Abstract P175: Total Fasting and Post-Load and Individual Fasting Non-Esterified Fatty Acids and Total and Cause-Specific Mortality: The Cardiovascular Health Study

Background: Total fasting non-esterified fatty acid (NEFA) levels have been associated with total and cause-specific mortality in older adults, but the corresponding associations with NEFA levels following the metabolic challenge of an oral glucose tolerance test (OGTT) and with individual fasting NEFA species have not been quantified Methods: We studied 1996 participants from the Cardiovascular Health Study with a mean age of 78 years who had total serum NEFA measured enzymatically before and two hours after an OGTT and fasting individual NEFA measured using gas chromatography in samples collected in 1996-1997. 1678 participants died over a median follow-up of 11 years. Multivariable Cox proportional hazard models were used to evaluate adjusted hazard ratios (aHR) for mortality associated with standard deviation increments of fasting and post-load total NEFA and fasting individual and subclasses (saturated, monounsaturated, n-3 and n-6 polyunsaturated, and trans) Results: Fasting NEFA were associated with an increased risk of all-cause mortality (aHR 1.17, 95% CI 1.10 - 1.23). In contrast, levels of post-load NEFA were not associated with mortality (aHR 0.98, 95% CI 0.93 - 1.03). Among NEFA subclasses, only monounsaturated fatty acid (MUFA) were associated with total mortality (aHR 1.24, 95% CI 1.09 - 1.41). In cause-specific analyses, MUFA were associated with higher risk of death from dementia, cardiovascular, respiratory, infectious and kidney disease. For individual NEFAs, nervonic acid (aHR 1.06, 95% CI 1.01 - 1.12) and petroselaidic acid (aHR 1.21, 95% CI 1.03 - 1.42) were associated with higher risk of all-cause mortality whereas eicosapentaenoic acid (aHR 0.90, 95% CI 0.82 - 0.99) was associated with lower risk Conclusion: Among community-dwelling older adults, total fasting but not post-load NEFA were associated with higher risk of death. Among subclasses and individual species, MUFA, nervonic, and petroselaidic acids were associated with higher risk, and eicosapentanoic acid with lower risk, of mortality.