Plasma fatty acids may lower vascular disease and mortality risk in T2D

  • Harris K & al.
  • Diabetologia
  • 8 May 2020

  • curated by Sarfaroj Khan
  • UK Clinical Digest
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Takeaway

  • In patients with type 2 diabetes (T2D), plasma n-3 fatty acids were associated with a reduction in the risk of macrovascular disease and mortality.
  • Docosahexaenoic acid (DHA) was associated with a lower risk of macrovascular disease.

Why this matters

  • Findings support the cardioprotective effects of plasma n-3 fatty acids and DHA, and further merit evaluating the role of high-dose supplementation with n-3 fatty acids in patients with T2D.

Study design

  • This biomarker case-cohort study included 3576 patients with T2D who participated in the ADVANCE study.
  • Primary outcomes: major macrovascular (composite of cardiovascular (CV) death, non-fatal myocardial infarction, and stroke) and microvascular (composite of new or worsening nephropathy or retinopathy) events and mortality.
  • Funding: The Chest Heart and Stroke Association Scotland and others.

Key results

  • 654 macrovascular events, 341 microvascular events, and 631 deaths were reported during a median follow-up of 5 years.
  • After adjustment for traditional cardiovascular risk factors, plasma n-3 fatty acids were associated with a lower risk of macrovascular events (HR, 0.87 [95% CI, 0.80-0.95] per 1 standard deviation [SD] higher percentage) and mortality (HR, 0.91 [95% CI, 0.84-0.99] per 1 SD higher percentage).
  • DHA was linked to a lower risk of macrovascular events (HR, 0.88 [95% CI, 0.81-0.96] per 1 SD higher percentage).
  • Plasma n-3 fatty acids and DHA were associated with a lower risk of:
    • CV death (HR, 0.85 [95% CI, 0.75-0.96] and HR, 0.86 [95% CI, 0.76-0.98] per 1 SD higher percentage, respectively); and
    • non-fatal stroke (HR, 0.82 [95% CI, 0.69-0.97] and HR, 0.82 [95% CI, 0.69-0.97] per 1 SD higher percentage, respectively).
  • No statistically significant associations were observed between any fatty acids and microvascular events.

Limitations

  • Results may have limited generalisability.
  • Risk of bias.