Highlights
- •Higher in vivo omega-3 levels are linked with lower risk for heart disease.
- •Omega-3 status is currently expressed using several different metrics.
- •The Omega-3 Index (O3I, RBC EPA + DHA) is a useful marker but cutpoints need validation.
- •Transformed data from a prior meta-analysis confirms O3I cutpoints of <4% and >8%.
Abstract
Background and aims
A recent 19-cohort meta-analysis examined the relationships between biomarkers of
omega-3 fatty acids and risk for coronary heart disease (CHD). That study did not,
however, report hazard ratios (HRs) specifically as a function of erythrocyte eicosapentaenoic
(EPA) plus docosahexaenoic (DHA) levels, a metric called the Omega-3 Index in which
EPA + DHA content is expressed as a percent of total fatty acids. The Omega-3 Index
has been used in several recent studies and is a validated biomarker of omega-3 fatty
acid tissue levels, but additional data are needed to confirm (or refute) the originally-proposed
clinical cut-points of <4% (higher risk) and 8%–12% (lower risk).
Methods
The present study was therefore undertaken using published data from this meta-analysis
to estimate HRs per 1-SD increase in the Omega-3 Index and median quintile values
for this metric across 10 of the cohorts for which the needed data were available.
Results
The overall mean (SD) for the Omega-3 Index in these 10 cohort studies was 6.1% (2.1%),
and the HR for a 1-SD increase was 0.85 (95% confidence interval, 0.80–0.91). Median
quintile 1 and 5 levels were 4.2% vs. 8.3%, respectively. Based on these values, we estimate that risk for fatal CHD would
have been reduced by about 30% moving from an Omega-3 Index of 4%–8%.
Conclusions
These findings support the use of <4% and >8% as reasonable therapeutic targets for
the Omega-3 Index.
Keywords
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Article info
Publication history
Published online: May 06, 2017
Accepted:
May 5,
2017
Received in revised form:
April 23,
2017
Received:
March 4,
2017
Identification
Copyright
© 2017 Elsevier B.V. All rights reserved.
