A case-cohort analysis nested within the Danish Diet, Cancer and Health cohort assessed associations between adipose tissue monounsaturated fatty acids (MUFAs) and the development of peripheral artery disease (PAD). The parent cohort included 57,053 participants, with 54,057 individuals eligible after exclusions. The stuyd was published in the Atherosclerosis.

Gluteal adipose tissue biopsies were collected from all identified PAD cases and from a randomly selected subcohort of 5,000 participants. Fatty acid composition was quantified using gas chromatography. Weighted Cox proportional hazards regression models were applied to estimate hazard ratios (HRs) for incident PAD across quintiles of MUFA content.

During a median follow-up of 20.6 years, 1,850 incident PAD cases were recorded. Higher adipose tissue levels of total MUFAs were associated with increased PAD risk when comparing the highest with the lowest quintile (HR 1.40; 95% CI 1.13–1.75). 

Among individual MUFAs, 16:1ω7 (HR 1.69; 95% CI 1.36–2.10) and 18:1ω7 (HR 2.48; 95% CI 1.95–3.16) demonstrated significant positive associations with PAD incidence. In contrast, no consistent associations were observed for 20:1ω9, 14:1ω5, 20:1ω11, and 18:1ω9. These findings indicate variability in the relationship between specific MUFAs and PAD risk.

Higher adipose tissue levels of selected MUFAs were associated with increased PAD incidence. The results suggest heterogeneity in cardiovascular risk across individual MUFAs.