Carotid and femoral plaque burden is inversely associated with the α-linolenic acid proportion of serum phospholipids in Spanish subjects with primary dyslipidemia.

Objective: α-Linolenic acid (ALA), the vegetable n-3 fatty acid, appears to have antiatherosclerotic properties akin to those of marine n-3 fatty acids. A prior study in a US population with low fish intake showed an inverse association between ALA intake and carotid plaque. We examined the association between the ALA status and advanced carotid and femoral atherosclerosis in subjects at high cardiovascular disease risk from Spain, a country with low coronary heart disease (CHD) rates and high fish consumption.

Methods: Cross-sectional study of 211 patients with primary dyslipidemia, with determination of fatty acid composition of serum phosphatidylcholine by gas chromatography and plaque outcomes (frequency, number, maximum height and sum of plaque heights) in carotid and femoral arteries by sonography.

Results: In multivariate regression analyses after adjusting for age, gender, lipid genotype, BMI, smoking, hypertension, diabetes mellitus, APOE4 genotype, prior statin treatment, and serum proportions of other unsaturated fatty acids known to relate to atherosclerosis, the proportion of ALA showed an inverse association with the risk of carotid plaque (OR [95% CI] 0.66 [0.44-0.91]) and concomitant carotid and femoral artery plaque (0.57 [0.38-0.86]).

Conclusion: The inverse relationship between ALA in serum phosphatidylcholine and plaque burden in carotid and femoral arteries supports its antiatherosclerotic effect independently of fish-derived n-3 fatty acids. However, whether ALA enrichment in phospholipids is beneficial per se or is a surrogate of the consumption of bioactive compounds in parent foods deserves further research.