title: Individual omega-9 monounsaturated fatty acids and mortality-The Ludwigshafen Risk and Cardiovascular Health Study.
abstract: The association of polyunsaturated omega-3 and omega-6 fatty acids with mortality has been extensively studied. Far less is known about the association of omega-9 monounsaturated fatty acids (omega-9 MUFA) with mortality.
  
  
  
  We aimed to study the association of individual omega-MUFA with all-cause and cardiovascular mortality.
  
  
  
  Omega-9 MUFA concentrations were measured in erythrocytes in 3259 patients participating in the Ludwigshafen Risk and Cardiovascular Health Study using the HS-Omega-3 index method. Associations with mortality were analyzed by Cox proportional hazards regression with adjustment for conventional risk factors separately for men and women.
  
  
  
  During a median follow-up of 10.0 years, 975 patients (29.9%) died. Partial correlation analysis adjusted for age and gender showed inverse correlations of oleic acid (OA), gondoic acid (GA), and nervonic acid (NA) with LDL-C, HDL-C, and eGFR but direct correlations with markers of inflammation and endothelial activation as well as heart failure. A 1-SD increase in OA, GA, and NA was associated with increased risk of all-cause mortality with HRs (95% CI) of 1.08 (1.01-1.16), 1.07 (1.01-1.13), and 1.12 (1.05-1.20), respectively. NA was the only omega-9 MUFA being associated with increased risk in men, whereas in women also GA was associated with risk. The association between OA and mortality seems to be U-shaped with a nadir at a concentration of approx 14%.
  
  
  
  All three omega-9 MUFA showed direct associations with mortality. Further studies are warranted to explore biologic and prognostic properties of omega-9 fatty acids, with a focus on nervonic acid.
authors.affiliation: Fifth Department of Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
authors.forename: Graciela E
authors.initials: GE
authors.lastname: Delgado
authors.affiliation: Fifth Department of Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
authors.forename: Bernhard K
authors.initials: BK
authors.lastname: Krämer
authors.affiliation: Department of Nutritional Biochemistry and Physiology, Institute of Nutrition, Friedrich Schiller University Jena, Jena, Germany; Competence Cluster of Nutrition and Cardiovascular Health (nutriCARD), Halle-Jena-Leipzig, Jena, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Lorkowski
authors.affiliation: Fifth Department of Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University Graz, Graz, Austria; Synlab Academy, Synlab Holding Deutschland GmbH, Mannheim and Augsburg, Germany.
authors.forename: Winfried
authors.initials: W
authors.lastname: März
authors.affiliation: Omegametrix, Martinsried, Germany; Department of Preventive Cardiology, Medizinische Klinik und Poliklinik I, Ludwig Maximilians University, Munich, Germany.
authors.forename: Clemens
authors.initials: C
authors.lastname: von Schacky
authors.affiliation: Fifth Department of Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; Department of Nutritional Biochemistry and Physiology, Institute of Nutrition, Friedrich Schiller University Jena, Jena, Germany; Competence Cluster of Nutrition and Cardiovascular Health (nutriCARD), Halle-Jena-Leipzig, Jena, Germany. Electronic address: marcus.kleber@medma.uni-heidelberg.de.
authors.forename: Marcus E
authors.initials: ME
authors.lastname: Kleber
mesh_terms: D002318:Cardiovascular Diseases / Q000097:blood* / Q000453:epidemiology / Q000401:mortality*; D004912:Erythrocytes / Q000378:metabolism; D005229:Fatty Acids, Monounsaturated / Q000097:blood*; D005231:Fatty Acids, Unsaturated / Q000097:blood; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D018570:Risk Assessment; D012307:Risk Factors
chemical_list: D005229:Fatty Acids, Monounsaturated; D005231:Fatty Acids, Unsaturated
keywords: Monounsaturated fatty acids; Mortality; Nervonic acid; Nutrition; Oleic acid