Ye Sun1, Woon-Puay Koh2, Jian-Min Yuan3, Hyungwon Choi4, Jin Su4, Choon Nam Ong5, Rob M van Dam6. 1. Saw Swee Hock School of Public Health, and NUS Graduate School for Integrative Sciences and Engineering, and. 2. Saw Swee Hock School of Public Health, and Duke-NUS Graduate Medical School Singapore, Singapore; 3. Division of Cancer Control and Population Sciences, University of Pittsburgh Cancer Institute, Pittsburgh, PA; Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA; and. 4. Saw Swee Hock School of Public Health, and. 5. Saw Swee Hock School of Public Health, and NUS Environmental Research Institute, National University of Singapore, Singapore; 6. Saw Swee Hock School of Public Health, and Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore (NUS) and National University Health System, Singapore; NUS Graduate School for Integrative Sciences and Engineering, and Department of Nutrition, Harvard School of Public Health, Boston, MA rob_martinus_van_dam@nuhs.edu.sg.
Abstract
BACKGROUND: Long-chain marine omega-3 polyunsaturated fatty acids (n-3 PUFAs) are associated with a lower risk of acute myocardial infarction (AMI), but results for plant-derived α-linolenic acid (ALA; 18:3n-3) are inconsistent. OBJECTIVE: We aimed to examine the association between plasma n-3 PUFAs and AMI risk and to explore potential mediation by cardiovascular disease risk factors. METHODS: A nested case-control study with 744 incident AMI cases and 744 matched controls was conducted within the Singapore Chinese Health Study for participants aged 47-83 y. Conditional logistic regression was used to calculate the multivariable ORs for AMI with and without adjustment for cardiovascular disease risk factors, including blood lipids, blood pressure, C-reactive protein, serum creatinine, and glycated hemoglobin. RESULTS: Plasma long-chain n-3 PUFAs were associated with lower AMI risk (multivariable OR: 0.62; 95% CI: 0.41, 0.94; for the highest compared with the lowest quartile; P-trend = 0.03). This association was not substantially changed after adjustment for cardiovascular disease risk factors. Dietary intakes of fish and long-chain n-3 PUFAs were similarly inversely associated with AMI risk. Plasma ALA was marginally associated with a lower risk of AMI (multivariable OR: 0.73; 95% CI: 0.51, 1.05; P-trend = 0.07) even in persons with high plasma concentrations of long-chain n-3 PUFAs. This association became significantly weaker after adjustment for blood pressure and LDL cholesterol. CONCLUSIONS: Plasma long-chain n-3 PUFAs are associated with a lower risk of AMI in this Asian population. Plasma ALA may be marginally associated with reduced AMI risk, even in persons with high concentrations of long-chain n-3 PUFAs, and this association may be partially mediated by lower blood pressure and LDL cholesterol.
BACKGROUND: Long-chain marine omega-3 polyunsaturated fatty acids (n-3 PUFAs) are associated with a lower risk of acute myocardial infarction (AMI), but results for plant-derived α-linolenic acid (ALA; 18:3n-3) are inconsistent. OBJECTIVE: We aimed to examine the association between plasma n-3 PUFAs and AMI risk and to explore potential mediation by cardiovascular disease risk factors. METHODS: A nested case-control study with 744 incident AMI cases and 744 matched controls was conducted within the Singapore Chinese Health Study for participants aged 47-83 y. Conditional logistic regression was used to calculate the multivariable ORs for AMI with and without adjustment for cardiovascular disease risk factors, including blood lipids, blood pressure, C-reactive protein, serum creatinine, and glycated hemoglobin. RESULTS: Plasma long-chain n-3 PUFAs were associated with lower AMI risk (multivariable OR: 0.62; 95% CI: 0.41, 0.94; for the highest compared with the lowest quartile; P-trend = 0.03). This association was not substantially changed after adjustment for cardiovascular disease risk factors. Dietary intakes of fish and long-chain n-3 PUFAs were similarly inversely associated with AMI risk. Plasma ALA was marginally associated with a lower risk of AMI (multivariable OR: 0.73; 95% CI: 0.51, 1.05; P-trend = 0.07) even in persons with high plasma concentrations of long-chain n-3 PUFAs. This association became significantly weaker after adjustment for blood pressure and LDL cholesterol. CONCLUSIONS: Plasma long-chain n-3 PUFAs are associated with a lower risk of AMI in this Asian population. Plasma ALA may be marginally associated with reduced AMI risk, even in persons with high concentrations of long-chain n-3 PUFAs, and this association may be partially mediated by lower blood pressure and LDL cholesterol.
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