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Omega-3 Fatty Acid/Fish Intake and Brachial Artery Flow-Mediated Dilation

in the Multi-Ethnic Study of Atherosclerosis. Omega-3 Fatty Acid/Fish Intake and Brachial Artery Flow-Mediated Dilation. Jennifer S. Anderson, MD, PhD, MEd Cardiology Fellow/Research Fellow. Background.

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Omega-3 Fatty Acid/Fish Intake and Brachial Artery Flow-Mediated Dilation

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  1. in the Multi-Ethnic Study of Atherosclerosis Omega-3 Fatty Acid/Fish Intake and Brachial Artery Flow-Mediated Dilation Jennifer S. Anderson, MD, PhD, MEd Cardiology Fellow/Research Fellow

  2. Background • Multiple studies have shown an inverse relationship between fish/omega-3 fatty acid consumption and cardiovascular events/death • One potential mechanism includes omega-3 fatty acids’ impact on endothelial function • Flow-mediated dilation (FMD) is a noninvasive surrogate for endothelial function • Few studies have examined the relationship between dietary fish and FMD

  3. Study Hypotheses Omega-3 rich (EPA, DHA) diet Flow-mediated dilation (FMD) • Consumption of non-fried fish foods rich in long-chain omega-3 fatty acids (eicosapentanoic acid (EPA), docosahexanoic acid (DHA)) will be positively associated with larger FMDacross ethnic groups. • 2. Concentrations of EPA and DHA in plasma phospholipids will demonstrate positive associations with FMD.

  4. Study Design • Cross-sectional analysis of MESA participants • n=6,814 men and women aged 45-85 years, free of CVD • Multi-center participation, 6 U.S. sites • Baseline data collection including: • 120-item food frequency questionnaire • FMD measures (n = 3,137) • plasma phospholipid/fatty acid measures (n = 1,642)

  5. Exposure Measures: Dietary Fish

  6. Exposure Measures: Plasma EPA and DHA

  7. Outcome: Brachial Artery Measures • Baseline brachial artery diameter • Maximum brachial artery diameter

  8. Statistics • Multivariate linear regression • Stepwise approach • Final model included: • Stratified by gender, race/ethnicity • Income level • Physical activity • Systolic & diastolic BP • Lipid levels • BMI • Age • Gender • Race/ethnicity • Smoking • Education

  9. Non-fried Fish & Brachial Measures: Overall Results, Baseline Artery Diameter *p < 0.001 (n = 642) (n = 943) (n = 838) (n = 714)

  10. Non-fried Fish & Brachial Measures: Baseline Diameter, Stratification by Gender* Men Women *p = 0.02 p = 0.10 (n = 338) (n = 455) (n = 411) (n = 344) (n = 304) (n = 488) (n = 427) (n = 370) *adjusted for age, race, BMI, smoking, diabetes, SBP, DBP, total:HDL, exercise, income, education, and HRT (women)

  11. Non-fried Fish & Brachial Measures: FMD, Stratification by Gender* Men Women *p = 0.007 p = 0.23 (n = 338) (n = 455) (n = 411) (n = 344) (n = 304) (n = 488) (n = 427) (n = 370) • Test for gender-fish interaction significant (p = 0.008 and 0.05 for baseline diameter & FMD, respectively) *adjusted for age, race, BMI, smoking, diabetes, SBP, DBP, total:HDL, exercise, income, education, and HRT (women)

  12. Non-fried Fish & Brachial Measures: FMD, Stratification by Gender* & Race/Ethnicity *p = 0.02 *results for women shown, fully adjusted model

  13. Plasma EPA+DHA & Brachial Measures: FMD, Stratification by Gender* p = 0.33 (n = 221) (n = 173) (n = 203) (n = 178) *adjusted for age, race, BMI, smoking, diabetes, SBP, DBP, total:HDL, exercise, income, education, and HRT (women)

  14. Plasma EPA+DHA & Brachial Measures: FMD, Stratification by Gender* p = 0.33 (n = 221) (n = 173) (n = 203) (n = 178) *adjusted for age, race, BMI, smoking, diabetes, SBP, DBP, total:HDL, exercise, income, education, and HRT (women)

  15. Summary • Gender differences were observed in the relationship between non-fried fish and both baseline artery diameter and FMD within the MESA cohort • Results examining plasma EPA+DHA levels corroborated results observed in dietary non-fried fish intake • Some race/ethnic differences were suggested

  16. Next Steps • Are gender differences in brachial measures explained by variation in plasma %EPA vs %DHA? • Gender differences in the relationship between fish consumption & clinical events within MESA? • Gender differences in fish consumption & other markers of subclinical CVD (i.e. IMT, LV structure/function)? • Results replicable in other large cohorts with mixed race/ethnic groups?

  17. Acknowledgements • Mentors & MESA coauthors: • David Herrington, MD, MHS Jennifer Nettleton, PhD David Siscovick, MD, MPH • Craig Johnson, MPH Michael Tsai, PhD And special thanks to: Georgia Saylor

  18. Thank You! Questions?

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