scholarly journals Marine n-3 Polyunsaturated Fatty Acids and the Risk of Ischemic Stroke

Stroke ◽  
2019 ◽  
Vol 50 (2) ◽  
pp. 274-282 ◽  
Author(s):  
Stine K. Venø ◽  
Christian S. Bork ◽  
Marianne U. Jakobsen ◽  
Søren Lundbye-Christensen ◽  
Peter L. McLennan ◽  
...  

Background and Purpose— We hypothesized that total marine n-3 polyunsaturated fatty acids (PUFA), in particular eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) in the diet and in adipose tissue (biomarkers of long-term intake and endogenous exposure) were inversely associated with the risk of ischemic stroke and its subtypes. Methods— The Diet, Cancer and Health cohort consisted of 57 053 participants aged 50 to 65 years at enrolment. All participants filled in a food frequency questionnaire and had an adipose tissue biopsy taken at baseline. Information on ischemic stroke during follow-up was obtained from The Danish National Patient Register, and all cases were validated. Cases and a random sample of 3203 subjects from the whole cohort had their fatty acid composition of adipose tissue determined by gas chromatography. Results— During 13.5 years of follow-up 1879 participants developed an ischemic stroke. Adipose tissue content of EPA was inversely associated with total ischemic stroke (hazard ratio [HR], 0.74; 95% CI, 0.62–0.88) when comparing the highest with the lowest quartile. Also, lower rates of large artery atherosclerosis were seen with higher intakes of total marine n-3 PUFA (HR, 0.69; 95% CI, 0.50–0.95), EPA (HR, 0.66; 95% CI, 0.48–0.91) and DHA (HR, 0.72; 95% CI, 0.53–0.99), and higher adipose tissue content of EPA (HR, 0.52; 95% CI, 0.36–0.76). Higher rates of cardioembolism were seen with higher intakes of total marine n-3 PUFA (HR, 2.50; 95% CI, 1.38–4.53) and DHA (HR, 2.12; 95% CI, 1.21–3.69) as well as with higher adipose tissue content of total marine n-3 PUFA (HR, 2.63; 95% CI, 1.33–5.19) and DHA (HR, 2.00; 95% CI, 1.04–3.84). The EPA content in adipose tissue was inversely associated with small-vessel occlusion (HR, 0.69; 95% CI, 0.55–0.88). Conclusions— EPA was associated with lower risks of most types of ischemic stroke, apart from cardioembolism, while inconsistent findings were observed for total marine n-3 PUFA and DHA.

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Yasuhisa Akaiwa ◽  
Hiroki Takano ◽  
Hiroyuki Arakawa ◽  
Itaru Ninomiya ◽  
Masahiro Uemura ◽  
...  

Background: : Intake of omega-3 polyunsaturated fatty acids, such as EPA, has been reported to have protective effects on various diseases including ischemic stroke. However, there have been few studies concerning the effect of omega-3 polyunsaturated fatty acids on hemorrhagic stroke. We studied associations of serum levels of EPA with stroke subtypes including primary ICH Methods: We have examined serum EPA and arachidonic acid (AA) levels in routine practice since 2009. To calibrate the EPA values, we calculated EPA/AA ratio. A total of 212 consecutive acute stroke patients and 27 control subjects were included. The patients 40 years old or younger were excluded. Ischemic stroke subtypes were determined based on TOAST criteria. Primary ICH was classified into lobar or nonlobar types, according to the region of the brain in which it occurred. Results: Of all the 157 ischemic stroke patients (female 47, mean age 72.9 years), 62 were classified with cardioembolic stroke (CES), 25 large-artery atherosclerotic (LAA), 22 small-vessel disease (SVD), and 48 other/undetermined causes (O/U). Of all the 55 ICH patients (female 23, mean age 71.0), 34 patients had nonlobar type, and 21 had lobar one. There were no significant intergroup differences in the mean EPA/AA ratio (p=0.525) among CES (EPA/AA= 0.67±0.42), LAA (0.70±0.30), SVD (0.65±0.45), O/U (0.62±0.38), nonlobar ICH (0.51±0.30), lobar ICH (0.64±0.33), and control (0.60±0.42) groups. However, the EPA/AA ratio of the nonlobar ICH group was considerably low. The EPA/AA ratio of the nonlobar ICH group was significantly (p=0.033) lower than that of the whole other groups (0.65±0.39) and significantly (p=0.003) lower than that of the entire ischemic stroke groups (0.67±0.40). Although the significant differences between the nonlobar ICH and the whole ischemic groups were also observed in systolic and diastolic blood pressure (195±37/107±25 mmHg vs 159±35/82±19 mmHg, p<0.001), multiple linear regression analyses showed the association between the EPA/AA and nonlobar ICH was independent from the blood pressure. Conclusions: Although the strongest risk factor for nonlobar ICH is hypertension, low EPA/AA ratio might play a role in the development of nonlobar ICH.


2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Bahram Hashemi ◽  
Erik Berg Schmidt ◽  
My Svensson ◽  
Søren Lundbye-Christensen ◽  
Christian Bork ◽  
...  

Abstract Background Chronic kidney disease (CKD) is associated with life style diseases such as hypertension and type 2 diabetes. However the role of diet is not yet clearly defined for development of CKD. Recent studies have shown that n-3 polyunsaturated fatty acids (PUFAs) may exert favourable effects on several processes that may inhibit the development and progression of CKD. A gold standard biomarker for long-term intake and metabolism of n-3 PUFAs, is their content in adipose tissue; because these fatty acids are essential and not endogenously produced. Aims The primary aim of this study is to investigate the association of adipose tissue content of marine and plant-based n-3 PUFAs to the risk of incident CKD. This study will also examine associations between the content of n-3 PUFAs in adipose tissue and the risk of main subtypes of CKD: Proteinuria with unknown cause, Hypertensive nephropathy, Glomerular diseases, Diabetic nephropathy and Chronic renal failure of unknown cause. Method In this case-cohort study based on data from the prospective Danish Diet, Cancer and Health cohort (DCH), information concerning diet and other lifestyle factors was obtained from 57,053 Danish men and women aged 50 to 65 years, using questionnaires and interviews. Anthropometric measurements were undertaken, and adipose tissue biopsies were taken from the buttocks of all participants at baseline. The follow-up period was from December 1993 to September 2017. The outcome CKD is defined as having a diagnosis of one of the CKDs causes in the Danish National Patient Registry (DNPR). Cases of CKD will be identified and included together with a randomly drawn subcohort, representative for all participants of the cohort. Adipose tissue samples will be analyzed by gas chromatography in all incident CKD cases and in 5,000 randomly drawn participants from the whole cohort. The outcome will be adjusted for age, sex, body mass index, physical activity, energy intake, alcohol consumption, fermented dairy products, education, smoking status, hormone replacement therapy and comorbidity. The study is approved by the Danish National Committee on Health Research Ethics (N-20180074) and the Danish Data Protection Agency (2018-139). Results No results are available yet. Conclusion Our hypothesis is that the content of total n-3 PUFAs, as well as both marine and plant-based n-3 PUFAs, in adipose tissue is inversely associated with the risk of CKD and its subtypes.


Nutrients ◽  
2018 ◽  
Vol 10 (11) ◽  
pp. 1648 ◽  
Author(s):  
Stine Venø ◽  
Christian Bork ◽  
Marianne Jakobsen ◽  
Søren Lundbye-Christensen ◽  
Flemming Bach ◽  
...  

We investigated the risk of ischemic stroke and its subtypes when red meat or poultry was substituted with fish. A total of 57,053 participants aged 50–65 years at baseline were included in the Danish Diet, Cancer and Health study. All participants filled in a food-frequency questionnaire at recruitment. Potential ischemic stroke cases were identified by linkage to the Danish National Patient Register, and all cases were validated and subclassified. Substitutions were investigated as 150 g/week of fish for 150 g/week of red meat or of poultry using multivariable Cox proportional hazard regression models. During 13.5 years of follow-up, 1879 participants developed an ischemic stroke. Replacing red meat or poultry with fish was not associated with the rate of total ischemic stroke, but there was a statistically significant lower rate of large artery atherosclerosis when fish replaced processed (hazard ratio (HR): 0.78; 95% confidence interval (CI): 0.67; 0.90) and unprocessed (HR: 0.87; 95% CI: 0.75; 0.99) red meat. A statistically significant higher rate of cardioembolism was found when poultry was replaced by total fish (HR: 1.42; 95% CI: 1.04; 1.93). When fatty fish replaced unprocessed red meat, a statistically significant lower rate of small-vessel occlusion was found (HR: 0.88; 95% CI: 0.77; 0.99). In conclusion, replacing red meat with fish was not associated with risk of total ischemic stroke but was associated with a lower risk of subtypes of ischemic stroke.


Nutrients ◽  
2019 ◽  
Vol 11 (7) ◽  
pp. 1467 ◽  
Author(s):  
Stine Krogh Venø ◽  
Erik Berg Schmidt ◽  
Christian Sørensen Bork

Ischemic stroke is a major cause of death and morbidity worldwide. It has been suggested that polyunsaturated fatty acids (PUFAs) may be associated with a lower risk ischemic stroke, but this has been far less studied than their role for coronary heart disease. In this paper, we summarize the main findings from previous follow-up studies investigating associations between intake or biomarkers of the major PUFAs including alpha-linolenic acid (ALA), marine n-3 PUFAs and linoleic acid (LA) and the development of ischemic stroke. Several follow-up studies have suggested that marine n-3 PUFAs may be associated with a lower risk of ischemic stroke although results have not been consistent and limited knowledge exist on the individual marine n-3 PUFAs and ischemic stroke and its subtypes. The role of ALA is less clear, but most studies have not supported that ALA is appreciably associated with ischemic stroke risk. Some studies have supported that LA might be associated with a lower risk of total ischemic stroke, while limited evidence exist on PUFAs and ischemic stroke subtypes. The associations may depend on the macronutrients that PUFAs replace and this substitution aspect together with focus on dietary patterns represent interesting areas for future research.


2016 ◽  
Vol 67 (8) ◽  
pp. 1008-1009 ◽  
Author(s):  
Anders Gammelmark ◽  
Michael S. Nielsen ◽  
Christian S. Bork ◽  
Søren Lundbye-Christensen ◽  
Anne Tjønneland ◽  
...  

2021 ◽  
pp. 0271678X2098239
Author(s):  
Adam E Goldman-Yassen ◽  
Matus Straka ◽  
Michael Uhouse ◽  
Seena Dehkharghani

The generalization of perfusion-based, anterior circulation large vessel occlusion selection criteria to posterior circulation stroke is not straightforward due to physiologic delay, which we posit produces physiologic prolongation of the posterior circulation perfusion time-to-maximum (Tmax). To assess normative Tmax distributions, patients undergoing CTA/CTP for suspected ischemic stroke between 1/2018-3/2019 were retrospectively identified. Subjects with any cerebrovascular stenoses, or with follow-up MRI or final clinical diagnosis of stroke were excluded. Posterior circulation anatomic variations were identified. CTP were processed in RAPID and segmented in a custom pipeline permitting manually-enforced arterial input function (AIF) and perfusion estimations constrained to pre-specified vascular territories. Seventy-one subjects (mean 64 ± 19 years) met inclusion. Median Tmax was significantly greater in the cerebellar hemispheres (right: 3.0 s, left: 2.9 s) and PCA territories (right: 2.9 s; left: 3.3 s) than in the anterior circulation (right: 2.4 s; left: 2.3 s, p < 0.001). Fetal PCA disposition eliminated ipsilateral PCA Tmax delays (p = 0.012). Median territorial Tmax was significantly lower with basilar versus any anterior circulation AIF for all vascular territories (p < 0.001). Significant baseline delays in posterior circulation Tmax are observed even without steno-occlusive disease and vary with anatomic variation and AIF selection. The potential for overestimation of at-risk volumes in the posterior circulation merits caution in future trials.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Lisha Hou ◽  
Mier Li ◽  
Ju Wang ◽  
Yawen Li ◽  
Qianwen Zheng ◽  
...  

AbstractThe relationship between exercise and stroke recurrence is controversial. This study was designed to test whether an association exists between exercise and ischemic stroke recurrence in first-ever ischemic stroke survivors. Data were collected from January 2010 to June 2016. Baseline information was obtained during face-to-face interviews, and follow-up phone interviews were conducted every 3 months. Exercise type, frequency, intensity, and duration were recorded. Discrete-time survival analysis was used to determine the relationship between exercise and stroke recurrence. 760 first-ever ischemic stroke survivors who were able to exercise were enrolled. After adjusting for covariates, patients who exercised 3.5–7 h per week and more than 7 h per week had a lower relapse risk than patients who did not exercise (3.5–7: OR 0.415; > 7: OR 0.356). Moreover, if the fluctuation of exercise duration was over 4 h, the patients had a higher risk of stroke recurrence than those with variability of less than 2 h (OR 2.153, P = 0.013). Stroke survivors who engage in long-term regular mild exercise (more than 5 sessions per week and lasting on average 40 min per session) have a lower recurrence rate. Irregular exercise increases the risk of stroke recurrence.


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