Bucher Heiner C, Hengstler Peter, Schindler Christian, Meier Gabriela
Institut für Klinische Epidemiologie, Kantonsspital Basel, Basel, Switzerland.
Am J Med. 2002 Mar;112(4):298-304. doi: 10.1016/s0002-9343(01)01114-7.
Observational studies have shown an inconsistent association between n-3 polyunsaturated fatty acids and the risk of coronary heart disease. We investigated the effects of dietary and non-dietary (supplemental) intake of n-3 polyunsaturated fatty acids on coronary heart disease.
We searched the literature to identify randomized controlled trials that compared dietary or non-dietary intake of n-3 polyunsaturated fatty acids with a control diet or placebo in patients with coronary heart disease. Studies had to have at least 6 months of follow-up data, and to have reported clinical endpoint data. We identified 11 trials, published between 1966 and 1999, which included 7951 patients in the intervention and 7855 patients in the control groups.
The risk ratio of nonfatal myocardial infarction in patients who were on n-3 polyunsaturated fatty acid-enriched diets compared with control diets or placebo was 0.8 (95% confidence interval [CI]: 0.5 to 1.2, P = 0.16; Breslow-Day test for heterogeneity, P = 0.01), and the risk ratio of fatal myocardial infarction was 0.7 (95% CI: 0.6 to 0.8, P <0.001; heterogeneity P >0.20). In 5 trials, sudden death was associated with a risk ratio of 0.7 (95% CI: 0.6 to 0.9, P <0.01; heterogeneity P >0.20), whereas the risk ratio of overall mortality was 0.8 (95% CI: 0.7 to 0.9, P <0.001; heterogeneity P >0.20). There was no difference in summary estimates between dietary and non-dietary interventions of n-3 polyunsaturated fatty acids for all endpoints.
This meta-analysis suggests that dietary and non-dietary intake of n-3 polyunsaturated fatty acids reduces overall mortality, mortality due to myocardial infarction, and sudden death in patients with coronary heart disease.
观察性研究表明，n-3多不饱和脂肪酸与冠心病风险之间的关联并不一致。我们研究了膳食和非膳食（补充剂）摄入n-3多不饱和脂肪酸对冠心病的影响。
我们检索文献，以确定在冠心病患者中将n-3多不饱和脂肪酸的膳食或非膳食摄入与对照饮食或安慰剂进行比较的随机对照试验。研究必须有至少6个月的随访数据，并报告临床终点数据。我们确定了1966年至1999年间发表的11项试验，干预组包括7951例患者，对照组包括7855例患者。
与对照饮食或安慰剂相比，食用富含n-3多不饱和脂肪酸饮食的患者发生非致命性心肌梗死的风险比为0.8（95%置信区间[CI]：0.5至1.2，P = 0.16；异质性的Breslow-Day检验，P = 0.01），致命性心肌梗死的风险比为0.7（95%CI：0.6至0.8，P <0.001；异质性P>0.20）。在5项试验中，猝死的风险比为0.7（95%CI：0.6至0.9，P <0.01；异质性P>0.20），而总死亡率的风险比为0.8（95%CI：0.7至0.9，P <0.001；异质性P>0.20）。对于所有终点，n-3多不饱和脂肪酸的膳食和非膳食干预之间的汇总估计没有差异。
这项荟萃分析表明，膳食和非膳食摄入n-3多不饱和脂肪酸可降低冠心病患者的总死亡率、心肌梗死所致死亡率和猝死率。
