Individual omega-9 monounsaturated fatty acids and mortality—The Ludwigshafen Risk and Cardiovascular Health Study

• Published in: Journal of clinical lipidology 2017-01, Vol.11 (1), p.126-135.e5
• Main Authors: Delgado, Graciela E., MSc, Krämer, Bernhard K., MD, Lorkowski, Stefan, PhD, März, Winfried, MD, von Schacky, Clemens, MD, Kleber, Marcus E., PhD
• Format: Article
• Language: English
• Subjects: Cardiovascular; Cardiovascular Diseases - blood; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - mortality; Erythrocytes - metabolism; Fatty Acids, Monounsaturated - blood; Fatty Acids, Unsaturated - blood; Female; Humans; Male; Middle Aged; Monounsaturated fatty acids; Mortality; Nervonic acid; Nutrition; Oleic acid; Proportional Hazards Models; Risk Assessment; Risk Factors
• ISSN: 1933-2874; 1876-4789
• DOI: 10.1016/j.jacl.2016.10.015

Background The association of polyunsaturated omega-3 and omega-6 fatty acids with mortality has been extensively studied. Far less is known about the association of omega-9 monounsaturated fatty acids (omega-9 MUFA) with mortality. Objective We aimed to study the association of individual omega-MUFA with all-cause and cardiovascular mortality. Methods Omega-9 MUFA concentrations were measured in erythrocytes in 3259 patients participating in the Ludwigshafen Risk and Cardiovascular Health Study using the HS-Omega-3 index method. Associations with mortality were analyzed by Cox proportional hazards regression with adjustment for conventional risk factors separately for men and women. Results During a median follow-up of 10.0 years, 975 patients (29.9%) died. Partial correlation analysis adjusted for age and gender showed inverse correlations of oleic acid (OA), gondoic acid (GA), and nervonic acid (NA) with LDL-C, HDL-C, and eGFR but direct correlations with markers of inflammation and endothelial activation as well as heart failure. A 1-SD increase in OA, GA, and NA was associated with increased risk of all-cause mortality with HRs (95% CI) of 1.08 (1.01–1.16), 1.07 (1.01–1.13), and 1.12 (1.05–1.20), respectively. NA was the only omega-9 MUFA being associated with increased risk in men, whereas in women also GA was associated with risk. The association between OA and mortality seems to be U-shaped with a nadir at a concentration of approx 14%. Conclusions All three omega-9 MUFA showed direct associations with mortality. Further studies are warranted to explore biologic and prognostic properties of omega-9 fatty acids, with a focus on nervonic acid.