Journal
JOURNAL OF VASCULAR SURGERY
Volume 58, Issue 5, Pages 1283-1290Publisher
MOSBY-ELSEVIER
DOI: 10.1016/j.jvs.2013.05.024
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Funding
- University of California San Francisco
- Northern California Institute for Research and Education
- Clinical Seed Grant from the Society for Vascular Surgery
- National Center for Research Resources [KL2RR024130]
- National Center for Advancing Translational Sciences, National Institutes of Health, through University of California San Francisco Clinical and Translational Science Institute [KL2 TR000143]
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Objective: The n-3 polyunsaturated fatty acids are dietary components derived from fish oil with beneficial cardiovascular effects that may relate in part to anti-inflammatory properties. Peripheral artery disease (PAD) is characterized by a marked proinflammatory state. We hypothesized that the n-3 polyunsaturated fatty acids content of red blood cells (omega-3 index) would be correlated with biomarkers of inflammation and vascular function in a PAD cohort. Methods: This was a cross-sectional study of subjects who presented to an outpatient vascular surgery clinic for evaluation of PAD. We used linear regression to evaluate the independent association between the omega-3 index, inflammatory biomarkers (C-reactive protein [CRP], intercellular adhesion molecule-1, interleukin-6, and tumor-necrosis-factor-alpha) and endothelial function (brachial artery flow mediated dilation). Results: 64 subjects (61 claudicants and three with critical limb ischemia) were recruited for the study. The mean CRP level was 5.0 +/- 5.0 mg/L, and the mean omega-3 index was 5.0% +/- 1.8%. In an unadjusted model, the omega- 3 index was negatively associated with CRP (38% increase in CRP for one standard deviation decrease in the omega-3 index; P = .007), which remained significant after adjustment for age, body mass index, smoking, ankle-brachial index, and high-density lipoprotein (33%; P = .04). There was also evidence for independent associations between the omega-3 index and IL-6 (P = .001). There were no significant associations between the omega-3 index and vascular function tests. Conclusions: In a cohort of patients with PAD, the omega- 3 index was inversely associated with biomarkers of inflammation even after adjustment for covariates including the ankle-brachial index. Because patients with PAD have a high inflammatory burden, further studies should be conducted to determine if manipulation of omega-3 index via dietary changes or fish oil supplementation could improve inflammation and symptoms in these patients.
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