201. Biomarkers of Dietary Omega-6 Fatty Acids and Incident Cardiovascular Disease and Mortality: An Individual-Level Pooled Analysis of 30 Cohort Studies
- Author
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Marklund, M, Wu, JHY, Imamura, F, Del Gobbo, LC, Fretts, A, De Goede, J, Shi, P, Tintle, N, Wennberg, M, Aslibekyan, S, Chen, TA, De Oliveira Otto, MC, Hirakawa, Y, Eriksen, HH, Kröger, J, Laguzzi, F, Lankinen, M, Murphy, RA, Prem, K, Samieri, C, Virtanen, J, Wood, AC, Wong, K, Yang, WS, Zhou, X, Baylin, A, Boer, JMA, Brouwer, IA, Campos, H, Chaves, PHM, Chien, KL, De Faire, U, Djoussé, L, Eiriksdottir, G, El-Abbadi, N, Forouhi, NG, Michael Gaziano, J, Geleijnse, JM, Gigante, B, Giles, G, Guallar, E, Gudnason, V, Harris, T, Harris, WS, Helmer, C, Hellenius, ML, Hodge, A, Hu, FB, Jacques, PF, Jansson, JH, Kalsbeek, A, Khaw, KT, Koh, WP, Laakso, M, Leander, K, Lin, HJ, Lind, L, Luben, R, Luo, J, Mcknight, B, Mursu, J, Ninomiya, T, Overvad, K, Psaty, BM, Rimm, E, Schulze, MB, Siscovick, D, Skjelbo Nielsen, M, Smith, AV, Steffen, BT, Steffen, L, Sun, Q, Sundström, J, Tsai, MY, Tunstall-Pedoe, H, Uusitupa, MIJ, Van Dam, RM, Veenstra, J, Monique Verschuren, WM, Wareham, N, Willett, W, Woodward, M, Yuan, JM, Micha, R, Lemaitre, RN, Mozaffarian, D, Risérus, U, Marklund, M, Wu, JHY, Imamura, F, Del Gobbo, LC, Fretts, A, De Goede, J, Shi, P, Tintle, N, Wennberg, M, Aslibekyan, S, Chen, TA, De Oliveira Otto, MC, Hirakawa, Y, Eriksen, HH, Kröger, J, Laguzzi, F, Lankinen, M, Murphy, RA, Prem, K, Samieri, C, Virtanen, J, Wood, AC, Wong, K, Yang, WS, Zhou, X, Baylin, A, Boer, JMA, Brouwer, IA, Campos, H, Chaves, PHM, Chien, KL, De Faire, U, Djoussé, L, Eiriksdottir, G, El-Abbadi, N, Forouhi, NG, Michael Gaziano, J, Geleijnse, JM, Gigante, B, Giles, G, Guallar, E, Gudnason, V, Harris, T, Harris, WS, Helmer, C, Hellenius, ML, Hodge, A, Hu, FB, Jacques, PF, Jansson, JH, Kalsbeek, A, Khaw, KT, Koh, WP, Laakso, M, Leander, K, Lin, HJ, Lind, L, Luben, R, Luo, J, Mcknight, B, Mursu, J, Ninomiya, T, Overvad, K, Psaty, BM, Rimm, E, Schulze, MB, Siscovick, D, Skjelbo Nielsen, M, Smith, AV, Steffen, BT, Steffen, L, Sun, Q, Sundström, J, Tsai, MY, Tunstall-Pedoe, H, Uusitupa, MIJ, Van Dam, RM, Veenstra, J, Monique Verschuren, WM, Wareham, N, Willett, W, Woodward, M, Yuan, JM, Micha, R, Lemaitre, RN, Mozaffarian, D, and Risérus, U
- Abstract
Background: Global dietary recommendations for and cardiovascular effects of linoleic acid, the major dietary omega-6 fatty acid, and its major metabolite, arachidonic acid, remain controversial. To address this uncertainty and inform international recommendations, we evaluated how in vivo circulating and tissue levels of linoleic acid (LA) and arachidonic acid (AA) relate to incident cardiovascular disease (CVD) across multiple international studies. Methods: We performed harmonized, de novo, individual-level analyses in a global consortium of 30 prospective observational studies from 13 countries. Multivariable-adjusted associations of circulating and adipose tissue LA and AA biomarkers with incident total CVD and subtypes (coronary heart disease, ischemic stroke, cardiovascular mortality) were investigated according to a prespecified analytic plan. Levels of LA and AA, measured as the percentage of total fatty acids, were evaluated linearly according to their interquintile range (ie, the range between the midpoint of the first and fifth quintiles), and categorically by quintiles. Study-specific results were pooled using inverse-variance-weighted meta-analysis. Heterogeneity was explored by age, sex, race, diabetes mellitus, statin use, aspirin use, omega-3 levels, and fatty acid desaturase 1 genotype (when available). Results: In 30 prospective studies with medians of follow-up ranging 2.5 to 31.9 years, 15 198 incident cardiovascular events occurred among 68 659 participants. Higher levels of LA were significantly associated with lower risks of total CVD, cardiovascular mortality, and ischemic stroke, with hazard ratios per interquintile range of 0.93 (95% CI, 0.88-0.99), 0.78 (0.70-0.85), and 0.88 (0.79-0.98), respectively, and nonsignificantly with lower coronary heart disease risk (0.94; 0.88-1.00). Relationships were similar for LA evaluated across quintiles. AA levels were not associated with higher risk of cardiovascular outcomes; in a comparison of extrem
- Published
- 2019