linoleic-acid and Stroke

Background We aimed at investigating the association of circulating fatty acids with coronary heart disease (CHD) and stroke risk. Methods and Results We conducted an individual-participant data meta-analysis of 5 UK-based cohorts and 1 matched case-control study. Fatty acids (ie, omega-3 docosahexaenoic acid, omega-6 linoleic acid, monounsaturated and saturated fatty acids) were measured at baseline using an automated high-throughput serum nuclear magnetic resonance metabolomics platform. Data from 3022 incident CHD cases (13 104 controls) and 1606 incident stroke cases (13 369 controls) were included. Logistic regression was used to model the relation between fatty acids and odds of CHD and stroke, adjusting for demographic and lifestyle variables only (ie, minimally adjusted model) or with further adjustment for other fatty acids (ie, fully adjusted model). Although circulating docosahexaenoic acid, but not linoleic acid, was related to lower CHD risk in the fully adjusted model (odds ratio, 0.85; 95% CI, 0.76-0.95 per standard unit of docosahexaenoic acid), there was evidence of high between-study heterogeneity and effect modification by study design. Stroke risk was consistently lower with increasing circulating linoleic acid (odds ratio for fully adjusted model, 0.82; 95% CI, 0.75-0.90). Circulating monounsaturated fatty acids were associated with higher CHD risk across all models and with stroke risk in the fully adjusted model (odds ratio, 1.22; 95% CI, 1.03-1.44). Saturated fatty acids were not related to increased CHD risk in the fully adjusted model (odds ratio, 0.94; 95% CI, 0.82-1.09), or stroke risk. Conclusions We found consistent evidence that linoleic acid was associated with decreased risk of stroke and that monounsaturated fatty acids were associated with increased risk of CHD. The different pattern between CHD and stroke in terms of fatty acids risk profile suggests future studies should be cautious about using composite events. Different study designs are needed to assess which, if any, of the associations observed is causal.

Topics: Adult; Aged; Biomarkers; Case-Control Studies; Coronary Artery Disease; Fatty Acids; Female; Heart Disease Risk Factors; Humans; Linoleic Acid; Male; Middle Aged; Prognosis; Protective Factors; Risk Assessment; Stroke; United Kingdom

Topics: alpha-Linolenic Acid; Cholesterol; Clinical Trials as Topic; Coronary Disease; Humans; Japan; Linoleic Acid; Lipids; Neoplasms; Nutrition Policy; Nutritional Physiological Phenomena; Societies, Medical; Stroke

Serum fatty acid (s-FA) compositions and their correlation with serum lipids (s-LPs) such as total cholesterol (T-CHO) and triglycerides (TG) have been reported in healthy young subjects. However, little is known about such features in acute ischaemic stroke (AIS). The aim of our study was to investigate s-FA characteristics and their correlation with AIS in elderly patients.. We conducted a cross-sectional study of patients aged 50 years or older who were admitted between September 2015 and March 2017 within 24 h of the first AIS onset. We evaluated concentrations and compositions of s-FAs and their association with s-LPs, age, and ischaemic stroke subtypes, including large-artery atherosclerosis (LAA), small-vessel occlusion (SVO), and cardioembolism (CE) or others.. One hundred ninety-one patients met our inclusion criteria. Their average age was 74.4 years, mean T-CHO and median TG were 203.4 and 94.5 mg/dl, respectively, and median or mean concentrations of palmitic acid (PA), oleic acid (OlA), linoleic acid (LiA), and docosahexaenoic acid (DHA) were 680.7, 602.5, 795.2, and 136.9 μg/ml, respectively, with mean compositions of 23.7, 21.3, 27.1, and 4.4%, respectively. PA, OlA, and LiA concentrations were weakly negatively associated with age and positively correlated with TG. In LAA or SVO (LAA_SVO) and CE or others (CE_O), mean age was 71.9 and 77.4 years (p < 0.001), mean T-CHO was 213.9 and 191.2 mg/dl (p < 0.0001), median TG was 106.5 and 88.5 mg/dl (p < 0.01), median PA was 717.2 and 648.4 μg/ml (p < 0.01), median OlA was 638.2 and 567.5 μg/ml (p < 0.01), and median LiA was 844.7 and 728.5 μg/ml (p < 0.01), respectively. DHA composition was weakly positively correlated with age. There were no differences in PA, OlA, LiA, and DHA compositions between LAA_SVO and CE_O.. In AIS elderly patients, concentrations, rather than compositions of PA, OlA, and LiA, correlated with age, TG, and ischaemic stroke subtypes. Patients with LAA_SVO were younger and had higher concentrations of PA, OlA, and LiA than those with CE_O. There were no differences in such compositions between LAA_SVO and CE_O.

Topics: Age Factors; Aged; Aged, 80 and over; Biomarkers; Brain Ischemia; Cross-Sectional Studies; Fatty Acids; Female; Humans; Linoleic Acid; Male; Middle Aged; Oleic Acid; Palmitic Acid; Retrospective Studies; Stroke

We investigated the association between the content of linoleic acid in adipose tissue, a biomarker of long-term intake of linoleic acid, and the risk of ischemic stroke and its subtypes.. The Danish cohort study Diet, Cancer and Health included 57 053 patients aged 50 to 65 years at enrollment. All participants had an adipose tissue biopsy performed at enrollment, while information on ischemic stroke during follow-up was obtained from the Danish National Patient Register. Stroke diagnoses were all validated and classified according to the Trial of Org 10172 in Acute Stroke Treatment (TOAST) classification. Cases and a randomly drawn subcohort of 3500 patients had their fatty acid composition in adipose tissue determined by gas chromatography. Hazard ratios with 95% confidence intervals were calculated using weighted Cox proportional hazard regression. During 13.5 years of follow-up, 1879 ischemic stroke cases were identified, for which 1755 adipose biopsies were available, while adipose biopsies were available for 3203 participants in the subcohort. When comparing the highest and the lowest quartiles of adipose tissue content of linoleic acid there was a negative association with the rate of total ischemic stroke (hazard ratio, 0.78; 95% confidence interval, 0.65-0.93) and large artery atherosclerosis (hazard ratio, 0.61; 95% confidence interval, 0.43-0.88), while there was an indication of a negative association with small-vessel occlusion (hazard ratio, 0.87; 95% confidence interval, 0.69-1.11). There was no clear association with the rate of cardioembolism.. The content of linoleic acid in adipose tissue was inversely associated with the risk of total ischemic stroke and stroke caused by large artery atherosclerosis.

Topics: Aged; Biomarkers; Brain Ischemia; Denmark; Female; Humans; Linoleic Acid; Male; Middle Aged; Prognosis; Risk Assessment; Risk Factors; Stroke; Subcutaneous Fat; Time Factors

Background and Purpose- The role of dietary fat on cardiovascular health and mortality remains under debate. Because the APOE is central to the transport and metabolism of lipids, we examined associations between plasma fatty acids and the risk of stroke, coronary heart disease, and mortality by APOE-ε4 genotype. Methods- We included 943 FHS (Framingham Heart Study) and 1406 3C (Three-City) Bordeaux Study participants. Plasma docosahexaenoic, linoleic, arachidonic, and palmitic fatty acids were measured at baseline by gas chromatography. All-cause stroke, ischemic stroke, coronary heart disease, and all-cause mortality events were identified prospectively using standardized protocols. Each cohort used Cox models to separately relate fatty acid levels to the risk of developing each event during ≤10 years of follow-up adjusting for potential confounders and stratifying by APOE genotype (ε4 carriers versus noncarriers). We then meta-analyzed summary statistics using random-effects models. Results- On average, participants had a mean age of 74 years, 61% were women, and 21% (n=483) were APOE-ε4 carriers. Meta-analysis results showed that, only among APOE-ε4 carriers, every SD unit increase in linoleic acid was associated with a reduced risk of all-cause stroke (hazard ratio [HR], 0.54 [95% CI, 0.38-0.78]), ischemic stroke (HR, 0.48 [95% CI, 0.33-0.71]), and all-cause mortality (HR, 0.70 [95% CI, 0.57-0.85]). In contrast, every SD unit increase in palmitic acid was related to an increased risk of all-cause stroke (HR, 1.58 [95% CI, 1.16-2.17]), ischemic stroke (HR, 1.76 [95% CI, 1.26-2.45]), and coronary heart disease (HR, 1.48 [95% CI, 1.09-2.01]), also in APOE-ε4 carriers only. Results for docosahexaenoic acid and arachidonic acid were heterogeneous between cohorts. Conclusions- These exploratory results suggest that APOE-ε4 carriers may be more susceptible to the beneficial or adverse impact of fatty acids on cardiovascular disease and mortality. In this subgroup, higher linoleic acid was protective for stroke and mortality, whereas palmitic acid was a risk factor for stroke and coronary heart disease. The mechanisms underlying these novel findings warrant further investigation.

Topics: Aged; Apolipoprotein E4; Arachidonic Acid; Cleft Lip; Coronary Disease; Dietary Fats; Docosahexaenoic Acids; Fatty Acids; Female; Humans; Linoleic Acid; Lipid Metabolism; Male; Mortality; Palmitic Acid; Proportional Hazards Models; Retinal Diseases; Risk Factors; Stroke

Ischemic stroke is a major health problem worldwide, but the influence of dietary factors on stroke risk is not well known. This study aimed to investigate the risk of ischemic stroke and its subtypes with a higher intake from linoleic acid and a concomitant lower intake from saturated fatty acids, monounsaturated fatty acids, or glycemic carbohydrates.. In the Danish prospective Diet, Cancer, and Health Study of 57 053 participants aged 50 to 64 years at baseline, information on diet was collected using a validated semiquantitative food frequency questionnaire. Information on ischemic stroke was obtained from the Danish National Patient Register, and cases were all validated and subclassified according to the TOAST (Trial of ORG 10172 in Acute Stroke Treatment) classification. Substitution of linoleic acid for saturated fatty acid, monounsaturated fatty acid, or glycemic carbohydrates was investigated in relation to the risk of ischemic stroke and subtypes. Cox proportional hazards regression was used to estimate the associations with ischemic stroke adjusting for appropriate confounders.. During 13.5 years of follow-up 1879 participants developed ischemic stroke. A slightly lower risk of ischemic stroke was found with a 5% higher intake of linoleic acid and a concomitant lower intake of saturated fatty acid (hazard ratio, 0.98; 95% confidence interval, 0.83-1.16), monounsaturated fatty acid (hazard ratio, 0.80; 95% confidence interval, 0.63-1.02), and glycemic carbohydrates (hazard ratio, 0.92; 95% confidence interval, 0.78-1.09), although not statistically significant. Similar patterns of association were found for large-artery atherosclerosis and small-vessel occlusions.. This study suggests that replacing saturated fatty acid, glycemic carbohydrate, or monounsaturated fatty acid with linoleic acid may be associated with a lower risk of ischemic stroke.

Topics: Brain Ischemia; Denmark; Diet; Diet Surveys; Dietary Carbohydrates; Fatty Acids; Fatty Acids, Monounsaturated; Female; Follow-Up Studies; Humans; Incidence; Linoleic Acid; Male; Middle Aged; Prospective Studies; Risk; Socioeconomic Factors; Stroke; Surveys and Questionnaires

Topics: Coronary Disease; Dietary Fats; Fatty Acids, Omega-6; Fatty Acids, Unsaturated; Female; Humans; Linoleic Acid; Male; Stroke

Topics: Coronary Disease; Dietary Fats; Fatty Acids, Omega-6; Fatty Acids, Unsaturated; Female; Humans; Linoleic Acid; Male; Stroke

Topics: Coronary Disease; Dietary Fats; Fatty Acids, Omega-6; Fatty Acids, Unsaturated; Female; Humans; Linoleic Acid; Male; Stroke

The unclear link between intake of polyunsaturated fatty acids (PUFAs) and risk of cardiovascular disease (CVD) could depend on genetic differences between individuals. Minor alleles of single-nucleotide polymorphisms (SNPs) in the ∆5 fatty acid desaturase (FADS) 1 gene were associated with lower blood concentrations of long-chain ω-3 (n-3) and ω-6 (n-6) PUFAs, indicating an associated loss of function effect. We examined whether the SNP rs174546 in FADS1 modifies the association between PUFA intakes and CVD risk. We included 24,032 participants (62% women, aged 44-74 y) from the Malmö Diet and Cancer cohort without prevalent CVD and diabetes. During a mean follow-up of 14 y, 2648 CVD cases were identified. Diet was assessed by a modified diet history method. A borderline interaction was observed between the α-linolenic acid (ALA) (18:3n-3)-to-linoleic acid (LA) (18:2n-6) intake ratio and FADS1 genotype on CVD incidence (P = 0.06). The ALA-to-LA intake ratio was inversely associated with CVD risk only among participants homozygous for the minor T-allele (HR for quintile 5 vs. quintile 1 = 0.72; 95% CI: 0.50, 1.04; P-trend = 0.049). When excluding participants reporting unstable food habits in the past (35%), the interaction between the ALA-to-LA intake ratio and FADS1 genotype on CVD incidence was strengthened and statistically significant (P = 0.04). Additionally, we observed a significant interaction between ALA and FADS1 genotype on ischemic stroke incidence (P = 0.03). ALA was inversely associated with ischemic stroke only among TT genotype carriers (HR for quintile 5 vs. quintile 1 = 0.50; 95% CI: 0.27, 0.94; P-trend = 0.02). In this large cohort, we found some weak, but not convincing, evidence of effect modification by genetic variation in FADS1 on the associations between PUFA intakes and CVD risk. For the 11% of the population homozygous for the minor T-allele of rs174546 that associates with lower ∆5 FADS activity, high ALA intake and ALA-to-LA intake ratio may be preferable in the prevention of CVD and ischemic stroke.

Topics: Adult; Aged; Alleles; alpha-Linolenic Acid; Cardiovascular Diseases; Delta-5 Fatty Acid Desaturase; Diet; Diet Surveys; Dietary Fats; Energy Intake; Fatty Acid Desaturases; Feeding Behavior; Female; Genotype; Humans; Linoleic Acid; Male; Middle Aged; Polymorphism, Single Nucleotide; Risk Factors; Stroke

Although omega-6 polyunsaturated fatty acids (n-6 PUFA) have been recommended to reduce coronary heart disease (CHD), controversy remains about benefits versus harms, including concerns over theorized proinflammatory effects of n-6 PUFA. We investigated associations of circulating n-6 PUFA including linoleic acid (the major dietary PUFA), γ-linolenic acid, dihomo-γ-linolenic acid, and arachidonic acid, with total and cause-specific mortality in the Cardiovascular Health Study, a community-based U.S. cohort.. Among 2792 participants(aged ≥65 years) free of cardiovascular disease at baseline, plasma phospholipid n-6 PUFA were measured at baseline using standardized methods. All-cause and cause-specific mortality, and total incident CHD and stroke, were assessed and adjudicated centrally. Associations of PUFA with risk were assessed by Cox regression. During 34 291 person-years of follow-up (1992-2010), 1994 deaths occurred (678 cardiovascular deaths), with 427 fatal and 418 nonfatal CHD, and 154 fatal and 399 nonfatal strokes. In multivariable models, higher linoleic acid was associated with lower total mortality, with extreme-quintile hazard ratio =0.87 (P trend=0.005). Lower death was largely attributable to cardiovascular disease causes, especially nonarrhythmic CHD mortality (hazard ratio, 0.51; 95% confidence interval, 0.32-0.82; P trend=0.001). Circulating γ-linolenic acid, dihomo-γ-linolenic acid, and arachidonic acid were not significantly associated with total or cause-specific mortality (eg, for arachidonic acid and CHD death, the extreme-quintile hazard ratio was 0.97; 95% confidence interval, 0.70-1.34; P trend=0.87). Evaluated semiparametrically, linoleic acid showed graded inverse associations with total mortality (P=0.005). There was little evidence that associations of n-6 PUFA with total mortality varied by age, sex, race, or plasma n-3 PUFA. Evaluating both n-6 and n-3 PUFA, lowest risk was evident with highest levels of both.. High circulating linoleic acid, but not other n-6 PUFA, was inversely associated with total and CHD mortality in older adults.

Topics: Aged; Arachidonic Acid; Biomarkers; Cohort Studies; Coronary Disease; Fatty Acids, Omega-3; Fatty Acids, Omega-6; Fatty Acids, Unsaturated; Female; Follow-Up Studies; Humans; Linoleic Acid; Male; Prospective Studies; Regression Analysis; Risk Factors; Stroke; Survival Rate; United States

Topics: Adult; Aged; Aged, 80 and over; alpha-Linolenic Acid; Animals; Arachidonic Acid; Coronary Artery Disease; Coronary Disease; Diet; Dietary Fats; Fatty Acids; Fatty Acids, Omega-3; Fatty Acids, Omega-6; Greece; Humans; Japan; Linoleic Acid; Lipids; Male; Middle Aged; Neoplasms; Risk Factors; Stroke; United States