Biomarkers of Dietary Omega-6 Fatty Acids and Incident Cardiovascular Disease and Mortality: An Individual-Level Pooled Analysis of 30 Cohort Studies

Matti Marklund; Jason H Y Wu; Fumiaki Imamura; Liana C Del Gobbo; Amanda Fretts; Janette de Goede; Peilin Shi; Nathan Tintle; Maria Wennberg; Stella Aslibekyan; Tzu-An Chen; Marcia C de Oliveira Otto; Yoichiro Hirakawa; Helle Højmark Eriksen; Janine Kröger; Federica Laguzzi; Maria Lankinen; Rachel A Murphy; Kiesha Prem; Cécilia Samieri; Jyrki Virtanen; Alexis C Wood; Kerry Wong; Wei-Sin Yang; Xia Zhou; Ana Baylin; Jolanda M A Boer; Ingeborg A Brouwer; Hannia Campos; Paulo H M Chaves; Kuo-Liong Chien; Ulf de Faire; Luc Djoussé; Gudny Eiriksdottir; Naglaa El-Abbadi; Nita G Forouhi; J Michael Gaziano; Johanna M Geleijnse; Bruna Gigante; Graham Giles; Eliseo Guallar; Vilmundur Gudnason; Tamara Harris; William S Harris; Catherine Helmer; Mai-Lis Hellénius; Allison Hodge; Frank B Hu; Paul F. Jacques; Jan-Håkan Jansson; Anya  Kalsbeek; Kay-Tee Khaw; Woon-Puay Koh; Markku Laakso; Karin Leander; Hung-Ju Lin; Lars Lind; Robert Luben; Juhua Luo; Barbara McKnight; Jaakko Mursu; Toshiharu Ninomiya; Kim Overvad; Bruce M. Psaty; Eric Rimm; Matthias B. Schulze; David Siscovick; Michael René Skjelbo Nielsen; Albert V. Smith; Brian T. Steffen; Lyn Steffen; Qi Sun; Johan Sundström; Michael Y. Tsai; Hugh Tunstall-Pedoe; Matti I. J. Uusitup; Rob M. van Dam; Jenna Veenstra; W.M. Monique Verschuren; Nick Wareham; Walter Willett,; Mark Woodward; Jian-Min Yuan; Renata Micha; Rozenn N Lemaitre,; Dariush Mozaffarian; Ulf Risérus; Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) Fatty Acids and Outcomes Research Consortium (FORCE)

doi:10.1161/CIRCULATIONAHA.118.038908

Biomarkers of Dietary Omega-6 Fatty Acids and Incident Cardiovascular Disease and Mortality: An Individual-Level Pooled Analysis of 30 Cohort Studies

Matti Marklund, Jason H Y Wu, Fumiaki Imamura, Liana C Del Gobbo, Amanda Fretts, Janette de Goede, Peilin Shi, Nathan Tintle, Maria Wennberg, Stella Aslibekyan, Tzu-An Chen, Marcia C de Oliveira Otto, Yoichiro Hirakawa, Helle Højmark Eriksen, Janine Kröger, Federica Laguzzi, Maria Lankinen, Rachel A Murphy, Kiesha Prem, Cécilia SamieriJyrki Virtanen, Alexis C Wood, Kerry Wong, Wei-Sin Yang, Xia Zhou, Ana Baylin, Jolanda M A Boer, Ingeborg A Brouwer, Hannia Campos, Paulo H M Chaves, Kuo-Liong Chien, Ulf de Faire, Luc Djoussé, Gudny Eiriksdottir, Naglaa El-Abbadi, Nita G Forouhi, J Michael Gaziano, Johanna M Geleijnse, Bruna Gigante, Graham Giles, Eliseo Guallar, Vilmundur Gudnason, Tamara Harris, William S Harris, Catherine Helmer, Mai-Lis Hellénius, Allison Hodge, Frank B Hu, Paul F. Jacques, Jan-Håkan Jansson, Anya Kalsbeek, Kay-Tee Khaw, Woon-Puay Koh, Markku Laakso, Karin Leander, Hung-Ju Lin, Lars Lind, Robert Luben, Juhua Luo, Barbara McKnight, Jaakko Mursu, Toshiharu Ninomiya, Kim Overvad, Bruce M. Psaty, Eric Rimm, Matthias B. Schulze, David Siscovick, Michael René Skjelbo Nielsen, Albert V. Smith, Brian T. Steffen, Lyn Steffen, Qi Sun, Johan Sundström, Michael Y. Tsai, Hugh Tunstall-Pedoe, Matti I. J. Uusitup, Rob M. van Dam, Jenna Veenstra, W.M. Monique Verschuren, Nick Wareham, Walter Willett,, Mark Woodward, Jian-Min Yuan, Renata Micha, Rozenn N Lemaitre,, Dariush Mozaffarian, Ulf Risérus, Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) Fatty Acids and Outcomes Research Consortium (FORCE)

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

193 Citationer (Scopus)

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 extreme quintiles, higher levels were associated with lower risk of total CVD (0.92; 0.86-0.99). No consistent heterogeneity by population subgroups was identified in the observed relationships. CONCLUSIONS: In pooled global analyses, higher in vivo circulating and tissue levels of LA and possibly AA were associated with lower risk of major cardiovascular events. These results support a favorable role for LA in CVD prevention.

Originalsprog	Engelsk
Tidsskrift	Circulation
Vol/bind	139
Udgave nummer	21
Sider (fra-til)	2422-2436
Antal sider	15
ISSN	0009-7322
DOI	https://doi.org/10.1161/CIRCULATIONAHA.118.038908
Status	Udgivet - 21 maj 2019

Adgang til dokumentet

10.1161/CIRCULATIONAHA.118.038908

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6582360/pdf/nihms-1527419.pdf

AUB Link

Søg efter materialet i Aalborg Universitetsbiblioteks søgemaskine

Andre filer og links

http://www.scopus.com/inward/record.url?scp=85066456162&partnerID=8YFLogxK

Citationsformater

Marklund, M., Wu, J. H. Y., Imamura, F., Del Gobbo, L. C., Fretts, A., de Goede, J., Shi, P., Tintle, N., Wennberg, M., Aslibekyan, S., Chen, T-A., de Oliveira Otto, M. C., Hirakawa, Y., Eriksen, H. H., Kröger, J., Laguzzi, F., Lankinen, M., Murphy, R. A., Prem, K., ... Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) Fatty Acids and Outcomes Research Consortium (FORCE) (2019). Biomarkers of Dietary Omega-6 Fatty Acids and Incident Cardiovascular Disease and Mortality: An Individual-Level Pooled Analysis of 30 Cohort Studies. Circulation, 139(21), 2422-2436. https://doi.org/10.1161/CIRCULATIONAHA.118.038908

@article{e9db7155f05b4bd4abd48a82da231020,

title = "Biomarkers of Dietary Omega-6 Fatty Acids and Incident Cardiovascular Disease and Mortality: An Individual-Level Pooled Analysis of 30 Cohort Studies",

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 extreme quintiles, higher levels were associated with lower risk of total CVD (0.92; 0.86-0.99). No consistent heterogeneity by population subgroups was identified in the observed relationships. CONCLUSIONS: In pooled global analyses, higher in vivo circulating and tissue levels of LA and possibly AA were associated with lower risk of major cardiovascular events. These results support a favorable role for LA in CVD prevention.",

keywords = "arachidonic acid, biomarkers, cardiovascular diseases, diet, epidemiology, linoleic acid, primary prevention",

author = "Matti Marklund and Wu, {Jason H Y} and Fumiaki Imamura and {Del Gobbo}, {Liana C} and Amanda Fretts and {de Goede}, Janette and Peilin Shi and Nathan Tintle and Maria Wennberg and Stella Aslibekyan and Tzu-An Chen and {de Oliveira Otto}, {Marcia C} and Yoichiro Hirakawa and Eriksen, {Helle H{\o}jmark} and Janine Kr{\"o}ger and Federica Laguzzi and Maria Lankinen and Murphy, {Rachel A} and Kiesha Prem and C{\'e}cilia Samieri and Jyrki Virtanen and Wood, {Alexis C} and Kerry Wong and Wei-Sin Yang and Xia Zhou and Ana Baylin and Boer, {Jolanda M A} and Brouwer, {Ingeborg A} and Hannia Campos and Chaves, {Paulo H M} and Kuo-Liong Chien and {de Faire}, Ulf and Luc Djouss{\'e} and Gudny Eiriksdottir and Naglaa El-Abbadi and Forouhi, {Nita G} and Gaziano, {J Michael} and Geleijnse, {Johanna M} and Bruna Gigante and Graham Giles and Eliseo Guallar and Vilmundur Gudnason and Tamara Harris and Harris, {William S} and Catherine Helmer and Mai-Lis Hell{\'e}nius and Allison Hodge and Hu, {Frank B} and Jacques, {Paul F.} and Jan-H{\aa}kan Jansson and Anya Kalsbeek and Kay-Tee Khaw and Woon-Puay Koh and Markku Laakso and Karin Leander and Hung-Ju Lin and Lars Lind and Robert Luben and Juhua Luo and Barbara McKnight and Jaakko Mursu and Toshiharu Ninomiya and Kim Overvad and Psaty, {Bruce M.} and Eric Rimm and Schulze, {Matthias B.} and David Siscovick and {Skjelbo Nielsen}, {Michael Ren{\'e}} and Smith, {Albert V.} and Steffen, {Brian T.} and Lyn Steffen and Qi Sun and Johan Sundstr{\"o}m and Tsai, {Michael Y.} and Hugh Tunstall-Pedoe and Uusitup, {Matti I. J.} and {van Dam}, {Rob M.} and Jenna Veenstra and Verschuren, {W.M. Monique} and Nick Wareham and Walter Willett, and Mark Woodward and Jian-Min Yuan and Renata Micha and Lemaitre,, {Rozenn N} and Dariush Mozaffarian and Ulf Ris{\'e}rus and {Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) Fatty Acids and Outcomes Research Consortium (FORCE)}",

year = "2019",

month = may,

day = "21",

doi = "10.1161/CIRCULATIONAHA.118.038908",

language = "English",

volume = "139",

pages = "2422--2436",

journal = "Circulation",

issn = "0009-7322",

publisher = "AHA/ASA",

number = "21",

}

Marklund, M, Wu, JHY, Imamura, F, Del Gobbo, LC, Fretts, A, de Goede, J, Shi, P, Tintle, N, Wennberg, M, Aslibekyan, S, Chen, T-A, 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, W-S, Zhou, X, Baylin, A, Boer, JMA, Brouwer, IA, Campos, H, Chaves, PHM, Chien, K-L, de Faire, U, Djoussé, L, Eiriksdottir, G, El-Abbadi, N, Forouhi, NG, Gaziano, JM, Geleijnse, JM, Gigante, B, Giles, G, Guallar, E, Gudnason, V, Harris, T, Harris, WS, Helmer, C, Hellénius, M-L, Hodge, A, Hu, FB, Jacques, PF, Jansson, J-H, Kalsbeek, A, Khaw, K-T, Koh, W-P, Laakso, M, Leander, K, Lin, H-J, Lind, L, Luben, R, Luo, J, McKnight, B, Mursu, J, Ninomiya, T, Overvad, K, Psaty, BM, Rimm, E, Schulze, MB, Siscovick, D, Skjelbo Nielsen, MR, Smith, AV, Steffen, BT, Steffen, L, Sun, Q, Sundström, J, Tsai, MY, Tunstall-Pedoe, H, Uusitup, MIJ, van Dam, RM, Veenstra, J, Verschuren, WMM, Wareham, N, Willett, W, Woodward, M, Yuan, J-M, Micha, R, Lemaitre, RN, Mozaffarian, D, Risérus, U & Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) Fatty Acids and Outcomes Research Consortium (FORCE) 2019, 'Biomarkers of Dietary Omega-6 Fatty Acids and Incident Cardiovascular Disease and Mortality: An Individual-Level Pooled Analysis of 30 Cohort Studies', Circulation, bind 139, nr. 21, s. 2422-2436. https://doi.org/10.1161/CIRCULATIONAHA.118.038908

TY - JOUR

T1 - Biomarkers of Dietary Omega-6 Fatty Acids and Incident Cardiovascular Disease and Mortality

T2 - An Individual-Level Pooled Analysis of 30 Cohort Studies

AU - Marklund, Matti

AU - Wu, Jason H Y

AU - Imamura, Fumiaki

AU - Del Gobbo, Liana C

AU - Fretts, Amanda

AU - de Goede, Janette

AU - Shi, Peilin

AU - Tintle, Nathan

AU - Wennberg, Maria

AU - Aslibekyan, Stella

AU - Chen, Tzu-An

AU - de Oliveira Otto, Marcia C

AU - Hirakawa, Yoichiro

AU - Eriksen, Helle Højmark

AU - Kröger, Janine

AU - Laguzzi, Federica

AU - Lankinen, Maria

AU - Murphy, Rachel A

AU - Prem, Kiesha

AU - Samieri, Cécilia

AU - Virtanen, Jyrki

AU - Wood, Alexis C

AU - Wong, Kerry

AU - Yang, Wei-Sin

AU - Zhou, Xia

AU - Baylin, Ana

AU - Boer, Jolanda M A

AU - Brouwer, Ingeborg A

AU - Campos, Hannia

AU - Chaves, Paulo H M

AU - Chien, Kuo-Liong

AU - de Faire, Ulf

AU - Djoussé, Luc

AU - Eiriksdottir, Gudny

AU - El-Abbadi, Naglaa

AU - Forouhi, Nita G

AU - Gaziano, J Michael

AU - Geleijnse, Johanna M

AU - Gigante, Bruna

AU - Giles, Graham

AU - Guallar, Eliseo

AU - Gudnason, Vilmundur

AU - Harris, Tamara

AU - Harris, William S

AU - Helmer, Catherine

AU - Hellénius, Mai-Lis

AU - Hodge, Allison

AU - Hu, Frank B

AU - Jacques, Paul F.

AU - Jansson, Jan-Håkan

AU - Kalsbeek, Anya

AU - Khaw, Kay-Tee

AU - Koh, Woon-Puay

AU - Laakso, Markku

AU - Leander, Karin

AU - Lin, Hung-Ju

AU - Lind, Lars

AU - Luben, Robert

AU - Luo, Juhua

AU - McKnight, Barbara

AU - Mursu, Jaakko

AU - Ninomiya, Toshiharu

AU - Overvad, Kim

AU - Psaty, Bruce M.

AU - Rimm, Eric

AU - Schulze, Matthias B.

AU - Siscovick, David

AU - Skjelbo Nielsen, Michael René

AU - Smith, Albert V.

AU - Steffen, Brian T.

AU - Steffen, Lyn

AU - Sun, Qi

AU - Sundström, Johan

AU - Tsai, Michael Y.

AU - Tunstall-Pedoe, Hugh

AU - Uusitup, Matti I. J.

AU - van Dam, Rob M.

AU - Veenstra, Jenna

AU - Verschuren, W.M. Monique

AU - Wareham, Nick

AU - Willett,, Walter

AU - Woodward, Mark

AU - Yuan, Jian-Min

AU - Micha, Renata

AU - Lemaitre,, Rozenn N

AU - Mozaffarian, Dariush

AU - Risérus, Ulf

AU - Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) Fatty Acids and Outcomes Research Consortium (FORCE)

PY - 2019/5/21

Y1 - 2019/5/21

N2 - 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 extreme quintiles, higher levels were associated with lower risk of total CVD (0.92; 0.86-0.99). No consistent heterogeneity by population subgroups was identified in the observed relationships. CONCLUSIONS: In pooled global analyses, higher in vivo circulating and tissue levels of LA and possibly AA were associated with lower risk of major cardiovascular events. These results support a favorable role for LA in CVD prevention.

AB - 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 extreme quintiles, higher levels were associated with lower risk of total CVD (0.92; 0.86-0.99). No consistent heterogeneity by population subgroups was identified in the observed relationships. CONCLUSIONS: In pooled global analyses, higher in vivo circulating and tissue levels of LA and possibly AA were associated with lower risk of major cardiovascular events. These results support a favorable role for LA in CVD prevention.

KW - arachidonic acid

KW - biomarkers

KW - cardiovascular diseases

KW - diet

KW - epidemiology

KW - linoleic acid

KW - primary prevention

UR - http://www.scopus.com/inward/record.url?scp=85066456162&partnerID=8YFLogxK

U2 - 10.1161/CIRCULATIONAHA.118.038908

DO - 10.1161/CIRCULATIONAHA.118.038908

M3 - Journal article

C2 - 30971107

SN - 0009-7322

VL - 139

SP - 2422

EP - 2436

JO - Circulation

JF - Circulation

IS - 21

ER -

Biomarkers of Dietary Omega-6 Fatty Acids and Incident Cardiovascular Disease and Mortality: An Individual-Level Pooled Analysis of 30 Cohort Studies

Abstract

Adgang til dokumentet

AUB Link

Andre filer og links

Fingeraftryk

Citationsformater