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Title: Red blood cell membrane concentration of cis-palmitoleic and cis-vaccenic acids and risk of coronary heart disease

Author
item DJOUSSE, LUC - Brigham & Women'S Hospital
item MATTHAN, NIRUPA - Jean Mayer Human Nutrition Research Center On Aging At Tufts University
item LICHTENSTEIN, ALICE - Jean Mayer Human Nutrition Research Center On Aging At Tufts University
item GAZIANO, JOHN - Brigham & Women'S Hospital

Submitted to: American Journal of Cardiology
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 4/3/2012
Publication Date: 5/12/2012
Citation: Djousse, L., Matthan, N.R., Lichtenstein, A.H., Gaziano, J.M. 2012. Red blood cell membrane concentration of cis-palmitoleic and cis-vaccenic acids and risk of coronary heart disease. American Journal of Cardiology. PMID:22579341.

Interpretive Summary: Although previous studies have suggested associations between plasma palmitoleic acid, a minor monounsaturated fatty acid, and heart disease risk factors, including blood pressure, inflammation, and insulin resistance, little is known about the relation of this fatty acid and heart disease. The relationship of these factors and plasmas vaccenic acid, another minor monounsaturated fatty acid has yet to be determined. This is an ancillary study of the Physicians' Health Study. It was designed to examine whether these two monounsaturated fatty acids, cis-palmitoleic acid and cis-vaccenic acid, both of which can be synthesized endogenously, are associated with heart disease risk. From the Physicians' Health Study 1,000 subjects were selected who had a heart disease event and 1,000 control subjects who did not have heart disease. Red blood cell membrane fatty acids were measured using gas chromatography. The heart disease cases were ascertained using an annual follow-up questionnaire and validated by an End Point Committee through a review of the medical records. After adjusting for differences in demographics, anthropometric, lifestyle factors, and co-morbidity factors, it was concluded that higher red blood cell concentrations of palmitoleic acid was associated with increased heart disease risk whereas higher concentrations of red blood cell membrane vaccenic acid was associated with lower heart disease risk. Because these fatty acids are synthesized by humans, it is yet to be determined whether dietary intake can alter their circulating levels.

Technical Abstract: Although previous studies have suggested associations between plasma palmitoleic acid and coronary heart disease (CHD) risk factors, including blood pressure, inflammation, and insulin resistance, little is known about the relation of palmitoleic acid and CHD. This ancillary study of the Physicians' Health Study was designed to examine whether red blood cell (RBC) membrane cis-palmitoleic acid and cis-vaccenic acid-2 fatty acids that can be synthesized endogenously-are associated with CHD risk. We used a risk set sampling method to prospectively select 1,000 incident CHD events and 1,000 matched controls. RBC membrane fatty acids were measured using gas chromatography. The CHD cases were ascertained using an annual follow-up questionnaire and validated by an End Point Committee through a review of the medical records. In a conditional logistic regression analysis adjusting for demographics, anthropometric, lifestyle factors, and co-morbidity, the odds ratios and 95% confidence intervals (CIs) for CHD were 1.0 (referent), 1.29 (95% CI 0.95 to 1.75), 1.08 (95% CI 0.78 to 1.51), 1.25 (95% CI 0.90 to 1.75), and 1.48 (95% CI 1.03 to 2.14) across consecutive quintiles of RBC membrane cis-palmitoleic acid (p for trend = 0.041). The odds ratio associated with each SD higher RBC membrane cis-palmitoleic acid level was 1.19 (95% CI 1.06 to 1.35) in a multivariate-adjusted model. Finally, RBC membrane cis-vaccenic acid was inversely associated with CHD risk (odds ratio 0.79, 95% CI 0.69 to 0.91, per SD increase). In conclusion, our data showed a positive association between RBC membrane cis-palmitoleic acid and CHD risk in male physicians. Furthermore, RBC membrane cis-vaccenic acid was inversely related to CHD. Although previous studies have suggested associations between plasma palmitoleic acid and coronary heart disease (CHD) risk factors, including blood pressure, inflammation, and insulin resistance, little is known about the relation of palmitoleic acid and CHD. This ancillary study of the Physicians' Health Study was designed to examine whether red blood cell (RBC) membrane cis-palmitoleic acid and cis-vaccenic acid-2 fatty acids that can be synthesized endogenously-are associated with CHD risk. We used a risk set sampling method to prospectively select 1,000 incident CHD events and 1,000 matched controls. RBC membrane fatty acids were measured using gas chromatography. The CHD cases were ascertained using an annual follow-up questionnaire and validated by an End Point Committee through a review of the medical records. In a conditional logistic regression analysis adjusting for demographics, anthropometric, lifestyle factors, and co-morbidity, the odds ratios and 95% confidence intervals (CIs) for CHD were 1.0 (referent), 1.29 (95% CI 0.95 to 1.75), 1.08 (95% CI 0.78 to 1.51), 1.25 (95% CI 0.90 to 1.75), and 1.48 (95% CI 1.03 to 2.14) across consecutive quintiles of RBC membrane cis-palmitoleic acid (p for trend = 0.041). The odds ratio associated with each SD higher RBC membrane cis-palmitoleic acid level was 1.19 (95% CI 1.06 to 1.35) in a multivariate-adjusted model. Finally, RBC membrane cis-vaccenic acid was inversely associated with CHD risk (odds ratio 0.79, 95% CI 0.69 to 0.91, per SD increase). In conclusion, our data showed a positive association between RBC membrane cis-palmitoleic acid and CHD risk in male physicians. Furthermore, RBC membrane cis-vaccenic acid was inversely related to CHD.