Table 2.
Multivariable-adjusted HRs (95 % CIs) of incident metabolic syndrome by intakes of LCω3PUFA, EPA, DHA and non-fried fish, the CARDIA study, 1985–2010 (n = 4356)
| Quintiles of LCω3PUFA intake | P for linear trenda | |||||
| Q1 (lowest) | Q2 | Q3 | Q4 | Q5 (highest) | ||
| Total LCω3PUFA | ||||||
| Median (IQR, g/day) | 0.03 (0.02–0.04) | 0.07 (0.06–0.08) | 0.11 (0.10–0.13) | 0.18 (0.16–0.20) | 0.33 (0.27–0.44) | |
| No. of events/participants | 258/868 | 230/870 | 224/871 | 204/877 | 153/870 | |
| Model 1b | 1 (referent) | 0.77 (0.64,0.92) | 0.68 (0.56,0.81) | 0.59 (0.49,0.71) | 0.42 (0.35,0.52) | <0.01 |
| Model 2c | 1 (referent) | 0.89 (0.75,1.07) | 0.76 (0.64,0.92) | 0.71 (0.59,0.87) | 0.54 (0.44,0.67) | <0.01 |
| Model 3ad | 1 (referent) | 0.91 (0.76,1.09) | 0.76 (0.63,0.92) | 0.71 (0.58,0.87) | 0.52 (0.41,0.65) | <0.01 |
| Model 3be | 1 (referent) | 0.90 (0.75,1.07) | 0.75 (0.62,0.90) | 0.69 (0.56,0.84) | 0.50 (0.40,0.63) | <0.01 |
| Model 4f | 1 (referent) | 0.91 (0.76,1.09) | 0.76 (0.63,0.91) | 0.71 (0.59,0.86) | 0.55 (0.44,0.68) | <0.01 |
| EPA | ||||||
| Median (IQR, g/day) | 0.01 (0.00–0.01) | 0.02 (0.02–0.03) | 0.04 (0.04–0.05) | 0.07 (0.06,0.08) | 0.14 (0.11,0.19) | |
| No. of events/participants | 255/873 | 214/869 | 217/889 | 211/848 | 172/877 | |
| Model 1b | 1 (referent) | 0.77 (0.64,0.92) | 0.70 (0.58,0.84) | 0.71 (0.59,0.85) | 0.55 (0.45,0.67) | <0.01 |
| Model 2c | 1 (referent) | 0.84 (0.70,1.004) | 0.79 (0.66,0.95) | 0.81 (0.67,0.98) | 0.69 (0.56,0.85) | <0.01 |
| Model 3ad | 1 (referent) | 0.86 (0.71,1.03) | 0.82 (0.68,0.99) | 0.83 (0.69,1.01) | 0.69 (0.56,0.86) | <0.01 |
| Model 3be | 1 (referent) | 0.85 (0.71,1.03) | 0.82 (0.67,0.99) | 0.82 (0.68,1.004) | 0.69 (0.55,0.85) | <0.01 |
| Model 4f | 1 (referent) | 0.86 (0.71,1.03) | 0.76 (0.64,0.92) | 0.79 (0.65,0.95) | 0.69 (0.56,0.85) | <0.01 |
| DHA | ||||||
| Median (IQR, g/day) | 0.01 (0.00–0.01) | 0.03 (0.02–0.03) | 0.05 (0.04–0.06) | 0.08 (0.07–0.10) | 0.16 (0.13–0.21) | |
| No. of events/participants | 289/832 | 242/909 | 209/882 | 182/852 | 147/881 | |
| Model 1b | 1 (referent) | 0.55 (0.46,0.65) | 0.44 (0.37,0.53) | 0.37 (0.30,0.44) | 0.28 (0.23,0.34) | <0.01 |
| Model 2c | 1 (referent) | 0.63 (0.53,0.75) | 0.52 (0.43,0.62) | 0.44 (0.36,0.53) | 0.36 (0.29,0.44) | <0.01 |
| Model 3ad | 1 (referent) | 0.65 (0.55,0.78) | 0.51 (0.42,0.62) | 0.43 (0.35,0.52) | 0.34 (0.27,0.42) | <0.01 |
| Model 3be | 1 (referent) | 0.64 (0.54,0.77) | 0.50 (0.42,0.61) | 0.42 (0.34,0.51) | 0.33 (0.26,0.41) | <0.01 |
| Model 4f | 1 (referent) | 0.65 (0.55,0.77) | 0.53 (0.44,0.64) | 0.43 (0.36,0.53) | 0.37 (0.30,0.46) | <0.01 |
| Non-fried fish consumption |
P for linear trenda |
|||||
| <1 month | 1–3 month | 1 week | 2–4 week | ≥5 week | ||
| Median (IQR, serving/day) | 0.00 (0.00–0.01) | 0.09 (0.06–0.12) | 0.21 (0.18–0.25) | 0.48 (0.38–0.59) | 1.32 (0.96–1.93) | |
| No. of events/participants | 87/250 | 81/317 | 111/458 | 293/1257 | 497/2074 | |
| Model 1b | 1 (referent) | 0.64 (0.47,0.86) | 0.55 (0.42,0.73) | 0.51 (0.40,0.65) | 0.51 (0.40,0.64) | <0.01 |
| Model 2c | 1 (referent) | 0.70 (0.51,0.95) | 0.68 (0.52,0.91) | 0.67 (0.53,0.86) | 0.71 (0.56,0.89) | 0.49 |
| Model 3ad | 1 (referent) | 0.69 (0.51,0.94) | 0.68 (0.51,0.90) | 0.69 (0.54,0.88) | 0.73 (0.58,0.93) | 0.80 |
| Model 3be | 1 (referent) | 0.71 (0.53,0.97) | 0.70 (0.53,0.93) | 0.70 (0.55,0.90) | 0.75 (0.59,0.96) | 0.84 |
| Model 4f | 1 (referent) | 0.68 (0.50,0.93) | 0.70 (0.53,0.93) | 0.65 (0.51,0.83) | 0.69 (0.55,0.88) | 0.44 |
All models were constructed using Cox proportional hazards regression analysis
CARDIA Coronary Artery Risk Development in Young Adults, CI confidence interval, DHA docosahexaenoic acid, EPA eicosapentaenoic acid, HR hazard ratio, IQR inter-quartile range, LCω3PUFA long-chain ω-3 polyunsaturated fatty acid
P for trend was examined by using medians in each quintile/subgroup of exposure of interest
Model 1: adjustment for age (years, continuous), gender, ethnicity (African American, Caucasian) and study center
Model 2: model 1 with additional adjustment for education (years, continuous), smoking status (never, former, current), family history of diabetes (yes or no), physical activity (quintiles), alcohol consumption (0, 0.1–9.9, 10–19.9, ≥20 g/day), and baseline body mass index (<25, 25–29.9, ≥30 kg/m2). Fried fish consumption (yes vs. no) was also adjusted when non-fried fish was the exposure
Model 3a (sensitivity analysis): model 2 with additional adjustment for intakes (quintiles) of protein, saturated fatty acid, polyunsaturated fatty acid, and total energy
Model 3b (sensitivity analysis): model 2 with additional adjustment for “Fruit-Vegetable” pattern (quintiles), meat pattern (quintile) and total energy intake (quintile)
Model 4 (sensitivity analysis): model 2 with additional adjustment for each component of metabolic syndrome at baseline, except baseline body mass index, because it is highly correlated with waist circumference