Inverse association of erythrocyte n-3 fatty acid levels with inflammatory biomarkers in patients with stable coronary artery disease: The Heart and Soul Study

Atherosclerosis. 2009 Aug;205(2):538-43. doi: 10.1016/j.atherosclerosis.2008.12.013. Epub 2008 Dec 14.


Objective: Dietary intake of polyunsaturated n-3 fatty acids has been associated with a reduced incidence of adverse cardiovascular events. The protective mechanisms involved are not fully understood, but may include anti-inflammatory factors. We sought to investigate the relationship between n-3 fatty acid levels in erythrocyte membranes and markers of systemic inflammation in 992 individuals with stable coronary artery disease.

Methods: Cross-sectional associations of C-reactive protein (CRP) and Interleukin-6 (Il-6) with docosahexaenoic acid (DHA) and eicosapentaenoic acid (EHA) were evaluated in multivariable linear regression models adjusted for demographics, cardiovascular risk factors, medication use, exercise capacity, body-mass index, and waist-to-hip ratio.

Results: After multivariable adjustment, n-3 fatty acid levels (DHA+EPA) were inversely associated with CRP and IL-6. The inverse association of n-3 fatty acids with CRP and IL-6 was not modified by demographics, body-mass index, smoking, LDL-cholesterol, or statin use (p values for interaction>0.1).

Conclusions: In patients with stable coronary artery disease, an independent and inverse association exists between n-3 fatty acid levels and inflammatory biomarkers. These findings suggest that inhibition of systemic inflammation may be a mechanism by which n-3 fatty acids prevent recurrent cardiovascular events.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Aged
  • Biomarkers
  • Body Mass Index
  • C-Reactive Protein / metabolism
  • Coronary Artery Disease / metabolism*
  • Coronary Artery Disease / prevention & control
  • Cross-Sectional Studies
  • Diet
  • Docosahexaenoic Acids / metabolism
  • Eicosapentaenoic Acid / metabolism
  • Erythrocytes / metabolism*
  • Fatty Acids, Omega-3 / metabolism*
  • Female
  • Humans
  • Inflammation
  • Male
  • Middle Aged


  • Biomarkers
  • Fatty Acids, Omega-3
  • Docosahexaenoic Acids
  • C-Reactive Protein
  • Eicosapentaenoic Acid