The Change in Low-Density Lipoprotein Cholesterol Concentration is Positively Related to Plasma Docosahexaenoic Acid but not Eicosapentaenoic Acid

Aim: The Japan EPA Lipid Intervention Study (JELIS) reported a 19% reduction of the risk for coronary artery disease after long-term use of pure eicosapentaenoic acid (EPA) in Japanese patients with hypercholesterolemia. The variation in plasma fatty acid composition influenced the risk of coronary events. The aim of this study was to examine in JELIS participants the possible correlation of changes in plasma fatty acids with those of serum lipids. Methods: The coefficient for the correlation between the absolute change in plasma fatty acid concentrations and the changes in serum lipids was calculated in 13,901 JELIS participants. Results: Low-density lipoprotein (LDL) cholesterol exhibited a positive correlation with docosahexaenoic acid (DHA; r = 0.117 in control group, r = 0.155 in EPA group) and linoleic acid (r = 0.139 in control group, r = 0.177 in EPA group), but the correlation coefficients with EPA (r = 0.097 in control group, r = -0.032 in EPA group) were less than 0.1. We distributed the patients into 9 groups according to tertiles of the change in EPA and DHA. The average absolute decrease of LDL cholesterol and L/H ratio in each group was significantly smaller (p<0.001) in the DHA-high tertile, but not in any EPA tertile. Conclusion: The changes in DHA, but not in EPA, showed a positive correlation with the changes in LDL-cholesterol.