Plasma Phospholipid Fatty Acid Concentration and Incident Coronary Heart Disease in Men and Women: The EPIC-Norfolk Prospective Study
Author(s)
Khaw, K-T
Friesen, MD
Riboli, E
Luben, R
Wareham, N
Type
Journal Article
Abstract
Background: The lack of association found in several cohort studies between dietary saturated fat and coronary heart
disease (CHD) risk has renewed debate over the link between dietary fats and CHD.
Methods and Findings: We assessed the relationship between plasma phospholipid fatty acid (PFA) concentration and
incident CHD using a nested case control design within a prospective study (EPIC-Norfolk) of 25,639 individuals aged 40–79
years examined in 1993–1997 and followed up to 2009. Plasma PFA concentrations were measured by gas chromatography
in baseline samples retrieved from frozen storage. In 2,424 men and women with incident CHD compared with 4,930
controls alive and free of cardiovascular disease, mean follow-up 13 years, saturated PFA (14:0, 16:0,18:0) plasma
concentrations were significantly associated with increased CHD risk (odds ratio [OR] 1.75, 95% CI 1.27–2.41, p,0.0001), in
top compared to bottom quartiles (Q), and omega-6 polyunsaturated PFA concentrations were inversely related (OR 0.77,
0.60–0.99, p,0.05) after adjusting for age, sex, body mass index, blood pressure, smoking, alcohol intake, plasma vitamin C,
social class, education, and other PFAs. Monounsaturated PFA, omega-3 PFA, and trans PFA concentrations were not
significantly associated with CHD. Odd chain PFA (15:0, 17:0) concentrations were significantly inversely associated with
CHD (OR 0.73, 0.59–0.91, p,0.001, Q4 versus Q1). Within families of saturated PFA or polyunsaturated PFA, significantly
heterogeneous relationships with CHD were observed for individual fatty acids.
Conclusions: In this study, plasma concentrations of even chain saturated PFA were found to be positively and omega-6
polyunsaturated PFA inversely related to subsequent coronary heart disease risk. These findings are consistent with
accumulating evidence suggesting a protective role of omega-6 fats substituting for saturated fats for CHD prevention.
disease (CHD) risk has renewed debate over the link between dietary fats and CHD.
Methods and Findings: We assessed the relationship between plasma phospholipid fatty acid (PFA) concentration and
incident CHD using a nested case control design within a prospective study (EPIC-Norfolk) of 25,639 individuals aged 40–79
years examined in 1993–1997 and followed up to 2009. Plasma PFA concentrations were measured by gas chromatography
in baseline samples retrieved from frozen storage. In 2,424 men and women with incident CHD compared with 4,930
controls alive and free of cardiovascular disease, mean follow-up 13 years, saturated PFA (14:0, 16:0,18:0) plasma
concentrations were significantly associated with increased CHD risk (odds ratio [OR] 1.75, 95% CI 1.27–2.41, p,0.0001), in
top compared to bottom quartiles (Q), and omega-6 polyunsaturated PFA concentrations were inversely related (OR 0.77,
0.60–0.99, p,0.05) after adjusting for age, sex, body mass index, blood pressure, smoking, alcohol intake, plasma vitamin C,
social class, education, and other PFAs. Monounsaturated PFA, omega-3 PFA, and trans PFA concentrations were not
significantly associated with CHD. Odd chain PFA (15:0, 17:0) concentrations were significantly inversely associated with
CHD (OR 0.73, 0.59–0.91, p,0.001, Q4 versus Q1). Within families of saturated PFA or polyunsaturated PFA, significantly
heterogeneous relationships with CHD were observed for individual fatty acids.
Conclusions: In this study, plasma concentrations of even chain saturated PFA were found to be positively and omega-6
polyunsaturated PFA inversely related to subsequent coronary heart disease risk. These findings are consistent with
accumulating evidence suggesting a protective role of omega-6 fats substituting for saturated fats for CHD prevention.
Date Issued
2012-07-01
Date Acceptance
2012-05-15
Citation
Plos Medicine, 2012, 9 (7)
ISSN
1549-1676
Publisher
Public Library of Science
Journal / Book Title
Plos Medicine
Volume
9
Issue
7
Copyright Statement
© 2012 Khaw et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits
unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
License URL
Subjects
Science & Technology
Life Sciences & Biomedicine
Medicine, General & Internal
General & Internal Medicine
MEDICINE, GENERAL & INTERNAL
CARDIOVASCULAR-DISEASE
MYOCARDIAL-INFARCTION
DIETARY-INTAKE
PROSPECTIVE POPULATION
PROSPECTIVE COHORT
PHYSICAL-ACTIVITY
ADIPOSE-TISSUE
SATURATED FAT
OLDER-ADULTS
MILK-FAT
Publication Status
Published
Article Number
e1001255