J Clin Endocrinol Metab. 2023 Sep 21. pii: dgad561. [Epub ahead of print]
BACKGROUND: Limited studies have shown a protective effect of very long chain saturated fatty acids (VLSFAs) on healthy aging, diabetes, heart failure and risk factors related to cardiovascular disease (CVD), but the role of VLSFAs on mortality risk is unclear. We aimed to investigate the association of serum docosanoic acid (C22:0) and serum lignoceric acid (C24:0) with all-cause and disease-specific mortality and to confirm the effect of VLSFAs on mortality risk in the whole, hyperlipidemia and hypertensive populations.METHODS: A total of 4132 individuals from the 2015-2016 National Health and Nutrition Examination Survey (NHANES) were included in this study. There were 1326 and 1456 participants in the hyperlipidemia and hypertensive population, respectively. Mortality information was confirmed using the National Death Index (NDI). Multiple model calibration was performed using COX regression analysis for known risk factors to explore the association between circulating VLSFAs and all-cause or CVD or coronary heart disease (CHD) mortality.
RESULTS: In the whole population, individuals with higher circulating C22:0 and C24:0 as a percentage of total serum fatty acid levels reduced the risks of mortality of all-cause (C22:0: HR = 0.409, 95%CI = 0.271-0.618; C24:0: HR = 0.430, 95%CI = 0.283-0.651), CVD (C22:0: HR = 0.286, 95%CI = 0.134-0.612; C24:0: HR = 0.233, 95%CI = 0.101-0.538) and CHD (C22:0: HR = 0.401, 95%CI = 0.187-0.913; C24:0: HR = 0.263, 95%CI = 0.082-0.846). Similar to the whole population, individuals with higher circulating C22:0 and C24:0 as a percentage of total serum fatty acid levels in the hyperlipidemia and hypertensive populations were also protective for all-cause, CHD and CVD mortality.
CONCLUSION: Our results confirm the protective effect of high levels of circulating VLSFAs (C22:0 and C24:0) on CVD, CHD and all-cause of death in the whole, hyperlipidemia and hypertensive populations.
Keywords: All-cause Mortality; Cardiovascular Mortality; Coronary Heart Mortality; Hyperlipidemia Population; Hypertensive Population; Very Long Chain Saturated Fatty Acids