European Journal of Nutrition

, Volume 56, Issue 1, pp 261–272 | Cite as

Associations between intake of fish and n-3 long-chain polyunsaturated fatty acids and plasma metabolites related to the kynurenine pathway in patients with coronary artery disease

  • Therese Karlsson
  • Elin Strand
  • Jutta Dierkes
  • Christian A. Drevon
  • Jannike Øyen
  • Øivind Midttun
  • Per M. Ueland
  • Oddrun A. Gudbrandsen
  • Eva Ringdal Pedersen
  • Ottar Nygård
Original Contribution



Enhanced tryptophan degradation via the kynurenine pathway has been related to several pathological conditions. However, little is known about the effect of diet on individual metabolites of this pathway. We investigated cross-sectional associations between reported intake of fish and omega-3 (n-3) long-chain PUFA (LC-PUFA) and plasma metabolites related to the kynurenine pathway.


Participants were 2324 individuals with coronary artery disease from the Western Norway B Vitamin Intervention Trial. Fish and n-3 LC-PUFA intakes were assessed using a food frequency questionnaire. Plasma concentrations of tryptophan, kynurenine, kynurenic acid, anthranilic acid, 3-hydroxykynurenine, xanthurenic acid, 3-hydroxyanthranilic acid, neopterin, and kynurenine-to-tryptophan ratio (KTR) were analyzed. Associations were investigated using partial Spearman’s rank correlations and multiple linear regressions.


Median age at inclusion was 62 years (80 % males), and 84 % had stable angina pectoris. Intake of fatty fish and n-3 LC-PUFA was inversely associated with plasma 3-hydroxykynurenine. Consumption of total fish, lean fish, and n-3 LC-PUFA was inversely associated with plasma neopterin. Intake of total fish, fatty fish, and n-3 LC-PUFA was inversely associated with KTR. All these correlations were weak (ρ between −0.12 and −0.06, P < 0.01). In 306 patients with diabetes, lean fish intake was positively associated with plasma 3-hydroxyanthranilic acid (ρ = 0.22, P < 0.001, P for interaction = 0.01), and total fish intake was inversely associated with KTR (ρ = −0.17, P < 0.01, P for interaction = 0.02).


Fish intake was not an important determinant of individual metabolites in the kynurenine pathway. However, some correlations were stronger in patients with diabetes. The inverse associations of fish or n-3 LC-PUFA with neopterin and KTR may suggest a slightly lower IFN-γ-mediated immune activation with a higher intake.


Fish intake Omega-3 polyunsaturated fatty acid Neopterin Kynurenine pathway 



We wish to thank Reinhard Seifert for valuable statistical advice. This work was supported by the Norwegian Seafood Research Fund (FHF). The funder had no role in the study design, in analysis or interpretation of data, or in the writing of the manuscript.

Compliance with ethical standards

Conflict of interest

None of the authors reported a conflict of interest.

Supplementary material

394_2015_1077_MOESM1_ESM.pdf (53 kb)
Supplementary material 1 (PDF 52 kb)


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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Therese Karlsson
    • 1
  • Elin Strand
    • 1
  • Jutta Dierkes
    • 2
  • Christian A. Drevon
    • 3
  • Jannike Øyen
    • 4
  • Øivind Midttun
    • 5
  • Per M. Ueland
    • 1
    • 6
  • Oddrun A. Gudbrandsen
    • 2
  • Eva Ringdal Pedersen
    • 1
  • Ottar Nygård
    • 1
    • 7
  1. 1.Department of Clinical Science, Faculty of Medicine and DentistryUniversity of BergenBergenNorway
  2. 2.Department of Clinical Medicine, Faculty of Medicine and DentistryUniversity of BergenBergenNorway
  3. 3.Department of Nutrition, Institute of Basic Medical Sciences, Faculty of MedicineUniversity of OsloOsloNorway
  4. 4.National Institute of Nutrition and Seafood ResearchBergenNorway
  5. 5.Bevital ASBergenNorway
  6. 6.Laboratory of Clinical BiochemistryHaukeland University HospitalBergenNorway
  7. 7.Department of Heart DiseaseHaukeland University HospitalBergenNorway

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