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Chen HC, Tai CJ, Huang JY, Kuo TA, Huang YD, Yen CH, Lee MC. Associations of fish oil with cardiovascular disease events: results from the Taiwan longitudinal study in aging. BMC Public Health 2024; 24:1979. [PMID: 39048951 PMCID: PMC11270879 DOI: 10.1186/s12889-024-19512-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Accepted: 07/17/2024] [Indexed: 07/27/2024] Open
Abstract
BACKGROUND The effectiveness of fish oil in preventing cardiovascular events is still debating. Some studies indicate a correlation between the use of fish oil supplements and reduced mortality or decreased incidence of stroke. However, other studies show no significant association between fish oil intake and stroke prevention, indicating an ongoing debate. This study aimed at exploring which subjects may benefit more from fish oil supplementation. METHODS This study utilized the data obtained through face-to-face interview from the Taiwan Longitudinal Study in Aging (TLSA). A total of 3,652 participants were included from the 2003 baseline data, after excluding patients with pre-existing ischemic heart disease or stroke. Participants were divided into two groups based on whether taking fish oil supplement or not. Participants were followed until 2015, estimating and comparing the all-cause mortality and cumulative incidence rate of stroke between both groups. RESULTS The results of the 12-year longitudinal study showed that the cumulative incidence rate of stroke in the fish oil supplementation group was 5.7%, compared to 7.7% in the non-supplemented group (P < 0.05). Additionally, the crude hazard ratio for stroke was significantly lower in the fish oil supplementation group (HR = 0.686;95% CI 0.476-0.987). However, after adjusting potential confounders, the adjusted risk of stroke was lower only for the diabetic patients supplemented with fish oil (aHR = 0.123; 95% CI 0.016-0.930) compared to non-diabetic patients (aHR = 0.917; 95% CI 0.616-1.364). CONCLUSION This study suggests that there is an association between fish oil supplementation and a lower cumulative incidence rate of subsequent stroke among diabetic patients.
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Affiliation(s)
- Hsiu-Chuan Chen
- Department of Family Medicine, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan
| | - Chi-Jung Tai
- Department of Family Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Department of Family Medicine, Kaohsiung Medical University Gangshan Hospital, Kaohsiung, Taiwan
- Department of Family Medicine, School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Jing-Yang Huang
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Tsu-Ann Kuo
- Department of Medical Sociology and Social Work, Chung Shan Medical University, Taichung, Taiwan
| | - Yuan-Der Huang
- Department of Obstetrics and Gynecology, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan
- Min-Hwei Junior College of Health Care Management, Tainan, Taiwan
| | - Chi-Hua Yen
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan.
- Department of Family and Community Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan.
| | - Meng-Chih Lee
- Department of Family Medicine, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan.
- College of Management, Chaoyang University of Technology, Taichung, Taiwan.
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan.
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2
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O’Keefe JH, Tintle NL, Harris WS, O’Keefe EL, Sala-Vila A, Attia J, Garg GM, Hure A, Bork CS, Schmidt EB, Venø SK, Chien KL, Chen YY(A, Egert S, Feldreich TR, Ärnlöv J, Lind L, Forouhi NG, Geleijnse JM, Pertiwi K, Imamura F, de Mello Laaksonen V, Uusitupa WM, Tuomilehto J, Laakso M, Lankinen MA, Laurin D, Carmichael PH, Lindsay J, Leander K, Laguzzi F, Swenson BR, Longstreth WT, Manson JE, Mora S, Cook NR, Marklund M, van Lent DM, Murphy R, Gudnason V, Ninomiya T, Hirakawa Y, Qian F, Sun Q, Hu F, Ardisson Korat AV, Risérus U, Lázaro I, Samieri C, Le Goff M, Helmer C, Steur M, Voortman T, Ikram MK, Tanaka T, Das JK, Ferrucci L, Bandinelli S, Tsai M, Guan W, Garg P, Verschuren WMM, Boer JMA, Biokstra A, Virtanen J, Wagner M, Westra J, Albuisson L, Yamagishi K, Siscovick DS, Lemaitre RN, Mozaffarian D. Omega-3 Blood Levels and Stroke Risk: A Pooled and Harmonized Analysis of 183 291 Participants From 29 Prospective Studies. Stroke 2024; 55:50-58. [PMID: 38134264 PMCID: PMC10840378 DOI: 10.1161/strokeaha.123.044281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 10/30/2023] [Indexed: 12/24/2023]
Abstract
BACKGROUND The effect of marine omega-3 PUFAs on risk of stroke remains unclear. METHODS We investigated the associations between circulating and tissue omega-3 PUFA levels and incident stroke (total, ischemic, and hemorrhagic) in 29 international prospective cohorts. Each site conducted a de novo individual-level analysis using a prespecified analytical protocol with defined exposures, covariates, analytical methods, and outcomes; the harmonized data from the studies were then centrally pooled. Multivariable-adjusted HRs and 95% CIs across omega-3 PUFA quintiles were computed for each stroke outcome. RESULTS Among 183 291 study participants, there were 10 561 total strokes, 8220 ischemic strokes, and 1142 hemorrhagic strokes recorded over a median of 14.3 years follow-up. For eicosapentaenoic acid, comparing quintile 5 (Q5, highest) with quintile 1 (Q1, lowest), total stroke incidence was 17% lower (HR, 0.83 [CI, 0.76-0.91]; P<0.0001), and ischemic stroke was 18% lower (HR, 0.82 [CI, 0.74-0.91]; P<0.0001). For docosahexaenoic acid, comparing Q5 with Q1, there was a 12% lower incidence of total stroke (HR, 0.88 [CI, 0.81-0.96]; P=0.0001) and a 14% lower incidence of ischemic stroke (HR, 0.86 [CI, 0.78-0.95]; P=0.0001). Neither eicosapentaenoic acid nor docosahexaenoic acid was associated with a risk for hemorrhagic stroke. These associations were not modified by either baseline history of AF or prevalent CVD. CONCLUSIONS Higher omega-3 PUFA levels are associated with lower risks of total and ischemic stroke but have no association with hemorrhagic stroke.
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Affiliation(s)
- James H O’Keefe
- Saint Luke’s Mid America Heart Institute, University of Missouri-Kansas City, Kansas City, MO
| | | | - William S Harris
- Fatty Acid Research Institute, Sioux Falls, SD
- University of South Dakota, Sioux Falls, SD
| | - Evan L O’Keefe
- Saint Luke’s Mid America Heart Institute, University of Missouri-Kansas City, Kansas City, MO
| | - Aleix Sala-Vila
- Fatty Acid Research Institute, Sioux Falls, SD
- Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - John Attia
- The University of Newcastle, School of Biomedical Sciences and Pharmacy, Callaghan, Australia
| | - G Manohar Garg
- The University of Newcastle, School of Biomedical Sciences and Pharmacy, Callaghan, Australia
| | - Alexis Hure
- The University of Newcastle, School of Biomedical Sciences and Pharmacy, Callaghan, Australia
| | | | - Erik Berg Schmidt
- Aalborg University Hospital, Department of Clinical Medicine, Aalborg, Denmark
| | - Stine Krogh Venø
- Aalborg University Hospital, Department of Clinical Biochemistry, Aalborg, Denmark
| | - Kuo-Liong Chien
- National Taiwan University, Institute of Epidemiology and Preventive Medicine, Taipei Taiwan
| | - Yun-Yu (Amelia) Chen
- Taichung Veterans General Hospital, Department of Medical Research, Taichung, Taiwan
| | - Sarah Egert
- University of Bonn, Institute of Nutrition and Food Sciences and Nutritional Physiology, Bonn, Germany
| | | | - Johan Ärnlöv
- Karolinska Institutet, Division of Family Medicine and Primary Care, Department of Neurobiology Care Sciences & Society, Solna, Sweden
| | - Lars Lind
- Uppsala University, Department of Medical Sciences Cardiovascular Epidemiology, Uppsala, Sweden
| | - Nita G Forouhi
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Johanna M Geleijnse
- Wageningen University & Research, Division of Human Nutrition and Health, Wageningen, Netherlands
| | - Kamalita Pertiwi
- Wageningen University & Research, Division of Human Nutrition and Health, Wageningen, Netherlands
| | - Fumiaki Imamura
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Vanessa de Mello Laaksonen
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - W Matti Uusitupa
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Jaakko Tuomilehto
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Markku Laakso
- University of Eastern Finland, School of Medicine, Department of Internal Medicine, Kuopio, Finland
| | - Maria Anneli Lankinen
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Danielle Laurin
- CHU de Québec-Université Laval and VITAM Research Centers, Centre d’Excellence sur le Vieillissement de Québec, Québec, Canada
| | - Pierre-Hugues Carmichael
- CHU de Québec-Université Laval and VITAM Research Centers, Centre d’Excellence sur le Vieillissement de Québec, Québec, Canada
| | - Joan Lindsay
- University of Ottawa, School of Epidemiology and Public Health, Ottawa, Canada
| | - Karin Leander
- Karolinska Institutet, Institute of Environmental Medicine, Unit of Cardiovascular and Nutritional Epidemiology, Stockholm, Sweden
| | - Federica Laguzzi
- Karolinska Institutet, Institute of Environmental Medicine, Unit of Cardiovascular and Nutritional Epidemiology, Stockholm, Sweden
| | - Brenton R Swenson
- University of Washington, Cardiovascular Health Research Unit, Seattle, WA
| | - William T Longstreth
- University of Washington, Departments of Neurology and Epidemiology, Seattle, WA
| | - JoAnn E Manson
- Harvard Medical School, Department of Medicine, Brigham & Women’s Hospital, Boston, MA
| | - Samia Mora
- Harvard Medical School, Department of Medicine, Brigham & Women’s Hospital, Boston, MA
| | - Nancy R Cook
- Harvard Medical School, Department of Medicine, Brigham & Women’s Hospital, Boston, MA
| | - Matti Marklund
- The George Institute for Global Health, University of New South Wales, Newtown, NSW Australia; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland: and Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Debora Melo van Lent
- University of Texas, Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases, San Antonio, TX
| | - Rachel Murphy
- University of British Columbia, Cancer Control Research, British Columbia Cancer, School of Population and Public Health, Vancouver, Canada
| | | | - Toshihara Ninomiya
- Kyushu University, Department of Epidemiology and Public Health and Center for Cohort Studies, Fukouka, Japan
| | - Yoichiro Hirakawa
- Kyushu University, Department of Epidemiology and Public Health and Center for Cohort Studies, Fukouka, Japan
| | - Frank Qian
- Harvard Medical School, T.H. Chan School of Public Health and Beth Deaconess Medical Center, Boston, MA
| | - Qi Sun
- Harvard Medical School, T.H. Chan School of Public Health and Channing Division of Network Medicine Brigham and Women’s Hospital, Boston, MA
| | - Frank Hu
- Harvard Medical School, T.H. Chan School of Public Health and Channing Division of Network Medicine Brigham and Women’s Hospital, Boston, MA
| | | | - Ulf Risérus
- Uppsala University, Department of Public Health and Caring Sciences Clinical Nutrition and Metabolism Unit, Uppsala, Sweden
| | - Iolanda Lázaro
- Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - Cecilia Samieri
- University of Bordeaux, Bordeaux Population Health Research Centre, Bordeaux, France
| | - Mélanie Le Goff
- University of Bordeaux, Bordeaux Population Health Research Centre, Bordeaux, France
| | - Catherine Helmer
- University of Bordeaux, Bordeaux Population Health Research Centre, Bordeaux, France
| | - Marinka Steur
- University Medical Center Rotterdam, Department of Epidemiology, Rotterdam, The Netherlands
| | - Trudy Voortman
- University Medical Center Rotterdam, Department of Epidemiology, Rotterdam, The Netherlands
| | - M Kamran Ikram
- University Medical Center Rotterdam, Department of Epidemiology, Rotterdam, The Netherlands
| | - Toshiko Tanaka
- National Institute of Health, National Institute on Aging, Longitudinal Studies Section, Baltimore, MD
| | | | - Luigi Ferrucci
- National Institute of Health, National Institute on Aging, Longitudinal Studies Section, Baltimore, MD
| | | | - Michael Tsai
- University of Minnesota, Department of Laboratory Medicine and Pathology, Minneapolis, MN
| | - Weihua Guan
- University of Minnesota, Division of Biostatistics, Minneapolis, MN
| | - Parveen Garg
- University of Southern California, Department of Medicine, Cardiology, Los Angeles, CA
| | - WM Monique Verschuren
- National Institute for Public Health and the Environment Bilthoven, The Netherlands, Julius Center for Health Sciences and Primary Care and Centre for Nutrition, Prevention and Health Services, Utrecht, The Netherlands
| | - Jolanda MA Boer
- National Institute for Public Health and the Environment Bilthoven, The Netherlands
| | - Anneke Biokstra
- National Institute for Public Health and the Environment Bilthoven, The Netherlands
| | - Jyrki Virtanen
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Michael Wagner
- University Hospital, Depts of Neurodegenerative Diseases and Geriatric Psychiatry and German Center for Neurodegenerative Diseases, Bonn, Germany
| | | | | | - Kazumasa Yamagishi
- University of Tsukubu, Department of Public Health Medicine, Tsukuba, Japan
| | - David S Siscovick
- New York Academy of Medicine, Department of Epidemiology, New York, New York
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Bae JH, Lim H, Lim S. The Potential Cardiometabolic Effects of Long-Chain ω-3 Polyunsaturated Fatty Acids: Recent Updates and Controversies. Adv Nutr 2023; 14:612-628. [PMID: 37031750 PMCID: PMC10334139 DOI: 10.1016/j.advnut.2023.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 03/09/2023] [Accepted: 03/30/2023] [Indexed: 04/11/2023] Open
Abstract
Various health-related effects of long-chain (LC) ω-3 PUFAs, EPA, and DHA have been suggested. LC ω-3 PUFAs reduce TG concentrations and have anti-inflammatory, immunomodulatory, antiplatelet, and vascular protective effects. Controversially, they might help in restoring glucose homeostasis via the gut microbiota. However, previous studies have not shown the clear benefits of LC ω-3 PUFAs for CVDs. REDUCE-IT and STRENGTH-representative randomized controlled trials (RCTs) that examined whether LC ω-3 PUFAs would prevent major adverse cardiovascular (CV) events (MACE)-showed conflicting results with differences in the types, doses, or comparators of LC ω-3 PUFAs and study populations. Therefore, we performed a meta-analysis using major RCTs to address this inconsistency and assess the clinical and biological effects of LC ω-3 PUFAs. We included RCTs that involved ≥500 participants with ≥1 y follow-up. Of 17 studies involving 143,410 people, LC ω-3 PUFA supplementation showed beneficial effects on CV death (RR: 0.94; 95% CI: 0.88, 0.99; P = 0.029) and fatal or nonfatal MI (RR: 0.83; 95% CI: 0.72, 0.95; P = 0.010). RCTs on EPA alone showed better results for 3-point MACE, CV death, and fatal or nonfatal MI. However, the benefits were not found for fatal or nonfatal stroke, all-cause mortality, and hospitalization for heart failure. Of note, studies of both the EPA/DHA combination and EPA alone showed a significant increase in risk of new-onset atrial fibrillation. Thus, well-designed studies are needed to investigate the underlying mechanisms involved in the distinct effects of EPA compared with DHA on cardiometabolic diseases. This review discusses the potential benefits and safety of LC ω-3 PUFAs from a cardiometabolic perspective focusing on recent updates and controversies.
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Affiliation(s)
- Jae Hyun Bae
- Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Hyunjung Lim
- Department of Medical Nutrition, Research Institute of Medical Nutrition, Graduate School of East-West Medical Science, Kyung Hee University, Yongin, Republic of Korea
| | - Soo Lim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea.
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Yavari M, Ramalingam L, Harris BN, Kahathuduwa CN, Chavira A, Biltz C, Mounce L, Maldonado KA, Scoggin S, Zu Y, Kalupahana NS, Yosofvand M, Moussa H, Moustaid-Moussa N. Eicosapentaenoic Acid Protects against Metabolic Impairments in the APPswe/PS1dE9 Alzheimer's Disease Mouse Model. J Nutr 2023; 153:1038-1051. [PMID: 36781072 PMCID: PMC10273166 DOI: 10.1016/j.tjnut.2023.01.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 01/18/2023] [Accepted: 01/26/2023] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Alzheimer's disease (AD) is an age-related neurodegenerative disease characterized by amyloid-β (Aβ) plaques. Systemic inflammation and obesity may exacerbate AD pathogenesis. We previously reported anti-inflammatory and anti-obesity effects of EPA in mice. OBJECTIVES We aimed to determine whether EPA reduces obesity-associated metabolic dysfunctions and Aβ accumulation in AD amyloidogenic mice. METHODS Two-mo-old APPswe/PS1dE9 transgenic (TG) mice and non-TG littermates were randomly assigned to low fat (LF; 10% kcal fat), high fat (HF; 45% kcal fat), or EPA (36 g/kg)-supplemented HF diets. Body composition, glucose tolerance, and energy expenditure were measured, and serum and brain metabolic markers were tested 38 wk postintervention. Outcomes were statistically analyzed via 3-factor ANOVA, modeling genotype, sex, and diet interactions. RESULTS HF-fed males gained more weight than females (Δ = 61 mg; P < 0.001). Compared with LF, HF increased body weights of wild-type (WT) males (Δ = 31 mg; P < 0.001). EPA reduced HF-induced weight gain in WT males (Δ = 24 mg; P = 0.054) but not in females. HF mice showed decreased glucose clearance and respiratory energy compared with LF-fed groups (Δ = -1.31 g/dL; P < 0.001), with no significant effects of EPA. However, EPA conferred metabolic improvements by decreasing serum leptin and insulin (Δ = -2.51 g/mL and Δ = -0.694 ng/mL, respectively compared with HF, P ≤ 0.05) and increasing adiponectin (Δ = 21.6 ng/mL; P < 0.001). As we expected, TG mice expressed higher serum and brain Aβ than WT mice (Δ = 0.131 ng/mL; P < 0.001 and Δ = 0.56%; P < 0.01, respectively), and EPA reduced serum Aβ1-40 in TG males compared with HF (Δ = 0.053 ng/mL; P ≤ 0.05). CONCLUSIONS To our knowledge, this is the first report that EPA reduces serum Aβ1-40 in obese AD male mice, warranting further investigations into tissue-specific mechanisms of EPA in AD.
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Affiliation(s)
- Mahsa Yavari
- Department of Nutritional Sciences, Texas Tech University, Lubbock, TX, USA; Obesity Research Institute, Office of Research & Innovation, Texas Tech University, Lubbock, TX, USA
| | - Latha Ramalingam
- Department of Nutritional Sciences, Texas Tech University, Lubbock, TX, USA
| | - Breanna N Harris
- Obesity Research Institute, Office of Research & Innovation, Texas Tech University, Lubbock, TX, USA; Department of Biological Sciences, Texas Tech University, Lubbock, TX, USA
| | - Chanaka Nadeeshan Kahathuduwa
- Obesity Research Institute, Office of Research & Innovation, Texas Tech University, Lubbock, TX, USA; Department of Laboratory Science and Primary Care, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Angela Chavira
- Department of Nutritional Sciences, Texas Tech University, Lubbock, TX, USA
| | - Caroline Biltz
- Department of Nutritional Sciences, Texas Tech University, Lubbock, TX, USA
| | - Logan Mounce
- Department of Biological Sciences, Texas Tech University, Lubbock, TX, USA
| | | | - Shane Scoggin
- Department of Nutritional Sciences, Texas Tech University, Lubbock, TX, USA
| | - Yujiao Zu
- Department of Nutritional Sciences, Texas Tech University, Lubbock, TX, USA; Obesity Research Institute, Office of Research & Innovation, Texas Tech University, Lubbock, TX, USA
| | - Nishan Sudheera Kalupahana
- Department of Nutritional Sciences, Texas Tech University, Lubbock, TX, USA; Obesity Research Institute, Office of Research & Innovation, Texas Tech University, Lubbock, TX, USA; Department of Physiology, University of Peradeniya, Sri Lanka
| | - Mohammad Yosofvand
- Department of Mechanical Engineering, Texas Tech University, Lubbock, TX, USA
| | - Hanna Moussa
- Department of Mechanical Engineering, Texas Tech University, Lubbock, TX, USA
| | - Naima Moustaid-Moussa
- Department of Nutritional Sciences, Texas Tech University, Lubbock, TX, USA; Obesity Research Institute, Office of Research & Innovation, Texas Tech University, Lubbock, TX, USA.
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Rodriguez D, Lavie CJ, Elagizi A, Milani RV. Update on Omega-3 Polyunsaturated Fatty Acids on Cardiovascular Health. Nutrients 2022; 14:nu14235146. [PMID: 36501174 PMCID: PMC9739673 DOI: 10.3390/nu14235146] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 11/30/2022] [Accepted: 12/01/2022] [Indexed: 12/12/2022] Open
Abstract
Twenty percent of deaths in the United States are secondary to cardiovascular diseases (CVD). In patients with hyperlipidemia and hypertriglyceridemia, studies have shown high atherosclerotic CVD (ASCVD) event rates despite the use of statins. Given the association of high triglyceride (TG) levels with elevated cholesterol and low levels of high-density lipoprotein cholesterol, the American Heart Association (AHA)/American College of Cardiology (ACC) cholesterol guidelines recommend using elevated TGs as a "risk-enhancing factor" for ASCVD and using omega 3 fatty acids (Ω3FAs) for patients with persistently elevated severe hypertriglyceridemia. Ω3FA, or fish oils (FOs), have been shown to reduce very high TG levels, hospitalizations, and CVD mortality in randomized controlled trials (RCTs). We have published the largest meta-analysis to date demonstrating significant effects on several CVD outcomes, especially fatal myocardial infarctions (MIs) and total MIs. Despite the most intensive research on Ω3FAs on CVD, their benefits have been demonstrated to cluster across multiple systems and pathologies, including autoimmune diseases, infectious diseases, chronic kidney disease, central nervous system diseases, and, most recently, the COVID-19 pandemic. A review and summary of the controversies surrounding Ω3FAs, some of the latest evidence-based findings, and the current and most updated recommendations on Ω3FAs are presented in this paper.
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Xuan J, Wang Z, Xia Q, Luo T, Mao Q, Sun Q, Han Z, Liu Y, Wei S, Liu S. Comparative Lipidomics Profiling of Acylglycerol from Tuna Oil Selectively Hydrolyzed by Thermomyces Lanuginosus Lipase and Candida Antarctica Lipase A. Foods 2022; 11:foods11223664. [PMID: 36429256 PMCID: PMC9689481 DOI: 10.3390/foods11223664] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 11/08/2022] [Accepted: 11/12/2022] [Indexed: 11/18/2022] Open
Abstract
Lipase hydrolysis is an effective method to develop different functional types of lipids. In this study, tuna oil was partially hydrolyzed at 30% and 60% by Thermomyces lanuginosus lipase (TL 100 L) and Candida Antarctica lipase A (ADL), respectively, to obtain lipid-modified acylglycerols. The lipidomic profiling of the acylglycerols was investigated by UPLC-Q-TOF-MS and GC-MS to clarify the lipid modification effect of these two lipases on tuna oil. The results showed that 247 kinds of acylglycerols and 23 kinds of fatty acids were identified in the five samples. In the ADL group, the content of triacylglycerols (TAG) and diacylglycerols (DAG) increased by 4.93% and 114.38%, respectively, with an increase in the hydrolysis degree (HD), while there was a decreasing trend in the TL 100 L group. TL 100 L had a better enrichment effect on DHA, while ADL was more inclined to enrich EPA and hydrolyze saturated fatty acids. Cluster analysis showed that the lipids obtained by the hydrolysis of TL 100 L and ADL were significantly different in the cluster analysis of TAG, DAG, and monoacylglycerols (MAG). TL 100 L has strong TAG selectivity and a strong ability to hydrolyze acylglycerols, while ADL has the potential to synthesize functional lipids containing omega-3 PUFAs, especially DAG.
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Affiliation(s)
- Junyong Xuan
- College of Food Science and Technology, Guangdong Ocean University, Guangdong Provincial Key Laboratory of Aquatic Product Processing and Safety, Guangdong Province Engineering Laboratory for Marine Biological Products, Guangdong Provincial Engineering Technology Research Center of Seafood, Key Laboratory of Advanced Processing of Aquatic Product of Guangdong Higher Education Institution, Zhanjiang 524088, China
| | - Zefu Wang
- College of Food Science and Technology, Guangdong Ocean University, Guangdong Provincial Key Laboratory of Aquatic Product Processing and Safety, Guangdong Province Engineering Laboratory for Marine Biological Products, Guangdong Provincial Engineering Technology Research Center of Seafood, Key Laboratory of Advanced Processing of Aquatic Product of Guangdong Higher Education Institution, Zhanjiang 524088, China
| | - Qiuyu Xia
- College of Food Science and Technology, Guangdong Ocean University, Guangdong Provincial Key Laboratory of Aquatic Product Processing and Safety, Guangdong Province Engineering Laboratory for Marine Biological Products, Guangdong Provincial Engineering Technology Research Center of Seafood, Key Laboratory of Advanced Processing of Aquatic Product of Guangdong Higher Education Institution, Zhanjiang 524088, China
- Correspondence:
| | - Tingyu Luo
- College of Food Science and Technology, Guangdong Ocean University, Guangdong Provincial Key Laboratory of Aquatic Product Processing and Safety, Guangdong Province Engineering Laboratory for Marine Biological Products, Guangdong Provincial Engineering Technology Research Center of Seafood, Key Laboratory of Advanced Processing of Aquatic Product of Guangdong Higher Education Institution, Zhanjiang 524088, China
| | - Qingya Mao
- College of Food Science and Technology, Guangdong Ocean University, Guangdong Provincial Key Laboratory of Aquatic Product Processing and Safety, Guangdong Province Engineering Laboratory for Marine Biological Products, Guangdong Provincial Engineering Technology Research Center of Seafood, Key Laboratory of Advanced Processing of Aquatic Product of Guangdong Higher Education Institution, Zhanjiang 524088, China
| | - Qinxiu Sun
- College of Food Science and Technology, Guangdong Ocean University, Guangdong Provincial Key Laboratory of Aquatic Product Processing and Safety, Guangdong Province Engineering Laboratory for Marine Biological Products, Guangdong Provincial Engineering Technology Research Center of Seafood, Key Laboratory of Advanced Processing of Aquatic Product of Guangdong Higher Education Institution, Zhanjiang 524088, China
| | - Zongyuan Han
- College of Food Science and Technology, Guangdong Ocean University, Guangdong Provincial Key Laboratory of Aquatic Product Processing and Safety, Guangdong Province Engineering Laboratory for Marine Biological Products, Guangdong Provincial Engineering Technology Research Center of Seafood, Key Laboratory of Advanced Processing of Aquatic Product of Guangdong Higher Education Institution, Zhanjiang 524088, China
| | - Yang Liu
- College of Food Science and Technology, Guangdong Ocean University, Guangdong Provincial Key Laboratory of Aquatic Product Processing and Safety, Guangdong Province Engineering Laboratory for Marine Biological Products, Guangdong Provincial Engineering Technology Research Center of Seafood, Key Laboratory of Advanced Processing of Aquatic Product of Guangdong Higher Education Institution, Zhanjiang 524088, China
| | - Shuai Wei
- College of Food Science and Technology, Guangdong Ocean University, Guangdong Provincial Key Laboratory of Aquatic Product Processing and Safety, Guangdong Province Engineering Laboratory for Marine Biological Products, Guangdong Provincial Engineering Technology Research Center of Seafood, Key Laboratory of Advanced Processing of Aquatic Product of Guangdong Higher Education Institution, Zhanjiang 524088, China
| | - Shucheng Liu
- College of Food Science and Technology, Guangdong Ocean University, Guangdong Provincial Key Laboratory of Aquatic Product Processing and Safety, Guangdong Province Engineering Laboratory for Marine Biological Products, Guangdong Provincial Engineering Technology Research Center of Seafood, Key Laboratory of Advanced Processing of Aquatic Product of Guangdong Higher Education Institution, Zhanjiang 524088, China
- Guangdong Laboratory of Southern Marine Science and Engineering (Zhanjiang), Zhanjiang 524088, China
- Collaborative Innovation Center for Key Technology of Marine Food Deep Processing, Dalian University of Technology, Dalian 116034, China
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Wierenga KA, Riemers FM, Westendorp B, Harkema JR, Pestka JJ. Single cell analysis of docosahexaenoic acid suppression of sequential LPS-induced proinflammatory and interferon-regulated gene expression in the macrophage. Front Immunol 2022; 13:993614. [PMID: 36405730 PMCID: PMC9669445 DOI: 10.3389/fimmu.2022.993614] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 09/22/2022] [Indexed: 11/06/2022] Open
Abstract
Preclinical and clinical studies suggest that consumption of long chain omega-3 polyunsaturated fatty acids (PUFAs) reduces severity of chronic inflammatory and autoimmune diseases. While these ameliorative effects are conventionally associated with downregulated expression of proinflammatory cytokine and chemokine genes, our laboratory has recently identified Type 1 interferon (IFN1)-regulated gene expression to be another key target of omega-3 PUFAs. Here we used single cell RNA sequencing (scRNAseq) to gain new mechanistic perspectives on how the omega-3 PUFA docosahexaenoic acid (DHA) influences TLR4-driven proinflammatory and IFN1-regulated gene expression in a novel self-renewing murine fetal liver-derived macrophage (FLM) model. FLMs were cultured with 25 µM DHA or vehicle for 24 h, treated with modest concentration of LPS (20 ng/ml) for 1 and 4 h, and then subjected to scRNAseq using the 10X Chromium System. At 0 h (i.e., in the absence of LPS), DHA increased expression of genes associated with the NRF2 antioxidant response (e.g. Sqstm1, Hmox1, Chchd10) and metal homeostasis (e.g.Mt1, Mt2, Ftl1, Fth1), both of which are consistent with DHA-induced polarization of FLMs to a more anti-inflammatory phenotype. At 1 h post-LPS treatment, DHA inhibited LPS-induced cholesterol synthesis genes (e.g. Scd1, Scd2, Pmvk, Cyp51, Hmgcs1, and Fdps) which potentially could contribute to interference with TLR4-mediated inflammatory signaling. At 4 h post-LPS treatment, LPS-treated FLMs reflected a more robust inflammatory response including upregulation of proinflammatory cytokine (e.g. Il1a, Il1b, Tnf) and chemokine (e.g.Ccl2, Ccl3, Ccl4, Ccl7) genes as well as IFN1-regulated genes (e.g. Irf7, Mx1, Oasl1, Ifit1), many of which were suppressed by DHA. Using single-cell regulatory network inference and clustering (SCENIC) to identify gene expression networks, we found DHA modestly downregulated LPS-induced expression of NF-κB-target genes. Importantly, LPS induced a subset of FLMs simultaneously expressing NF-κB- and IRF7/STAT1/STAT2-target genes that were conspicuously absent in DHA-pretreated FLMs. Thus, DHA potently targeted both the NF-κB and the IFN1 responses. Altogether, scRNAseq generated a valuable dataset that provides new insights into multiple overlapping mechanisms by which DHA may transcriptionally or post-transcriptionally regulate LPS-induced proinflammatory and IFN1-driven responses in macrophages.
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Affiliation(s)
- Kathryn A. Wierenga
- Department of Biochemistry and Molecular Biology, Michigan State University, Lansing, MI, United States
- Institute for Integrative Toxicology, Michigan State University, Lansing, MI, United States
| | - Frank M. Riemers
- Department of Biomolecular Health Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, Netherlands
| | - Bart Westendorp
- Department of Biomolecular Health Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, Netherlands
| | - Jack R. Harkema
- Institute for Integrative Toxicology, Michigan State University, Lansing, MI, United States
- Department of Pathobiology and Diagnostic Investigation, Michigan State University, Lansing, MI, United States
| | - James J. Pestka
- Institute for Integrative Toxicology, Michigan State University, Lansing, MI, United States
- Department of Microbiology and Molecular Genetics, Michigan State University, Lansing, MI, United States
- Department of Food Science and Human Nutrition, Michigan State University, Lansing, MI, United States
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8
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Is Omega-3 Index necessary for fish oil supplements for CVD risk prevention? CARDIOLOGY PLUS 2022. [DOI: 10.1097/cp9.0000000000000015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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9
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Oppedisano F, Mollace R, Tavernese A, Gliozzi M, Musolino V, Macrì R, Carresi C, Maiuolo J, Serra M, Cardamone A, Volterrani M, Mollace V. PUFA Supplementation and Heart Failure: Effects on Fibrosis and Cardiac Remodeling. Nutrients 2021; 13:nu13092965. [PMID: 34578843 PMCID: PMC8471017 DOI: 10.3390/nu13092965] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 08/21/2021] [Accepted: 08/24/2021] [Indexed: 12/11/2022] Open
Abstract
Heart failure (HF) characterized by cardiac remodeling is a condition in which inflammation and fibrosis play a key role. Dietary supplementation with n-3 polyunsaturated fatty acids (PUFAs) seems to produce good results. In fact, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) have anti-inflammatory and antioxidant properties and different cardioprotective mechanisms. In particular, following their interaction with the nuclear factor erythropoietin 2 related factor 2 (NRF2), the free fatty acid receptor 4 (Ffar4) receptor, or the G-protein coupled receptor 120 (GPR120) fibroblast receptors, they inhibit cardiac fibrosis and protect the heart from HF onset. Furthermore, n-3 PUFAs increase the left ventricular ejection fraction (LVEF), reduce global longitudinal deformation, E/e ratio (early ventricular filling and early mitral annulus velocity), soluble interleukin-1 receptor-like 1 (sST2) and high-sensitive C Reactive protein (hsCRP) levels, and increase flow-mediated dilation. Moreover, lower levels of brain natriuretic peptide (BNP) and serum norepinephrine (sNE) are reported and have a positive effect on cardiac hemodynamics. In addition, they reduce cardiac remodeling and inflammation by protecting patients from HF onset after myocardial infarction (MI). The positive effects of PUFA supplementation are associated with treatment duration and a daily dosage of 1–2 g. Therefore, both the European Society of Cardiology (ESC) and the American College of Cardiology/American Heart Association (ACC/AHA) define dietary supplementation with n-3 PUFAs as an effective therapy for reducing the risk of hospitalization and death in HF patients. In this review, we seek to highlight the most recent studies related to the effect of PUFA supplementation in HF. For that purpose, a PubMed literature survey was conducted with a focus on various in vitro and in vivo studies and clinical trials from 2015 to 2021.
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Affiliation(s)
- Francesca Oppedisano
- Department of Health Sciences, Institute of Research for Food Safety & Health (IRC-FSH), University Magna Graecia, 88100 Catanzaro, Italy; (R.M.); (A.T.); (M.G.); (V.M.); (R.M.); (C.C.); (J.M.); (M.S.); (A.C.)
- Nutramed S.c.a.r.l., Complesso Ninì Barbieri, Roccelletta di Borgia, 88021 Catanzaro, Italy
- Correspondence: (F.O.); (V.M.)
| | - Rocco Mollace
- Department of Health Sciences, Institute of Research for Food Safety & Health (IRC-FSH), University Magna Graecia, 88100 Catanzaro, Italy; (R.M.); (A.T.); (M.G.); (V.M.); (R.M.); (C.C.); (J.M.); (M.S.); (A.C.)
- Division of Cardiology, University Hospital Policlinico Tor Vergata, 00133 Rome, Italy
- Department of Cardiology, IRCCS San Raffaele Pisana, 00166 Rome, Italy;
| | - Annamaria Tavernese
- Department of Health Sciences, Institute of Research for Food Safety & Health (IRC-FSH), University Magna Graecia, 88100 Catanzaro, Italy; (R.M.); (A.T.); (M.G.); (V.M.); (R.M.); (C.C.); (J.M.); (M.S.); (A.C.)
- Nutramed S.c.a.r.l., Complesso Ninì Barbieri, Roccelletta di Borgia, 88021 Catanzaro, Italy
| | - Micaela Gliozzi
- Department of Health Sciences, Institute of Research for Food Safety & Health (IRC-FSH), University Magna Graecia, 88100 Catanzaro, Italy; (R.M.); (A.T.); (M.G.); (V.M.); (R.M.); (C.C.); (J.M.); (M.S.); (A.C.)
- Nutramed S.c.a.r.l., Complesso Ninì Barbieri, Roccelletta di Borgia, 88021 Catanzaro, Italy
| | - Vincenzo Musolino
- Department of Health Sciences, Institute of Research for Food Safety & Health (IRC-FSH), University Magna Graecia, 88100 Catanzaro, Italy; (R.M.); (A.T.); (M.G.); (V.M.); (R.M.); (C.C.); (J.M.); (M.S.); (A.C.)
- Nutramed S.c.a.r.l., Complesso Ninì Barbieri, Roccelletta di Borgia, 88021 Catanzaro, Italy
| | - Roberta Macrì
- Department of Health Sciences, Institute of Research for Food Safety & Health (IRC-FSH), University Magna Graecia, 88100 Catanzaro, Italy; (R.M.); (A.T.); (M.G.); (V.M.); (R.M.); (C.C.); (J.M.); (M.S.); (A.C.)
- Nutramed S.c.a.r.l., Complesso Ninì Barbieri, Roccelletta di Borgia, 88021 Catanzaro, Italy
| | - Cristina Carresi
- Department of Health Sciences, Institute of Research for Food Safety & Health (IRC-FSH), University Magna Graecia, 88100 Catanzaro, Italy; (R.M.); (A.T.); (M.G.); (V.M.); (R.M.); (C.C.); (J.M.); (M.S.); (A.C.)
- Nutramed S.c.a.r.l., Complesso Ninì Barbieri, Roccelletta di Borgia, 88021 Catanzaro, Italy
| | - Jessica Maiuolo
- Department of Health Sciences, Institute of Research for Food Safety & Health (IRC-FSH), University Magna Graecia, 88100 Catanzaro, Italy; (R.M.); (A.T.); (M.G.); (V.M.); (R.M.); (C.C.); (J.M.); (M.S.); (A.C.)
- Nutramed S.c.a.r.l., Complesso Ninì Barbieri, Roccelletta di Borgia, 88021 Catanzaro, Italy
| | - Maria Serra
- Department of Health Sciences, Institute of Research for Food Safety & Health (IRC-FSH), University Magna Graecia, 88100 Catanzaro, Italy; (R.M.); (A.T.); (M.G.); (V.M.); (R.M.); (C.C.); (J.M.); (M.S.); (A.C.)
| | - Antonio Cardamone
- Department of Health Sciences, Institute of Research for Food Safety & Health (IRC-FSH), University Magna Graecia, 88100 Catanzaro, Italy; (R.M.); (A.T.); (M.G.); (V.M.); (R.M.); (C.C.); (J.M.); (M.S.); (A.C.)
| | | | - Vincenzo Mollace
- Department of Health Sciences, Institute of Research for Food Safety & Health (IRC-FSH), University Magna Graecia, 88100 Catanzaro, Italy; (R.M.); (A.T.); (M.G.); (V.M.); (R.M.); (C.C.); (J.M.); (M.S.); (A.C.)
- Nutramed S.c.a.r.l., Complesso Ninì Barbieri, Roccelletta di Borgia, 88021 Catanzaro, Italy
- Department of Cardiology, IRCCS San Raffaele Pisana, 00166 Rome, Italy;
- Correspondence: (F.O.); (V.M.)
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10
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Wierenga KA, Pestka JJ. Omega-3 Fatty Acids And Inflammation - You Are What You Eat! FRONTIERS FOR YOUNG MINDS 2021; 9:601068. [PMID: 35174177 PMCID: PMC8846546 DOI: 10.3389/frym.2021.601068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Have you ever heard the phrase, "You are what you eat"? Of course, if you eat a donut, you will not actually turn into a donut - but bits and pieces of what we eat do become parts of us! In this article, we will talk about how the fatty acids in our cells can help protect us from various diseases by controlling inflammation. Specifically, we will focus on food components called omega-3 polyunsaturated fatty acids, which are most abundant in seafood. We will talk about how eating foods rich in omega-3s increases the levels of omega-3s in your cell membranes and may protect against several diseases that are associated with uncontrolled inflammation.
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Affiliation(s)
- Kathryn A Wierenga
- Department of Biochemistry and Molecular Biology
- Institute for Integrative Toxicology
| | - James J Pestka
- Institute for Integrative Toxicology
- Department of Food Science and Human Nutrition
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11
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Murray R, Kitaba N, Antoun E, Titcombe P, Barton S, Cooper C, Inskip HM, Burdge GC, Mahon PA, Deanfield J, Halcox JP, Ellins EA, Bryant J, Peebles C, Lillycrop K, Godfrey KM, Hanson MA. Influence of Maternal Lifestyle and Diet on Perinatal DNA Methylation Signatures Associated With Childhood Arterial Stiffness at 8 to 9 Years. Hypertension 2021; 78:787-800. [PMID: 34275334 PMCID: PMC8357051 DOI: 10.1161/hypertensionaha.121.17396] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Supplemental Digital Content is available in the text. Increases in aortic pulse wave velocity, a measure of arterial stiffness, can lead to elevated systolic blood pressure and increased cardiac afterload in adulthood. These changes are detectable in childhood and potentially originate in utero, where an adverse early life environment can alter DNA methylation patterns detectable at birth. Here, analysis of epigenome-wide methylation patterns using umbilical cord blood DNA from 470 participants in the Southampton’s Women’s Survey identified differential methylation patterns associated with systolic blood pressure, pulse pressure, arterial distensibility, and descending aorta pulse wave velocity measured by magnetic resonance imaging at 8 to 9 years. Perinatal methylation levels at 16 CpG loci were associated with descending aorta pulse wave velocity, with identified CpG sites enriched in pathways involved in DNA repair (P=9.03×10−11). The most significant association was with cg20793626 methylation (within protein phosphatase, Mg2+/Mn2+ dependent 1D; β=−0.05 m/s/1% methylation change, [95% CI, −0.09 to −0.02]). Genetic variation was also examined but had a minor influence on these observations. Eight pulse wave velocity-linked dmCpGs were associated with prenatal modifiable risk factors, with cg08509237 methylation (within palmitoyl-protein thioesterase-2) associated with maternal oily fish consumption in early and late pregnancy. Lower oily fish consumption in early pregnancy modified the relationship between methylation and pulse wave velocity, with lower consumption strengthening the association between cg08509237 methylation and increased pulse wave velocity. In conclusion, measurement of perinatal DNA methylation signatures has utility in identifying infants who might benefit from preventive interventions to reduce risk of later cardiovascular disease, and modifiable maternal factors can reduce this risk in the child.
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Affiliation(s)
- Robert Murray
- From the School of Human Development and Health, Institute of Developmental Sciences Building, Faculty of Medicine (R.M., N.K., E.A., G.C.B., K.M.G., M.A.H.), University of Southampton, United Kingdom
| | - Negusse Kitaba
- From the School of Human Development and Health, Institute of Developmental Sciences Building, Faculty of Medicine (R.M., N.K., E.A., G.C.B., K.M.G., M.A.H.), University of Southampton, United Kingdom
| | - Elie Antoun
- From the School of Human Development and Health, Institute of Developmental Sciences Building, Faculty of Medicine (R.M., N.K., E.A., G.C.B., K.M.G., M.A.H.), University of Southampton, United Kingdom.,Centre for Biological Sciences, Faculty of Natural and Environmental Sciences (E.A., K.L.), University of Southampton, United Kingdom
| | - Philip Titcombe
- MRC Lifecourse Epidemiology Unit (P.T., S.B., C.C., H.M.I., P.A.M., K.M.G.), University of Southampton, United Kingdom
| | - Sheila Barton
- MRC Lifecourse Epidemiology Unit (P.T., S.B., C.C., H.M.I., P.A.M., K.M.G.), University of Southampton, United Kingdom
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Unit (P.T., S.B., C.C., H.M.I., P.A.M., K.M.G.), University of Southampton, United Kingdom
| | - Hazel M Inskip
- MRC Lifecourse Epidemiology Unit (P.T., S.B., C.C., H.M.I., P.A.M., K.M.G.), University of Southampton, United Kingdom.,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, United Kingdom (H.M.I., K.L., K.M.G., M.A.H.)
| | - Graham C Burdge
- From the School of Human Development and Health, Institute of Developmental Sciences Building, Faculty of Medicine (R.M., N.K., E.A., G.C.B., K.M.G., M.A.H.), University of Southampton, United Kingdom
| | - Pamela A Mahon
- MRC Lifecourse Epidemiology Unit (P.T., S.B., C.C., H.M.I., P.A.M., K.M.G.), University of Southampton, United Kingdom
| | - John Deanfield
- Institute of Cardiovascular Sciences, University College London, United Kingdom (J.D.)
| | - Julian P Halcox
- Swansea University Medical School, Swansea University, United Kingdom (J.P.H., E.A.E.)
| | - Elizabeth A Ellins
- Swansea University Medical School, Swansea University, United Kingdom (J.P.H., E.A.E.)
| | - Jennifer Bryant
- Department of Cardiac Magnetic Resonance Imaging, National Heart Centre Singapore (J.B.)
| | - Charles Peebles
- Wessex Cardiothoracic Centre, Southampton University Hospitals NHS Trust, United Kingdom (C.P.)
| | - Karen Lillycrop
- Centre for Biological Sciences, Faculty of Natural and Environmental Sciences (E.A., K.L.), University of Southampton, United Kingdom.,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, United Kingdom (H.M.I., K.L., K.M.G., M.A.H.)
| | - Keith M Godfrey
- From the School of Human Development and Health, Institute of Developmental Sciences Building, Faculty of Medicine (R.M., N.K., E.A., G.C.B., K.M.G., M.A.H.), University of Southampton, United Kingdom.,MRC Lifecourse Epidemiology Unit (P.T., S.B., C.C., H.M.I., P.A.M., K.M.G.), University of Southampton, United Kingdom.,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, United Kingdom (H.M.I., K.L., K.M.G., M.A.H.)
| | - Mark A Hanson
- From the School of Human Development and Health, Institute of Developmental Sciences Building, Faculty of Medicine (R.M., N.K., E.A., G.C.B., K.M.G., M.A.H.), University of Southampton, United Kingdom.,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, United Kingdom (H.M.I., K.L., K.M.G., M.A.H.)
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12
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Ruscica M, Penson PE, Ferri N, Sirtori CR, Pirro M, Mancini GBJ, Sattar N, Toth PP, Sahebkar A, Lavie CJ, Wong ND, Banach M. Impact of nutraceuticals on markers of systemic inflammation: Potential relevance to cardiovascular diseases - A position paper from the International Lipid Expert Panel (ILEP). Prog Cardiovasc Dis 2021; 67:40-52. [PMID: 34186099 DOI: 10.1016/j.pcad.2021.06.010] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 06/24/2021] [Indexed: 02/05/2023]
Abstract
Inflammation is a marker of arterial disease stemming from cholesterol-dependent to -independent molecular mechanisms. In recent years, the role of inflammation in atherogenesis has been underpinned by pharmacological approaches targeting systemic inflammation that have led to a significant reduction in cardiovascular disease (CVD) risk. Although the use of nutraceuticals to prevent CVD has largely focused on lipid-lowering (e.g, red-yeast rice and omega-3 fatty acids), there is growing interest and need, especially now in the time of coronavirus pandemic, in the use of nutraceuticals to reduce inflammatory markers, and potentially the inflammatory CVD burden, however, there is still not enough evidence to confirm this. Indeed, diet is an important lifestyle determinant of health and can influence both systemic and vascular inflammation, to varying extents, according to the individual nutraceutical constituents. Thus, the aim of this Position Paper is to provide the first attempt at recommendations on the use of nutraceuticals with effective anti-inflammatory properties.
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Affiliation(s)
- Massimiliano Ruscica
- Department of Pharmacology and Biomolecular Sciences, Università degli Studi di Milano, Milano, Italy
| | - Peter E Penson
- School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Liverpool, UK; Liverpool Centre for Cardiovascular Science, Liverpool, UK
| | - Nicola Ferri
- Department of Pharmaceutical and Pharmacological Sciences, Università degli Studi di Padova, Padova, Italy
| | - Cesare R Sirtori
- Department of Pharmacology and Biomolecular Sciences, Università degli Studi di Milano, Milano, Italy
| | - Matteo Pirro
- Internal Medicine Section, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - G B John Mancini
- Center for Cardiovascular Innovation, University of British Columbia, Vancouver, BC, Canada
| | - Naveed Sattar
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, United Kingdom
| | - Peter P Toth
- Cicarrone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Amirhossein Sahebkar
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Carl J Lavie
- Department of Medicine, John Ochsner Medical Center, New Orleans, LA, USA
| | - Nathan D Wong
- Heart Disease Prevention Program, Division of Cardiology, University of California Irvine, Irvine, CA, USA
| | - Maciej Banach
- Department of Hypertension, Medical University of Lodz (MUL), Lodz, Poland; Cardiovascular Research Centre, University of Zielona Gora, Zielona Gora, Poland.
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13
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Bernasconi AA, Lavie CJ, Milani RV, Laukkanen JA. Omega-3 Benefits Remain Strong Post-STRENGTH. Mayo Clin Proc 2021; 96:1371-1372. [PMID: 33838920 DOI: 10.1016/j.mayocp.2021.03.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 03/01/2021] [Indexed: 12/20/2022]
Affiliation(s)
- Aldo A Bernasconi
- Global Organization for EPA and DHA Omega-3s (GOED), Salt Lake City, UT
| | - Carl J Lavie
- John Ochsner Heart and Vascular Institute, Ochsner Clinical School, The University of Queensland School of Medicine, New Orleans, LA
| | - Richard V Milani
- John Ochsner Heart and Vascular Institute, Ochsner Clinical School, The University of Queensland School of Medicine, New Orleans, LA
| | - Jari A Laukkanen
- University of Eastern Finland, Kuopio, University of Jyväskylä, Finland, Central Finland Health Care District
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14
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Narasimhan B, Kaplin S, Wang Z, Krittanawong C. Impact of a High-Shrimp Diet on Cardiovascular Risk: An NHANES Analysis. Mayo Clin Proc 2021; 96:506-508. [PMID: 33549272 DOI: 10.1016/j.mayocp.2020.10.044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 10/22/2020] [Indexed: 11/18/2022]
Affiliation(s)
- Bharat Narasimhan
- Department of Cardiovascular Diseases, Icahn School of Medicine at Mount Sinai, Mount Sinai Heart, New York, New York
| | - Scott Kaplin
- Division of Cardiovascular Diseases, New York University Grossman School of Medicine, New York, New York
| | - Zhen Wang
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Division of Health Care Policy and Research, Mayo Clinic, Rochester, Minnesota
| | - Chayakrit Krittanawong
- Department of Cardiovascular Diseases, Icahn School of Medicine at Mount Sinai, Mount Sinai Heart, New York, New York, Section of Cardiology, Baylor College of Medicine, Houston, Texas
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15
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Lavie CJ, Milani RV, Laukkanen JA, Bernasconi AA. In Reply-Impact of a High-Shrimp Diet on Cardiovascular Risk: An NHANES Analysis. Mayo Clin Proc 2021; 96:508. [PMID: 33549273 DOI: 10.1016/j.mayocp.2020.10.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 10/22/2020] [Indexed: 11/27/2022]
Affiliation(s)
- Carl J Lavie
- John Ochsner Heart and Vascular Institute, Ochsner Clinical School, The University of Queensland School of Medicine, New Orleans, Louisiana
| | - Richard V Milani
- John Ochsner Heart and Vascular Institute, Ochsner Clinical School, The University of Queensland School of Medicine, New Orleans, Louisiana
| | | | - Aldo A Bernasconi
- Global Organization for EPA and DHA Omega-3s (GOED), Salt Lake City, Utah
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16
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Matsuo N, Miyoshi T, Takaishi A, Kishinoue T, Yasuhara K, Tanimoto M, Nakano Y, Onishi N, Ueeda M, Ito H. High Plasma Docosahexaenoic Acid Associated to Better Prognoses of Patients with Acute Decompensated Heart Failure with Preserved Ejection Fraction. Nutrients 2021; 13:nu13020371. [PMID: 33530352 PMCID: PMC7911271 DOI: 10.3390/nu13020371] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 01/21/2021] [Accepted: 01/22/2021] [Indexed: 12/31/2022] Open
Abstract
The clinical relevance of polyunsaturated fatty acids (PUFAs) in heart failure remains unclear. The aim of this study was to investigate the association between PUFA levels and the prognosis of patients with heart failure with preserved ejection fraction (HFpEF). This retrospective study included 140 hospitalized patients with acute decompensated HFpEF (median age 84.0 years, 42.9% men). The patients' nutritional status was assessed, using the geriatric nutritional risk index (GNRI), and their plasma levels of eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), arachidonic acid (AA), and dihomo-gamma-linolenic acid (DGLA) were measured before discharge. The primary outcome was all-cause mortality. During a median follow-up of 23.3 months, the primary outcome occurred in 37 patients (26.4%). A Kaplan-Meier analysis showed that lower DHA and DGLA levels, but not EPA or AA levels, were significantly associated with an increase in all-cause death (log-rank; p < 0.001 and p = 0.040, respectively). A multivariate Cox regression analysis also revealed that DHA levels were significantly associated with the incidence of all-cause death (HR: 0.16, 95% CI: 0.06-0.44, p = 0.001), independent of the GNRI. Our results suggest that low plasma DHA levels may be a useful predictor of all-cause mortality and potential therapeutic target in patients with acute decompensated HFpEF.
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Affiliation(s)
- Naoaki Matsuo
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan; (N.M.); (H.I.)
| | - Toru Miyoshi
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan; (N.M.); (H.I.)
- Correspondence: ; Tel.: +81-86-235-7351
| | - Atsushi Takaishi
- Department of Cardiovascular Medicine, Mitoyo General Hospital, Kagawa 769-1601, Japan; (A.T.); (T.K.); (K.Y.); (M.T.); (N.O.)
| | - Takao Kishinoue
- Department of Cardiovascular Medicine, Mitoyo General Hospital, Kagawa 769-1601, Japan; (A.T.); (T.K.); (K.Y.); (M.T.); (N.O.)
| | - Kentaro Yasuhara
- Department of Cardiovascular Medicine, Mitoyo General Hospital, Kagawa 769-1601, Japan; (A.T.); (T.K.); (K.Y.); (M.T.); (N.O.)
| | - Masafumi Tanimoto
- Department of Cardiovascular Medicine, Mitoyo General Hospital, Kagawa 769-1601, Japan; (A.T.); (T.K.); (K.Y.); (M.T.); (N.O.)
| | - Yukari Nakano
- Nakano Cardiovascular Clinic, Kagawa 762-0012, Japan;
| | - Nobuhiko Onishi
- Department of Cardiovascular Medicine, Mitoyo General Hospital, Kagawa 769-1601, Japan; (A.T.); (T.K.); (K.Y.); (M.T.); (N.O.)
| | | | - Hiroshi Ito
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan; (N.M.); (H.I.)
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17
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Elagizi A, Lavie CJ, O’Keefe E, Marshall K, O’Keefe JH, Milani RV. An Update on Omega-3 Polyunsaturated Fatty Acids and Cardiovascular Health. Nutrients 2021; 13:nu13010204. [PMID: 33445534 PMCID: PMC7827286 DOI: 10.3390/nu13010204] [Citation(s) in RCA: 66] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 01/05/2021] [Accepted: 01/10/2021] [Indexed: 12/19/2022] Open
Abstract
Interest in the potential cardiovascular (CV) benefits of omega-3 polyunsaturated fatty acids (Ω-3) began in the 1940s and was amplified by a subsequent landmark trial showing reduced CV disease (CVD) risk following acute myocardial infarction. Since that time, however, much controversy has circulated due to discordant results among several studies and even meta-analyses. Then, in 2018, three more large, randomized trials were released—these too with discordant findings regarding the overall benefits of Ω-3 therapy. Interestingly, the trial that used a higher dose (4 g/day highly purified eicosapentaenoic acid (EPA)) found a remarkable, statistically significant reduction in CVD events. It was proposed that insufficient Ω-3 dosing (<1 g/day EPA and docosahexaenoic acid (DHA)), as well as patients aggressively treated with multiple other effective medical therapies, may explain the conflicting results of Ω-3 therapy in controlled trials. We have thus reviewed the current evidence regarding Ω-3 and CV health, put forth potential reasoning for discrepant results in the literature, highlighted critical concepts such as measuring blood levels of Ω-3 with a dedicated Ω-3 index and addressed current recommendations as suggested by health care professional societies and recent significant scientific data.
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Affiliation(s)
- Andrew Elagizi
- Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School, The University of Queensland School of Medicine, New Orleans, LA 70121, USA; (A.E.); (R.V.M.)
| | - Carl J. Lavie
- Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School, The University of Queensland School of Medicine, New Orleans, LA 70121, USA; (A.E.); (R.V.M.)
- Correspondence: ; Tel.: +1-504-842-1281; Fax: +1-504-842-5875
| | - Evan O’Keefe
- Tulane Medical Center, New Orleans, LA 70112, USA;
| | - Keri Marshall
- Director Medical and Scientific Communications, Pharmavite LLC., West Hills, CA 91304, USA;
| | - James H. O’Keefe
- Saint Luke’s of Kansas City, Mid America Heart Institute, University of Missouri, Kansas City, MO 64111, USA;
| | - Richard V. Milani
- Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School, The University of Queensland School of Medicine, New Orleans, LA 70121, USA; (A.E.); (R.V.M.)
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18
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ω-3PUFA supplementation ameliorates adipose tissue inflammation and insulin-stimulated glucose disposal in subjects with obesity: a potential role for apolipoprotein E. Int J Obes (Lond) 2021; 45:1331-1341. [PMID: 33753887 PMCID: PMC8159741 DOI: 10.1038/s41366-021-00801-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 02/16/2021] [Accepted: 03/04/2021] [Indexed: 02/01/2023]
Abstract
BACKGROUND Long chain omega-3 polyunsaturated fatty acids (ω-3PUFA) supplementation in animal models of diet-induced obesity has consistently shown to improve insulin sensitivity. The same is not always reported in human studies with insulin resistant (IR) subjects with obesity. OBJECTIVE We studied whether high-dose ω-3PUFA supplementation for 3 months improves insulin sensitivity and adipose tissue (AT) inflammation in IR subjects with obesity. METHODS Thirteen subjects (BMI = 39.3 ± 1.6 kg/m2) underwent 80 mU/m2·min euglycemic-hyperinsulinemic clamp with subcutaneous (Sc) AT biopsy before and after 3 months of ω-3PUFA (DHA and EPA, 4 g/daily) supplementation. Cytoadipokine plasma profiles were assessed before and after ω-3PUFA. AT-specific inflammatory gene expression was evaluated on Sc fat biopsies. Microarray analysis was performed on the fat biopsies collected during the program. RESULTS Palmitic and stearic acid plasma levels were significantly reduced (P < 0.05) after ω-3PUFA. Gene expression of pro-inflammatory markers and adipokines were improved after ω-3PUFA (P < 0.05). Systemic inflammation was decreased after ω-3PUFA, as shown by cytokine assessment (P < 0.05). These changes were associated with a 25% increase in insulin-stimulated glucose disposal (4.7 ± 0.6 mg/kg ffm•min vs. 5.9 ± 0.9 mg/kg ffm•min) despite no change in body weight. Microarray analysis identified 53 probe sets significantly altered post- ω-3PUFA, with Apolipoprotein E (APOE) being one of the most upregulated genes. CONCLUSION High dose of long chain ω-3PUFA supplementation modulates significant changes in plasma fatty acid profile, AT, and systemic inflammation. These findings are associated with significant improvement of insulin-stimulated glucose disposal. Unbiased microarray analysis of Sc fat biopsy identified APOE as among the most differentially regulated gene after ω-3PUFA supplementation. We speculate that ω-3PUFA increases macrophage-derived APOE mRNA levels with anti-inflammatory properties.
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Chatterjee S, Hajra A, Bandyopadhyay D, Ghosh RK, Deedwania PC. Defining the Role of Icosapent Ethyl in Clinical Practice. Am J Cardiovasc Drugs 2020; 20:517-524. [PMID: 32157567 DOI: 10.1007/s40256-020-00402-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The health benefit of fish oil, i.e. omega-3 fatty acids (ω-3 FA) has a long history of debate. While there are a number of medications to reduce serum triglyceride levels, none have shown unanimous cardiovascular (CV) benefits. The most recent Reduction of Cardiovascular Events with Icosapent Ethyl-Intervention Trial (REDUCE-IT) assessing the CV outcome of one highly purified prescription ω-3 FA has certainly rejuvenated the debate. While this trial has been regarded as one of the most important landmark trials in preventive cardiology, the tolerability issue in a very high dose (4 g/day, as administered in the trial) is still a matter of concern. This article summarizes the current status and future perspective of icosapent ethyl in clinical practice in light of REDUCE-IT.
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20
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Wierenga KA, Strakovsky RS, Benninghoff AD, Rajasinghe LD, Lock AL, Harkema JR, Pestka JJ. Requisite Omega-3 HUFA Biomarker Thresholds for Preventing Murine Lupus Flaring. Front Immunol 2020; 11:1796. [PMID: 32973753 PMCID: PMC7473030 DOI: 10.3389/fimmu.2020.01796] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 07/06/2020] [Indexed: 12/28/2022] Open
Abstract
Lupus is a systemic autoimmune disease typified by uncontrolled inflammation, disruption of immune tolerance, and intermittent flaring - events triggerable by environmental factors. Preclinical and clinical studies reveal that consumption of the marine ω-3 highly unsaturated fatty acids (HUFAs) eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) might be used as a precision nutrition intervention to lessen lupus symptoms. The anti-inflammatory and pro-resolving effects of ω-3 HUFAs are inextricably linked to their presence in membrane phospholipids. The ω-3 HUFA score, calculated as [100 × (ω-3 HUFAs/(ω-3 HUFAs + ω-6 HUFAs))] in red blood cells (RBCs), and the Omega-3 Index (O3I), calculated as [100 × ((DHA+EPA)/total fatty acids)] in RBCs, are two biomarkers potentially amenable to relating tissue HUFA balance to clinical outcomes in individuals with lupus. Using data from three prior preclinical DHA supplementation studies, we tested the hypothesis that the ω-3 HUFA score and the O3I inversely correlate with indicators of autoimmune pathogenesis in the cSiO2-triggered lupus flaring model. The three studies employed both low and high fat rodent diets, as well as more complex diets emulating the U.S. dietary pattern. The ω-3 HUFA scores in RBCs were comparatively more robust than the O3I at predicting HUFA balances in the kidney, liver, spleen, and lung. Importantly, increases in both the ω-3 HUFA score (>40%) and the O3I (>10%) were strongly associated with suppression of cSiO2-triggered (1) expression of interferon-regulated genes, proinflammatory cytokine production, leukocyte infiltration, and ectopic lymphoid structure development in the lung, (2) pulmonary and systemic autoantibody production, and (3) glomerulonephritis. Collectively, these findings identify achievable ω-3 HUFA scores and O3I thresholds that could be targeted in future human intervention studies querying how ω-3 HUFA consumption influences lupus and other autoimmune diseases.
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MESH Headings
- Animal Feed
- Animals
- Autoimmunity
- Biomarkers/blood
- Bronchoalveolar Lavage Fluid/immunology
- Cytokines/metabolism
- Diet
- Disease Models, Animal
- Erythrocytes/metabolism
- Fatty Acids, Omega-3/administration & dosage
- Fatty Acids, Omega-3/blood
- Fatty Acids, Omega-6/administration & dosage
- Fatty Acids, Omega-6/blood
- Female
- Inflammation Mediators/metabolism
- Lupus Erythematosus, Systemic/blood
- Lupus Erythematosus, Systemic/diagnosis
- Lupus Erythematosus, Systemic/diet therapy
- Lupus Erythematosus, Systemic/immunology
- Mice, Inbred NZB
- Predictive Value of Tests
- Symptom Flare Up
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Affiliation(s)
- Kathryn A. Wierenga
- Department of Biochemistry and Molecular Biology, Michigan State University, East Lansing, MI, United States
- Institute for Integrative Toxicology, Michigan State University, East Lansing, MI, United States
| | - Rita S. Strakovsky
- Institute for Integrative Toxicology, Michigan State University, East Lansing, MI, United States
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI, United States
| | - Abby D. Benninghoff
- Department of Animal, Dairy and Veterinary Sciences and USTAR Applied Nutrition Research, Utah State University, Logan, UT, United States
| | - Lichchavi D. Rajasinghe
- Institute for Integrative Toxicology, Michigan State University, East Lansing, MI, United States
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI, United States
| | - Adam L. Lock
- Department of Animal Science, Michigan State University, East Lansing, MI, United States
| | - Jack R. Harkema
- Institute for Integrative Toxicology, Michigan State University, East Lansing, MI, United States
- Department of Pathobiology and Diagnostic Investigation, Michigan State University, East Lansing, MI, United States
| | - James J. Pestka
- Institute for Integrative Toxicology, Michigan State University, East Lansing, MI, United States
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI, United States
- Department of Microbiology and Molecular Genetics, Michigan State University, East Lansing, MI, United States
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21
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Harris K, Oshima M, Sattar N, Würtz P, Jun M, Welsh P, Hamet P, Harrap S, Poulter N, Chalmers J, Woodward M. Plasma fatty acids and the risk of vascular disease and mortality outcomes in individuals with type 2 diabetes: results from the ADVANCE study. Diabetologia 2020; 63:1637-1647. [PMID: 32385604 PMCID: PMC7351876 DOI: 10.1007/s00125-020-05162-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 04/01/2020] [Indexed: 11/02/2022]
Abstract
AIMS/HYPOTHESIS This biomarker study aimed to quantify the association of essential and other plasma fatty acid biomarkers with macrovascular disease, microvascular disease and death in individuals with type 2 diabetes. METHODS A case-cohort study (N = 3576), including 654 macrovascular events, 341 microvascular events and 631 deaths during 5 years of (median) follow-up, was undertaken as a secondary analysis of the Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified-Release Controlled Evaluation (ADVANCE) study (full details of the study design and primary endpoints of the ADVANCE trial and its case-cohort have been published previously). This current study considers new data: fatty acids measured from baseline plasma samples by proton NMR analysis. The fatty acids measured were n-3, docosahexaenoic acid (DHA), n-6, linoleic acid, and polyunsaturated, monounsaturated and saturated fatty acids. HRs were modelled per SD higher (percentage) fatty acid. C statistics and continuous net reclassification improvement were used to test the added value of fatty acids compared with traditional cardiovascular risk factors. RESULTS After adjustment for traditional cardiovascular risk factors, an inverse association was observed for n-3 fatty acids and DHA with the risk of macrovascular events (HR [95% CI]: 0.87 [0.80, 0.95] and 0.88 [0.81, 0.96], respectively, per 1 SD higher percentage), and for n-3 fatty acids with the risk of death (HR 0.91 [95% CI 0.84, 0.99] per 1 SD higher percentage). Such associations were also evident when investigating absolute levels of fatty acids. There were no statistically significant associations between any fatty acids and microvascular disease after adjustment. However, there was limited improvement in the predictive ability of models when any fatty acid was added. CONCLUSIONS/INTERPRETATION Plasma n-3 fatty acids and DHA were found to be inversely associated with macrovascular disease, while n-3 fatty acids were also inversely associated with death. These results support the cardioprotective effects of n-3 fatty acids and DHA and further merit testing the role of high-dose supplementation with n-3 fatty acids in individuals with type 2 diabetes. TRIAL REGISTRATION ClinicalTrials.gov NCT00145925. Graphical abstract.
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Affiliation(s)
- Katie Harris
- The George Institute for Global Health, UNSW Sydney, Level 10, King George V Building, 83-117 Missenden Road, Camperdown, Sydney, NSW, 2050, Australia.
| | - Megumi Oshima
- The George Institute for Global Health, UNSW Sydney, Level 10, King George V Building, 83-117 Missenden Road, Camperdown, Sydney, NSW, 2050, Australia
- Department of Nephrology and Laboratory Medicine, Kanazawa University, Ishikawa, Japan
| | - Naveed Sattar
- BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | | | - Min Jun
- The George Institute for Global Health, UNSW Sydney, Level 10, King George V Building, 83-117 Missenden Road, Camperdown, Sydney, NSW, 2050, Australia
| | - Paul Welsh
- BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Pavel Hamet
- Centre de Recherche, Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, QC, Canada
| | - Stephen Harrap
- Department of Physiology, Royal Melbourne Hospital, University of Melbourne, Melbourne, VIC, Australia
| | - Neil Poulter
- Imperial Clinical Trials Unit, School of Public Health, Imperial College London, London, UK
| | - John Chalmers
- The George Institute for Global Health, UNSW Sydney, Level 10, King George V Building, 83-117 Missenden Road, Camperdown, Sydney, NSW, 2050, Australia
| | - Mark Woodward
- The George Institute for Global Health, UNSW Sydney, Level 10, King George V Building, 83-117 Missenden Road, Camperdown, Sydney, NSW, 2050, Australia.
- The George Institute for Global Health, University of Oxford, 1st Floor, Hayes House, 75 George Street, Oxford, OX1 2BQ, UK.
- Department of Epidemiology, Johns Hopkins University, Baltimore, MD, USA.
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