Serum Fatty Acids and Incidence of Ischemic Stroke Among Postmenopausal Women

Abstract

Background and Purpose While studies have linked types of fatty acids with coronary heart disease, data on individual fatty acids and risk of ischemic stroke are limited. We aimed to examine the associations between serum fatty acid concentrations and incidence of ischemic stroke and its subtypes. Methods We conducted a prospective case-control study nested in the Women's Health Initiative Observational Study cohort of postmenopausal US women aged 50 to 79 years. Between 1993 and 2003, incident cases of ischemic stroke were matched 1:1 to controls on age, race, and length of follow-up (964 matched pairs). Conditional logistic regression was used to estimate odds ratios (OR) and 99.9% confidence intervals (CI) for ischemic stroke and its subtypes. Results The multivariable adjusted OR and 99.9% CI of ischemic stroke associated with a 1-standard deviation (SD) increment in serum fatty acid concentration was 1.38 (99.9% CI, 1.05-1.83) for linelaidic acid (18:2tt, SD=0.04%); 1.27 (99.9% CI, 1.06-1.51) for palmitic acid (16:0, SD=2.74%); 1.20 (99.9% CI, 1.01-1.43) for oleic acid (18:1n9, SD=2.32%); 0.72 (99.9% CI, 0.59-0.87) for docosapentaenoic acid (22:5n3, SD=0.18%); 0.72 (99.9% CI, 0.59-0.87) for docosahexaenoic acid (22:6n3, SD=0.91%); and 0.81 (99.9% CI, 0.67-0.98) for arachidonic acid (20:4n6, SD=2.02%). These associations were generally consistent for atherothrombotic and lacunar stroke, but not cardioembolic stroke. Conclusions These findings suggest that individual serum trans, saturated, and monounsaturated fatty acids are positively associated with particular ischemic stroke subtypes, while individual n3 and n6 polyunsaturated fatty acids are inversely associated.

Associations of serum n-3 and n-6 PUFA and hair mercury with the risk of incident stroke in men: the Kuopio Ischaemic Heart Disease Risk Factor Study (KIHD)

“…However, as in our cohort, this has not been observed in all studies (6,15,18) . Our results on the lack of association with AA, GLA and dihomo-γ-linolenic acid are consistent with other findings from other observational studies (6,14,17,19,21) . In the KIHD cohort, high hair Hg content was associated with a higher risk of CVD and with attenuation of the inverse association between n-3 PUFA and these events (22,23) .…”

“…Circulating fatty acids provide an objective measure of exposure, and are thus less subject to random error. However, previous studies that have used circulating PUFA as exposure have not produced consistent findings (6)(7)(8)(14)(15)(16)(17)(18)(19)(20)(21) . Therefore, the aim of our study was to investigate the associations between serum n-3 and n-6 PUFA and risk of stroke in men.…”

“…In prospective studies, consumption of longchain n-3 PUFA has been associated with modestly lower risk of stroke (7) , but only a few studies have investigated the association with the intermediate-chain length n-3 PUFA α-linolenic acid (ALA) and the results have been mixed (8)(9)(10) . The n-6 PUFA have not generally been associated with stroke risk (11)(12)(13)(14) . Assessment of dietary intakes by subjective methods such as FFQ is subject to misclassification, which creates random error, and therefore can attenuate the associations between dietary factors and risk of diseases.…”

Cerebrospinal Fluid Free Fatty Acid Levels Are Associated with Stroke Subtypes and Severity in Chinese Patients with Acute Ischemic Stroke

“…There have been a few papers in literature linking serum FFA and stroke (5,21,25), fewer linking CSF FFA and stroke status and, as far as I could find, none in an ethnic Chinese sample. As such, this manuscript significantly adds to the literature, especially as strokes in the ethnic Chinese origin make up such a high proportion of the world, and the results are likely to be generalizable in a non-Chinese population.…”

“…Thus far, those results have been inconsistent (25). FFA accumulation can result in an uncoupling of oxidative phosphorylation and the formation of inflammatory by-products, including reactive oxygen species.…”