mortality in the Women's Health Initiative Memory Study.

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