Erythrocyte n-6 Fatty Acids and Risk for Cardiovascular Outcomes and Total Mortality in the Framingham Heart Study
Department of Internal Medicine, Sanford School of Medicine, University of South Dakota, Vermillion, SD 57069, USA
OmegaQuant Analytics, LLC, Sioux Falls, SD 57106, USA
Department of Mathematics & Statistics, Dordt College, Sioux Center, IA 51250, USA
National Heart Lung and Blood Institute’s and Boston University’s Framingham Heart Study, Framingham, MA 02118, USA
Departments of Cardiology and Preventive Medicine, Department of Medicine, Boston University School of Medicine, Boston, MA 02118, USA
Department of Biostatistics, Boston University School of Public Health, Boston, MA 02118, USA
Author to whom correspondence should be addressed.
Nutrients 2018, 10(12), 2012; https://doi.org/10.3390/nu10122012
Received: 7 November 2018 / Revised: 11 December 2018 / Accepted: 12 December 2018 / Published: 19 December 2018
(This article belongs to the Special Issue Fatty Acids and Cardiometabolic Health)
Background: The prognostic value of erythrocyte levels of n-6 fatty acids (FAs) for total mortality and cardiovascular disease (CVD) outcomes remains an open question. Methods: We examined cardiovascular (CV) outcomes and death in 2500 individuals in the Framingham Heart Study Offspring cohort without prevalent CVD (mean age 66 years, 57% women) as a function of baseline levels of different length n-6 FAs (18 carbon, 20 carbon, and 22 carbon) in the erythrocyte membranes. Clinical outcomes were monitored for up to 9.5 years (median follow up, 7.26 years). Cox proportional hazards models were adjusted for a variety of demographic characteristics, clinical status, and red blood cell (RBC) n-6 and long chain n-3 FA content. Results: There were 245 CV events, 119 coronary heart disease (CHD) events, 105 ischemic strokes, 58 CVD deaths, and 350 deaths from all causes. Few associations between either mortality or CVD outcomes were observed for n-6 FAs, with those that were observed becoming non-significant after adjusting for n-3 FA levels. Conclusions: Higher circulating levels of marine n-3 FA levels are associated with reduced risk for incident CVD and ischemic stroke and for death from CHD and all-causes; however, in the same sample little evidence exists for association with n-6 FAs. Further work is needed to identify a full profile of FAs associated with cardiovascular risk and mortality.