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American Journal of Epidemiology Vol. 153, No. 3 : 292-298
Copyright © 2001 by The Johns Hopkins University School of Hygiene and Public Health


ORIGINAL CONTRIBUTIONS

High Plasma Nonesterified Fatty Acids Are Predictive of Cancer Mortality but Not of Coronary Heart Disease Mortality: Results from the Paris Prospective Study

Marie Aline Charles1, Annick Fontbonne1, Nadine Thibult1, Jean-Roger Claude2, Jean-Michel Warnet3, Gabriel Rosselin4, Pierre Ducimetière1 and Eveline Eschwège1

1 Institut National de la Santé et de la Recherche Médicale (INSERM), Unit 258, Villejuif, France.
2 Laboratoire de Toxicologie, Faculté des Sciences Pharmaceutiques, Paris, France.
3 Pharmacie, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, France.
4 Institut National de la Santé et de la Recherche Médicale (INSERM), Unit 55, Hôpital St. Antoine, Paris, France.

To assess the association of fasting plasma nonesterified fatty acid (NEFA) concentration with the risk of death from coronary heart disease and cancer, the authors computed 15-year mortality rates for the 4,589 working men aged 43–53 years who were included in the Paris Prospective Study between 1967 and 1972. A total of 251 and 126 men died from cancer and coronary heart disease, respectively. For coronary heart disease death, the age- and tobacco-adjusted relative risk for men in the highest 20% of the fasting plasma NEFA concentrations compared with those in the lowest 80% was 1.54 (95% confidence interval (CI): 1.01, 2.34). It became nonsignificant after further adjustment for blood pressure, iliac/thigh ratio, and plasma insulin and cholesterol concentrations. In contrast, a high fasting plasma NEFA concentration exhibited a strong independent relation with cancer mortality (relative risk = 1.66, 95% CI: 1.25, 2.21, after adjustment for age, cigarette consumption, heart rate, and body mass index). Despite pathophysiologic mechanisms linking NEFA metabolism with visceral fat and plasma glucose, insulin, and triglyceride concentrations, the plasma NEFA concentration does not appear to be a good marker for coronary heart disease risk. In contrast, an unexpected association with cancer mortality was found that may point to the need for further investigation.

coronary disease; fatty acids, nonesterified; mortality; neoplasms; prospective studies

Abbreviations: CI, confidence interval; NEFA, nonesterified fatty acid.


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