Document Detail


Plasma phospholipid long-chain ω-3 fatty acids and total and cause-specific mortality in older adults: a cohort study.
MedLine Citation:
PMID:  23546563     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Long-chain ω-3 polyunsaturated fatty acids (ω3-PUFAs), including eicosapentaenoic acid (EPA) (20:5ω-3), docosapentaenoic acid (DPA) (22:5ω-3), and docosahexaenoic acid (DHA) (22:6ω-3), have been shown to reduce cardiovascular risk, but effects on cause-specific and total mortality and potential dose-responses remain controversial. Most observational studies have assessed self-reported dietary intake and most randomized trials have tested effects of adding supplements to dietary intake and evaluated secondary prevention, thus limiting inference for dietary ω3-PUFAs or primary prevention.
OBJECTIVE: To investigate associations of plasma phospholipid EPA, DPA, DHA, and total ω3-PUFA levels with total and cause-specific mortality among healthy older adults not receiving supplements.
DESIGN: Prospective cohort study.
SETTING: 4 U.S. communities.
PARTICIPANTS: 2692 U.S. adults aged 74 years (±5 years) without prevalent coronary heart disease (CHD), stroke, or heart failure at baseline.
MEASUREMENTS: Phospholipid fatty acid levels and cardiovascular risk factors were measured in 1992. Relationships with total and cause-specific mortality and incident fatal or nonfatal CHD and stroke through 2008 were assessed.
RESULTS: During 30 829 person-years, 1625 deaths (including 570 cardiovascular deaths), 359 fatal and 371 nonfatal CHD events, and 130 fatal and 276 nonfatal strokes occurred. After adjustment, higher plasma levels of ω3-PUFA biomarkers were associated with lower total mortality, with extreme-quintile hazard ratios of 0.83 for EPA (95% CI, 0.71 to 0.98; P for trend = 0.005), 0.77 for DPA (CI, 0.66 to 0.90; P for trend = 0.008), 0.80 for DHA (CI, 0.67 to 0.94; P for trend = 0.006), and 0.73 for total ω3-PUFAs (CI, 0.61 to 0.86; P for trend < 0.001). Lower risk was largely attributable to fewer cardiovascular than noncardiovascular deaths. Individuals in the highest quintile of phospholipid ω3-PUFA level lived an average of 2.22 more years (CI, 0.75 to 3.13 years) after age 65 years than did those in the lowest quintile.
LIMITATION: Temporal changes in fatty acid levels and misclassification of causes of death may have resulted in underestimated associations, and unmeasured or imperfectly measured covariates may have caused residual confounding.
CONCLUSION: Higher circulating individual and total ω3-PUFA levels are associated with lower total mortality, especially CHD death, in older adults.
PRIMARY FUNDING SOURCE: National Institutes of Health.
Authors:
Dariush Mozaffarian; Rozenn N Lemaitre; Irena B King; Xiaoling Song; Hongyan Huang; Frank M Sacks; Eric B Rimm; Molin Wang; David S Siscovick
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Annals of internal medicine     Volume:  158     ISSN:  1539-3704     ISO Abbreviation:  Ann. Intern. Med.     Publication Date:  2013 Apr 
Date Detail:
Created Date:  2013-04-02     Completed Date:  2013-05-22     Revised Date:  2013-07-11    
Medline Journal Info:
Nlm Unique ID:  0372351     Medline TA:  Ann Intern Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  515-25     Citation Subset:  AIM; IM    
Affiliation:
Harvard School of Public Health, 665 Huntington Avenue, Boston, MA 02115, USA. dmozaffa@hsph.harvard.edu
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MeSH Terms
Descriptor/Qualifier:
Aged
Biological Markers / blood
Cause of Death*
Coronary Disease / mortality,  prevention & control
Diet Records
Docosahexaenoic Acids / blood
Eicosapentaenoic Acid / blood
Fatty Acids, Omega-3 / blood*
Fatty Acids, Unsaturated / blood
Female
Food Habits*
Humans
Male
Prospective Studies
Risk Assessment
Stroke / mortality,  prevention & control
Grant Support
ID/Acronym/Agency:
AG-023629/AG/NIA NIH HHS; AG-027058/AG/NIA NIH HHS; AG-15928/AG/NIA NIH HHS; AG-20098/AG/NIA NIH HHS; HL080295/HL/NHLBI NIH HHS; N01 HC-15103/HC/NHLBI NIH HHS; N01 HC-55222/HC/NHLBI NIH HHS; N01-HC-35129/HC/NHLBI NIH HHS; N01-HC-45133/HC/NHLBI NIH HHS; N01-HC-75150/HC/NHLBI NIH HHS; N01-HC-85079/HC/NHLBI NIH HHS; N01-HC-85080/HC/NHLBI NIH HHS; N01-HC-85081/HC/NHLBI NIH HHS; N01-HC-85082/HC/NHLBI NIH HHS; N01-HC-85083/HC/NHLBI NIH HHS; N01-HC-85084/HC/NHLBI NIH HHS; N01-HC-85085/HC/NHLBI NIH HHS; N01-HC-85086/HC/NHLBI NIH HHS; N01-HC-85239/HC/NHLBI NIH HHS; R01 HL085710/HL/NHLBI NIH HHS; R01-HL-085710/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Fatty Acids, Omega-3; 0/Fatty Acids, Unsaturated; 1553-41-9/Eicosapentaenoic Acid; 25167-62-8/Docosahexaenoic Acids; 25448-00-4/docosapentaenoic acid
Comments/Corrections

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