Serum non-esterified fatty acids and risk of incident stroke in older adults: the cardiovascular health study

Authors: HUANG, NEIL - Jean Mayer Human Nutrition Research Center On Aging At Tufts University; MATTHAN, NIRUPA - Jean Mayer Human Nutrition Research Center On Aging At Tufts University; BIGGS, MARY - University Of Washington; LONGSTRETH, JR., WILL - University Of Washington; SISCOVICK, DAVID - New York Academy Of Sciences; DJOUSSE, LUC - Brigham & Women'S Hospital; MUKAMAL, KENNETH - Beth Israel Deaconess Medical Center; LICHTENSTEIN, ALICE - Jean Mayer Human Nutrition Research Center On Aging At Tufts University

Submitted to: Circulation
Publication Type: Abstract Only
Publication Acceptance Date: 2/20/2020
Publication Date: 3/2/2020
Citation: Huang, N.K., Matthan, N.R., Biggs, M.L., Longstreth, Jr., W.T., Siscovick, D., Djousse, L., Mukamal, K.J., Lichtenstein, A.H. 2020. Serum non-esterified fatty acids and risk of incident stroke in older adults: the cardiovascular health study [abstract]. Circulation. 141:Abstract 560. https://doi.org/10.1161/circ.141.suppl_1.P560.
DOI: https://doi.org/10.1161/circ.141.suppl_1.P560

Interpretive Summary:

Technical Abstract: Introduction: Serum non-esterified fatty acids (NEFAs) have been linked to both local and systemic inflammation and are higher in individuals with obesity, diabetes, cardiovascular disease, and ischemic stroke risk. Significant associations between total plasma NEFA concentrations and incident ischemic stroke have been reported in some but not all prospective studies. Given the functional and structural diversity among circulating NEFA, the associations of individual or clusters of circulating NEFAs may provide additional insight into their relationship with incident stroke. Hypothesis: Fasting serum n-3 NEFAs are inversely associated, and saturated and trans NEFAs are positively associated with incident stroke. Methods: We analyzed the incidence of stroke among Cardiovascular Health Study (CHS) participants who were free of stroke in 1996-1997 and underwent fasting NEFA profile measurement. At baseline, mean age was 77.8+/-4.5, body mass index was 26.7+/-4.4 and 61% were female. A total of 38 individual NEFAs in 5 classes (saturated, monounsaturated, polyunsaturated n-6, polyunsaturated n-3 and trans NEFAs) were measured using gas chromatography. Cox regression was used to evaluate the association of individual NEFA species with incident stroke, adjusting for: age, sex, race, and field center (model 1); model 1 covariates plus smoking, education, physical activity, alcohol consumption, eGFR, BMI, aspirin use, waist circumference, hypertension, prevalent diabetes, and cholesterol (model 2). Results: A total of 338 cases of incident stroke occurred during median follow-up of 10.5 years. In the fully adjusted model, trans-palmitoleic acid was inversely associated with incident stroke (HR per 1 mol% of NEFA composition: 0.03 [95% CI: 0.00 to 0.77], P<0.03). Serum docosahexaenoic acid levels were associated with lower risk of incident stroke (HR: 0.63 [95% CI: 0.40 to 1.00], P<0.05). Total n-3 fatty acids (HR: 0.78 [95% CI: 0.63 to 0.97]) and docosapentaenoic acid (HR: 0.12 [95% CI: 0.02 to 0.88]) were each associated with lower risk of incident stroke only in model 1. No significant association of saturated NEFAs with incidence of stroke was observed. Conclusion: Among fasting serum NEFA, docosahexaenoic acid and trans-palmitoleic acid were inversely associated with incident stroke, suggesting that these fatty acids may protect older adults from stroke.