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Associations of circulating fatty acids with incident coronary heart disease: a prospective study of 89,242 individuals in UK Biobank

Associations of circulating fatty acids with incident coronary heart disease: a prospective study of 89,242 individuals in UK Biobank
Associations of circulating fatty acids with incident coronary heart disease: a prospective study of 89,242 individuals in UK Biobank
Background: the role of fatty acids in coronary heart disease (CHD) remains uncertain. There is little evidence from large-scale epidemiological studies on the relevance of circulating fatty acids levels to CHD risk. This study aims to examine the independent associations of the major circulating types of fatty acids with CHD risk.

Methods: UK Biobank is a prospective study of adults aged 40–69 in 2006–2010; in 2012–2013, a subset of the participants were resurveyed. Analyses were restricted to 89,242 participants with baseline plasma fatty acids (measured using nuclear magnetic resonance spectroscopy) and without prior CHD. Cox proportional hazards models were used to estimate hazard ratios (HRs) for the associations with incidence CHD, defined as the first-ever myocardial infarction, unstable angina pectoris, coronary-related death, or relevant procedure. And the major types of fatty acids were mutually adjusted to examine the independent associations. Hazard ratios were corrected for regression dilution using the correlation of baseline and resurvey fatty acids measures.

Results: during a median follow-up of 11.8 years, 3,815 incident cases of CHD occurred. Independently of other fatty acids, CHD risk was positively associated with saturated fatty acids (SFA) and monounsaturated fatty acids (MUFA), inversely associated with omega-3 polyunsaturated fatty acids (PUFA), but there was no strong evidence of an association with omega-6 PUFA: HR per standard deviation higher were 1.14 (95% CI, 1.09–1.20), 1.15 (1.10–1.21), 0.91 (0.87–0.94), and 1.04 (0.99–1.09) respectively. Independently of triglycerides and cholesterol, the inverse association with omega-3 PUFA was not materially changed, but the positive associations with SFA and MUFA attenuated to null after adjusting for triglycerides levels.

Conclusions: this large-scale study has quantitated the independent associations of circulating fatty acids with CHD risk. Omega-3 PUFA was inversely related to CHD risk, independently of other fatty acids and major lipid fractions. By contrast, independently of other fatty acids, the positive associations of circulating SFA and MUFA with CHD risk were mostly attributed to their relationship with triglycerides.
Coronary heart disease, Fatty acids, Lipids, Nuclear magnetic resonance, UK Biobank
1471-2261
Jin, Danyao
3b4bb056-3dc1-4729-80ce-602181221e28
Trichia, Eirini
56c1a4dc-dee2-408a-90ce-92314de4548a
Islam, Nazrul
e5345196-7479-438f-b4f6-c372d2135586
Lewington, Sarah
b47fcba0-25ce-481a-81c6-5b30ea95ae34
Lacey, Ben
38227149-1faa-42d3-bf28-a9345d0c0872
Jin, Danyao
3b4bb056-3dc1-4729-80ce-602181221e28
Trichia, Eirini
56c1a4dc-dee2-408a-90ce-92314de4548a
Islam, Nazrul
e5345196-7479-438f-b4f6-c372d2135586
Lewington, Sarah
b47fcba0-25ce-481a-81c6-5b30ea95ae34
Lacey, Ben
38227149-1faa-42d3-bf28-a9345d0c0872

Jin, Danyao, Trichia, Eirini, Islam, Nazrul, Lewington, Sarah and Lacey, Ben (2023) Associations of circulating fatty acids with incident coronary heart disease: a prospective study of 89,242 individuals in UK Biobank. BMC Cardiovascular Disorders, 23 (1), [365]. (doi:10.1186/s12872-023-03394-6).

Record type: Article

Abstract

Background: the role of fatty acids in coronary heart disease (CHD) remains uncertain. There is little evidence from large-scale epidemiological studies on the relevance of circulating fatty acids levels to CHD risk. This study aims to examine the independent associations of the major circulating types of fatty acids with CHD risk.

Methods: UK Biobank is a prospective study of adults aged 40–69 in 2006–2010; in 2012–2013, a subset of the participants were resurveyed. Analyses were restricted to 89,242 participants with baseline plasma fatty acids (measured using nuclear magnetic resonance spectroscopy) and without prior CHD. Cox proportional hazards models were used to estimate hazard ratios (HRs) for the associations with incidence CHD, defined as the first-ever myocardial infarction, unstable angina pectoris, coronary-related death, or relevant procedure. And the major types of fatty acids were mutually adjusted to examine the independent associations. Hazard ratios were corrected for regression dilution using the correlation of baseline and resurvey fatty acids measures.

Results: during a median follow-up of 11.8 years, 3,815 incident cases of CHD occurred. Independently of other fatty acids, CHD risk was positively associated with saturated fatty acids (SFA) and monounsaturated fatty acids (MUFA), inversely associated with omega-3 polyunsaturated fatty acids (PUFA), but there was no strong evidence of an association with omega-6 PUFA: HR per standard deviation higher were 1.14 (95% CI, 1.09–1.20), 1.15 (1.10–1.21), 0.91 (0.87–0.94), and 1.04 (0.99–1.09) respectively. Independently of triglycerides and cholesterol, the inverse association with omega-3 PUFA was not materially changed, but the positive associations with SFA and MUFA attenuated to null after adjusting for triglycerides levels.

Conclusions: this large-scale study has quantitated the independent associations of circulating fatty acids with CHD risk. Omega-3 PUFA was inversely related to CHD risk, independently of other fatty acids and major lipid fractions. By contrast, independently of other fatty acids, the positive associations of circulating SFA and MUFA with CHD risk were mostly attributed to their relationship with triglycerides.

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Published date: 21 July 2023
Additional Information: Funding Information: The Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU) receives research grants from industry that are governed by University of Oxford contracts that protect its independence and has a staff policy of not taking personal payments from industry; further details can be found at https://www.ndph.ox.ac.uk/files/about/ndph-independence-of-research-policy-jun-20.pdf . This research used UK Biobank data assets made available by National Safe Haven as part of the Data and Connectivity National Core Study, led by Health Data Research UK in partnership with the Office for National Statistics and funded by UK Research and Innovation (grant ref MC_PC_20058). Funding Information: SL reports grants from the Medical Research Council (MRC) and research funding from the US Centers for Disease Control and Prevention Foundation (with support from Amgen) and from the World Health Organization during the conduct of the study, all outside the submitted work. Other remaining authors declared no conflict of interest. Publisher Copyright: © 2023, The Author(s).
Keywords: Coronary heart disease, Fatty acids, Lipids, Nuclear magnetic resonance, UK Biobank

Identifiers

Local EPrints ID: 483692
URI: http://eprints.soton.ac.uk/id/eprint/483692
ISSN: 1471-2261
PURE UUID: eadac72d-a1bf-4bfb-a493-8409e8d68276
ORCID for Nazrul Islam: ORCID iD orcid.org/0000-0003-3982-4325

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Date deposited: 03 Nov 2023 17:54
Last modified: 18 Mar 2024 04:08

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Contributors

Author: Danyao Jin
Author: Eirini Trichia
Author: Nazrul Islam ORCID iD
Author: Sarah Lewington
Author: Ben Lacey

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