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Abstract
Saturated fatty acids with different chain lengths have different biological activities, but little is known about very-long-chain saturated fatty acids (VLCSFAs). This study investigated the associations between the circulating VLCSFAs and cardiovascular health. This community-based cohort study included 2198 adults without carotid artery plaques (CAPs) at baseline. The percentage of baseline erythrocyte VLCSFA (arachidic acid (C20:0), behenic acid (C22:0), and lignoceric acid (C24:0)) was measured by gas chromatography. The presence of CAPs was determined at baseline and every 3 years thereafter by ultrasound examination. A meta-analysis was conducted to summarize the pooled associations between circulating VLCSFAs and the risk of cardiovascular diseases (CVDs). During a median of 7.2 years of follow-up, 573 women (35.1%) and 281 men (49.6%) were identified as CAP incident cases. VLCSFAs were inversely related with CAP risk in women (all p-trend <0.05) but not in men. Multivariate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of CAPs for the highest (vs. lowest) quartile were 0.80 (0.63–1.01) for C20:0, 0.71 (0.56–0.89) for C22:0, 0.75 (0.59–0.94) for C24:0, and 0.69 (0.55–0.87) for total VLCSFAs in women. The pooled HRs (95% CIs) of CVDs for the highest (vs. lowest) circulating VLCSFAs from seven studies including 8592 participants and 3172 CVD events were 0.67 (0.57–0.79) for C20:0, 0.66 (0.48–0.90) for C22:0, and 0.57 (0.42–0.79) for C24:0, respectively. Our findings suggested that circulating VLCSFAs were inversely associated with cardiovascular health.
Highlights
Atherosclerosis, a chronic inflammatory disease involving the deposition of cholesterol and foam cell formation within artery walls, is the dominant cause of cardiovascular disease (CVD) [1].cardiovascular diseases (CVDs), ischemic heart disease and stroke, was the major cause of death and accounted for 18 million deaths worldwide in 2017 [2]
Beneficial associations of circulating proportions of very-long-chain saturated fatty acids (VLCSFAs), including arachidic acid (C20:0), behenic acid (C22:0), and tetracosanoic acid (C24:0), with the risks of coronary heart disease (CHD) [21,22], heart failure [23], atrial fibrillation [24], sudden cardiac arrest [25], and/or CVD mortality [14] were observed in the Cardiovascular Health Study [14,23,24], the Prevención con Dieta Mediterránea trial [21], the Nurses’
The findings were generally consistent with our study, as inverse associations between total VLCSFA proportions and the risk of CHD incidence were reported in two nested case–control studies from the Prevención con Dieta Mediterránea trial with 408 participants (136 cases and 272 controls) [21] and the Nurses’ Health Study and Health Professionals Follow-Up Study with 2027 subjects [22]
Summary
Atherosclerosis, a chronic inflammatory disease involving the deposition of cholesterol and foam cell formation within artery walls, is the dominant cause of cardiovascular disease (CVD) [1]. Positive associations between the proportions of SFAs, palmitic acid (16:0), with atherosclerosis [8,9] and CVD risks [10,11] have been reported. Previous studies revealed inverse associations between the proportions of circulating very-long-chain SFAs (VLCSFAs), with 20 carbons or more, and CVD-related risk factors, such as subclinical inflammation [15], adverse metabolic profiles [16], and insulin resistance [17]. Beneficial associations of circulating proportions of VLCSFAs, including arachidic acid (C20:0), behenic acid (C22:0), and tetracosanoic acid (C24:0), with the risks of coronary heart disease (CHD) [21,22], heart failure [23], atrial fibrillation [24], sudden cardiac arrest [25], and/or CVD mortality [14] were observed in the Cardiovascular Health Study [14,23,24], the Prevención con Dieta Mediterránea trial [21], the Nurses’. VLCSFAs (C20:0, C22:0, and C24:0) with the incidence of atherosclerotic carotid artery plaques (CAPs) in middle-aged and elderly Chinese adults, and we conducted a meta-analysis to summarize the current evidence assessing associations between the proportions of individual VLCSFA and risks of CVD events
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