Red blood cell polyunsaturated fatty acids and mortality in the Women's Health Initiative Memory Study

William Harris, Juhua Luo, James V. Pottala, Mark A. Espeland, Karen L. Margolis, Joann E. Manson, Lu Wang, Theodore M. Brasky, Jennifer G. Robinson

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Background: The prognostic value of circulating polyunsaturated fatty acid (PUFA) levels is unclear. Objectives: To determine the associations between red blood cell (RBC) PUFA levels and risk for death. Methods: This prospective cohort study included 6501 women aged 65 to 80 years who participated in the Women's Health Initiative Memory Study (enrolment began 1996). RBC PUFA levels were measured at baseline and expressed as a percent of total RBC PUFAs. PUFAs of primary interest were the n-3 PUFAs eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) and their sum (the Omega-3 Index). PUFAs of secondary interest included the 2 major n-6 PUFAs, linoleic acid and arachidonic acid, and the PUFA factor score (a calculated variable including 6 PUFAs that accounts for their intercorrelations). The primary outcome was total mortality through August 2014. Results: After a median of 14.9 years of follow-up, 1851 women (28.5%) had died. RBC levels of EPA and DHA were higher in the survivors (P < .002 for each). In the fully adjusted models, the hazard ratios (99% confidence intervals) for mortality associated with a 1 standard deviation PUFA increase for total mortality were 0.92 (0.85, 0.98) for the Omega-3 Index, 0.89 (0.82, 0.96) for EPA, 0.93 (0.87, 1.0) for DHA, and 0.76 (0.64, 0.90) for the PUFA factor score. There were no significant associations of alpha-linolenic acid, arachidonic acid or linoleic acid with total mortality. Conclusions: Higher RBC levels of marine n-3 PUFAs were associated with reduced risk for all-cause mortality. These findings support the beneficial relationship between the Omega-3 Index and health outcomes.

Original languageEnglish (US)
JournalJournal of Clinical Lipidology
DOIs
StateAccepted/In press - Sep 23 2016
Externally publishedYes

Fingerprint

Women's Health
Unsaturated Fatty Acids
Erythrocytes
Eicosapentaenoic Acid
Mortality
Docosahexaenoic Acids
Omega-3 Fatty Acids
Linoleic Acid
Arachidonic Acid
alpha-Linolenic Acid
Proportional Hazards Models
Survivors
Cohort Studies
Prospective Studies
Confidence Intervals
Health

Keywords

  • Docosahexaenoic acid
  • Eicosapentaenoic acid
  • Epidemiology
  • Omega-3 fatty acids
  • Omega-6 fatty acids
  • Prospective cohort study

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Nutrition and Dietetics
  • Cardiology and Cardiovascular Medicine

Cite this

Harris, W., Luo, J., Pottala, J. V., Espeland, M. A., Margolis, K. L., Manson, J. E., ... Robinson, J. G. (Accepted/In press). Red blood cell polyunsaturated fatty acids and mortality in the Women's Health Initiative Memory Study. Journal of Clinical Lipidology. https://doi.org/10.1016/j.jacl.2016.12.013

Red blood cell polyunsaturated fatty acids and mortality in the Women's Health Initiative Memory Study. / Harris, William; Luo, Juhua; Pottala, James V.; Espeland, Mark A.; Margolis, Karen L.; Manson, Joann E.; Wang, Lu; Brasky, Theodore M.; Robinson, Jennifer G.

In: Journal of Clinical Lipidology, 23.09.2016.

Research output: Contribution to journalArticle

Harris, W, Luo, J, Pottala, JV, Espeland, MA, Margolis, KL, Manson, JE, Wang, L, Brasky, TM & Robinson, JG 2016, 'Red blood cell polyunsaturated fatty acids and mortality in the Women's Health Initiative Memory Study', Journal of Clinical Lipidology. https://doi.org/10.1016/j.jacl.2016.12.013
Harris, William ; Luo, Juhua ; Pottala, James V. ; Espeland, Mark A. ; Margolis, Karen L. ; Manson, Joann E. ; Wang, Lu ; Brasky, Theodore M. ; Robinson, Jennifer G. / Red blood cell polyunsaturated fatty acids and mortality in the Women's Health Initiative Memory Study. In: Journal of Clinical Lipidology. 2016.
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abstract = "Background: The prognostic value of circulating polyunsaturated fatty acid (PUFA) levels is unclear. Objectives: To determine the associations between red blood cell (RBC) PUFA levels and risk for death. Methods: This prospective cohort study included 6501 women aged 65 to 80 years who participated in the Women's Health Initiative Memory Study (enrolment began 1996). RBC PUFA levels were measured at baseline and expressed as a percent of total RBC PUFAs. PUFAs of primary interest were the n-3 PUFAs eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) and their sum (the Omega-3 Index). PUFAs of secondary interest included the 2 major n-6 PUFAs, linoleic acid and arachidonic acid, and the PUFA factor score (a calculated variable including 6 PUFAs that accounts for their intercorrelations). The primary outcome was total mortality through August 2014. Results: After a median of 14.9 years of follow-up, 1851 women (28.5{\%}) had died. RBC levels of EPA and DHA were higher in the survivors (P < .002 for each). In the fully adjusted models, the hazard ratios (99{\%} confidence intervals) for mortality associated with a 1 standard deviation PUFA increase for total mortality were 0.92 (0.85, 0.98) for the Omega-3 Index, 0.89 (0.82, 0.96) for EPA, 0.93 (0.87, 1.0) for DHA, and 0.76 (0.64, 0.90) for the PUFA factor score. There were no significant associations of alpha-linolenic acid, arachidonic acid or linoleic acid with total mortality. Conclusions: Higher RBC levels of marine n-3 PUFAs were associated with reduced risk for all-cause mortality. These findings support the beneficial relationship between the Omega-3 Index and health outcomes.",
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AU - Espeland, Mark A.

AU - Margolis, Karen L.

AU - Manson, Joann E.

AU - Wang, Lu

AU - Brasky, Theodore M.

AU - Robinson, Jennifer G.

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N2 - Background: The prognostic value of circulating polyunsaturated fatty acid (PUFA) levels is unclear. Objectives: To determine the associations between red blood cell (RBC) PUFA levels and risk for death. Methods: This prospective cohort study included 6501 women aged 65 to 80 years who participated in the Women's Health Initiative Memory Study (enrolment began 1996). RBC PUFA levels were measured at baseline and expressed as a percent of total RBC PUFAs. PUFAs of primary interest were the n-3 PUFAs eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) and their sum (the Omega-3 Index). PUFAs of secondary interest included the 2 major n-6 PUFAs, linoleic acid and arachidonic acid, and the PUFA factor score (a calculated variable including 6 PUFAs that accounts for their intercorrelations). The primary outcome was total mortality through August 2014. Results: After a median of 14.9 years of follow-up, 1851 women (28.5%) had died. RBC levels of EPA and DHA were higher in the survivors (P < .002 for each). In the fully adjusted models, the hazard ratios (99% confidence intervals) for mortality associated with a 1 standard deviation PUFA increase for total mortality were 0.92 (0.85, 0.98) for the Omega-3 Index, 0.89 (0.82, 0.96) for EPA, 0.93 (0.87, 1.0) for DHA, and 0.76 (0.64, 0.90) for the PUFA factor score. There were no significant associations of alpha-linolenic acid, arachidonic acid or linoleic acid with total mortality. Conclusions: Higher RBC levels of marine n-3 PUFAs were associated with reduced risk for all-cause mortality. These findings support the beneficial relationship between the Omega-3 Index and health outcomes.

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