Dietary fatty acids kand inflammatory markers in patients with coronary artery disease

Authors

1 Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

2 Department of Epidemiology and Biostatistics, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran

3 Department of Cardiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Atherosclerosis, with its major manifestation, coronary artery disease (CAD) is a chronic inflammatory disease. Dietary fatty acids intakes favorably effect on inflammatory responses. This study was conducted to examine the association between dietary fatty acid intakes and inflammatory markers, interleukin 6 (IL-6) and high sensitivity C-reactive protein (hs-CRP), in CAD patients among Iranian population.
Materials and Methods: This hospital-based, cross-sectional study was conducted in Chamran Heart Hospital, Isfahan, Iran in 2012. Patients aged ≥45 years with first ever symptomatic CAD confirmed by angiography were included. A semi-quantitative food frequency questionnaire (FFQ) was used to assess the usual intakes of dietary fatty acids.
Results: The energy-adjusted daily intakes (mean ± SD) of saturated fatty acid (SFA), monounsaturated fatty acid (MUFA), linoleic acid, α-linolenic acid, and eicosapentaenoic acid and docosahexaenoic acid (EPA + DHA) were 27 ± 9, 22 ± 6, 21 ± 5, 0.4 ± 0.32, and 0.85 ± 0.82 g/d; respectively. After adjustment for potential confounders, SFA was directly related to hs-CRP (P = 0.01) and IL-6 (P < 0.001) concentrations. Intakes of EPA + DHA and MUFA, were significantly adversely related to plasma hs-CRP concentration (P = 0.002 and 0.001, respectively) but not IL-6, albeit MUFA was modestly inversely related to IL-6 (P = 0.08). No significant relationships were observed for other fatty acids, α-linolenic acid, and linoleic acid.
Conclusions: These findings suggest that saturated fatty acids, EPA + DHA and MUFA were significantly related to plasma inflammatory markers in CAD patients.

Keywords

1. Libby P, Ridker PM, Maseri A. Inflammation and atherosclerosis. Circulation 2002;105:1135-43.  Back to cited text no. 1
    
2. Willerson JT. Systemic and local inflammation in patients with unstable atherosclerotic plaques. Prog Cardiovasc Dis 2002;44:469-78.  Back to cited text no. 2
    
3. Vozarova B, Weyer C, Hanson K, Tataranni PA, Bogardus C, Pratley RE. Circulating interleukin-6 in relation to adiposity, insulin action, and insulin secretion. Obes Res 2001;9:414-7.  Back to cited text no. 3
    
4. Pradhan AD, Manson JE, Rossouw JE, Siscovick DS, Mouton CP, Rifai N, et al. Inflammatory biomarkers, hormone replacement therapy, and incident coronary heart disease: Prospective analysis from the Women′s Health Initiative observational study. JAMA 2002;288:980-7.  Back to cited text no. 4
    
5. Wilson PW. Evidence of systemic inflammation and estimation of coronary artery disease risk: A population perspective. Am J Med 2008;121 (10 Suppl 1):S15-20.  Back to cited text no. 5
    
6. Okrainec K, Banerjee DK, Eisenberg MJ. Coronary artery disease in the developing world. Am Heart J 2004;148:7-15.  Back to cited text no. 6
    
7. Azarpazhooh MR, Etemadi MM, Donnan GA, Mokhber N, Majdi MR, Ghayour-Mobarhan M, et al. Excessive incidence of stroke in Iran: Evidence from the Mashhad Stroke Incidence Study (MSIS), a population-based study of stroke in the Middle East. Stroke 2010;41:e3-10.  Back to cited text no. 7
    
8. Mehta JL, Saldeen TG, Rand K. Interactive role of infection, inflammation and traditional risk factors in atherosclerosis and coronary artery disease. J Am Coll Cardiol 1998;31:1217-25.  Back to cited text no. 8
    
9. Alexander RW. Inflammation and coronary artery disease. N Engl J Med 1994;331:468-9.  Back to cited text no. 9
    
10. Buja LM. Does atherosclerosis have an infectious etiology? Circulation 1996;94:872-3.  Back to cited text no. 10
    
11. Iso H, Rexrode KM, Stampfer MJ, Manson JE, Colditz GA, Speizer FE, et al. Intake of fish and omega-3 fatty acids and risk of stroke in women. JAMA 2001;285:304-12.  Back to cited text no. 11
    
12. Liu S, Manson JE, Stampfer MJ, Rexrode KM, Hu FB, Rimm EB, et al. Whole grain consumption and risk of ischemic stroke in women: A prospective study. JAMA 2000;284:1534-40.  Back to cited text no. 12
    
13. Hall WL. Dietary saturated and unsaturated fats as determinants of blood pressure and vascular function. Nutr Res Rev 2009;22:18-38.  Back to cited text no. 13
    
14. Pischon T, Hankinson SE, Hotamisiligi GS, Rifai N, Willett WC, Rimm EB. Habitual dietary intake of n-3 and n-6 fatty acids in relation to inflammatory markers among US men and women. Circulation 2003;108:155-60.  Back to cited text no. 14
    
15. Esmaillzadeh A, Azadbakht L. Home use of vegetable oils, markers of systemic inflammation, and endothelial dysfunction among women. Am J Clin Nutr 2008;88:913-21.  Back to cited text no. 15
    
16. Mozaffarian D, Rimm EB, King IB, Lawler RL, McDonald GB, Levy WC. Trans fatty acids and systemic inflammation in heart failure. Am J Clin Nutr 2004;80:1521-5.  Back to cited text no. 16
    
17. Kalogeropoulos N, Panagiotakos DB, Pitsavos C, Chrysohoou C, Rousinou G, Toutouza M, et al. Unsaturated fatty acids are inversely associated and n-6/n-3 ratios are positively related to inflammation and coagulation markers in plasma of apparently healthy adults. Clin Chim Acta 2010;411:584-91.  Back to cited text no. 17
    
18. Margioris AN. Fatty acids and postprandial inflammation. Curr Opin Clin Nutr Metab Care 2009;12:129-37.  Back to cited text no. 18
    
19. Yoneyama S, Miura K, Sasaki S, Yoshita K, Morikawa Y, Ishizaki M, et al. Dietary intake of fatty acids and serum C-reactive protein in Japanese. J Epidemiol 2007;17:86-92.  Back to cited text no. 19
    
20. Superko HR, Nejedly M, Garrett B. Small LDL and its clinical importance as a new CAD risk factor: A female case study. Prog Cardiovasc Nurs 2002;17:167-73.  Back to cited text no. 20
    
21. Petersson H, Lind L, Hulthe J, Elmgren A, Cederholm T, Risérus U. Relationships between serum fatty acid composition and multiple markers of inflammation and endothelial function in an elderly population. Atherosclerosis 2009;203:298-303.  Back to cited text no. 21
    
22. Kennedy A, Martinez K, Chuang CC, LaPoint K, McIntosh M. Saturated fatty acid-mediated inflammation and insulin resistance in adipose tissue: Mechanisms of action and implications. J Nutr 2009;139:1-4.  Back to cited text no. 22
    
23. Esfahani FH, Asghari G, Mirmiran P, Azizi F. Reproducibility and relative validity of food group intake in a food frequency questionnaire developed for the Tehran Lipid and Glucose Study. J Epidemiol 2010;20:150-8.  Back to cited text no. 23
    
24. Ghaffarpour M, Houshiar-Rad A, Kianfar H. The manual for household measures, cooking yields factors and edible portion of foods. Tehran: Keshaverzi Press; 1999. p. 1-46. (in Farsi).  Back to cited text no. 24
    
25. Ainsworth BE, Haskell WL, Whitt MC, Irwin ML, Swartz AM, Strath SJ, et al. Compendium of physical activities: An update of activity codes and MET intensities. Med Sci Sports Exerc 2002;32:S498-504.  Back to cited text no. 25
    
26. Ridker PM. Clinical application of C-reactive protein for cardiovascular disease detection and prevention. Circulation 2003;107:363-9.  Back to cited text no. 26
    
27. Tilg H, Trehu E, Atkins MB, Dinarello CA, Mier JW. Interleukin-6 (IL-6) as an anti-inflammatory cytokine: Induction of circulating IL-1 receptor antagonist and soluble tumor necrosis factor receptor p55. Blood 1994;83:113-8.  Back to cited text no. 27
    
28. Tayyebi-Khosroshahi H, Houshyar J, Deghan-Hesari R, Alikhah H, Vatankhah AM, Safaeian AR, et al. Effect of treatment with omega-3 Fatty acids on C-reactive protein and tumor necrosis facor-alfa in hemodialysis patients. Saudi J Kidney Dis Transpl 2012;23:500-6.  Back to cited text no. 28
[PUBMED]  Medknow Journal  
29. Poudel-Tandukar K, Nanri A, Matsushita Y, Sasaki S, Ohta M, Sato M, et al. Dietary intakes of alpha-linolenic and linoleic acids are inversely associated with serum C-reactive protein levels among Japanese men. Nutr Res 2009;29:363-70.  Back to cited text no. 29
    
30. van Dijk SJ, Feskens EJ, Bos MB, Hoelen DW, Heijligenberg R, Bromhaar MG, et al. A saturated fatty acid-rich diet induces an obesity-linked proinflammatory gene expression profile in adipose tissue of subjects at risk of metabolic syndrome. Am J Clin Nutr 2009;90:1656-64.  Back to cited text no. 30
    
31. Gillingham LG, Gustafson JA, Han SY, Jassal DS, Jones PJ. High-oleic rapeseed (canola) and flaxseed oils modulate serum lipids and inflammatory biomarkers in hypercholesterolaemic subjects. Br J Nutr 2011;105:417-27.  Back to cited text no. 31
    
32. Petersson H, Riserus U, McMonnagle J, Gulseth HL, Tierney AC, Morange S, et al. Effect of dietary fat modification on oxidative stress and inflammatory markers in the LIPPGENE study. Br J Nutr 2010;104:1357-62.  Back to cited text no. 32
    
33. Arya S, Isharwal S, Misra A, Pandey RM, Rastogi K, Vikram NK, et al. C-reactive protein and dietary nutrients in urban Asian Indian adolescents and young adults. Nutrition 2006;22:865-71.  Back to cited text no. 33
    
34. Bassett CM, McCullough RS, Edel AL, Maddaford TG, Dibrov E, Blackwood DP, et al. Trans-fatty acids in the diet stimulates atherosclerosis. Metabolism 2009;58:1802-8.  Back to cited text no. 34
    
35. Seo T, Qi K, Chang C, Liu Y, Worgall TS, Ramakrishnan R, et al. Saturated fat-rich diet enhances selective uptake of LDL cholesteryl esters in the arterial wall. J Clin Invest 2005;115:2214-22.  Back to cited text no. 35
    
36. Mensink RP, Zock PL, Kester AD, Katan MB. Effects of dietary fatty acids and carbohydrates on the ratio of serum total to HDL cholesterol and on serum lipids and apolipoproteins: A meta-analysis of 60 controlled trials. Am J Clin Nutr 2003;77:1146-55.  Back to cited text no. 36
    
37. Devaraj S, Kasim-Karakas S, Jialal I. The effect of weight loss and dietary fatty acids on inflammation. Curr Atheroscler Rep 2006;8:477-86.  Back to cited text no. 37
    
38. Basu A, Devaraj S, Jialal I. Dietary factors that promote or retard inflammation. Arterioscler Thromb Vasc Biol 2006;26:995-1001.  Back to cited text no. 38
    
39. Daviglus ML, Stamler J, Orencia AJ, Dyer AR, Liu K, Greenland P, et al. Fish consumption and the 30-year risk of fatal myocardial infarction. N Engl J Med 1997;336:1046-53.  Back to cited text no. 39
    
40. Albert CM, Hennekens CH, O′Donnell CJ, Ajani UA, Carey VJ, Willett WC, et al. Fish consumption and risk of sudden cardiac death. JAMA 1998;279:23-8.  Back to cited text no. 40
    
41. Harris WS. N-3 fatty acids and serum lipoproteins: Human studies. Am J Clin Nutr 1997;65 Suppl 5:1645-54S.  Back to cited text no. 41
    
42. Geelen A, Brouwer IA, Zock PL, Katan MB. Antiarrhythmic effects of n-3 fatty acids: Evidence from human studies. Curr Opin Lipidol 2004;15:25-30.  Back to cited text no. 42
    
43. Whelan J, Broughton KS, Kinsella JE. The comparative effects of dietary alpha-linolenic acid and fish oil on 4- and 5-series leukotriene formation in vivo. Lipids 1991;26:119-26.  Back to cited text no. 43
    
44. Pawlosky RJ, Hibbeln JR, Novotny JA, Salem N Jr. Physiological compartmental analysis of alpha-linolenic acid metabolism in adult humans. J Lipid Res 2001;42:1257-65.  Back to cited text no. 44
    
45. Emken EA, Adlof RO, Gulley RM. Dietary linoleic acid influences desaturation and acylation of deuterium-labeled linoleic and linolenic acids in young adult males. Biochim Biophys Acta 1994;1213:277-88.  Back to cited text no. 45
    
46. Calder PC, Grimble RF. Polyunsaturated fatty acids, inflammation and immunity. Eur J Clin Nutr 2002;56 Suppl 3:S14-9.  Back to cited text no. 46
    
47. Simopoulos AP The importance of the omega-6/omega-3 fatty acid ratio in cardiovascular disease and other chronic diseases. Exp Biol Med (Maywood) 2008;233:674-88.  Back to cited text no. 47
    
48. Czernichow S, Thomas D, Bruckert E. n-6 Fatty acids and cardiovascular health: A review of the evidence for dietary intake recommendations. Br J Nut 2010;104:788-96.  Back to cited text no. 48
    
49. Horrobin DF. Commentary on workshop statement: Are we really sure that arachidonic acid and lonoleic acid are bad thing? Prostaglandings Leukot Essent Fatty Acids 2000;63:145-7.  Back to cited text no. 49
    
50. Cho HP, Nakamura M, Clarke SD. Cloning, expression, and fatty acid regulation of the human delta-5 desaturase. J Biol Chem 1999;274:37335-9.  Back to cited text no. 50
    
51. Ringbom T, Huss U, Stenholm A, Flock S, Skattebøl L, Perera P, et al. Cox-2 inhibitory effects of naturally occurring and modified fatty acids. J Nat Prod 2001;64:745-9.  Back to cited text no. 51
    
52. Friedenreich CM, Howe GR, Miller AB. An investigation of recall bias in the reporting of past food intake among breast cancer cases and controls. Ann Epidemiol 1991;1:439-53.  Back to cited text no. 52
    
53. Hislop TG, Lamb CW, Ng VT. Differential misclassification bias and dietary recall for the distant past using a food frequency questionnaire. Nutr Cancer 1990;13:223-33.  Back to cited text no. 53