The eicosapentaenoic acid (EPA) content in adipose tissue was found to be associated with atrial fibrillation (AF) risk. These findings of a case-cohort study were published in the European Journal of Clinical Investigation.

Data from the Danish Diet, Cancer, and Health Cohort, which comprised adults (N=57,053) without cancer living in Copenhagen and Aarhus between 1993 and 1997, were analyzed for this study. Participants responded to a questionnaire about lifestyle and provided a buttock adipose tissue biopsy. Clinical outcomes through 2013 were assessed and risk for AF was compared with a randomly selected subcohort of study participants.

During the 16.9-year follow-up, 5255 cases of incident AF were recorded; 2920 cases were among men and 1821 were among women. The cohorts of men and women with AF comprised individuals who had a median age of 58.1 and 59.4 years at baseline, 22.6% and 26.8% had hypertension, and their body mass index (BMI) was 27.0 and 25.8, respectively. The subcohorts of 1728 and 1478 randomly selected men and women had a mean age of 56.3 and 56.2 years at baseline, 15.5% and 16.9% had hypertension, and their BMI was 26.4 and 24.70.1%, respectively.

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The median EPA content of adipose tissue was 0.10% (95% CI, 0.05% to 0.20%) among men and 0.09% (95% CI, 0.04% to 0.19%) among women. Stratified by quintiles of adipose EPA content, risk for AF was 45% lower among the highest quintile compared with the lowest (adjusted hazard ratio [aHR], men: 0.55, 95% CI, 0.41-0.69; women: 0.55; 95% CI, 0.41-0.72).

The median docosahexaenoic acid (DHA) content of adipose tissue was 0.25% (95% CI, 0.12% to 0.51%) among men and 0.28% (95% CI, 0.14% to 0.55%) among women. Stratified by quintiles of adipose EPA content, risk for AF was 30% lower among the highest quintile compared with the lest among women (aHR, 0.70, 95% CI, 0.54-0.91) and did not differ among men (aHR, 0.92; 95% CI, 0.74-1.14).

This study was an observational case-cohort study that did not assess causality. Additional studies are needed to evaluate the biological mechanism linking AF with adipose tissue omega-3 fatty acid content.

These data indicated there was an inverse relationship between EPA content in adipose tissue with AF risk. Women also had a similar relationship between AF and DHA.


Rix TA, Dinesen P, Lundbye-Christensen S, et al. Omega-3 fatty acids in adipose tissue and risk of atrial fibrillation. Eur J Clin Invest. 2021;e13649. doi:10.1111/eci.13649