Marine n-3 Fatty Acids and Prevention of Cardiovascular Disease and Cancer.
Marine n-3 Fatty Acids and Prevention of Cardiovascular Disease and Cancer.
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海洋N-3脂肪酸和心血管疾病和癌症的预防。
DOI：
10.1056/nejmoa1811403
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发表时间：
2019-01-03
期刊：
影响因子：
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通讯作者：
VITAL Research Group
中科院分区：
文献类型：
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作者：
Manson JE;Cook NR;Lee IM;Christen W;Bassuk SS;Mora S;Gibson H;Albert CM;Gordon D;Copeland T;D'Agostino D;Friedenberg G;Ridge C;Bubes V;Giovannucci EL;Willett WC;Buring JE;VITAL Research Group
补充omega-3脂肪酸是否能降低心血管疾病或癌症的风险仍不清楚。维生素D和OmegA-3试验（VITAL）是一项随机、安慰剂对照、2X2析因试验，研究维生素D3（2000 IU/天）和海洋omega-3脂肪酸（1 g/天）在25，871名年龄≥50岁的美国男性和年龄>55岁的女性（包括5，106名非洲裔美国人）中对心血管疾病和癌症的一级预防作用。主要终点为主要心血管事件（心肌梗死、卒中和心血管死亡率）和总浸润性癌症。次要结局包括心血管复合终点的单个组分、复合终点加冠状动脉血运重建、部位特异性癌症和癌症死亡率。本文报道了omega-3和安慰剂的结果。在中位数为5.3年的时间里，omega-3和安慰剂组之间的主要结局率没有差异- 805名参与者发生了重大心血管事件，风险比[HR]= 0.92; 95%置信区间[CI]，0.80-1.06，p= 0.24。1，617名参与者被诊断出浸润性癌症，HR 1.03（0.93-1.13，p=0.56）。在关键次要终点分析中，比较omega-3与安慰剂的风险比和95% CI为：扩展心血管事件，HR 0.93（0.82-1.04）;总心肌梗死HR 0.72（0.59-0.90）;总卒中，HR 1.04（0.83-1.31）;心血管死亡率HR 0.96（0.76-1.21）;和癌症死亡（n=341，HR 0.97（0.79-1.20）。对于全因死亡（n=978），HR为1.02（0.90-1.15）。未观察到出血或其他严重不良事件的过度风险。补充Omega-3脂肪酸并不能降低主要心血管事件或癌症发病率。
Whether omega-3 fatty acid supplementation reduces risk of cardiovascular disease or cancer remains unclear. The VITamin D and OmegA-3Trial (VITAL) was a randomized, placebo-controlled, 2X2 factorial trial of vitamin D3 (2000IU/day) and marine omega-3 fatty acids (1 g/day) in the primary prevention of cardiovascular disease and cancer among 25,871 U.S. men aged ≥50 and women aged >55, including 5,106 African Americans. Primary endpoints were major cardiovascular events (myocardial infarction, stroke, and cardiovascular mortality) and total invasive cancer. Secondary outcomes included individual components of the cardiovascular composite, the composite plus coronary revascularization, site-specific cancers, and cancer mortality. This paper reports the results of omega-3 and placebo. During a median 5.3 years, rates of the primary outcomes did not differ between the omega-3 and placebo groups -- 805 participants had a major cardiovascular event, hazard ratio [HR]= 0.92; 95% confidence interval [CI], 0.80–1.06, p= 0.24. Invasive cancer was diagnosed in 1,617 participants, HR 1.03 (0.93-1.13, p=0.56). In the analysis of key secondary endpoints, hazard ratios and 95% CIs comparing omega-3 to placebo were: expanded cardiovascular events, HR 0.93 (0.82-1.04); total myocardial infarction HR 0.72 (0.59-0.90); total stroke, HR 1.04 (0.83-1.31); cardiovascular mortality HR 0.96 (0.76-1.21); and cancer deaths (n=341, HR 0.97 (0.79-1.20). For all-cause mortality (n=978), the HR was 1.02 (0.90-1.15). No excess risks of bleeding or other serious adverse events were observed. Omega-3 fatty acid supplementation did not reduce major cardiovascular events or cancer incidence.