Omega-3 Fatty Acids and Risk of Ischemic Stroke in REGARDS

Zsuzsanna Ament; Amit Patki; Varun M Bhave; Naruchorn Kijpaisalratana; Alana C Jones; Catharine A Couch; Robert J Stanton; Pamela M Rist; Mary Cushman; Suzanne E Judd; D Leann Long; M Ryan Irvin; W Taylor Kimberly

doi:10.1007/s12975-024-01256-7

Omega-3 Fatty Acids and Risk of Ischemic Stroke in REGARDS

Transl Stroke Res. 2024 Apr 27. doi: 10.1007/s12975-024-01256-7. Online ahead of print.

Authors

Zsuzsanna Ament^{1

2}, Amit Patki³, Varun M Bhave⁴, Naruchorn Kijpaisalratana^{2

5}, Alana C Jones⁶, Catharine A Couch³, Robert J Stanton⁷, Pamela M Rist^{8

9}, Mary Cushman¹⁰, Suzanne E Judd¹¹, D Leann Long¹¹, M Ryan Irvin³, W Taylor Kimberly^{12

13}

Affiliations

¹ Center for Genomic Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
² Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.
³ Department of Epidemiology, School of Public Health at the University of Alabama at Birmingham, Birmingham, AL, USA.
⁴ Harvard Medical School, Boston, MA, USA.
⁵ Division of Neurology, Department of Medicine and Division of Academic Affairs, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
⁶ Medical Scientist Training Program, University of Alabama at Birmingham, Birmingham, AL, USA.
⁷ Department of Neurology, University of Cincinnati Medical Center, Cincinnati, OH, USA.
⁸ Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
⁹ Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
¹⁰ Department of Medicine, Larner College of Medicine at the University of Vermont, Burlington, VT, USA.
¹¹ Department of Biostatistics, School of Public Health at the University of Alabama at Birmingham, Birmingham, AL, USA.
¹² Center for Genomic Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. [email protected].
¹³ Department of Neurology, Massachusetts General Hospital, Boston, MA, USA. [email protected].

PMID: 38676880
DOI: 10.1007/s12975-024-01256-7

Abstract

We examined associations between lipidomic profiles and incident ischemic stroke in the REasons for Geographic and Racial Differences in Stroke (REGARDS) cohort. Plasma lipids (n = 195) were measured from baseline blood samples, and lipids were consolidated into underlying factors using exploratory factor analysis. Cox proportional hazards models were used to test associations between lipid factors and incident stroke, linear regressions to determine associations between dietary intake and lipid factors, and the inverse odds ratio weighting (IORW) approach to test mediation. The study followed participants over a median (IQR) of 7 (3.4-11) years, and the case-cohort substudy included 1075 incident ischemic stroke and 968 non-stroke participants. One lipid factor, enriched for docosahexaenoic acid (DHA, an omega-3 fatty acid), was inversely associated with stroke risk in a base model (HR = 0.84; 95%CI 0.79-0.90; P = 8.33 × 10^-8) and fully adjusted model (HR = 0.88; 95%CI 0.83-0.94; P = 2.79 × 10^-4). This factor was associated with a healthy diet pattern (β = 0.21; 95%CI 0.12-0.30; P = 2.06 × 10^-6), specifically with fish intake (β = 1.96; 95%CI 0.95-2.96; P = 1.36 × 10^-4). DHA was a mediator between fish intake and incident ischemic stroke (30% P = 5.78 × 10^-3). Taken together, DHA-containing plasma lipids were inversely associated with incident ischemic stroke and mediated the relationship between fish intake and stroke risk.

Keywords: Docosahexaenoic acid (DHA); Epidemiology; Exploratory factor analysis; Incident ischemic stroke; Omega-3.

Abstract

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