Abstract

Background: Coronary artery calcification (CAC) is an established biomarker of coronary atherosclerosis and predicts future cardiovascular (CV) events. Basic science shows that marine omega-3 fatty acids (OM3) have anti-atherogenic properties yet previous studies in Western countries reported that dietary intake of OM3 had no significant association with CAC. Dietary intake of OM3 in Japan is >10x higher than in the US. We hypothesize that blood levels of OM3 in Japanese have a significant inverse association with CAC. Methods: A population-based sample of 982 men in Kusatsu, Shiga, Japan without CV disease was examined for blood levels of OM3, CV risk factors, and CAC. CAC was assessed by electron-beam tomography and quantified using the Agatston method. OM3 was measured by gas-liquid chromatography. We analyzed the association of OM3 with CAC scores at 67th and 80th percentiles adjusting for CV risk factors using quantile regression as the distribution of CAC scores is highly skewed. Results: Mean (SD) age of the participants was 58.7 (10.9). Rates (%) of hypertension, diabetes, current smoker were 47.3, 16.3, and 38.4, respectively. Mean (SD) LDL-C and OM3 was 127.8 (33.6) mg/dL and 10.2 (3.2) %, respectively. CAC scores were 0, 2, 19, 83, and 476 at 33th, 50th, 67th, 80th, and 95th percentiles, respectively. Blood levels of OM3 had significant inverse associations with CAC both at 67th and 80th percentiles after adjusting for CV risk factors (Table). Conclusions: This cross sectional study of Japanese whose blood levels of OM3 are 2-fold higher compared to the US shows that OM3 had a significant inverse association with atherosclerosis, suggesting that high blood levels of OM3 may have anti-atherogenic properties.

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