High plasma nonesterified fatty acids are predictive of cancer mortality but not of coronary heart disease mortality: Results from the Paris prospective study

To assess the association of fasting plasma nonesterified fatty acid (NEFA) concentration with the risk of death from coronary heart disease and cance r, the authors computed 15-year mortality rates for the 4,589 working men a ged 43-53 years who were included in the Paris Prospective Study between 19 67 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 toba cco-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% co nfidence interval (CI): 1.01, 2.34), It became nonsignificant after further adjustment for blood pressure, iliac/thigh ratio, and plasma insulin and c holesterol concentrations. In contrast, a high fasting plasma NEFA concentr ation exhibited a strong independent relation with cancer mortality (relati ve risk = 1.66, 95% CI: 1.25, 2.21, after adjustment for age, cigarette con sumption, heart rate, and body mass index). Despite pathophysiologic mechan isms linking NEFA metabolism with visceral fat and plasma glucose, insulin, and triglyceride concentrations, the plasma NEFA concentration does not ap pear to be a good marker for coronary heart disease risk. In contrast, an u nexpected association with cancer mortality was found that may point to the need for further investigation.