Serum Polyunsaturated Fatty Acid Profile and Carotid Intima-media Thickness in Japanese Atherosclerotic Patients Hospitalized for Endovascular Therapy

Aims: Serum eicosapentaenoic acid (EPA) to arachidonic acid (AA) ratio (EPA/AA) in Japanese is rapidly changing according to the senescence and food westernization, and sonographic carotid artery intima-media thickness (IMT) is increasingly used as a surrogate of systemic atherosclerosis. However, the relationship between IMT and EPA/AA in Japanese remains unclear.

Place of the Study: Vascular Laboratory of Heart Center, Kyushu University Hospital, Fukuoka, Japan.

Methodology: Seventy consecutive Japanese atherosclerotic patients (69.7±7.8 years) hospitalized for elective endovascular therapy without purified EPA agent administration were enrolled in this study. IMT was estimated by high-resolution duplex ultrasonography in vascular laboratory. Conventional vascular risk factors were under the intensive treatment. Demographic variables were extracted from medical records after obtaining informed consent.

Results: IMT was strongly age-dependent (P = .003) and age-adjusted multiple correlation analyses revealed no significant correlations among vascular risk factors, although positive partial correlation between serum EPA/AA and IMT (r = .277, P = .056) and negative partial correlation between EPA/AA and HbA1c (r = -.281, P = .053) were marginal. Stepwise multiple regression analyses demonstrated age and serum EPA/AA as positive contributors to the IMT (P < .001). EPA/AA was a seemingly paradoxical positive contributor to IMT due to age-dependent complicated profile of EPA/AA. Multiple correlation analyses were performed by multiple adjustments, which yielded significant negative correlation between EPA/AA and IMT (r = -.262, P = .049).

Conclusions: This study demonstrated that EPA/AA is a determinant of IMT among other vascular risk factors at least in Japanese atherosclerotic patients hospitalized for endovascular therapy.