Adipose tissue content of monounsaturated fatty acids and the risk of myocardial infarction: a Danish case-cohort study

Introduction Guidelines for prevention of cardiovascular disease (CVD) recommend dietary replacement of saturated fatty acids with polyunsaturated fatty acids or monounsaturated fatty acids (MUFAs). However, recent studies have shown conflicting results regarding the role of MUFAs for the development of CVD. Purpose We aimed to investigate the association between the content of MUFAs in adipose tissue – a biomarker of endogenous exposure - and the risk of incident myocardial infarction (MI). Methods We used a case-cohort design. Between 1993 and 1997, a total of 57,053 participants aged 50-65 years were enrolled into the Danish Diet, Cancer and Health Cohort. Gluteal adipose tissue biopsies were collected at baseline and analysed for fatty acid composition in a random sample of approximately 5,000 participants and in all cases of MI identified through nationwide registries. Statistical analyses were performed using weighted Cox proportional hazard regression with age as underlying time scale allowing for separate baseline hazards among men and women with adjustment for established risk factors. Results A total of 3,478 incident MI cases were identified during a median of 19.1 years of follow-up. In multivariate analyses, no clear pattern of association was observed between adipose tissue content of total MUFAs and the risk of MI (Table 1). Thus, comparing the highest to the lowest quintile of MUFAs in adipose tissue, the hazard ratio of MI was 1.07 (95% CI: 0.90, 1.26). Conclusion The content of total MUFAs in adipose tissue was not associated with the risk of MI. Our findings do not support a beneficial role of MUFAs on the risk of MI.