Adipose tissue content of alpha-linolenic acid and development of peripheral artery disease: a Danish case-cohort study
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ORIGINAL CONTRIBUTION
Adipose tissue content of alpha‑linolenic acid and development of peripheral artery disease: a Danish case‑cohort study Christian S. Bork1 · Anne N. Lasota2 · Søren Lundbye‑Christensen3 · Marianne U. Jakobsen4 · Anne Tjønneland5,6 · Kim Overvad1,7 · Erik B. Schmidt1,8 Received: 15 May 2019 / Accepted: 4 December 2019 © Springer-Verlag GmbH Germany, part of Springer Nature 2019
Abstract Purpose The aim of this study was to investigate the association between adipose tissue content of the plant-derived n-3 fatty acid, alpha-linolenic acid, and the rate of incident peripheral artery disease (PAD). Methods We conducted a case-cohort study nested within the Danish Diet, Cancer and Health cohort (n = 57,053), which was established between 1993 and 1997. Potential PAD cases were identified using linkage with The Danish National Patient Register and all potential cases were validated. Adipose tissue samples from the buttock were collected at baseline and fatty acid composition was determined in cases and in a random sample (n = 3500) from the cohort by gas chromatography. Statistical analyses were performed using weighted Cox regression allowing for different baseline hazards among sexes. Results During a median of 13.5 years of follow-up, we identified 863 PAD cases with complete information. The median adipose tissue content of ALA in the sub-cohort (n = 3197) was 0.84% (interquartile range 0.73–0.94%) of total fatty acids. In multivariate analyses including adjustment for established risk factors, we observed a U-shaped association between ALA in adipose tissue and rate of PAD, but the association was not statistically significant (P = 0.131). Similar pattern of associations were observed between ALA content in adipose tissue and the rate of PAD among men and women. Conclusions We found indications of a U-shaped association between adipose tissue content of ALA and the rate of PAD, but the association was not statistically significant. Keywords Alpha-linolenic acid · n-3 Fatty acids · Peripheral artery disease · Case-cohort study · Adipose tissue
Introduction
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00394-019-02159-2) contains supplementary material, which is available to authorized users. * Christian S. Bork [email protected] 1
Department of Cardiology, Aalborg University Hospital, Søndre Skovvej 15, 9000 Aalborg, Denmark
2
Department of Vascular Surgery, Aalborg University Hospital, Aalborg, Denmark
3
Unit of Clinical Biostatistics, Aalborg University Hospital, Aalborg, Denmark
4
Division of Diet, Disease Prevention and Toxicology, National Food Institute, Technical University of Denmark, Kgs. Lyngby, Denmark
Peripheral artery disease (PAD) is an atherosclerotic manifestation characterized by stenosis and occlusion of the arteries, which may compromise blood supply to the lower extremities [1]. PAD covers a clinical spectrum from no symptoms, exercise-induced ischemic discomfort and/or pain and in its 5
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