Red blood cell membrane alpha-linolenic acid and the risk of sudden cardiac arrest

Abstract

Higher levels of long-chain n-3 polyunsaturated fatty acids in red blood cell membranes are associated with lower risk of sudden cardiac arrest. Whether membrane levels of alpha-linolenic acid, a medium-chain n-3 polyunsaturated fatty acid, show a similar association is unclear. We investigated the association of red blood cell membrane alpha-linolenic acid with sudden cardiac arrest risk in a population-based case-control study. Cases, aged 25 to 74 years, were out-of-hospital sudden cardiac arrest patients attended by paramedics in Seattle, WA (n = 265). Controls, matched to cases by age, sex, and calendar year, were randomly identified from the community (n = 415). All participants were free of prior clinically diagnosed heart disease. Blood was obtained at the time of cardiac arrest (cases) or at the time of an interview (controls). Higher membrane alpha-linolenic acid was associated with a higher risk of sudden cardiac arrest: after adjustment for matching factors and smoking, diabetes, hypertension, education, physical activity, weight, height, and total fat intake, the odds ratios corresponding to increasing quartiles of alpha-linolenic acid were 1.7 (95% confidence interval [CI], 1.0-3.0), 1.9 (95% CI, 1.1-3.3), and 2.5 (95% CI, 1.3-4.8) compared with the lowest quartile. The association was independent of red blood cell levels of long-chain n-3 fatty acids, trans-fatty acids, and linoleic acid. Higher membrane levels of alpha-linolenic acid are associated with higher risk of sudden cardiac arrest.

Association of α-linolenic acid with sudden cardiac arrest according to subject characteristics

The figure shows odds ratios and 95% confidence intervals corresponding to one standard deviation increase in RBC membrane ALA levels for groups with and without several characteristics. The numbers at the right of the figure are p-values for test of interactions (see methods). For example the first odds ratio is for men, the second for women, and the first p-value is for the test of interaction with gender. Abbreviations are as follow. M=men, W=women; Y=Yes, N=No; H = High defined as ≥ median value, L = Low defined as < median value. Median values: Age: 57 yr; weight: 82 kg; Fat Index: 21; dietary DHA+EPA: 4.0g/month; RBC DHA+EPA: 4.53 % of total fatty acids; RBC 18:2n6: 9.03 % of total fatty acids; RBC trans 18:1 fatty acids: 1.48 % of total fatty acids; RBC trans 18:2 fatty acids: 0.173 % of total fatty acids.