Abstract P034: Circulating Omega-3 Fatty Acids and Risk of Acute Myocardial Infarction in Singapore Chinese
Introduction: Omega-3 fatty acids have been associated with reduced risk of coronary heart disease, but it remains unclear whether plant-based alpha-linolenic acid (ALA) provide similar benefits as marine-originated eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), and evidence from Asian populations is limited.
Objective: We aimed to examine the association between plasma omega-3 fatty acid biomarkers, including ALA, EPA and DHA, and risk of acute myocardial infarction (AMI) in a Chinese population in Singapore, and to explore the potential biological mediators of their effects.
Methods: We conducted a nested case control study with 759 incident fatal and non-fatal AMI cases and 796 matched controls selected from the Singapore Chinese Health Study, who were of ages 45-74 at the time of recruitment and free of cardiovascular disease at the time of blood collection. Plasma fatty acid biomarkers were measured using gas chromatography tandem mass spectrometry. Conditional logistic regression was used to calculate the odds ratios (ORs) with adjustment for other risk factors.
Results: In multivariable adjusted models, all three omega-3 fatty acid biomarkers were inversely associated with incident AMI. As compared with the lowest quartile, the OR for the highest quartile was 0.65 (95% CI: 0.45-0.94, Ptrend=0.068) for ALA, 0.67 (95% CI: 0.45-0.98, Ptrend =0.018) for EPA, and 0.59 (95% CI: 0.39-0.89, Ptrend =0.013) for DHA. The inverse association for ALA tended to be more pronounced for fatal AMI (OR 0.53; 95% CI: 0.29-0.96) than for nonfatal MI (OR 0.75; 95% CI: 0.48-1.16), but this was not observed for EPA or DHA.
Linear regression suggested that ALA was associated with lower systolic blood pressure (p<0.01) and LDL cholesterol (p<0.001), while EPA was associated with higher HDL cholesterol (p<0.01). The association of ALA with AMI appeared partially mediated by lower systolic blood pressure (27.2%) and lower LDL cholesterol (31.2%), while the association for EPA appeared partially mediated by higher HDL cholesterol (8.5%).
Conclusions: Circulating EPA, DHA and ALA are all associated with a lower risk of AMI, with the association for ALA being more pronounced for AMI death than for non-fatal MI. Associations appeared partially mediated by changes in blood pressure and blood lipids. These findings suggest that higher intake of omega-3 fatty acids from both marine and non-marine sources may protect against risk of coronary heart disease in Singapore Chinese population.
Author Disclosures: Y. Sun: None. W. Koh: None. J. Yuan: None. H. Choi: None. C. Ong: None. R.M. van Dam: None.
- © 2015 by American Heart Association, Inc.