Highlights
- •We investigate fatty acids on the risk of cardiovascular and all-cause death events.
- •Trans fat and saturated fat were predictors for all-cause death risk.
- •EPA was inversely related to all-cause death.
Abstract
Background
The issue of whether saturated fats and trans fats are superior predictors of all-cause
death and cardiovascular disease than n-3 polyunsaturated fatty acids, such as eicosapentaenoic
acid (EPA) and docosahexaenoic acid (DHA), remains a matter of contention. Furthermore,
few studies have examined the relationship between fatty acids and the outcomes of
cardiovascular disease (CVD) in Asian populations. The aim of this study was to compare
the effectiveness of various plasma fatty acids as predictors for all-cause death
and CVD events in an ethnic Chinese population.
Methods
This study assembled a community-based prospective cohort, comprising 1833 participants
(60.6 ± 10.5 yrs, 44.5% women) who underwent a comprehensive evaluation of fatty acids
in blood using gas chromatography. None of the subjects had a history of CVD at the
time of recruitment.
Results
A total of 568 individuals died and 275 individuals developed CVD during the follow-up
period (median of 9.6 years; interquartile range of 8.9–10.5 years). Following adjustment
for established cardiovascular risk factors, the relative risk of all-cause death
in the highest quartile, compared with the lowest quartile, was 1.33 for saturated
fats (95% confidence interval [CI], 1.01–1.75, test for trend, P = 0.015), 1.71 for trans fats (95% CI, 1.27–2.31, test for trend, P = 0.0003), 0.77 for EPA (95% CI, 0.59–1.00, test for trend, P = 0.048), and 0.89 for DHA (95% CI, 0.68–1.18, test for trend, P = 0.354). Similar patterns were observed for CVD events. Trans fats presented the
largest area under the receiver operator characteristic curve (0.740, 95% CI, 0.716–0.766)
for the prediction of all-cause death. A mutually adjusted two-marker model indicated
that saturated fats and trans fats were significant predictors of all-cause death
and CVD; however, the other fatty acids were not. In addition, trans fats presented
the greatest improvement in net reclassification for all-cause death (7.7%, P = 0.003), followed by EPA (3.8%, P = 0.033). Saturated fats presented the greatest improvement in net reclassification
for CVD events (5.6%, P = 0.039).
Conclusions
Our data provides strong evidence to support that plasma saturated fats and trans
fats can predict all-cause death and CVD more effectively than other fatty acid markers.
Keywords
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Article info
Publication history
Accepted:
June 20,
2013
Received in revised form:
June 19,
2013
Received:
December 3,
2012
Identification
Copyright
© 2013 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
