| Abstrakt: |
Background:Studies have documented the beneficial effects of omega-3 fatty acids, specifically, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) as found in oily fish and/or fish oil capsules, on cardiovascular disease (CVD) risk reduction. JELIS using purified EPA 1800 mg/day and REDUCE-IT using EPA 4 g/day reported significant reductions in CVD endpoints in statin-treated subjects versus controls. Median plasma EPA levels increased from 97 to 166 μg/mL in the treatment group in JELIS and from 26 to 169 μg/mL in REDUCE-IT. Reductions in CVD endpoints were related to EPA levels. No benefit on CVD risk was observed in STRENGTH, when subjects were given 4 g/day of a carboxylic acid formulation containing both EPA and DHA.Objective:We aimed to ascertain interrelationships of sex and age with plasma fatty acids, especially omega-3 fatty acids, in a very large clinical population.Methods:Plasma fatty acids were measured by gas chromatography/mass spectrometry after lipid extraction in 1,169,621 fasting United States subjects (56.2% female; median age 58.2 yr).Results:Plasma fatty acid indices (median±IQR), expressed as percentage of total fatty acids, were 31.5±1.5% for saturated fatty acids (sum of 14:0, 16:0, and 18:0); 21.4±2.2%, monounsaturated fatty acids (sum of 16:1n7-cisand 18:1n9-cis); 0.45±0.23%, transfatty acids (sum of 16:1n7-transand 18:1n9-trans); 42.4±3.0%, omega-6 fatty acids (sum of 18:2n6, 20:3n6, and 20:4n6); and 2.55±0.80%, omega-3 fatty acids (sum of 20:5n3 and 22:6n3). EPA plasma levels were 22.0±9.6 μg/mL (median±IQR), significantly lower than levels ≥150 μg/mL required for significant CVD risk reduction in randomized trials. Females had significantly (P<0.0001) lower indices of monounsaturated (-4.31%) and transfatty acids (-9.30%) and significantly higher indices of omega-6 (+2.79%) and omega-3 fatty acids (+6.82%) than males. Older subjects (≥65 years of age) had a significantly (P<0.001) higher median omega-3 fatty acid index (+29.68%) and higher plasma EPA levels (+57.05%) than younger subjects (<30 years of age).Conclusion:In one of the largest US population studies looking at fatty acids, we found sex and age specific differences. Plasma EPA levels were very low in all groups. |
