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Association of subclinical atherosclerosis with lipoprotein particles, alcohol consumption, and long-chain n-3 polyunsaturated fatty acids among healthy middle-aged men in an international population-based study

Mahajan, Hemant (2018) Association of subclinical atherosclerosis with lipoprotein particles, alcohol consumption, and long-chain n-3 polyunsaturated fatty acids among healthy middle-aged men in an international population-based study. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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Abstract

This dissertation includes three manuscripts examining the determinants of subclinical atherosclerosis among asymptomatic middle-aged men from four races/ethnicities. The present study sought to examine: 1) Do differences in the distribution of NMR-measured lipoproteins account for differences in the prevalence of coronary artery calcification (CAC) between Caucasians residing in the US (US White) and Japanese residing in Japan? 2) Is alcohol consumption associated with aortic calcification among middle-aged men? and 3) Are serum levels long-chain n-3 polyunsaturated fatty acids (LCn-3PUFAs) inversely related to aortic calcification among middle-aged men? We examined the proposed research questions using data from the Electron-Beam Tomography, Risk Factor Assessment among Japanese and U.S. Men in Post-World War II Birth Cohort (ERA-JUMP) study.
The major findings were: 1) in a population-based sample of 570 middle-aged men, US White compared to Japanese had significantly different NMR-measured lipoprotein particle distributions. The US White had significantly higher prevalence of CAC ≥10 compared to Japanese after adjustment for cardiovascular risk factors [Odds ratio = 3.25; 95% CI= 1.55, 6.84], and this difference was partially attenuated with further adjustment for lipoprotein levels [Odds ratio = 2.58; 95% CI= 1.16, 5.77]. In a multiethnic population-based study of 1033 asymptomatic men aged 40-49 years, after adjusting for cardiovascular risk factors and patential confounders: 2) the heavy drinkers had significantly higher expected aortic calcification score compared to nondrinkers [Tobit ratio (95% CI) = 2.15 (1.01, 4.57); Odds ratio (95% CI) =1.60 (1.07, 2.41)]; and 3) one standard deviation increase in total LCn-3PUFAs (3.3%), EPA (1.3%), and DHA (2.1%) (using Tobit regression) was associated with 29% (95% CI = 0.51, 1.00), 9% (95% CI = 0.68, 1.23), and 35% (95% CI = 0.46, 0.91) lower expected aortic calcification score respectively.
Adequately powered longitudinal studies are warranted: 1) to systematically examine the specific reasons for lower subclinical atherosclerosis among Japanese compared to western countries; 2) to further clarify the association between alcohol consumption and the incidence and the progression of atherosclerosis; and 3) to disentangle the differential effect of EPA and DHA on atherosclerosis, and the underlying biological mechanisms. From the public health importance, current study findings extend our understanding of NMR-measured lipoproteins, alcohol consumption, and LCn-3PUFAs related to subclinical atherosclerosis.


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Details

Item Type: University of Pittsburgh ETD
Status: Unpublished
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Mahajan, Hemanthdm12@pitt.eduhdm12
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Sekikawa, Akiraakira@pitt.eduakira
Chang, Joycechangjh@upmc.educhangjh
Miljkovic, Ivaivm1@pitt.eduivm1
Costacou, TinaCostacouT@edc.pitt.eduCostacouT
Songer, Thomastjs@pitt.edutjs
Date: 30 January 2018
Date Type: Publication
Defense Date: 1 December 2017
Approval Date: 30 January 2018
Submission Date: 24 November 2017
Access Restriction: 5 year -- Restrict access to University of Pittsburgh for a period of 5 years.
Number of Pages: 202
Institution: University of Pittsburgh
Schools and Programs: Graduate School of Public Health > Epidemiology
Degree: DrPH - Doctor of Public Health
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: alcohol, aorta, calcification, coronary, LC n-3 PUFA, lipoprotein, NMR,
Date Deposited: 30 Jan 2018 22:52
Last Modified: 30 Jan 2018 22:52
URI: http://d-scholarship.pitt.edu/id/eprint/33414

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