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@ARTICLE{Shi:293933,
      author       = {F. Shi and R. Chowdhury and E. Sofianopoulou and A. Koulman
                      and L. Sun and M. Steur and K. Aleksandrova and C. C. Dahm
                      and M. B. Schulze and Y. T. van der Schouw and C. Agnoli and
                      P. Amiano and J. M. A. Boer and C. S. Bork and N.
                      Cabrera-Castro and F. Eichelmann and A. Elbaz and M. Farràs
                      and A. K. Heath and R. Kaaks$^*$ and V. Katzke$^*$ and P.
                      Keski-Rahkonen and G. Masala and C. Moreno-Iribas and S.
                      Panico and K. Papier and D. Petrova and J. R. Quirós and F.
                      Ricceri and G. Severi and A. Tjønneland and T. Y. N. Tong
                      and R. Tumino and N. Wareham and E. Weiderpass and E. Di
                      Angelantonio and N. Forouhi and J. Danesh and A. S.
                      Butterworth and S. Kaptoge},
      title        = {{A}ssociation of circulating fatty acids with
                      cardiovascular disease risk: {A}nalysis of individual-level
                      data in three large prospective cohorts and updated
                      meta-analysis.},
      journal      = {European journal of preventive cardiology},
      volume       = {32},
      number       = {3},
      issn         = {2047-4873},
      address      = {Oxford},
      publisher    = {Oxford University Press},
      reportid     = {DKFZ-2024-02000},
      pages        = {233-246},
      year         = {2025},
      note         = {2025 Feb 18;32(3):233-246},
      abstract     = {Associations of saturated and unsaturated fatty acids (FAs)
                      with cardiovascular disease (CVD) remain controversial. We
                      therefore aimed to investigate the prospective associations
                      of objectively measured FAs with CVD, including incident
                      coronary heart disease (CHD) and stroke, as well as CVD
                      mortality.Circulating FA concentrations expressed as the
                      percentage of total FAs were assayed in 172,891 participants
                      without prior vascular disease at baseline from the European
                      Prospective Investigation into Cancer and Nutrition-CVD
                      (EPIC-CVD) (7,343 CHD; 6,499 stroke), UK Biobank (1,825;
                      1,474), and INTERVAL (285; 209) cohort studies. Hazard ratio
                      (HR) per 1-standard deviation (SD) higher FA concentrations
                      was estimated using Cox regression models and pooled by
                      random-effects meta-analysis. Systematic reviews with
                      meta-analysis published by 6 May 2023 on associations
                      between FAs and CVDs were systematically searched and
                      updated meta-analyses using random-effects model were
                      conducted. Evidence from randomized controlled trials (RCTs)
                      was also summarized.Higher concentrations of total saturated
                      FAs (SFAs) were associated with higher cardiovascular risks
                      in the combined analysis, with differential findings noted
                      for SFA subtypes in further analysis restricted to EPIC-CVD:
                      positive associations for even-chain SFA [HR for CHD 1.24
                      $(95\%$ CI: 1.18-1.32); stroke 1.23 (1.10-1.38)] and
                      negative associations for odd-chain [0.82 (0.76-0.87); 0.73
                      (0.67-0.78)] and longer-chain [0.95 (0.80-1.12); 0.84
                      (0.72-0.99)] SFA. In the combined analysis, total n-3
                      polyunsaturated FA (PUFA) [0.91 (0.85-0.97)], including
                      docosahexaenoic acid (DHA) [0.91 (0.84-0.98)], was
                      negatively associated with incident CHD risk. Similarly,
                      total n-6 PUFA [0.94 (0.91-0.98)], including linoleic acid
                      (LA) [0.89 (0.83-0.95)], was negatively associated with
                      incident stroke risk. By contrast, more detailed analyses in
                      EPIC-CVD revealed that several downstream n-6 PUFAs of LA
                      were positively associated with CHD risk. Updated
                      meta-analyses of 37 FAs including 49 non-overlapping
                      studies, involving between 7,787 to 22,802 CHD and 6,499 to
                      14,221 stroke cases, showed broadly similar results as our
                      combined empirical analysis and further suggested
                      significant inverse associations of individual long-chain
                      n-3 PUFAs and LA on both CHD and stroke. The findings of
                      long-chain n-3 PUFAs were consistent with those from
                      published RCTs on CHD despite insufficient evidence in
                      monotherapy, while RCT evidence remained unclear for the
                      rest of the explored FAs.Our study provides an overview of
                      the most recent evidence on the associations between
                      objectively measured FAs and CVD outcomes. Collectively, the
                      data reveals notable differences in associations by SFA
                      subtypes and calls for further studies, especially RCTs, to
                      explore these links.},
      cin          = {C020},
      ddc          = {610},
      cid          = {I:(DE-He78)C020-20160331},
      pnm          = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
      pid          = {G:(DE-HGF)POF4-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:39365172},
      doi          = {10.1093/eurjpc/zwae315},
      url          = {https://inrepo02.dkfz.de/record/293933},
}