Fatty Acids and Associated Cardiovascular Risk

Caroline Le Goff, Jean-François Kaux, Ludovic Leroy, Joël Pincemail, Jean-Paul Chapelle, Etienne Cavalier

CREDEC, Department of Cardiovascular Surgery, University Hospital of Liege, Liege, Belgium..
Department of Clinical Chemistry, University and University Hospital of Liege, Liege, Belgium.
Department of Clinical Sciences, University and University Hospital of Liege, Liege, Belgium.

DOI: 10.4236/fns.2013.49A1026                

Abstract

Introduction: A fatty acid (FA) is a carboxylic acid with a long aliphatic chain, which is either saturated or unsaturated. Recently, the role of FA and particularly omega-3 and -6 has emerged as cardiovascular risk factor in the literature. The aim of our study was to establish reference values for these FA and to compare them with data obtained in a population of acute myocardial infarction (AMI) patients. Materials and methods: Hundred thirty five healthy subjects (59.38 ± 27.12 yo, 75 men) were selected as reference population. We also evaluated FA in thirty three patients (55 ± 9 yo, 23 men) admitted in the Emergency Department of our Institution for AMI. The fasting whole blood was drawn in vacutainer containing EDTA. Before analysis, samples were washed and transmethylated. We performed the quantification of different FA by gas chromatography associated with flame ionization detector (GCFID). Results: We obtained results in control healthy patients to be used as reference values. In the AMI group, levels of omega-6 were significantly higher (p < 0.05) for C18:2n6 and C18:3n6 than the reference population and omega-3 values were significantly lower (p < 0.01) compared to reference value for C22:6n3. The omega-3 index was lower and the ratio omega-6/omega-3 was higher in AMI group compared to reference values. Conclusions: We have established reference value for FA and have compared these values with the results obtained in AMI population. FA determination is a new tool we are able to use and to process in our laboratory which can help the clinician to screen patients with the highest cardiovascular risks because of the implication of FA in the etiopathogeny of atherosclerosis.

Keywords

Fatty Acids; Acute Myocardial Infarction; Gas Chromatography

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	A. D. McNaught and A. Wilkinson, “IUPAC Compendium of Chemical Terminology,” 2nd Edition, Blackwell Science, Oxford, 1997.
[2]	A. Freije, “Fatty Acid Profile of the Erythrocyte Membranes of Healthy Bahraini Citizens in Comparison with Coronary Heart Disease Patients,” Journal of Oleo Science, Vol. 58, No. 7, 2009, pp. 379-388. doi:10.5650/jos.58.379
[3]	G. Durand and J. L. Beaudeux, “Biochimie Médicale: Marqueurs Actuels et Perspectives,” Lavoisier, Paris, 2008.
[4]	W. S. Harris and C. Von Schacky, “The Omega-3 Index: A New Risk Factor for Death from Coronary Heart Disease?” Preventive Medicine, Vol. 39, No. 1, 2004, pp. 212-220. doi:10.1016/j.ypmed.2004.02.030
[5]	C. M. Albert, H. Campos, M. J. Stampfer, P. M. Ridker, J. E. Manson, W. C. Willett, et al., “Blood Levels of Long-Chain n-3 Fatty Acids and the Risk of Sudden Death,” The New England Journal of Medicine, Vol. 346, No. 15, 2002, pp. 1113-1138. doi:10.1056/NEJMoa012918
[6]	F. Paganelli, J. M. Maixent, M. J. Duran, R. Parhizgar, G. Pieroni and S. Sennoune, “Altered Erythrocyte n-3 Fatty Acids in Mediterranean Patients with Coronary Artery Disease,” International Journal of Cardiology, Vol. 78, No. 1, 2001, pp. 27-32. doi:10.1016/S0167-5273(00)00442-3
[7]	H. Rupp, D. Wagner, T. Rupp, L. M. Schulte and B. Maisch, “Risk Stratification by the ‘EPA + DHA Level’ and the ‘EPA/AA Ratio’ Focus on Anti-Inflammatory and Antiarrhythmogenic Effects of Long-Chain Omega-3 Fatty Acids,” Herz, Vol. 29, No. 7, 2004, pp. 673-685. doi:10.1007/s00059-004-2602-4
[8]	A. M. Hodge, D. R. English, K. O’Dea, A. J. Sinclair, M. Makrides, R. A. Gibson, et al., “Plasma Phospholipid and Dietary Fatty Acids as Predictors of Type 2 Diabetes: Interpreting the Role of Linoleic Acid,” The American Journal of Clinical Nutrition, Vol. 86, No. 1, 2007, pp. 189-197.
[9]	G. Mamalakis, M. Kiriakakis, G. Tsibinos, E. Jansen, H. Cremers, C. Strien, et al., “Lack of an Association of Depression with n-3 Polyunsaturated Fatty Acids in Adipose Tissue and Serum Phospholipids in Healthy Adults,” Pharmacology Biochemistry and Behavior, Vol. 89, No. 1, 2008, pp. 6-10. doi:10.1016/j.pbb.2007.10.015
[10]	S. M. Hirabara, R. Curi and P. Maechler, “Saturated Fatty Acid-Induced Insulin Resistance Is Associated with Mitochondrial Dysfunction in Skeletal Muscle Cells,” Journal of Cellular Physiology, Vol. 222, No. 1, 2010, pp. 187-194. doi:10.1002/jcp.21936
[11]	J. Lovergrove, L. Brady, S. Lesauvage, A. M. Minihane and C. Williams, “Platelet Membrane Phospholipid Fatty Acids Are Weakly Associated with Markers of Insulin Resistance and Some CVD Risk Factors,” ISSFAL2008.
[12]	S. Walrand, F. Fisch and J. M. Bourre, “Do Saturated Fatty Acids Have the Same Metabolic Effect?” Nutrition Clinique et Metabolisme, Vol. 24, No. 2, 2010, pp. 63-75. doi:10.1016/j.nupar.2010.02.003
[13]	S. Sierra, F. Lara-Villoslada, M. Comalada, M. Olivares and J. Xaus, “Dietary Eicosapentaenoic Acid and Docosahexaenoic Acid Equally Incorporate as Decosahexaenoic Acid but Differ in Inflammatory Effects,” Nutrition, Vol. 24, No. 3, 2008, pp. 245-254. doi:10.1016/j.nut.2007.11.005
[14]	R. B. Moore and S. H. Appel, “Methylation of Erythrocyte Membrane Phospholipids in Patients with Myotonic and Duchenne Muscular Dystrophy,” Experimental Neurology, Vol. 70, No. 2, 1980, pp. 380-391. doi:10.1016/0014-4886(80)90035-7
[15]	P. R. Kidd, “Cell Membranes, Endothelia, and Atherosclerosis—The Importance of Dietary Fatty Acid Balance,” Alternative Medicine Review, Vol. 1, No. 3, 1996, pp. 148-165.
[16]	C. Von Schacky, “Prophylaxis of Atherosclerosis with Marine Omega-3 Fatty Acids. A Comprehensive Strategy,” Annals of Internal Medicine, Vol. 107, No. 6, 1987, pp. 890-899. doi:10.7326/0003-4819-107-6-890
[17]	T. A. Dolecek, “Epidemiological Evidence of Relationships between Dietary Polyunsaturated Fatty Acids and Mortality in the Multiple Risk Factor Intervention Trial,” Proceedings of the Society for Experimental Biology and Medicine, Vol. 200, No. 2, 1992, pp. 177-182. doi:10.3181/00379727-200-43413
[18]	C. M. Albert, C. H. Hennekens, C. J. O’Donnell, U. A. Ajani, V. J. Carey, W. C. Willett, et al., “Fish Consumption and Risk of Sudden Cardiac Death,” JAMA, Vol. 279, No. 1, 1998, pp. 23-28. doi:10.1001/jama.279.1.23
[19]	D. S. Siscovick, T. E. Raghunathan, I. King, S. Weinmann, K. G. Wicklund, J. Albright, et al., “Dietary Intake and Cell Membrane Levels of Long-Chain n-3 Polyunsaturated Fatty Acids and the Risk of Primary Cardiac Arrest,” JAMA, Vol. 274, No. 17, 1995, pp. 1363-1367. doi:10.1001/jama.1995.03530170043030
[20]	M. L. Daviglus, J. Stamler, A. J. Orencia, A. R. Dyer, K. Liu, P. Greenland, et al., “Fish Consumption and the 30-Year Risk of Fatal Myocardial Infarction,” The New England Journal of Medicine, Vol. 336, No. 15, 1997, pp. 1046-1053. doi:10.1056/NEJM199704103361502
[21]	J. Dyerberg and H. O. Bang, “Haemostatic Function and Platelet Polyunsaturated Fatty Acids in Eskimos,” Lancet, Vol. 2, No. 8140, 1979, pp. 433-435. doi:10.1016/S0140-6736(79)91490-9
[22]	W. E. Kaminski, E. Jendraschak, R. Kiefl and C. von Schacky, “Dietary Omega-3 Fatty Acids Lower Levels of Platelet-Derived Growth Factor mRNA in Human Mononuclear Cells,” Blood, Vol. 81, No. 7, 1993, pp. 18711879.
[23]	S. Endres and C. von Schacky, “n-3 Polyunsaturated Fatty Acids and Human Cytokine Synthesis,” Current Opinion in Lipidology, Vol. 7, No. 1, 1996, pp. 48-52. doi:10.1097/00041433-199602000-00011
[24]	C. Von Schacky, “Cardiovascular Effects of n-3 Fatty Acids,” In: J. C. Frolich and C. Von Schacky, Ed., Fish, Fish Oil, and Human Health, Zuckschwerdt Verlag, Munich, 1992, pp. 167-178.
[25]	H. M. Sinclair, “Deficiency of Essential Fatty Acids and Atherosclerosis, Etcetera,” Lancet, Vol. 270, No. 6919, 1956, pp. 381-383.
[26]	M. Wilhelm, R. Tobias, F. Asskali, R. Kraehner, S. Kuly, L. Klinghammer, et al., “Red Blood Cell Omega-3 Fatty Acids and the Risk of Ventricular Arrhythmias in Patients with Heart Failure,” American Heart Journal, Vol. 155, No. 6, 2008, pp. 971-977. doi:10.1016/j.ahj.2007.11.045
[27]	P. Saravanan, N. C. Davidson, E. B. Schmidt and P. C. Calder, “Cardiovascular Effects of Marine Omega-3 Fatty Acids,” Lancet, Vol. 376, No. 9740, 2010, pp. 540-50. doi:10.1016/S0140-6736(10)60445-X
[28]	F. B. Hu, M. J. Stampfer, J. E. Manson, E. Rimm, G. A. Colditz, B. A. Rosner, et al., “Dietary Fat Intake and the Risk of Coronary Heart Disease in Women,” The New England Journal of Medicine, Vol. 337, No. 21, 1997, pp. 1491-1499. doi:10.1056/NEJM199711203372102
[29]	W. C. Willett, M. J. Stampfer, J. E. Manson, G. A. Colditz, F. E. Speizer, B. A. Rosner, et al., “Intake of Trans Fatty Acids and Risk of Coronary Heart Disease among Women,” Lancet, Vol. 341, No. 8845, 1993, pp. 581-585. doi:10.1016/0140-6736(93)90350-P
[30]	D. Mozaffarian, “Trans Fatty Acids—Effects on Systemic Inflammation and Endothelial Function,” Atherosclerosis Supplements, Vol. 7, No. 2, 2006, pp. 29-32. doi:10.1016/j.atherosclerosissup.2006.04.007
[31]	A. P. Simopoulos and L. G. Cleland, “Omega-6/Omega-3 Essential Fatty Acid Ratio: The Scientific Evidence,” Karger AG, Basel, 2003.
[32]	Q. Sun, J. Ma, H. Campos, S. E. Hankinson and F. B. Hu, “Comparison between Plasma and Erythrocyte Fatty Acid Content as Biomarkers of Fatty Acid Intake in US Women,” The American Journal of Clinical Nutrition, Vol. 86, No. 1, 2007, pp. 74-81.
[33]	W. C. Smith and H. Tunstall-Pedoe, “European Regional Variation in Cardiovascular Mortality,” British Medical Bulletin, Vol. 40, No. 4, 1984, pp. 374-379.
[34]	J. Muller-Nordhorn, S. Binting, S. Roll and S. N. Willich, “An Update on Regional Variation in Cardiovascular Mortality within Europe,” European Heart Journal, Vol. 29, No. 10, 2008, pp. 1316-1326. doi:10.1093/eurheartj/ehm604
[35]	World Health Organization, “Prevention of Cardiovascular Disease : Guidelines for Assessment and Management of Total Cardiovascular Risk,” World Health Organization, Geneva, 2007.
[36]	J. B. Brill, “The Mediterranean Diet and Your Health,” American Journal of Lifestyle Medicine, Vol. 3, No. 1, 2009, pp. 44-56. doi:10.1177/1559827608325476
[37]	D. R. Morgan, L. J. Dixon, C. G. Hanratty, N. El-Sherbeeny, P. B. Hamilton, L. T. McGrath, et al., “Effects of Dietary Omega-3 Fatty Acid Supplementation on Endothelium-Dependent Vasodilation in Patients with Chronic Heart Failure,” American Journal of Cardiology, Vol. 97, No. 4, 2006, pp. 547-551. doi:10.1016/j.amjcard.2005.08.075
[38]	Y. Park, J. Lim, Y. Kwon and J. Lee, “Correlation of Erythrocyte Fatty Acid Composition and Dietary Intakes with Markers of Atherosclerosis in Patients with Myocardial Infarction,” Nutrition Research, Vol. 29, No. 6, 2009, pp. 391-396. doi:10.1016/j.nutres.2009.05.010
[39]	D. Mozaffarian, T. Pischon, S. E. Hankinson, N. Rifai, K. Joshipura, W. C. Willett, et al., “Trans-Fatty Acid Intake and Systemic Inflammation among Women,” Circulation, Vol. 109, No. 7, 2004, p. 195.