Milk and dairy consumption and risk of cardiovascular diseases and all-cause mortality: dose-response meta-analysis of prospective cohort studies.
Milk and dairy consumption and risk of cardiovascular diseases and all-cause mortality: dose-response meta-analysis of prospective cohort studies.
复制标题
DOI：
10.1007/s10654-017-0243-1
复制
发表时间：
2017-04
影响因子：
13.6
通讯作者：
Soedamah-Muthu SS
中科院分区：
文献类型：
--
作者：
Guo J;Astrup A;Lovegrove JA;Gijsbers L;Givens DI;Soedamah-Muthu SS
随着越来越多的前瞻性队列研究，一项关于牛奶和乳制品与全因死亡率、冠心病或心血管疾病的最新剂量-反应荟萃分析已经开展。在PubMed， Embase和Scopus中检索了截至2016年9月发表的文章。对全乳（高脂/低脂）、牛奶、发酵乳、奶酪和酸奶进行随机效应荟萃分析，汇总剂量-反应数据。采用脊柱模型研究非线性关联，并通过亚组分析研究异质性。共有29项队列研究可用于荟萃分析，共有938,465名参与者，93,158例死亡，28,419例冠心病和25,416例心血管疾病。没有发现总乳制品（高脂/低脂）和牛奶与死亡率、冠心病或心血管疾病的健康结果有关。发现发酵乳制品总量（包括酸乳产品、奶酪或酸奶；每20克/天）与死亡率（RR 0.98, 95% CI 0.97-0.99; I2 = 94.4%）和心血管疾病风险（RR 0.98, 95% CI 0.97-0.99; I2 = 87.5%）呈负相关。对奶酪和酸奶发酵乳制品的进一步分析显示，每10克/天，奶酪患心血管疾病的风险降低2% (RR 0.98, 95% CI 0.95-1.00; I2 = 82.6%)，但酸奶没有。在敏感度分析中，通过剔除一项大型瑞典研究，完全发酵乳制品和奶酪的所有这些边际负相关都被减弱了。这项荟萃分析结合了29项前瞻性队列研究的数据，表明乳制品与心血管和全因死亡率之间存在中性关联。对于未来的研究，重要的是更详细地研究如何用其他食物代替乳制品。本文的在线版本（doi:10.1007/s10654-017-0243-1）包含补充资料，仅供授权用户使用。
With a growing number of prospective cohort studies, an updated dose–response meta-analysis of milk and dairy products with all-cause mortality, coronary heart disease (CHD) or cardiovascular disease (CVD) have been conducted. PubMed, Embase and Scopus were searched for articles published up to September 2016. Random-effect meta-analyses with summarised dose–response data were performed for total (high-fat/low-fat) dairy, milk, fermented dairy, cheese and yogurt. Non-linear associations were investigated using the spine models and heterogeneity by subgroup analyses. A total of 29 cohort studies were available for meta-analysis, with 938,465 participants and 93,158 mortality, 28,419 CHD and 25,416 CVD cases. No associations were found for total (high-fat/low-fat) dairy, and milk with the health outcomes of mortality, CHD or CVD. Inverse associations were found between total fermented dairy (included sour milk products, cheese or yogurt; per 20 g/day) with mortality (RR 0.98, 95% CI 0.97–0.99; I2 = 94.4%) and CVD risk (RR 0.98, 95% CI 0.97–0.99; I2 = 87.5%). Further analyses of individual fermented dairy of cheese and yogurt showed cheese to have a 2% lower risk of CVD (RR 0.98, 95% CI 0.95–1.00; I2 = 82.6%) per 10 g/day, but not yogurt. All of these marginally inverse associations of totally fermented dairy and cheese were attenuated in sensitivity analyses by removing one large Swedish study. This meta-analysis combining data from 29 prospective cohort studies demonstrated neutral associations between dairy products and cardiovascular and all-cause mortality. For future studies it is important to investigate in more detail how dairy products can be replaced by other foods. The online version of this article (doi:10.1007/s10654-017-0243-1) contains supplementary material, which is available to authorized users.