Dietary linoleic acid and risk of coronary heart disease: a systematic review and meta-analysis of prospective cohort studies.
Dietary linoleic acid and risk of coronary heart disease: a systematic review and meta-analysis of prospective cohort studies.
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DOI：
10.1161/circulationaha.114.010236
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发表时间：
2014-10-28
期刊：
影响因子：
37.8
通讯作者：
Hu FB
中科院分区：
文献类型：
--
作者：
Farvid MS;Ding M;Pan A;Sun Q;Chiuve SE;Steffen LM;Willett WC;Hu FB
先前关于亚油酸（LA）、主要的n-6脂肪酸摄入和冠心病（CHD）风险的研究得出了不一致的结果。我们对前瞻性队列研究进行了系统回顾和荟萃分析，以总结有关膳食LA摄入量与冠心病风险关系的证据。我们在MEDLINE和EMBASE数据库中检索了截至2013年6月的前瞻性队列研究，这些研究报告了饮食LA与冠心病事件之间的关联。此外，我们还利用了先前合并项目中未发表的队列研究数据。我们使用固定效应荟萃分析合并了多变量调整相对风险（RR），比较了最高和最低的LA摄入类别。我们确定了13项已发表和未发表的队列研究，共涉及310,602人，12,479例冠心病事件，包括5,882例冠心病死亡。与最高类别和最低类别相比，膳食LA与冠心病事件风险降低15%相关(合并RR， 0.85； 95%可信区间（95% CI）： 0.78-0.92；I2=35.5%)，冠心病死亡风险降低21%（合并RR， 0.79; 95% CI, 0.71-0.89; I2=0.0%）。摄入5%的能量增量替代饱和脂肪摄入的能量，与冠心病事件风险降低9% （RR, 0.91; 95% CI, 0.86-0.96）和冠心病死亡风险降低13% （RR, 0.87; 95% CI, 0.82-0.94）相关。在前瞻性观察性研究中，膳食LA摄入量与冠心病风险呈剂量-反应负相关。这些数据为目前建议用多不饱和脂肪代替饱和脂肪预防冠心病提供了支持。
Prior studies on intake of linoleic acid (LA), the predominant n-6 fatty acid, and coronary heart disease (CHD) risk have generated inconsistent results. We performed a systematic review and meta-analysis of prospective cohort studies to summarize the evidence regarding the relation of dietary LA intake and CHD risk. We searched MEDLINE and EMBASE databases through June, 2013 for prospective cohort studies that reported the association between dietary LA and CHD events. In addition, we utilized unpublished data from cohort studies in a previous pooling project. We pooled the multivariate-adjusted relative risk (RR) comparing the highest with the lowest categories of LA intake using fixed-effect meta-analysis. We identified 13 published and unpublished cohort studies with a total of 310,602 individuals and 12,479 total CHD events including 5,882 CHD deaths. Comparing the highest to the lowest category, dietary LA was associated with a 15% lower risk of CHD events (pooled RR, 0.85; 95% confidence intervals (95% CI): 0.78–0.92; I2=35.5%) and a 21% lower risk of CHD deaths (pooled RR, 0.79; 95% CI, 0.71–0.89; I2=0.0%). A 5% of energy increment in LA intake replacing energy from saturated fat intake was associated with a 9% lower risk of CHD events (RR, 0.91; 95% CI, 0.86–0.96) and a 13% lower risk of CHD deaths (RR, 0.87; 95% CI, 0.82–0.94). In prospective observational studies, dietary LA intake is inversely associated with CHD risk in a dose-response manner. These data provide support for current recommendations to replace saturated fat with polyunsaturated fat for primary prevention of CHD.