A low serum
tocopherol concentration and a low proportion of
linoleic acid in plasma
cholesterol esters have been reported to be associated with
coronary heart disease. This study was undertaken to evaluate the predictive importance of the serum
cholesterol ester fatty acid composition and serum
tocopherol concentration in addition to established risk factors for
myocardial infarction. The study comprised 2322 fifty-year-old men who participated in a health survey in 1970-1973 regarding risk factors for
coronary heart disease. The proportions of myristic, palmitic, palmitoleic, and
dihomogammalinolenic acid were significantly higher in 1970-1973 in subjects who suffered
myocardial infarction during the following 19 years, while the proportion of
linoleic acid was lower, than in those who remained healthy. Serum
tocopherol did not differ significantly between the groups.
LDL/HDL ratio, systolic blood pressure, and
arachidonic acid/
dihomogammalinolenic acid ratio were significant independent discriminators between cases and controls in a stepwise logistic regression analysis. This study suggests that middle-aged men who later develop a
myocardial infarction are characterized not only by conventional risk factors but also by an altered
fatty acid composition of serum
cholesterol esters, with a low arachidonic to
dihomogammalinolenic acid ratio, indicating reduced
delta 5 desaturase activity. This may imply that changes in the quality of
dietary fat intake, or an altered capacity to metabolize
fatty acids in the body, could precede the development of
coronary heart disease.