Dietary n-3 alpha-linolenic and n-6 linoleic acids modestly lower serum lipoprotein(a) concentration but differentially influence other atherogenic lipoprotein traits: A randomized trial

Petrus Nuotio; Maria A Lankinen; Topi Meuronen; Vanessa D de Mello; Taisa Sallinen; Kirsi A Virtanen; Jussi Pihlajamäki; Markku Laakso; Ursula Schwab

doi:10.1016/j.atherosclerosis.2024.117562

Dietary n-3 alpha-linolenic and n-6 linoleic acids modestly lower serum lipoprotein(a) concentration but differentially influence other atherogenic lipoprotein traits: A randomized trial

Atherosclerosis. 2024 Apr 23:117562. doi: 10.1016/j.atherosclerosis.2024.117562. Online ahead of print.

Authors

Petrus Nuotio¹, Maria A Lankinen², Topi Meuronen³, Vanessa D de Mello², Taisa Sallinen², Kirsi A Virtanen⁴, Jussi Pihlajamäki⁵, Markku Laakso⁶, Ursula Schwab⁵

Affiliations

¹ Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, 70211, Kuopio, Finland. Electronic address: petrus.nuotio@uef.fi.
² Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, 70211, Kuopio, Finland.
³ Food Sciences Unit, Department of Life Technologies, Faculty of Technology, University of Turku, 20500, Turku, Finland.
⁴ Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, 70211, Kuopio, Finland; Department of Medicine, Endocrinology and Clinical Nutrition, Kuopio University Hospital, 70029, Kuopio, Finland; Turku PET Centre, University of Turku, 20520, Turku, Finland.
⁵ Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, 70211, Kuopio, Finland; Department of Medicine, Endocrinology and Clinical Nutrition, Kuopio University Hospital, 70029, Kuopio, Finland.
⁶ Institute of Clinical Medicine, Internal Medicine, University of Eastern Finland, 70029, Kuopio, Finland; Kuopio University Hospital, Kuopio, Finland.

PMID: 38714425
DOI: 10.1016/j.atherosclerosis.2024.117562

Abstract

Background and aims: Lipoprotein(a) [Lp(a)] is a causal, genetically determined cardiovascular risk factor. Limited evidence suggests that dietary unsaturated fat may increase serum Lp(a) concentration by 10-15 %. Linoleic acid may increase Lp(a) concentration through its endogenous conversion to arachidonic acid, a process regulated by the fatty acid desaturase (FADS) gene cluster. We aimed to compare the Lp(a) and other lipoprotein trait-modulating effects of dietary alpha-linolenic (ALA) and linoleic acids (LA). Additionally, we examined whether FADS1 rs174550 genotype modifies Lp(a) responses.

Methods: A genotype-based randomized trial was performed in 118 men homozygous for FADS1 rs174550 SNP (TT or CC). After a 4-week run-in period, the participants were randomized to 8-week intervention diets enriched with either Camelina sativa oil (ALA diet) or sunflower oil (LA diet) 30-50 mL/day based on their BMI. Serum lipid profile was measured at baseline and at the end of the intervention.

Results: ALA diet lowered serum Lp(a) concentration by 7.3 % (p = 0.003) and LA diet by 9.5 % (p < 0.001) (p = 0.089 for between-diet difference). Both diets led to greater absolute decreases in individuals with higher baseline Lp(a) concentration (p < 0.001). Concentrations of LDL cholesterol (LDL-C), non-HDL-C, remnant-C, and apolipoprotein B were lowered more by the ALA diet (p < 0.01). Lipid or lipoprotein responses were not modified by the FADS1 rs174550 genotype.

Conclusions: A considerable increase in either dietary ALA or LA from vegetable oils has a similar Lp(a)-lowering effect, whereas ALA may lower other major atherogenic lipids and lipoproteins to a greater extent than LA. Genetic differences in endogenous PUFA conversion may not influence serum Lp(a) concentration.

Keywords: Diet; Dietary fat; Human; Lp(a); Polyunsaturated fatty acids.