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Atherosclerosis. 2018 May;272:226-232. doi: 10.1016/j.atherosclerosis.2017.12.004. Epub 2017 Dec 8.

Plasma levels of n-3 fatty acids and risk of coronary heart disease among Japanese: The Japan Public Health Center-based (JPHC) study.

Collaborators (137)

Tsugane S8, Sawada N8, Iwasaki M8, Sasazuki S8, Yamaji T8, Shimazu T8, Goto A8, Hidaka A8, Hanaoka T8, Ogata J9, Baba S9, Mannami T9, Okayama A9, Kokubo Y9, Miyakawa K10, Saito F10, Koizumi A10, Sano Y10, Hashimoto I10, Ikuta T10, Tanaba Y10, Sato H10, Roppongi Y10, Takashima T10, Suzuki H10, Miyajima Y11, Suzuki N11, Nagasawa S11, Furusugi Y11, Nagai N11, Ito Y11, Komatsu S11, Minamizono T11, Sanada H12, Hatayama Y12, Kobayashi F12, Uchino H12, Shirai Y12, Kondo T12, Sasaki R12, Watanabe Y12, Miyagawa Y12, Kobayashi Y12, Machida M12, Kobayashi K12, Tsukada M12, Kishimoto Y13, Takara E13, Fukuyama T13, Kinjo M13, Irei M13, Sakiyama H13, Imoto K14, Yazawa H14, Seo T14, Seiko A14, Ito F14, Shoji F14, Saito R14, Murata A15, Minato K15, Motegi K15, Fujieda T15, Yamato S15, Doi M15, Matsui K16, Abe T16, Katagiri M16, Suzuki M16, Doi M17, Terao A17, Ishikawa Y17, Tagami T17, Sueta H18, Doi H18, Urata M18, Okamoto N18, Ide F18, Goto H18, Fujita R18, Sou Y18, Sakiyama H19, Onga N19, Takaesu H19, Uehara M19, Nakasone T19, Yamakawa M19, Horii F20, Asano I20, Yamaguchi H20, Aoki K20, Maruyama S20, Ichii M20, Takano M20, Tsubono Y21, Suzuki K22, Honda Y23, Yamagishi K23, Sakurai S23, Tsuchiya N23, Kabuto M24, Yamaguchi M25, Matsumura Y25, Sasaki S25, Watanabe S25, Akabane M26, Kadowaki T27, Inoue M27, Noda M28, Mizoue T28, Kawaguchi Y29, Takashima Y30, Yoshida Y30, Nakamura K31, Takachi R32, Ishihara J33, Matsushima S34, Natsukawa S34, Shimizu H35, Sugimura H36, Tominaga S37, Hamajima N38, Iso H39, Sobue T39, Iida M40, Ajiki W40, Ioka A40, Sato S41, Maruyama E42, Konishi M43, Okada K43, Saito I43, Yasuda N44, Kono S45, Akiba S46, Isobe T47, Sato Y48.

Author information

1
Department of Public Health, Faculty of Medicine, University of Toyama, Toyama, Japan. Electronic address: keihama@med.u-toyama.ac.jp.
2
Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan.
3
Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan; Department of Public Health and Preventive Medicine, Faculty of Medicine, Minia University, Egypt.
4
Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan; Department of Hygiene and Public Health, Osaka Medical College, Osaka, Japan.
5
Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan; Department of Public Health, Juntendo University, Tokyo, Japan.
6
Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan.
7
Department of Clinical Sciences, Institute of Natural Medicine, University of Toyama, Toyama, Japan.
8
National Cancer Center, Tokyo, Japan.
9
National Cerebral and Cardiovascular Center, Osaka, Japan.
10
Iwate Prefectural Ninohe Public Health Center, Iwate, Japan.
11
Akita Prefectural Yokote Public Health Center, Akita, Japan.
12
Nagano Prefectural Saku Public Health Center, Nagano, Japan.
13
Okinawa Prefectural Chubu Public Health Center, Okinawa, Japan.
14
Katsushika Public Health Center, Tokyo, Japan.
15
Ibaraki Prefectural Mito Public Health Center, Ibaraki, Japan.
16
Niigata Prefectural Kashiwazaki and Nagaoka Public Health Center, Niigata, Japan.
17
Kochi Prefectural Chuo-higashi Public Health Center, Kochi, India.
18
Nagasaki Prefectural Kamigoto Public Health Center, Nagasaki, Japan.
19
Okinawa Prefectural Miyako Public Health Center, Okinawa, Japan.
20
Osaka Prefectural Suita Public Health Center, Osaka, Japan.
21
Tohoku University, Miyagi, Japan.
22
Research Institute for Brain and Blood Vessels Akita, Akita, Japan.
23
University of Tsukuba, Ibaraki, Japan.
24
National Institute for Environmental Studies, Ibaraki, Japan.
25
National Institute of Health and Nutrition, Tokyo, Japan.
26
Tokyo University of Agriculture, Tokyo, Japan.
27
The University of Tokyo, Tokyo, Japan.
28
National Center for Global Health and Medicine, Tokyo, Japan.
29
Tokyo Medical and Dental University, Tokyo, Japan.
30
Kyorin University, Tokyo, Japan.
31
Niigata University, Niigata, Japan.
32
Nara Women's University, Nara, Japan.
33
Sagami Women's University, Kanagawa, Japan.
34
Saku General Hospital, Nagano, Japan.
35
Sakihae Institute, Gifu, Japan.
36
Hamamatsu University School of Medicine, Shizuoka, Japan.
37
Aichi Cancer Center, Aichi, Japan.
38
Nagoya University, Aichi, Japan.
39
Osaka University, Osaka, Japan.
40
Osaka Medical Center for Cancer and Cardiovascular Disease, Osaka, Japan.
41
Chiba Prefectural Institute of Public Health, Chiba, Japan.
42
Kobe University, Hyogo, Japan.
43
Ehime University, Ehime, Japan.
44
Kochi University, Kochi, India.
45
Kyushu University, Fukuoka, Japan.
46
Kagoshima University, Kagoshima, Japan.
47
Keio University, Tokyo, Japan.
48
Tokyo Gakugei University, Tokyo, Japan.

Abstract

BACKGROUND AND AIMS:

Higher intake of fish or n-3 polyunsaturated fatty acids (PUFAs) has been associated with reduced risk of coronary heart disease (CHD). However, it is unclear whether increased blood levels of n-3 PUFAs are associated with reduced risk of CHD in the Japanese population.

METHODS:

The relationship between circulating levels of n-3 PUFAs (eicosapentaenoic acid + docosapentaenoic acid + docosahexaenoic acid) and risk of CHD was examined in a nested case-control study among participants in the Japan Public Health Center (JPHC)-based Study Cohort. Plasma n-3 PUFA phospholipid levels were measured at baseline by gas chromatography in 209 cases with CHD and 418 controls matched for sex, age, date of blood draw, time elapsed since last meal before blood collection, and study location. The CHD cases (n = 209) comprised 168 cases of myocardial infarction and 41 of sudden cardiac death, otherwise classified as 157 non-fatal and 52 fatal coronary events, respectively. Mean duration of follow-up was 13.5 years.

RESULTS:

Multivariate conditional logistic analysis showed no significant association between n-3 PUFAs and risk of total CHD. The odds ratio (OR) for the highest versus lowest quartiles of plasma n-3 PUFAs was 0.79 (95% confidence interval [95% CI]: 0.41-1.51, p for trend = 0.51). Subtype analysis of CHD revealed that the multivariate ORs for the highest versus lowest quartiles for n-3 PUFAs were 0.91 (95% CI: 0.43-1.89, p for trend = 0.90) for myocardial infarction, 0.08 (95% CI: 0.01-0.88, p for trend = 0.04) for sudden cardiac death, 0.89 (95% CI: 0.42-1.89, p for trend = 0.97) for nonfatal coronary events, and 0.12 (95% CI: 0.02-0.75, p for trend = 0.03) for fatal coronary events.

CONCLUSIONS:

Plasma n-3 PUFA levels were not associated with risk of total CHD but were inversely associated with risks of sudden cardiac death and fatal coronary events among middle-aged Japanese individuals.

KEYWORDS:

Coronary heart disease; Nested case-control study; n-3 polyunsaturated fatty acids

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