Fish consumption and stroke risk in elderly individuals - The cardiovascular health study
Fish consumption and stroke risk in elderly individuals - The cardiovascular health study
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DOI：
10.1001/archinte.165.2.200
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发表时间：
2005-01-24
影响因子：
--
通讯作者：
Siscovick, DS
中科院分区：
文献类型：
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作者：
Mozaffarian, D;Longstreth, WT;Siscovick, DS
背景：食用鱼类与中风风险之间的关系并不一致，可能是因为食用的鱼粉种类不同。此外，这种关系尚未在老年人中进行专门评估，老年人的疾病负担可能较高，饮食影响较小。方法：对4775名65岁及以上（65-98岁）、1989-1990年无已知脑血管疾病的成年人，采用食物频率问卷对其日常膳食摄入量进行评估。在一个子集中，食用金枪鱼或其他烤鱼，但不食用炸鱼或鱼三明治（鱼汉堡），与血浆磷脂长链n-3脂肪酸水平相关。前瞻性地确定意外中风。结果：在12年的随访中，参与者经历了626次中风，其中包括529次缺血性中风。在多变量分析中，金枪鱼/其他鱼类的摄入量与总卒中（P= 0.04）和缺血性卒中（P= 0.02）呈负相关，每周摄入1至4次缺血性卒中的风险降低27%（风险比[HR]， 0.73； 95%可信区间[CI]， 0.55-0.98），每周摄入5次或更多的风险降低30%（风险比，0.70;95% CI, 0.50-0.99）与每月摄入少于一次的人相比。相比之下，食用炸鱼/鱼肉三明治与总卒中（P= 0.006）和缺血性卒中（P= 0.003）呈正相关，每周食用一次以上的人患缺血性卒中的风险比每月食用一次以下的人高44% （HR, 1.44; 95% CI, 1.12-1.85）。食用鱼类与出血性中风无关。结论：在老年人中，食用金枪鱼或其他烤鱼与缺血性中风的风险较低相关，而食用炸鱼或鱼三明治与缺血性中风的风险较高相关。这些结果表明，吃鱼可能会影响晚年中风的风险；潜在的机制和其他解释值得进一步研究。
Background: Associations between fish consumption and stroke risk have been inconsistent, possibly because of the differences in types of fish meals consumed. Additionally, such relationships have not been specifically evaluated in the elderly, in whom disease burden may be high and diet less influential.Methods: Among 4775 adults 65 years or older (range, 65-98 years) and free of known cerebrovascular disease at baseline in 1989-1990, usual dietary intake was assessed using a food frequency questionnaire. In a subset consumption of tuna or other broiled or baked fish, but not fried fish or fish sandwiches (fish burgers), correlated with plasma phospholipid long-chain n-3 fatty acid levels. Incident strokes were prospectively ascertained.Results: During 12 years of follow-up, participants experienced 626 incident strokes, including 529 ischemic strokes. In multivariate analyses, tuna/other fish consumption was inversely associated with total stroke (P=.04) and ischemic stroke (P=.02), with 27% lower risk of ischemic stroke with an intake of 1 to 4 times per week (hazard ratio [HR], 0.73; 95% confidence interval [CI], 0.55-0.98) and 30% lower risk with intake of 5 or more times per week (HR, 0.70; 95% CI, 0.50-0.99) compared with an intake of less than once per month. In contrast, fried fish/fish sandwich consumption was positively associated with total stroke (P=.006) and ischemic stroke (P=.003), with a 44% higher risk of ischemic stroke with consumption of more than once per week (HR, 1.44; 95% CI, 1.12-1.85) compared with consumption of less than once per month. Fish consumption was not associated with hemorrhagic stroke.Conclusions: Among elderly individuals, consumption of tuna or other broiled or baked fish is associated with lower risk of ischemic stroke, while intake of fried fish or fish sandwiches is associated with higher risk. These results suggest that fish consumption may influence stroke risk late in life; potential mechanisms and alternate explanations warrant further study.