Epidemiology

Association of blood levels of marine omega-3 fatty acids with coronary calcification and calcium density in Japanese men

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Abstract

Background/objectives:

Clinical trials of eicosapentaenoic acid (EPA) among high-risk groups in Japan in which consumption of mairne-omega-3 fatty acids (OM3) is much higher than other countries showed slower progression of coronary atherosclerosis. We aimed to determine the cross-sectional associations of coronary artery calcification (CAC) and calcium density with OM3, EPA, and docosahexaenoic acid (DHA), two principal OM3, in the general population in Japan.

Subjects/methods:

The Shiga Epidemiological Study of Subclinical Atherosclerosis examined a population-based sample of 1074 men aged 40–79 in 2006–08 for computed tomography-measured CAC score (CCS), a well-established biomarker of coronary atherosclerosis, CAC density score (CDS), a potential marker of plaque stabilization, serum levels of OM3, and risk factors.

Results:

Prevalence of CCS > 0, ≥ 100, and ≥ 300 was 65.8%, 25.9%, and 12.9%, respectively; the mean (SD) OM3, EPA, and DHA were 10.1% (3.2), 3.2% (1.7), and 5.9% (1.6), respectively. Odds ratios (95% CI, p-value) of CCS 0, 100, and 300 in ordinal logistic regression associated with 1 SD increase of OM3, EPA, and DHA were 0.91 (0.81–1.03, p = 0.12), 0.99 (0.88–1.11, p = 0.87) and 0.84 (0.74–0.94, p = < 0.01), respectively. The inverse association of DHA with CCS remained significant in multivariate-adjusted model: odds ratio of 0.87 (0.77–0.99, p = 0.03). Blood levels of OM3, EPA, or DHA did not have any significant associations with CDS.

Conclusions:

DHA but not EPA had a significant inverse association with coronary atherosclerosis in the general population with high levels of OM3. Future trials are warranted comparing the effect of high-dose DHA and EPA on atherosclerosis and cardiovascular outcomes.

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Acknowledgements

This research project is supported by the following grants: NIH R01 HL068200 and RF1 AG051615; Grants-in-aid for Scientific Research from the Ministry of Education, Culture, Sports, Science, and Technology, Japan: (A) 13307016, (A) 17209023, (A) 21249043, (A) 23249036, (A) 25253046, (A) 15H02528, (B) 15H04773, (B) 26293140, and (B) 21790579; and a grant from Glaxo-Smith Klein, GB.

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Correspondence to Akira Sekikawa.

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