Higher Plasma Omega-3 Levels are Associated With Improved Exacerbation Risk and Respiratory-Specific Quality of Life in COPD.

Abstract

Omega-3 polyunsaturated fatty acids (PUFAs) have been associated with systemic anti-inflammatory responses. Dietary intake of omega-3 PUFAs eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) has also been associated with lower COPD morbidity using self-report food frequency questionnaires. To investigate the relationship between measured PUFA intake using plasma EPA+DHA levels and COPD morbidity. Former smokers with moderate-severe COPD living in low-income communities were enrolled in a 6-month prospective cohort study. Participants completed standardized questionnaires, spirometry, and plasma samples at 3-month intervals. Total plasma PUFAs were analyzed using gas chromatography/ mass spectrometry for DHA and EPA concentrations. Linear or logistic mixed model regression was used to evaluate EPA+DHA's and COPD morbidity's association, accounting for demographics, lung function, pack years, comorbidities, and neighborhood poverty. 133 plasma EPA+DHA samples from 57 participants were available. Participants exhibited average plasma EPA and DHA levels of 14.7±7.3 µg/mL and 40.2±17.2 µg/mL, respectively, across the three clinic visits. Each standard deviation increase in EPA+DHA levels was associated with 2.7 points lower SGRQ score (95% CI -5.2, -0.2) and lower odds of moderate exacerbation (OR 0.4; 95% CI 0.2, 0.9) but lacked significant association with CAT score (95% CI -2.4, 0.8), mMRC (95% CI -02, 0.2), or severe exacerbations (95% CI 0.3, 1.4). Plasma EPA+DHA levels are associated with better respiratory-specific quality of life and lower odds of moderate exacerbations in patients with moderate-to-severe COPD. Further research is warranted to investigate the efficacy of an omega-3 dietary intervention in the management of COPD morbidities.