N-6 and n-3 fatty acid cholesteryl esters in relation to incident stroke in a Dutch adult population: a nested case-control study

Nutr Metab Cardiovasc Dis. 2013 Aug;23(8):737-43. doi: 10.1016/j.numecd.2012.03.001. Epub 2012 May 24.

Abstract

Background and aims: There are few prospective studies on fatty acid status in relation to incident stroke, with inconsistent results. We assessed the associations of plasma n-6 and n-3 PUFA in cholesteryl esters with the risk of total stroke and stroke subtypes in Dutch adults.

Methods and results: We conducted a nested case-control study using data from a population-based cohort study in adults aged 20-65 years. Blood sampling and data collection took place during 1993-1997 and subjects were followed for 8-13 years. We identified 179 incident cases of stroke and 179 randomly selected controls, matched on age, gender, and enrollment date. Odds ratios (OR) with 95% confidence intervals (95%CI) were calculated per standard deviation (SD) increase of PUFA in cholesteryl esters using multivariable conditional logistic regression. Cases comprised 93 ischemic, 50 hemorrhagic, and 36 unspecified strokes. The n-6 PUFA linoleic acid and arachidonic acid contributed ~55% and ~6.5% respectively to total plasma fatty acids, whereas the n-3 PUFA alpha-linolenic acid contributed ~0.5% and eicosapentaenoic acid plus docosahexaenoic acid (EPA-DHA) ~1.3%. After adjustment for confounders, n-6 and n-3 PUFA were not associated with incident total stroke or stroke subtypes. The OR (95% CI) for total stroke was 0.95 (0.74-1.23) per SD increase in linoleic acid and 1.02 (0.80-1.30) per SD increase in arachidonic acid. ORs (95% CI) for total stroke were 0.94 (0.72-1.21) for alpha-linolenic acid and 1.16 (0.94-1.45) for EPA-DHA.

Conclusion: In the present study, plasma n-6 or n-3 fatty acids were not related to incident stroke or stroke subtypes.

Keywords: CI; Cardiovascular disease; DHA; EPA; Epidemiology; MORGEN; Monitoring Project on Risk Factors for Chronic Diseases; OR; PUFA; Polyunsaturated fatty acids; SD; confidence interval; docosahexaenoic acid; eicosapentaenoic acid; odds ratio; polyunsaturated fatty acids; standard deviation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Case-Control Studies
  • Cholesterol Esters / blood*
  • Dietary Fats / administration & dosage
  • Fatty Acids, Omega-3 / blood*
  • Fatty Acids, Omega-6 / blood*
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Logistic Models
  • Male
  • Middle Aged
  • Netherlands / epidemiology
  • Odds Ratio
  • Prospective Studies
  • Risk Factors
  • Stroke / blood
  • Stroke / epidemiology*
  • Young Adult

Substances

  • Cholesterol Esters
  • Dietary Fats
  • Fatty Acids, Omega-3
  • Fatty Acids, Omega-6