TABLE 3.
Multivariable-adjusted associations of fatty acid patterns with 14-y risks of coronary heart disease and stroke in the Cardiovascular Health Study (n = 2972)1
| Quintile of each fatty acid pattern score |
||||||
| 1 | 2 | 3 | 4 | 5 | P-trend | |
| Ischemic heart disease incidence | ||||||
| trans Fatty acid pattern | ||||||
| Cases (rate/1000 person-years) | 98 (15.1) | 112 (17) | 105 (15.6) | 96 (14.3) | 101 (15.4) | |
| Multivariable-adjusted HR (95% CI)2 | 1.0 (reference) | 1.14 (0.81, 1.58) | 1.02 (0.71, 1.46) | 1.02 (0.70, 1.48) | 1.04 (0.72, 1.50) | 0.93 |
| + corrected for regression-dilution bias3 | 1.0 (reference) | 1.04 (0.54, 2.00) | 1.00 (0.49, 2.05) | 1.01 (0.49, 2.08) | 1.01 (0.49, 2.08) | 0.99 |
| De novo lipogenesis pattern | ||||||
| Cases (rate/1000 person-years) | 89 (13.6) | 100 (14.6) | 106 (16.1) | 122 (18.5) | 95 (14.5) | |
| Multivariable-adjusted HR (95% CI)2 | 1.0 (reference) | 0.99 (0.70, 1.41) | 1.07 (0.77, 1.50) | 1.19 (0.85, 1.66) | 1.08 (0.76, 1.53) | 0.48 |
| + Corrected for regression-dilution bias3 | 1.0 (reference) | 0.98 (0.53, 1.84) | 1.14 (0.63, 2.09) | 1.40 (0.76, 2.57) | 1.16 (0.62, 2.16) | 0.43 |
| LCMUFA pattern | ||||||
| Cases (rate/1000 person-years) | 87 (12.5) | 92 (13.4) | 98 (14.6) | 97 (15.2) | 138 (22.3) | |
| Multivariable-adjusted HR (95% CI)2 | 1.0 (reference) | 0.98 (0.69, 1.37) | 0.89 (0.61, 1.28) | 1.08 (0.75, 1.57) | 1.34 (0.93, 1.93) | 0.06 |
| + Corrected for regression-dilution bias3 | 1.0 (reference) | 0.94 (0.42, 2.12) | 0.75 (0.31, 1.78) | 1.21 (0.51, 2.89) | 1.99 (0.84, 4.74) | 0.06 |
| Stroke incidence | ||||||
| trans Fatty acid pattern | ||||||
| Cases (rate/1000 person-years) | 56 (8.6) | 61 (9.0) | 60 (8.8) | 75 (11.2) | 94 (14.4) | |
| Multivariable-adjusted HR (95% CI)2 | 1.0 (reference) | 1.52 (0.97, 2.40) | 1.39 (0.90, 2.16) | 1.70 (1.08, 2.67) | 2.22 (1.41, 3.48) | 0.001 |
| + Corrected for regression-dilution bias3 | 1.0 (reference) | 2.28 (0.94, 5.54) | 1.91 (0.81, 4.51) | 2.81 (1.16, 6.82) | 4.74 (1.95, 11.5) | 0.001 |
| De novo lipogenesis pattern | ||||||
| Cases (rate/1000 person-years) | 67 (10.2) | 70 (10.3) | 66 (9.9) | 66 (9.8) | 77 (11.7) | |
| Multivariable-adjusted HR (95% CI)2 | 1.0 (reference) | 1.11 (0.72, 1.71) | 0.77 (0.48, 1.23) | 0.80 (0.51, 1.26) | 1.31 (0.85, 2.01) | 0.33 |
| + Corrected for regression-dilution bias3 | 1.0 (reference) | 1.19 (0.55, 2.58) | 0.64 (0.28, 1.46) | 0.68 (0.31, 1.53) | 1.59 (0.74, 3.42) | 0.34 |
| LCMUFA pattern | ||||||
| Cases (rate/1000 person-years) | 74 (10.7) | 56 (8.2) | 64 (9.5) | 90 (14.2) | 62 (9.6) | |
| Multivariable-adjusted HR (95% CI)2 | 1.0 (reference) | 0.93 (0.62, 1.39) | 0.91 (0.60, 1.39) | 1.27 (0.84, 1.90) | 1.08 (0.70, 1.68) | 0.41 |
| + Corrected for regression-dilution bias3 | 1.0 (reference) | 0.90 (0.35, 2.32) | 0.88 (0.33, 2.34) | 1.41 (0.54, 3.69) | 1.12 (0.40, 3.15) | 0.61 |
LCMUFA, long-chain MUFA.
Values were derived by Cox regression analysis. The model was adjusted for age, sex, race (white or nonwhite), education (<high school, high school graduate, college graduate, or >college), smoking status (never, former, or current), exercise intensity (no exercise, low, moderate, or high), leisure-time physical activity (kcal/wk), 3-y weight change (kg), prevalent diabetes (yes or no), treated hypertension (yes or no), alcohol intake (tertile categories), total energy intake (kcal/d), and food consumptions (fish, high-fat dairy products, margarine, sweets, nuts, fried products, meats, and processed meats; servings/wk each). The 3 patterns were also mutually adjusted.
Regression calibration was applied to correct the estimates for bias as a result of temporal variation of the exposures (3 fatty acid patterns) and selected covariates (physical activity and dietary consumptions) after no significant nonlinear association was confirmed. The assumption of a linear association was met for each association (P-nonlinearity > 0.10) according to restricted cubic spline analyses that allowed a test for a nonlinear association.