Table 5.
Prospective Association of Plasma Phospholipid Trans–Fatty Acid With Total Coronary Heart Disease With Mutual Adjustment (n=2742)
| Quintiles of Plasma Phospholipid Trans–Fatty Acid Levels | P Value For Trend* | |||||
|---|---|---|---|---|---|---|
| I | II | III | IV | V | ||
| Total coronary heart disease (n=639) | ||||||
| Trans16:1n9 | 1.00 (ref) | 1.26 (0.96, 1.64) | 1.35 (1.01, 1.80) | 1.36 (0.99, 1.87) | 1.30 (0.90, 1.88) | 0.22 |
| Total trans18:1* | 1.00 (ref) | 0.89 (0.68, 1.18) | 0.83 (0.61, 1.14) | 0.78 (0.54, 1.13) | 0.77 (0.51, 1.16) | 0.23 |
| Cis/trans18:2 | 1.00 (ref) | 0.63 (0.48, 0.82) | 0.57 (0.43, 0.77) | 0.53 (0.38, 0.74) | 0.50 (0.34, 0.73) | 0.001 |
| Trans/cis18:2 | 1.00 (ref) | 1.13 (0.87, 1.48) | 1.16 (0.86, 1.56) | 1.65 (1.21, 2.25) | 1.67 (1.17, 2.40) | 0.002 |
| Trans/trans18:2 | 1.00 (ref) | 1.14 (0.88, 1.49) | 1.43 (1.11, 1.85) | 1.40 (1.07, 1.81) | 1.39 (1.06, 1.83) | 0.01 |
| Coronary heart disease mortality (n=362)* | ||||||
| Trans16:1n9 | 1.00 (ref) | 1.28 (0.91, 1.81) | 1.26 (0.86, 1.85) | 1.20 (0.79, 1.83) | 1.17 (0.71, 1.91) | 0.68 |
| Total trans18:1* | 1.00 (ref) | 0.70 (0.49, 1.00) | 0.65 (0.43, 0.96) | 0.60 (0.37, 0.98) | 0.65 (0.38, 1.13) | 0.20 |
| Cis/trans18:2 | 1.00 (ref) | 0.85 (0.61, 1.20) | 0.75 (0.50, 1.11) | 0.75 (0.48, 1.18) | 0.64 (0.38, 1.08) | 0.10 |
| Trans/cis18:2 | 1.00 (ref) | 0.92 (0.65, 1.31) | 0.89 (0.60, 1.32) | 1.32 (0.88, 1.98) | 1.38 (0.86, 2.23) | 0.07 |
| Trans/trans18:2 | 1.00 (ref) | 1.23 (0.87, 1.74) | 1.30 (0.91, 1.84) | 1.36 (0.96, 1.93) | 1.36 (0.94, 1.96) | 0.11 |
| Nonfatal coronary heart disease (n=377)* | ||||||
| Trans16:1n9 | 1.00 (ref) | 1.36 (0.94, 1.96) | 1.72 (1.17, 2.54) | 1.61 (1.05, 2.47) | 1.68 (1.03, 2.73) | 0.06 |
| Total trans18:1* | 1.00 (ref) | 1.09 (0.74, 1.59) | 1.15 (0.76, 1.74) | 1.00 (0.61, 1.61) | 0.97 (0.56, 1.66) | 0.72 |
| Cis/trans18:2 | 1.00 (ref) | 0.47 (0.33, 0.66) | 0.44 (0.30, 0.64) | 0.38 (0.25, 0.58) | 0.35 (0.21, 0.56) | <0.001 |
| Trans/cis18:2 | 1.00 (ref) | 1.37 (0.96, 1.95) | 1.52 (1.03, 2.24) | 2.11 (1.41, 3.16) | 2.06 (1.29, 3.28) | 0.002 |
| Trans/trans18:2 | 1.00 (ref) | 1.10 (0.77, 1.56) | 1.40 (1.00, 1.95) | 1.29 (0.92, 1.82) | 1.36 (0.95, 1.95) | 0.08 |
Models were adjusted for age (years), sex (male/female), race (white/nonwhite), education (<high school, high school, some college, college graduate), enrollment site, diabetes (yes/no), hypertension (yes/no), smoking (never/former/current), alcohol consumption (servings/week), physical activity (kcal/week), BMI (kg/m2), waist circumference (cm), dietary saturated fat (%energy), dietary monounsaturated fat (%energy), dietary fiber (g/day), plasma phospholipid EPA+DHA (% fatty acids), plasma phospholipid linoleic acid (% fatty acids), and other types of plasma phospholipid trans fatty acids (% of fatty acids). BMI indicates body–mass index; EPA+DHA, eicosapentaenoic acids plus docosahexaenoic acids.
P‐trend was evaluated by assigning each participant the median value of each quintile category and evaluating this as a continuous variable.
Total trans18:1 consisted of subtypes including trans‐18:1n6, n7, n8, n9, n10‐12 that were highly inter‐related (pairwise correlations=0.83 to 0.93).
Subtypes of total coronary heart disease.