title: Novel circulating fatty acid patterns and risk of cardiovascular disease: the Cardiovascular Health Study.
abstract: BACKGROUND
  Complex interplays of diet and metabolism influence circulating fatty acids (FAs), possibly constituting FA patterns related to cardiovascular disease (CVD) risk.
  
  
  OBJECTIVE
  We aimed to derive FA patterns from circulating FAs, relate the patterns to CVD incidence, and extend the derived patterns to atherosclerosis progression in another independent cohort.
  
  
  METHODS
  We used principal component analysis (PCA) to derive FA patterns from 38 plasma phospholipid FAs in 2972 older adults in the Cardiovascular Health Study (CHS). Identified patterns were evaluated for prospective associations with 14-y incidence of CVD [ischemic heart disease (IHD) or stroke]. In another independent cohort of postmenopausal women with IHD, we evaluated associations of the CHS-derived patterns with 3.2-y progression of angiographically defined coronary atherosclerosis.
  
  
  RESULTS
  Three distinct patterns were identified, characterized by higher proportions of trans FAs, de novo lipogenesis (DNL) FAs, and long-chain MUFAs (LCMUFAs). During 32,265 person-years, 780 incident CVD events occurred. The trans FA pattern was associated with higher CVD risk (multivariable-adjusted HR for the highest compared with the lowest quintiles = 1.58; 95% CI: 1.17, 2.12; P-trend = 0.006), primarily attributable to higher risk of stroke (HR: 2.46; 95% CI: 1.54, 3.92; P-trend = 0.005). The DNL and LCMUFA patterns were not associated with CVD incidence or with IHD or stroke (P-trend > 0.11 each). In the second cohort, the trans FA pattern, but not the other 2 patterns, was positively associated with progression of coronary atherosclerosis (P-trend < 0.05).
  
  
  CONCLUSIONS
  PCA appears to provide informative circulating FA patterns. A pattern driven mainly by trans FA levels related to greater CVD risk in older adults and coronary atherosclerosis progression in women with IHD.
authors.affiliation: Department of Epidemiology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA. fimamura@hsph.harvard.edu
authors.forename: Fumiaki
authors.initials: F
authors.lastname: Imamura
authors.forename: Rozenn N
authors.initials: RN
authors.lastname: Lemaitre
authors.forename: Irena B
authors.initials: IB
authors.lastname: King
authors.forename: Xiaoling
authors.initials: X
authors.lastname: Song
authors.forename: Alice H
authors.initials: AH
authors.lastname: Lichtenstein
authors.forename: Nirupa R
authors.initials: NR
authors.lastname: Matthan
authors.forename: David M
authors.initials: DM
authors.lastname: Herrington
authors.forename: David S
authors.initials: DS
authors.lastname: Siscovick
authors.forename: Dariush
authors.initials: D
authors.lastname: Mozaffarian
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology* / Q000209:etiology; D015331:Cohort Studies; D003324:Coronary Artery Disease / Q000097:blood / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000097:blood / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D025341:Principal Component Analysis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D020521:Stroke / Q000097:blood / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D044242:Trans Fatty Acids / Q000009:adverse effects / Q000097:blood*; D014481:United States / Q000453:epidemiology
chemical_list: D015415:Biomarkers; D044242:Trans Fatty Acids