老年人的鱼类消费与中风风险：心血管健康研究
Fish consumption and stroke risk in elderly individuals: the cardiovascular health study.
作者信息
Mozaffarian Dariush, Longstreth W T, Lemaitre Rozenn N, Manolio Teri A, Kuller Lewis H, Burke Gregory L, Siscovick David S
机构信息
Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Harvard School of Public Health, Boston, MA, USA.
出版信息
Arch Intern Med. 2005 Jan 24;165(2):200-6. doi: 10.1001/archinte.165.2.200.
BACKGROUND
Associations between fish consumption and stroke risk have been inconsistent, possibly because of the differences in types of fish meals consumed. Additionally, such relationships have not been specifically evaluated in the elderly, in whom disease burden may be high and diet less influential.
METHODS
Among 4775 adults 65 years or older (range, 65-98 years) and free of known cerebrovascular disease at baseline in 1989-1990, usual dietary intake was assessed using a food frequency questionnaire. In a subset, consumption of tuna or other broiled or baked fish, but not fried fish or fish sandwiches (fish burgers), correlated with plasma phospholipid long-chain n-3 fatty acid levels. Incident strokes were prospectively ascertained.
RESULTS
During 12 years of follow-up, participants experienced 626 incident strokes, including 529 ischemic strokes. In multivariate analyses, tuna/other fish consumption was inversely associated with total stroke (P = .04) and ischemic stroke (P = .02), with 27% lower risk of ischemic stroke with an intake of 1 to 4 times per week (hazard ratio [HR], 0.73; 95% confidence interval [CI], 0.55-0.98) and 30% lower risk with intake of 5 or more times per week (HR, 0.70; 95% CI, 0.50-0.99) compared with an intake of less than once per month. In contrast, fried fish/fish sandwich consumption was positively associated with total stroke (P = .006) and ischemic stroke (P = .003), with a 44% higher risk of ischemic stroke with consumption of more than once per week (HR, 1.44; 95% CI, 1.12-1.85) compared with consumption of less than once per month. Fish consumption was not associated with hemorrhagic stroke.
CONCLUSIONS
Among elderly individuals, consumption of tuna or other broiled or baked fish is associated with lower risk of ischemic stroke, while intake of fried fish or fish sandwiches is associated with higher risk. These results suggest that fish consumption may influence stroke risk late in life; potential mechanisms and alternate explanations warrant further study.
背景
鱼类消费与中风风险之间的关联并不一致，这可能是由于所食用的鱼类餐食类型存在差异。此外，此类关系在老年人中尚未得到专门评估，而老年人的疾病负担可能较高且饮食影响较小。
方法
在1989 - 1990年基线时，对4775名65岁及以上（年龄范围65 - 98岁）且无已知脑血管疾病的成年人，使用食物频率问卷评估其日常饮食摄入量。在一个子集中，金枪鱼或其他烤制或烘焙鱼类的消费，但不包括油炸鱼或鱼肉三明治（鱼肉汉堡），与血浆磷脂长链n - 3脂肪酸水平相关。前瞻性地确定新发中风情况。
结果
在12年的随访期间，参与者经历了626次新发中风，其中包括529次缺血性中风。在多变量分析中，金枪鱼/其他鱼类的消费与总中风（P = 0.04）和缺血性中风（P = 0.02）呈负相关，每周摄入1至4次时缺血性中风风险降低27%（风险比[HR]，0.73；95%置信区间[CI]，0.55 - 0.98），每周摄入5次或更多次时风险降低30%（HR，0.70；95% CI，0.50 - 0.99），而每月摄入少于一次。相比之下，油炸鱼/鱼肉三明治的消费与总中风（P = 0.006）和缺血性中风（P = 0.003）呈正相关，每周消费超过一次时缺血性中风风险比每月消费少于一次高44%（HR，1.44；95% CI，1.12 - 1.85）。鱼类消费与出血性中风无关。
结论
在老年人中，食用金枪鱼或其他烤制或烘焙鱼类与较低的缺血性中风风险相关，而食用油炸鱼或鱼肉三明治则与较高风险相关。这些结果表明，鱼类消费可能会影响晚年的中风风险；潜在机制和其他解释值得进一步研究。
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