Fatty acids in serum phospholipids and carotid intima-media thickness in Spanish subjects with primary dyslipidemia.
BACKGROUND
Low rates of incident ischemic heart disease (IHD) and cardiac death occur in Spain despite a high prevalence of cardiovascular risk factors. High consumption of unsaturated fatty acid-rich foods, such as olive oil, nuts, and seafood, might underlie this paradox.


OBJECTIVE
We investigated whether serum phosphatidylcholine enrichment in oleic, linoleic, alpha-linolenic, and n-3 (omega-3) long-chain polyunsaturated fatty acids (as biomarkers of olive oil, seed oil, walnut, and fish intake, respectively) relate to carotid atherosclerosis in Spanish subjects at risk of IHD.


METHODS
In a cross-sectional study, we measured fatty acid concentrations in serum phosphatidylcholine and measured carotid intima-media thickness (IMT) by using ultrasound in 451 asymptomatic subjects (261 men, 190 women; mean age: 45 y) with primary dyslipidemia. Main and secondary outcomes were mean and maximum IMT in the common carotid artery (CCA) and other carotid segments, respectively.


RESULTS
Phosphatidylcholine fatty acid composition was similar to that reported for other Spanish populations. Multiple regression analyses showed that proportions of oleic and docosahexaenoic acids were inversely related to mean CCA IMT (P < 0.02, all) after adjustment for several confounders. In similar models, alpha-linolenic acid related inversely to mean and maximum internal carotid artery IMT (P < 0.05 for all). Linoleic and eicosapentaenoic acids were unrelated to IMT.


CONCLUSIONS
Higher phospholipid proportions of oleic, alpha-linolenic, and docosahexaenoic acids showed inverse associations with IMT at specific carotid segments in subjects with primary dyslipidemia. High intakes of healthy fats might explain, in part, the Spanish paradox of low IHD rates in the face of a high burden of cardiovascular risk factors.
Sala-Vila
Aleix
A
Unitat de Lípids, Sunyer Hospital Clínic, Barcelona, Spain. asala@clinic.ub.es
Cofán
Montserrat
M
Pérez-Heras
Ana
A
Núñez
Isabel
I
Gilabert
Rosa
R
Junyent
Mireia
M
Mateo-Gallego
Rocío
R
Cenarro
Ana
A
Civeira
Fernando
F
Ros
Emilio
E
D000328:Adult; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000473:pathology*; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003430:Cross-Sectional Studies; D004041:Dietary Fats; D050171:Dyslipidemias / Q000097:blood* / Q000473:pathology*; D005227:Fatty Acids / Q000097:blood* / Q000378:metabolism; D015525:Fatty Acids, Omega-3 / Q000097:blood; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D054709:Lecithins / Q000097:blood; D008297:Male; D008875:Middle Aged; D009754:Nuts; D009829:Oleic Acids / Q000097:blood; D010743:Phospholipids / Q000097:blood*; D012307:Risk Factors; D013030:Spain; D017539:Tunica Intima / Q000473:pathology*; D017540:Tunica Media / Q000473:pathology*; D014463:Ultrasonography
D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D004041:Dietary Fats; D005227:Fatty Acids; D015525:Fatty Acids, Omega-3; D054709:Lecithins; D009829:Oleic Acids; D010743:Phospholipids; D002784:Cholesterol