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Title: Red blood cell MUFAs and risk of coronary artery disease in the Physicians’ Health Study

Author
item MATSUMOTO, CHISA - 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, MICHAEL - Harvard Medical School
item DJOUSSE, LUC - Boston Veterans Affairs Healthcare System

Submitted to: The American Journal of Clinical Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 5/17/2013
Publication Date: 7/3/2013
Citation: Matsumoto, C., Matthan, N.R., Lichtenstein, A.H., Gaziano, M.J., Djousse, L. 2013. Red blood cell MUFAs and risk of coronary artery disease in the Physicians’ Health Study. American Journal of Clinical Nutrition. 98:749-754.

Interpretive Summary: Previous studies have reported beneficial effects of a Mediterranean diet rich in monounsaturated fatty acids (MUFAs) on coronary artery disease risk. However, these findings remain inconsistent because some experimental studies have suggested MUFAs have unfavorable effects on cells that make up the heart. We examined the relationship between red blood cell long-chain and very-long-chain MUFAs and the risk of coronary artery disease in the Physicians’ Health Study. Selected for this study were 1000 cases of coronary artery disease and 1000 control subjects matched for age, year of birth, and time of blood collection. Red blood cell MUFAs were measured by using gas chromatography, and coronary artery disease was validated by an endpoint committee. The mean age was 68.7 years. After controlling for factors that were different among people, including red blood cell saturated and omega-3 fatty acids, and established heart disease risk factors, the risk of developing heart disease was not related to the major red blood cell monounsaturated fatty acid, 18:1n9, but was lower in individuals who had higher levels of a minor red blood cell monounsaturated fatty acid, 22:1n-9. Our data were limited to heart disease risk in individuals participating in the Physicians’ Health Study. It will be important to validate this observation in other cohorts with different characteristics.

Technical Abstract: Previous studies have reported beneficial effects of a Mediterranean diet rich in monounsaturated fatty acids (MUFAs) on coronary artery disease (CAD) risk. However, these findings remain inconsistent because some experimental studies have suggested atherogenic and lipotoxicity effects of long-chain and very-long-chain MUFAs on cardiomyocytes. We examined whether red blood cell (RBC) long-chain and very-long-chain MUFAs are associated with risk of CAD in the Physicians’ Health Study. The ancillary study used a prospective nested case-control design to select 1000 cases of incident CAD and 1000 control subjects matched for age, year of birth, and time of blood collection. RBC MUFAs were measured by using gas chromatography, and CAD was validated by an endpoint committee. Conditional logistic regression was used to estimate RRs. The mean (+/-SD) age was 68.7 +/- 8.7 y. In a multivariable model that was controlled for matching factors and established CAD risk factors and RBC saturated and omega-3 (n-3) fatty acids, ORs for CAD associated with each SD increase of 20:1n-9 and log 22:1n-9 were 0.89 (95% CI: 0.80, 1.00; P = 0.0441) and 0.83 (95% CI: 0.72, 0.95; P = 0.0086). However, only the 22:1n-9–CAD relation remained statistically significant after Bonferroni correction (P < 0.0125). RBC cis 18:1n-9 and 24:1n-9 were not associated with CAD risk. Our data suggest an inverse association of RBC 22:1n-9 but not 20:1n-9, 18:1n-9, or 24:1n-9 with CAD risk after Bonferroni correction in the Physicians’ Health Study.