Dietary exposure to polychlorinated biphenyls is associated with increased risk of stroke in women
Dietary exposure to polychlorinated biphenyls is associated with increased risk of stroke in women
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DOI：
10.1111/joim.12194
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发表时间：
2014-09-01
影响因子：
11.1
通讯作者：
Akesson, A.
中科院分区：
文献类型：
--
作者：
Bergkvist, C.;Kippler, M.;Akesson, A.
目标。食用鱼类对中风的潜在有益影响可能会被鱼类中的主要食物污染物所改变。特别是多氯联苯（PCBs）被认为在中风的病因学中起作用。本研究的目的是评估饮食中多氯联苯暴露与中风风险与摄入长链omega-3鱼类脂肪酸和食用鱼类之间的关系。前瞻性人群为基础的瑞典乳房x线摄影队列进行了检查。调查对象包括34591名在1997年基线时无心血管疾病和癌症的妇女，随访12年。饮食中多氯联苯暴露的有效估计是通过基线时的食物频率问卷获得的。通过挂号联系法确定脑卒中病例。在12年的随访期间（397 309人年），共发生卒中2015例（缺血性卒中1532例，脑出血216例，蛛网膜下腔出血94例，不明原因卒中173例）。多变量调整相对危险度（RR），控制已知的卒中危险因素和鱼类消费，与饮食中PCB暴露最高四分位数（中位数288 ng /天（-1））的女性相比，总卒中为1.67[95%置信区间（CI）， 1.29-2.17]，缺血性卒中为1.61 (95% CI, 1.19-2.17)，出血性卒中为2.80 （95% CI, 1.42-5.55）。饮食中接触多氯联苯与女性中风风险增加有关，尤其是出血性中风。研究结果为鱼类消费的风险-收益分析提供了重要信息，特别是对脑血管疾病的预防。
Objective. The potentially beneficial effects of fish consumption on stroke may be modified by major food contaminants in fish. Polychlorinated biphenyls (PCBs) in particular are proposed to play a role in the aetiology of stroke. The aim of this study was to assess the association between dietary PCB exposure and stroke risk with the intake of long-chain omega-3 fish fatty acids and fish consumption.Design. The prospective population-based Swedish Mammography Cohort was examined. It was comprised of 34 591 women free of cardiovascular diseases and cancer at baseline in 1997 and followed up for 12 years. Validated estimates of dietary PCB exposure were obtained via a food frequency questionnaire at baseline. Incident cases of stroke were ascertained through register linkage.Results. During 12 years of follow-up (397 309 person-years), there were 2015 incident cases of total stroke (1532 ischaemic strokes, 216 intracerebral haemorrhages, 94 subarachnoid haemorrhages and 173 unspecified strokes). Multivariable-adjusted relative risks (RR), controlled for known stroke risk factors and fish consumption, were 1.67 [95% confidence interval (CI), 1.29-2.17] for total stroke, 1.61 (95% CI, 1.19-2.17) for ischaemic stroke and 2.80 (95% CI, 1.42-5.55) for haemorrhagic stroke for women in the highest quartile of dietary PCB exposure (median 288 ng day(-1)) compared with women in the lowest quartile (median 101 ng day(-1)).Conclusion. Dietary exposure to PCBs was associated with an increased stroke risk in women, especially haemorrhagic stroke. The results provide important information regarding the risk-benefit analysis of fish consumption, particularly for cerebrovascular disease prevention.