Plasma n-3 and n-6 fatty acids are differentially related to carotid plaque and its progression: The multi-ethnic study of atherosclerosis

Brian T. Steffen, Weihua Guan, James H. Stein, Mathew C. Tattersall, Joel D. Kaufman, Veit Sandfort, Moyses Szklo, Michael Y. Tsai

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


Objective-ω-3 (n-3) fatty acids (FAs) have long been considered healthful dietary components, yet recent clinical trials have questioned their cardiovascular benefits. By contrast, the ω-6 (n-6) FAs have been considered harmful, proatherogenic macronutrients, despite an absence of empirical evidence supporting this hypothesis. We aimed to determine whether plasma n-3 and n-6 FAs are related to risk of carotid plaque and its progression in 3327 participants of MESA (Multi- Ethnic Study of Atherosclerosis). Approach and Results-Carotid plaque was assessed using ultrasonography at baseline and after a median period of 9.5 years. Plasma phospholipid n-3 and n-6 FAs were determined using gas chromatography-flame ionization detection. Relative risk regression analyses assessed the relations of FAs with the presence or progression of carotid plaque adjusted for typical cardiovascular disease risk factors. At baseline, it was found that participants in the fourth quartile of n-3 docosahexaenoic acid showed a 9% lower risk of carotid plaque (P=0.05), whereas those in the second quartile of n-3 α- linolenic acid showed an 11% greater risk compared with respective referent quartiles (P=0.02). In prospective analyses, individuals in the top quartile of docosahexaenoic acid showed a 12% lower risk of carotid plaque progression during 9.5 years compared with those in the referent quartile (P=0.002). No significant relations were observed among n-6 FAs and plaque outcomes. No significant race/ethnicity interactions were found. Conclusions-These findings support docosahexaenoic acid as an atheroprotective macronutrient, whereas null findings for n-6 FAs challenge the view that they promote atherosclerosis.

Original languageEnglish (US)
Pages (from-to)653-659
Number of pages7
JournalArteriosclerosis, thrombosis, and vascular biology
Issue number3
StatePublished - 2018

Bibliographical note

Funding Information:
This research was supported by contracts HHSN268201500003I; N01-HC-95159 through N01-HC-95169 from the National Heart, Lung, and Blood Institute; grants UL1-TR-000040, UL1-TR-001079, and UL1-TR-001420 from the National Center for Advancing Translational Sciences; and the Multi-Ethnic Study of Atherosclerosis and Air Pollution, funded by grant RD 831697 from the Environmental Protection Agency Science to Achieve Results (STAR [Science to Achieve Results]) Program.


  • Atherosclerosis
  • Fatty acids
  • Humans
  • Prospective studies
  • Risk factors

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