Association between fish consumption, long chain omega 3 fatty acids, and risk of cerebrovascular disease: systematic review and meta-analysis.
Association between fish consumption, long chain omega 3 fatty acids, and risk of cerebrovascular disease: systematic review and meta-analysis.
复制标题
DOI：
10.1136/bmj.e6698
复制
发表时间：
2012-10-30
期刊：
影响因子：
--
通讯作者：
Franco OH
中科院分区：
文献类型：
--
作者：
Chowdhury R;Stevens S;Gorman D;Pan A;Warnakula S;Chowdhury S;Ward H;Johnson L;Crowe F;Hu FB;Franco OH
目的探讨长链欧米伽- 3脂肪酸与脑血管病发病风险的关系，为脑血管病的一级和二级预防提供依据。设计系统回顾和荟萃分析。数据来源通过Medline、Embase、BIOSIS和Science Citation Index数据库的电子检索确定2012年9月之前发表的研究。前瞻性队列研究和随机对照试验报告了食用鱼类与长链omega - 3脂肪酸（基于饮食自我报告）、omega - 3脂肪酸生物标志物或补充剂与脑血管疾病（定义为任何致死性或非致死性缺血性卒中、出血性卒中、脑血管意外或短暂性缺血性发作）之间的关联。一级和二级预防研究（包括基线时有无心血管疾病的受试者）均符合条件。结果纳入26项前瞻性队列研究和12项随机对照试验，共纳入79.4万名非重叠人群和34 817例脑血管结局。在比较鱼类摄入量类别的队列研究中，每周2-4次食用与每周≤1次食用相比，脑血管疾病的总相对危险度为0.94(95%可信区间0.90 - 0.98)，每周≥5次食用与每周1次食用相比，总相对危险度为0.88（0.81 - 0.96）。基线长链omega - 3脂肪酸的前三分之一与循环生物标志物的后三分之一相比，脑血管疾病的相对风险为1.04(0.90至1.20)，饮食暴露的相对风险为0.90（0.80至1.01）。在随机对照试验中，与对照组相比，长链omega - 3补充剂在一级预防试验中的相对脑血管疾病风险为0.98(0.89 ~ 1.08)，在二级预防试验中为1.17（0.99 ~ 1.38）。对于鱼类或omega - 3脂肪酸，缺血性和出血性脑血管事件的估计大致相似。证据缺乏跨研究或亚组的异质性和发表偏倚。结论现有的观察数据表明，食用鱼类和长链omega - 3脂肪酸与脑血管风险呈中等负相关。在观察性研究中作为循环生物标志物或在一级和二级预防试验中作为补充剂测量的长链omega - 3脂肪酸与脑血管疾病无关。摄入鱼类对脑血管风险的有益影响可能是通过鱼类中丰富的多种营养物质的相互作用来调节的。
Objective To clarify associations of fish consumption and long chain omega 3 fatty acids with risk of cerebrovascular disease for primary and secondary prevention. Design Systematic review and meta-analysis. Data sources Studies published before September 2012 identified through electronic searches using Medline, Embase, BIOSIS, and Science Citation Index databases. Eligibility criteria Prospective cohort studies and randomised controlled trials reporting on associations of fish consumption and long chain omega 3 fatty acids (based on dietary self report), omega 3 fatty acids biomarkers, or supplementations with cerebrovascular disease (defined as any fatal or non-fatal ischaemic stroke, haemorrhagic stroke, cerebrovascular accident, or transient ischaemic attack). Both primary and secondary prevention studies (comprising participants with or without cardiovascular disease at baseline) were eligible. Results 26 prospective cohort studies and 12 randomised controlled trials with aggregate data on 794 000 non-overlapping people and 34 817 cerebrovascular outcomes were included. In cohort studies comparing categories of fish intake the pooled relative risk for cerebrovascular disease for 2-4 servings a week versus ≤1 servings a week was 0.94 (95% confidence intervals 0.90 to 0.98) and for ≥5 servings a week versus 1 serving a week was 0.88 (0.81 to 0.96). The relative risk for cerebrovascular disease comparing the top thirds of baseline long chain omega 3 fatty acids with the bottom thirds for circulating biomarkers was 1.04 (0.90 to 1.20) and for dietary exposures was 0.90 (0.80 to 1.01). In the randomised controlled trials the relative risk for cerebrovascular disease in the long chain omega 3 supplement compared with the control group in primary prevention trials was 0.98 (0.89 to 1.08) and in secondary prevention trials was 1.17 (0.99 to 1.38). For fish or omega 3 fatty acids the estimates for ischaemic and haemorrhagic cerebrovascular events were broadly similar. Evidence was lacking of heterogeneity and publication bias across studies or within subgroups. Conclusions Available observational data indicate moderate, inverse associations of fish consumption and long chain omega 3 fatty acids with cerebrovascular risk. Long chain omega 3 fatty acids measured as circulating biomarkers in observational studies or supplements in primary and secondary prevention trials were not associated with cerebrovascular disease. The beneficial effect of fish intake on cerebrovascular risk is likely to be mediated through the interplay of a wide range of nutrients abundant in fish.
登录
查看更多内容
影响因子：
5
作者：
GREENLAND, S;LONGNECKER, MP
通讯作者：
LONGNECKER, MP
影响因子：
24
作者：
D'Elia, Lanfranco;Barba, Gianvincenzo;Strazzullo, Pasquale
通讯作者：
Strazzullo, Pasquale
影响因子：
4.3
作者：
Harris, Kristina;Fleming, Jennifer;Kris-Etherton, Penny
通讯作者：
Kris-Etherton, Penny
影响因子：
120.7
作者：
He, K;Rimm, EB;Ascherio, A
通讯作者：
Ascherio, A
影响因子：
105.7
作者：
Higgins, JPT;Thompson, SG;Altman, DG
通讯作者：
Altman, DG