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Tissue omega-6/omega-3 fatty acid ratio and risk for coronary artery disease.

Harris WS, Assaad B, Poston WC

Department of Medicine, Mid America Heart Institute of Saint Luke's Health System, Kansas City, Missouri, USA. bill.harris@usd.edu

A ratio that estimates tissue proportions of omega-6 fatty acids (linoleic acid and/or arachidonic acid [AA]) and omega-3 fatty acids (eicosapentaenoic acid [EPA], docosahexaenoic acid [DHA], and/or alpha-linolenic acid) has been proposed as a biomarker of risk for coronary artery disease (CAD). Use of an omega-6/omega-3 fatty acid ratio instead of either fatty acid class alone is based on theoretical reasons and has not been validated. The relationship between risk for CAD events and tissue omega-3 and omega-6 fatty acid composition was evaluated by pooling data from case-control or prospective cohort studies that examined the risk for CAD end points as a function of tissue fatty acid composition. Thirteen studies were included, 11 case-control and 2 prospective cohort studies, and case-control differences in computed averages of several fatty acids and fatty acid ratios were compared. The largest and most consistent difference was for the sum of EPA + DHA (-11% in cases, p = 0.002). Proportions of EPA, DHA, and AA were about 8% lower in cases, but none of these differences was significant. Total omega-3 and omega-6 fatty acids were lower by 7% and 4%, respectively, in cases versus controls, but only the total omega-3 fatty acid difference was significant. The AA/EPA ratio was nonsignificantly lower by 10% in cases. Fatty acid ratios generally failed to distinguish cases from controls, and any discriminatory power they had derived from the omega-3 fatty acid component. Tissue EPA + DHA appears to be the best fatty acid metric for evaluating for CAD risk.

Published 21 August 2006 in Am J Cardiol, 98(4): 19i-26i.
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