Listed in Issue 229


SEKIDAWA and COLLEAGUES,  (1)Department of Epidemiology, University of Pittsburgh,  Pittsburgh, Pennsylvania, USA sought to determine whether serum concentrations of long chain n-3 polyunsaturated fatty acids (LCn3PUFAs) contribute to the difference in the incidence rate of coronary artery calcification (CAC) between Japanese men in Japan and white men in the USA.


In a population based, prospective cohort study, 214 Japanese men and 152 white men aged 40-49 years at baseline (2002-2006) with coronary calcium score (CCS)=0 were re-examined for CAC in 2007-2010. Among these, 175 Japanese men and 113 white men participated in the follow-up exam. Incident cases were defined as participants with CCS≥10 at follow-up. A relative risk regression analysis was used to model the incidence rate ratio between the Japanese and white men. The incidence rate ratio was first adjusted for potential confounders at baseline and then further adjusted for serum LCn3PUFAs at baseline.


Mean (SD) serum percentage of LCn3PUFA was >100% higher in Japanese men than in white men (9.08 (2.49) vs 3.84 (1.79), respectively, p<0.01). Japanese men had a significantly lower incidence rate of CAC compared to white men (0.9 vs 2.9/100 person-years, respectively, p<0.01). The incidence rate ratio of CAC taking follow-up time into account between Japanese and white men was 0.321 (95% CI 0.150 to 0.690; p<0.01). After adjusting for age, systolic blood pressure, low density lipoprotein cholesterol, diabetes, and other potential confounders, the ratio remained significant (0.262, 95% CI 0.094 to 0.731; p=0.01). After further adjusting for LCn3PUFAs, however, the ratio was attenuated and became non-significant (0.376, 95% CI 0.090 to 1.572; p=0.18).



LCn3PUFAs significantly contributed to the difference in the incidence of CAC between Japanese and white men.


Sekikawa A(1), Miura K, Lee S, Fujiyoshi A, Edmundowicz D, Kadowaki T, Evans RW,  Kadowaki S, Sutton-Tyrrell K, Okamura T, Bertolet M, Masaki KH, Nakamura Y, Barinas-Mitchell EJ, Willcox BJ, Kadota A, Seto TB, Maegawa H, Kuller LH, Ueshima H; ERA JUMP Study Group. Long chain n-3 polyunsaturated fatty acids and incidence rate of coronary artery  calcification in Japanese men in Japan and white men in the USA: population based prospective cohort study. Heart. Apr 2014. 100(7):569-73. doi: 10.1136/heartjnl-2013-304421. Epub Dec 18 2013. Comment in Heart. 100(7):523. Apr 2014.


Japanese have markedly higher dietary intake of long chain n-3 polyunsaturated fatty acids LCn3PUFAs compared to other populations, e.g., 1,000 mg/day in Japan versus <100 mg/day in typical Western diet including the US due to their higher intake of fish. The above research demonstrates how this significantly impacts upon the incidence of coronary artery calcification (CAC).

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