Free fatty acids, cardiovascular disease, and mortality in the Multi-Ethnic Study of Atherosclerosis

Sarah O. Nomura, Amy B. Karger, Natalie L. Weir, Daniel A. Duprez, Michael Y. Tsai

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Fasting free fatty acid (FFA) levels may be associated with cardiovascular disease (CVD) and mortality, but research among generally healthy adults, females, and racially/ethnically diverse populations is lacking. Objective: The primary aim of this project was to investigate prospective associations between fasting FFAs and coronary heart disease (CHD) and CVD incidence and CVD-specific and all-cause mortality in a generally healthy age, sex, and racially/ethnically heterogeneous population. Methods: This study was conducted in the Multi-Ethnic Study of Atherosclerosis cohort using baseline (2000–2002) fasting FFAs and outcome data through 2015 (N = 6678). Cox proportional hazards regression was used to calculate hazard ratios for associations between FFAs and CHD, CVD, CVD-specific mortality, and all-cause mortality. Interactions by age, sex, race/ethnicity, and metabolic syndrome were evaluated by stratification and cross-product terms. A secondary analysis was conducted to evaluate associations between FFAs, and inflammatory and endothelial activation biomarkers were evaluated using linear regression (analytic N range: 964–6662). Results: FFA levels were not associated with CHD or CVD incidence. Higher FFAs were associated with CVD-specific and all-cause mortality, but associations were attenuated in fully adjusted models with a borderline significant association remaining only for all-cause mortality (fully adjusted, per standard deviation increase hazard ratio = 1.07, 95% confidence interval: 1.00–1.14). Associations did not differ by age, sex, race/ethnicity, or metabolic syndrome. Conclusions: Fasting FFAs were not associated with CHD, CVD, or CVD-specific mortality and were modestly associated with all-cause mortality, regardless of age, sex, race/ethnicity, or metabolic syndrome status.

Original languageEnglish (US)
Pages (from-to)531-541
Number of pages11
JournalJournal of Clinical Lipidology
Volume14
Issue number4
DOIs
StatePublished - Jul 12 2020

Bibliographical note

Funding Information:
The authors thank the other investigators, the staff, and the participants of the MESA study for their valuable contributions. A full list of participating MESA investigators and institutions can be found at http://www.mesa-nhlbi.org. The views expressed in this manuscript are those of the authors and do not necessarily represent the views of the National Heart, Lung, and Blood Institute; the National Institutes of Health; or the U.S. Department of Health and Human Services.

Funding Information:
Sources of funding: This research was supported by contracts HHSN268201500003I, N01-HC-95159, N01-HC-95160, N01-HC-95161, N01-HC-95162, N01-HC-95163, N01-HC-95164, N01-HC-95165, N01-HC-95166, N01-HC-95167, N01-HC-95168 and N01-HC-95169 from the National Heart, Lung, and Blood Institute and by grants UL1-TR-000040 and UL1-TR-001079 from NCRR.

Publisher Copyright:
© 2020 National Lipid Association

Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.

Keywords

  • Cardiovascular disease
  • Coronary heart disease
  • Endothelial activation
  • Free fatty acids
  • Inflammation
  • Mortality

PubMed: MeSH publication types

  • Journal Article
  • Research Support, N.I.H., Extramural

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