METHODS: This study assembled a community-based prospective cohort, comprising 1833 participants (60.6 ± 10.5 yrs, 44.5% women) who underwent a comprehensive evaluation of
fatty acids in blood using gas chromatography. None of the subjects had a history of CVD at the time of recruitment.
RESULTS: A total of 568 individuals died and 275 individuals developed CVD during the follow-up period (median of 9.6 years; interquartile range of 8.9-10.5 years). Following adjustment for established cardiovascular risk factors, the relative risk of all-cause death in the highest quartile, compared with the lowest quartile, was 1.33 for saturated
fats (95% confidence interval [CI], 1.01-1.75, test for trend, P = 0.015), 1.71 for trans
fats (95% CI, 1.27-2.31, test for trend, P = 0.0003), 0.77 for EPA (95% CI, 0.59-1.00, test for trend, P = 0.048), and 0.89 for DHA (95% CI, 0.68-1.18, test for trend, P = 0.354). Similar patterns were observed for CVD events. Trans
fats presented the largest area under the receiver operator characteristic curve (0.740, 95% CI, 0.716-0.766) for the prediction of all-cause death. A mutually adjusted two-marker model indicated that saturated
fats and trans
fats were significant predictors of all-cause death and CVD; however, the other
fatty acids were not. In addition, trans
fats presented the greatest improvement in net reclassification for all-cause death (7.7%, P = 0.003), followed by EPA (3.8%, P = 0.033). Saturated
fats presented the greatest improvement in net reclassification for CVD events (5.6%, P = 0.039).
CONCLUSIONS: