Landmark Knud, Aursnes Ivar
Institutt for farmakoterapi, Postboks 1065 Blindern, 0316 Oslo.
Tidsskr Nor Laegeforen. 2004 Jan 22;124(2):198-200.
Several clinical studies have documented that intake of fish may reduce mortality from coronary heart disease, and two epidemiological investigations have shown a 50% reduction in the incidence of sudden death and of "primary cardiac arrest" in subjects eating fish. However, in some studies no beneficial effects of fish intake on coronary heart disease could be found; one Finnish study even found a positive correlation between intake of freshwater fish and coronary heart disease. One possible explanation for this paradox could be a high content of mercury in fish.
We have studied the relevant literature describing beneficial, less beneficial and negative effects of fish intake on the development of coronary heart disease. Furthermore, we have studied reports that mercury may have properties that enhance the development of coronary heart disease.
Several studies have shown an inverse correlation between omega-3 fatty acids from fish in serum/adipose tissue and coronary heart disease. However, a high content of mercury in hair/toe nail had a negative effect, and in one study the odds ratio for myocardial infarction in those with the highest content of mercury was 2.16. A positive correlation between mercury in hair and the progression of carotid atherosclerosis has been found. Intake of fish is a major source of exposure to mercury, and a high content of mercury probably inhibits the beneficial effects of omega-3 fatty acids on the development of coronary artery disease.
多项临床研究记录了摄入鱼类可能降低冠心病死亡率，两项流行病学调查显示，食用鱼类的人群猝死和“原发性心脏骤停”的发生率降低了50%。然而，在一些研究中未发现摄入鱼类对冠心病有有益影响；一项芬兰研究甚至发现淡水鱼摄入量与冠心病之间存在正相关。对这一矛盾现象的一种可能解释是鱼类中汞含量高。
我们研究了描述鱼类摄入对冠心病发展的有益、益处较少和负面影响的相关文献。此外，我们还研究了汞可能具有促进冠心病发展特性的报告。
多项研究表明，血清/脂肪组织中鱼类的ω-3脂肪酸与冠心病之间存在负相关。然而，头发/趾甲中汞含量高有负面影响，在一项研究中，汞含量最高者发生心肌梗死的比值比为2.16。已发现头发中的汞与颈动脉粥样硬化进展之间存在正相关。鱼类摄入是汞暴露的主要来源，汞含量高可能会抑制ω-3脂肪酸对冠状动脉疾病发展的有益作用。
