Marine n-3 Polyunsaturated Fatty Acids and the Risk of Ischemic Stroke

Stine K Venø*, Christian S Bork, Marianne Uhre Jakobsen, Søren Lundbye-Christensen, Peter L McLennan, Flemming W Bach, Kim Overvad, Erik B Schmidt

*Corresponding author for this work

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Abstract

Background and Purpose- We hypothesized that total marine n-3 polyunsaturated fatty acids (PUFA), in particular eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) in the diet and in adipose tissue (biomarkers of long-term intake and endogenous exposure) were inversely associated with the risk of ischemic stroke and its subtypes. Methods- The Diet, Cancer and Health cohort consisted of 57 053 participants aged 50 to 65 years at enrolment. All participants filled in a food frequency questionnaire and had an adipose tissue biopsy taken at baseline. Information on ischemic stroke during follow-up was obtained from The Danish National Patient Register, and all cases were validated. Cases and a random sample of 3203 subjects from the whole cohort had their fatty acid composition of adipose tissue determined by gas chromatography. Results- During 13.5 years of follow-up 1879 participants developed an ischemic stroke. Adipose tissue content of EPA was inversely associated with total ischemic stroke (hazard ratio [HR], 0.74; 95% CI, 0.62-0.88) when comparing the highest with the lowest quartile. Also, lower rates of large artery atherosclerosis were seen with higher intakes of total marine n-3 PUFA (HR, 0.69; 95% CI, 0.50-0.95), EPA (HR, 0.66; 95% CI, 0.48-0.91) and DHA (HR, 0.72; 95% CI, 0.53-0.99), and higher adipose tissue content of EPA (HR, 0.52; 95% CI, 0.36-0.76). Higher rates of cardioembolism were seen with higher intakes of total marine n-3 PUFA (HR, 2.50; 95% CI, 1.38-4.53) and DHA (HR, 2.12; 95% CI, 1.21-3.69) as well as with higher adipose tissue content of total marine n-3 PUFA (HR, 2.63; 95% CI, 1.33-5.19) and DHA (HR, 2.00; 95% CI, 1.04-3.84). The EPA content in adipose tissue was inversely associated with small-vessel occlusion (HR, 0.69; 95% CI, 0.55-0.88). Conclusions- EPA was associated with lower risks of most types of ischemic stroke, apart from cardioembolism, while inconsistent findings were observed for total marine n-3 PUFA and DHA.
Original languageEnglish
JournalStroke
Volume50
Issue number2
Pages (from-to)274-282
ISSN0039-2499
DOIs
Publication statusPublished - 2019

Keywords

  • adipose tissue
  • docosahexaenoic acids
  • eicosapentaenoic acid
  • fatty acids

Cite this

Venø, S. K., Bork, C. S., Jakobsen, M. U., Lundbye-Christensen, S., McLennan, P. L., Bach, F. W., ... Schmidt, E. B. (2019). Marine n-3 Polyunsaturated Fatty Acids and the Risk of Ischemic Stroke. Stroke, 50(2), 274-282. https://doi.org/10.1161/STROKEAHA.118.023384
Venø, Stine K ; Bork, Christian S ; Jakobsen, Marianne Uhre ; Lundbye-Christensen, Søren ; McLennan, Peter L ; Bach, Flemming W ; Overvad, Kim ; Schmidt, Erik B. / Marine n-3 Polyunsaturated Fatty Acids and the Risk of Ischemic Stroke. In: Stroke. 2019 ; Vol. 50, No. 2. pp. 274-282.
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title = "Marine n-3 Polyunsaturated Fatty Acids and the Risk of Ischemic Stroke",
abstract = "Background and Purpose- We hypothesized that total marine n-3 polyunsaturated fatty acids (PUFA), in particular eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) in the diet and in adipose tissue (biomarkers of long-term intake and endogenous exposure) were inversely associated with the risk of ischemic stroke and its subtypes. Methods- The Diet, Cancer and Health cohort consisted of 57 053 participants aged 50 to 65 years at enrolment. All participants filled in a food frequency questionnaire and had an adipose tissue biopsy taken at baseline. Information on ischemic stroke during follow-up was obtained from The Danish National Patient Register, and all cases were validated. Cases and a random sample of 3203 subjects from the whole cohort had their fatty acid composition of adipose tissue determined by gas chromatography. Results- During 13.5 years of follow-up 1879 participants developed an ischemic stroke. Adipose tissue content of EPA was inversely associated with total ischemic stroke (hazard ratio [HR], 0.74; 95{\%} CI, 0.62-0.88) when comparing the highest with the lowest quartile. Also, lower rates of large artery atherosclerosis were seen with higher intakes of total marine n-3 PUFA (HR, 0.69; 95{\%} CI, 0.50-0.95), EPA (HR, 0.66; 95{\%} CI, 0.48-0.91) and DHA (HR, 0.72; 95{\%} CI, 0.53-0.99), and higher adipose tissue content of EPA (HR, 0.52; 95{\%} CI, 0.36-0.76). Higher rates of cardioembolism were seen with higher intakes of total marine n-3 PUFA (HR, 2.50; 95{\%} CI, 1.38-4.53) and DHA (HR, 2.12; 95{\%} CI, 1.21-3.69) as well as with higher adipose tissue content of total marine n-3 PUFA (HR, 2.63; 95{\%} CI, 1.33-5.19) and DHA (HR, 2.00; 95{\%} CI, 1.04-3.84). The EPA content in adipose tissue was inversely associated with small-vessel occlusion (HR, 0.69; 95{\%} CI, 0.55-0.88). Conclusions- EPA was associated with lower risks of most types of ischemic stroke, apart from cardioembolism, while inconsistent findings were observed for total marine n-3 PUFA and DHA.",
keywords = "adipose tissue, docosahexaenoic acids, eicosapentaenoic acid, fatty acids",
author = "Ven{\o}, {Stine K} and Bork, {Christian S} and Jakobsen, {Marianne Uhre} and S{\o}ren Lundbye-Christensen and McLennan, {Peter L} and Bach, {Flemming W} and Kim Overvad and Schmidt, {Erik B}",
year = "2019",
doi = "10.1161/STROKEAHA.118.023384",
language = "English",
volume = "50",
pages = "274--282",
journal = "Stroke",
issn = "0039-2499",
publisher = "Lippincott Williams & Wilkins",
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Venø, SK, Bork, CS, Jakobsen, MU, Lundbye-Christensen, S, McLennan, PL, Bach, FW, Overvad, K & Schmidt, EB 2019, 'Marine n-3 Polyunsaturated Fatty Acids and the Risk of Ischemic Stroke', Stroke, vol. 50, no. 2, pp. 274-282. https://doi.org/10.1161/STROKEAHA.118.023384

Marine n-3 Polyunsaturated Fatty Acids and the Risk of Ischemic Stroke. / Venø, Stine K; Bork, Christian S; Jakobsen, Marianne Uhre; Lundbye-Christensen, Søren; McLennan, Peter L; Bach, Flemming W; Overvad, Kim; Schmidt, Erik B.

In: Stroke, Vol. 50, No. 2, 2019, p. 274-282.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - Marine n-3 Polyunsaturated Fatty Acids and the Risk of Ischemic Stroke

AU - Venø, Stine K

AU - Bork, Christian S

AU - Jakobsen, Marianne Uhre

AU - Lundbye-Christensen, Søren

AU - McLennan, Peter L

AU - Bach, Flemming W

AU - Overvad, Kim

AU - Schmidt, Erik B

PY - 2019

Y1 - 2019

N2 - Background and Purpose- We hypothesized that total marine n-3 polyunsaturated fatty acids (PUFA), in particular eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) in the diet and in adipose tissue (biomarkers of long-term intake and endogenous exposure) were inversely associated with the risk of ischemic stroke and its subtypes. Methods- The Diet, Cancer and Health cohort consisted of 57 053 participants aged 50 to 65 years at enrolment. All participants filled in a food frequency questionnaire and had an adipose tissue biopsy taken at baseline. Information on ischemic stroke during follow-up was obtained from The Danish National Patient Register, and all cases were validated. Cases and a random sample of 3203 subjects from the whole cohort had their fatty acid composition of adipose tissue determined by gas chromatography. Results- During 13.5 years of follow-up 1879 participants developed an ischemic stroke. Adipose tissue content of EPA was inversely associated with total ischemic stroke (hazard ratio [HR], 0.74; 95% CI, 0.62-0.88) when comparing the highest with the lowest quartile. Also, lower rates of large artery atherosclerosis were seen with higher intakes of total marine n-3 PUFA (HR, 0.69; 95% CI, 0.50-0.95), EPA (HR, 0.66; 95% CI, 0.48-0.91) and DHA (HR, 0.72; 95% CI, 0.53-0.99), and higher adipose tissue content of EPA (HR, 0.52; 95% CI, 0.36-0.76). Higher rates of cardioembolism were seen with higher intakes of total marine n-3 PUFA (HR, 2.50; 95% CI, 1.38-4.53) and DHA (HR, 2.12; 95% CI, 1.21-3.69) as well as with higher adipose tissue content of total marine n-3 PUFA (HR, 2.63; 95% CI, 1.33-5.19) and DHA (HR, 2.00; 95% CI, 1.04-3.84). The EPA content in adipose tissue was inversely associated with small-vessel occlusion (HR, 0.69; 95% CI, 0.55-0.88). Conclusions- EPA was associated with lower risks of most types of ischemic stroke, apart from cardioembolism, while inconsistent findings were observed for total marine n-3 PUFA and DHA.

AB - Background and Purpose- We hypothesized that total marine n-3 polyunsaturated fatty acids (PUFA), in particular eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) in the diet and in adipose tissue (biomarkers of long-term intake and endogenous exposure) were inversely associated with the risk of ischemic stroke and its subtypes. Methods- The Diet, Cancer and Health cohort consisted of 57 053 participants aged 50 to 65 years at enrolment. All participants filled in a food frequency questionnaire and had an adipose tissue biopsy taken at baseline. Information on ischemic stroke during follow-up was obtained from The Danish National Patient Register, and all cases were validated. Cases and a random sample of 3203 subjects from the whole cohort had their fatty acid composition of adipose tissue determined by gas chromatography. Results- During 13.5 years of follow-up 1879 participants developed an ischemic stroke. Adipose tissue content of EPA was inversely associated with total ischemic stroke (hazard ratio [HR], 0.74; 95% CI, 0.62-0.88) when comparing the highest with the lowest quartile. Also, lower rates of large artery atherosclerosis were seen with higher intakes of total marine n-3 PUFA (HR, 0.69; 95% CI, 0.50-0.95), EPA (HR, 0.66; 95% CI, 0.48-0.91) and DHA (HR, 0.72; 95% CI, 0.53-0.99), and higher adipose tissue content of EPA (HR, 0.52; 95% CI, 0.36-0.76). Higher rates of cardioembolism were seen with higher intakes of total marine n-3 PUFA (HR, 2.50; 95% CI, 1.38-4.53) and DHA (HR, 2.12; 95% CI, 1.21-3.69) as well as with higher adipose tissue content of total marine n-3 PUFA (HR, 2.63; 95% CI, 1.33-5.19) and DHA (HR, 2.00; 95% CI, 1.04-3.84). The EPA content in adipose tissue was inversely associated with small-vessel occlusion (HR, 0.69; 95% CI, 0.55-0.88). Conclusions- EPA was associated with lower risks of most types of ischemic stroke, apart from cardioembolism, while inconsistent findings were observed for total marine n-3 PUFA and DHA.

KW - adipose tissue

KW - docosahexaenoic acids

KW - eicosapentaenoic acid

KW - fatty acids

U2 - 10.1161/STROKEAHA.118.023384

DO - 10.1161/STROKEAHA.118.023384

M3 - Journal article

VL - 50

SP - 274

EP - 282

JO - Stroke

JF - Stroke

SN - 0039-2499

IS - 2

ER -

Venø SK, Bork CS, Jakobsen MU, Lundbye-Christensen S, McLennan PL, Bach FW et al. Marine n-3 Polyunsaturated Fatty Acids and the Risk of Ischemic Stroke. Stroke. 2019;50(2):274-282. https://doi.org/10.1161/STROKEAHA.118.023384