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Circulating polyunsaturated fatty acids percentages and coronary artery disease incidence and mortality:

Qiuxuan Liu1, Yifan Kong1, Haonan Kang1

  • 1Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China.

Clinical Nutrition (Edinburgh, Scotland)
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High docosahexaenoic acid (DHA)% protects against coronary artery disease (CAD) mortality, especially in older adults. Omega-6% shows sex-specific benefits for preventing CAD events. Age and sex are crucial for PUFA-based CAD prevention strategies.

Keywords:
Coronary artery diseaseMendelian randomizationPolyunsaturated fatty acidsUK Biobank

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Area of Science:

  • Cardiovascular Research
  • Nutritional Epidemiology
  • Genetic Epidemiology

Background:

  • The role of polyunsaturated fatty acids (PUFAs) in preventing coronary artery disease (CAD) is debated.
  • Investigating circulating PUFA percentages and CAD outcomes is crucial for public health.

Purpose of the Study:

  • To examine the association between circulating polyunsaturated fatty acid (PUFA) percentages and coronary artery disease (CAD) outcomes.
  • To utilize both observational and Mendelian randomization (MR) approaches for robust analysis.

Main Methods:

  • Analysis of UK Biobank data from 203,373 participants without baseline CAD.
  • Assessment of four PUFA percentages (DHA%, omega-3%, LA%, omega-6%) against incident CAD and CAD mortality.
  • Application of one-sample and two-sample MR, including linear, nonlinear, univariable, and multivariable methods, stratified by age and sex.

Main Results:

  • Observational data showed inverse associations between all PUFA percentages and CAD outcomes.
  • One-sample MR revealed genetically predicted high DHA% significantly reduced CAD mortality risk, particularly in older adults (≥58 years).
  • Genetically predicted omega-6% was associated with reduced incident CAD risk, with a significant effect observed in females but not males. Two-sample MR confirmed these findings, with partial mediation via lipid pathways.

Conclusions:

  • Elevated docosahexaenoic acid (DHA)% is protective against CAD mortality, especially in older individuals.
  • Omega-6% demonstrates sex-specific inverse associations with incident CAD.
  • Future CAD prevention strategies incorporating PUFAs should consider age and sex-specific effects.