Omega-3 polyunsaturated fatty acid biomarkers and risk of type 2 diabetes, cardiovascular disease, cancer, and mortality
Omega-3 polyunsaturated fatty acid biomarkers and risk of type 2 diabetes, cardiovascular disease, cancer, and mortality
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DOI：
10.1016/j.clnu.2022.06.034
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发表时间：
2022-07-10
影响因子：
6.3
通讯作者：
Ma, Le
中科院分区：
文献类型：
--
作者：
Jiang, Hong;Wang, Lina;Ma, Le
背景与目的：omega-3多不饱和脂肪酸(PUFA)在预防心脏代谢性疾病中的作用已引起相当多的关注，这导致了饮食建议增加omega-3脂肪酸的摄入量。对omega-3多不饱和脂肪酸生物标记物与重大慢性病发病风险之间关系的前瞻性研究的证据进行荟萃分析。方法：检索4个电子数据库中从最初到2022年3月1日的文章。使用随机效应模型估计omega-3多不饱和脂肪酸，包括亚麻酸(ALA)、二十碳五烯酸(EPA)、二十二碳五烯酸(DPA)和二十二碳六烯酸(DHA)与发生2型糖尿病(T2D)、心血管疾病(CVD)(包括冠心病(CHD)和中风、癌症和死亡率)之间的合并相对风险(RR)和95%可信区间(CI)。结果：共确定67项前瞻性研究，涉及310,955名参与者。单个omega-3多不饱和脂肪酸与感兴趣的研究结果显示出不同的关联。在ALA(相对风险[RR]：0.89，95%可信区间[CI]：0.82-0.96)、EPA(相对风险：0.85，95%可信区间：0.72-0.99)和DPA(相对风险：0.84，95%可信区间：0.73-0.96)生物标志物类别中，观察到与T2D风险显著负相关。海洋来源的omega-3脂肪酸生物标志物而不是ALA显著地与总心血管疾病、冠心病和总死亡率的较低风险相关，RRS从0.70(DHA-CHD关联)到0.85(EPA-CHD关联)。DPA(相对危险度：0.76，95%CI：0.59-0.98)和DHA(相对危险度：0.80；95%可信区间：0.65-0.99)水平越高，患结直肠癌的风险越低，而与其他结果无关。此外，EPA、DPA或DHA生物标志物水平的升高与心血管疾病的风险降低之间存在剂量-反应关系。结论：海洋来源的omega-3多不饱和脂肪酸生物标志物的浓度越高，总心血管疾病、冠心病和总死亡率的风险就越低。ALA水平与T2D的低风险呈负相关，但与心血管疾病相关的结局无关。这些数据支持饮食建议，倡导omega-3多不饱和脂肪酸在保持总体较低的心血管疾病和过早死亡风险方面的作用。(C)2022年爱思唯尔有限公司和欧洲临床营养和代谢学会。版权所有。
Background & aims: Considerable attention has focused on the role of omega-3 polyunsaturated fatty acids (PUFA) in the prevention of cardiometabolic diseases, which has led to dietary recommendations to increase omega-3 fatty acid intake. A meta-analysis was conducted to summarize evidence from prospective studies regarding associations between omega-3 PUFA biomarkers and risk of developing major chronic diseases.Methods: Four electronic databases were searched for articles from inception to March 1, 2022. Random-effects model was used to estimate the pooled relative risk (RR) and 95% confidence intervals (CIs) for the association of omega-3 PUFAs, including ci-linolenic acid (ALA), eicosapentaenoic acid (EPA), docosapentaenoic acid (DPA), and docosahexaenoic acid (DHA), with risk of developing type 2 diabetes (T2D), cardiovascular disease (CVD), including coronary heart disease (CHD) and stroke, cancer, and mortality. The Grades of Recommendation, Assessment, Development and Evaluation assessment tool was used to rates the confidence in estimates.Results: A total of 67 prospective studies comprised of 310,955 participants were identified. Individual omega-3 PUFAs showed divergent associations with the study outcomes of interest. A significant inverse association with T2D risk was observed across categories of ALA (relative risk [RR]: 0.89, 95% confidence interval [CI]: 0.82-0.96), EPA (RR: 0.85, 95% CI: 0.72-0.99) and DPA (RR: 0.84, 95% CI: 0.73-0.96) biomarkers. The marine-origin omega-3 fatty acids biomarkers but not ALA was significantly associated with lower risks of total CVD, CHD, and overall mortality, with RRs ranging from 0.70 for DHA-CHD association to 0.85 for EPA-CHD association. A lower risk of colorectal cancer was observed at higher levels of DPA (RR: 0.76, 95% CI: 0.59-0.98) and DHA (RR: 0.80; 95% CI: 0.65-0.99), whereas no association was noted for other outcomes. In addition, a dose-response relationship was observed between an increasing level of EPA, DPA, or DHA biomarker and lower risk of CVD.Conclusions: Higher concentrations of marine-derived omega-3 PUFA biomarkers were associated with a significantly reduced risk of total CVD, CHD, and total mortality. Levels of ALA were inversely associated with a lower risk of T2D but not CVD-related outcomes. These data support the dietary recommendations advocating the role of omega-3 PUFAs in maintaining an overall lower risk of developing cardiovascular disease and premature deaths. (C) 2022 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.