Association of Fish Consumption-Derived Ratio of Serum n-3 to n-6 Polyunsaturated Fatty Acids and Cardiovascular Risk With the Prevalence of Coronary Artery Disease

Abstract

SummaryWe investigated the relationships between the ratio of serum n-3 polyunsaturated fatty acids (n-3PUFAs: eicosapentaenoic acid [EPA] and docosahexaenoic acid [DHA]) to n-6PUFA (arachidonic acid [AA]) and the prevalence of coronary artery disease (CAD), and assessed the association of the ratio of serum n-3 to n-6 PUFAs with atherosclerosis-related markers.This study was designed as a hospital-based cross-sectional study of 649 consecutive outpatients who had undergone regular examinations between April 2009 and October 2009. We divided the patients into 5 groups based on the quintiles of the EPA/AA ratio or quintiles of the DHA/AA ratio to determine independent factors for the prevalence of CAD.In multivariate logistic regression analyses after adjustment for coronary risk factors and serum n-3PUFAs levels to minimize confounding factors to the extent possible because the serum levels of EPA and DHA showed a strong correlation (r = 0.812, P < 0.0001), the group with the highest EPA/AA ratio had a lower probability of CAD prevalence (odds ratio: 0.328, 95% confidence interval: 0.113 to 0.956, P = 0.041), but this was not true for the DHA/AA ratio. Multivariate analysis showed an increase in the EPA/AA ratio, but not in the DHA/AA ratio, was associated with effects on atherosclerosis-related markers, especially triglyceride-rich lipoproteins, high-density lipoprotein cholesterol (HDL-C) containing apolipoprotein A-1, and leukocyte count in an anti-atherogenic direction.The results suggest a higher EPA/AA ratio, but not a higher DHA/AA ratio, might be associated with a lower prevalence of CAD and improvements of triglyceride metabolism and HDL metabolism, and systemic inflammation. (Int Heart J 2015; 56: 260-268)

Peripheral Artery Disease Is Associated with a Deficiency of Erythrocyte Membrane n‐3 Polyunsaturated Fatty Acids

“…Low plasma levels of n-3 PUFA have been associated with the presence and severity of coronary plaques (Urabe et al, 2013), progression of CAD (Erkkila et al, 2006), rate of adverse cardiac events (Itakura et al, 2011), and mortality (Masson et al, 2013). Similarly, a lower ratio of EPA to ARA in the plasma has been associated with higher prevalence of CAD (Tani et al, 2015) and acute coronary syndrome (Iwamatsu et al, 2016). The O3I, which is likely a more reliable and consistent measure of n-3 PUFA tissue content (Harris and Thomas, 2010), has been recognized as a marker of high cardiovascular risk and may actually measure a physiological phenomenon directly linked to the pathogenesis of cardiovascular disease and poor outcomes (Harris, 2009).…”

Relationship between n-3 Polyunsaturated Fatty Acids and Extent of Vessel Disease in Patients with ST Elevation Myocardial Infarction

“…[1][2][3][4] Fish oil includes n-3 polyunsaturated fatty acids (PUFAs), among which eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are known to be inversely associated with the extent of atherosclerosis, cardiovascular events, and mortality. [5][6][7][8][9][10][11][12] …”

Rye polyphenols and the metabolism of n-3 fatty acids in rats: a dose dependent fatty fish-like effect

“…The n-3 and n-6 LCFA are in competition at the level of several major enzymatic desaturation-elongation systems, as well as the prostaglandin and lipoxygenase pathways. It is thought to be the ratio n-3/n-6 rather than the absolute levels of n-3 and n-6 LCFA describing better the risk of cardiovascular disease252627. If our data on 18:2n-6 are confirmed in humans, we may have identified a major (double) mechanism by which rye polyphenols exert their health effects, namely by increasing n-3 and by decreasing n-6 LCFA in vivo .…”