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Open AccessArticle

Plasma Phospholipid Fatty Acids and Coronary Heart Disease Risk: A Matched Case-Control Study within the Women’s Health Initiative Observational Study

Department of Epidemiology, School of Public Health, Brown University, Providence, RI 02912, USA
Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA 02111, USA
Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA
MedStar Health Research Institute, Hyattsville, MD 20782, USA
Georgetown-Howard Universities Center for Clinical and Translational Science, Washington, DC 20057, USA
Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA
Department of Preventive Medicine, Fineberg School of Medicine, Northwest University, 680 N Lake Shore Drive, Suite 1400, Chicago, IL 60611, USA
National Heart, Lung, and Blood Institute, Bethesda, MD 20892, USA
University of California, La Jolla, San Diego, CA 92093, USA
VA San Diego Healthcare System, San Diego, CA 92161, USA
Division of Cardiology, George Washington University School of Medicine and Health Sciences, Washington, DC 20052, USA
Health Statistics and Geography Lab, Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA
Department of Epidemiology, University of Iowa, 200 Hawkins Drive, Iowa City, IA 52242, USA
Center for Primary Care and Prevention, Kent Hospital, Pawtucket, RI 02860, USA
Department of Family Medicine, Brown University Alpert Medical School, Providence, RI 02903, USA
Author to whom correspondence should be addressed.
Nutrients 2019, 11(7), 1672;
Received: 10 June 2019 / Revised: 12 July 2019 / Accepted: 17 July 2019 / Published: 21 July 2019
(This article belongs to the Special Issue Dietary Fat and Human Health)
Background and Aims: The association of fatty acids with coronary heart disease (CHD) has been examined, mainly through dietary measurements, and has generated inconsistent results due to measurement error. Large observational studies and randomized controlled trials have shown that plasma phospholipid fatty acids (PL-FA), especially those less likely to be endogenously synthesized, are good biomarkers of dietary fatty acids. Thus, PL-FA profiles may better predict CHD risk with less measurement error. Methods: We performed a matched case-control study of 2428 postmenopausal women nested in the Women’s Health Initiative Observational Study. Plasma PL-FA were measured using gas chromatography and expressed as molar percentage (moL %). Multivariable conditional logistic regression was used to calculate odds ratios (95% CIs) for CHD associated with 1 moL % change in PL-FA. Results: Higher plasma PL long-chain saturated fatty acids (SFA) were associated with increased CHD risk, while higher n-3 polyunsaturated fatty acids (PUFA) were associated with decreased risk. No significant associations were observed for very-long-chain SFA, monounsaturated fatty acids (MUFA), PUFA n-6 or trans fatty acids (TFA). Substituting 1 moL % PUFA n-6 or TFA with an equivalent proportion of PUFA n-3 were associated with lower CHD risk. Conclusions: Higher plasma PL long-chain SFA and lower PUFA n-3 were associated with increased CHD risk. A change in diet by limiting foods that are associated with plasma PL long-chain SFA and TFA while enhancing foods high in PUFA n-3 may be beneficial in CHD among postmenopausal women. View Full-Text
Keywords: plasma phospholipid fatty acids; coronary heart disease; postmenopausal women plasma phospholipid fatty acids; coronary heart disease; postmenopausal women
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Liu, Q.; Matthan, N.R.; Manson, J.E.; Howard, B.V.; Tinker, L.F.; Neuhouser, M.L.; Van Horn, L.V.; Rossouw, J.E.; Allison, M.A.; Martin, L.W.; Li, W.; Snetselaar, L.G.; Wang, L.; Lichtenstein, A.H.; Eaton, C.B. Plasma Phospholipid Fatty Acids and Coronary Heart Disease Risk: A Matched Case-Control Study within the Women’s Health Initiative Observational Study. Nutrients 2019, 11, 1672.

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