Content of Omega-3 Fatty Acids in Adipose Tissue Tied to AF Risk

Statins, or generic pills, pouring from a bottle. Close up with shallow depth of field
docosahexaenoic acid affected the risk for incident atrial fibrillation.

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.

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