鱼油对人体心率的影响：随机对照试验的荟萃分析

Effect of fish oil on heart rate in humans: a meta-analysis of randomized controlled trials.

作者信息

Mozaffarian Dariush, Geelen Anouk, Brouwer Ingeborg A, Geleijnse Johanna M, Zock Peter L, Katan Martijn B

机构信息

Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.

出版信息

Circulation. 2005 Sep 27;112(13):1945-52. doi: 10.1161/CIRCULATIONAHA.105.556886. Epub 2005 Sep 19.

DOI:10.1161/CIRCULATIONAHA.105.556886

PMID:16172267

Abstract

BACKGROUND

The effect of fish oil on heart rate (HR), a major risk factor for sudden death, is not well established. We calculated this effect in a meta-analysis of randomized, double-blind, placebo-controlled trials in humans.

METHODS AND RESULTS

Randomized trials of fish oil that evaluated HR were identified through MEDLINE (1966 through January 2005), hand-searching of references, and contact with investigators for unpublished results. Two investigators independently extracted trial data. A pooled estimate was calculated from random-effects meta-analysis. Predefined stratified meta-analyses and meta-regression were used to explore potential heterogeneity. Of 197 identified articles, 30 met inclusion criteria. Evidence for publication bias was not present. In the overall pooled estimate, fish oil decreased HR by 1.6 bpm (95% CI, 0.6 to 2.5; P=0.002) compared with placebo. Between-trial heterogeneity was evident (Q test, P<0.001). Fish oil reduced HR by 2.5 bpm (P<0.001) in trials with baseline HR > or =69 bpm (median) but had little effect (0.04-bpm reduction; P=0.56) in trials with baseline HR <69 bpm (P for interaction=0.03). Fish oil reduced HR by 2.5 bpm (P<0.001) in trials with duration > or =12 weeks but had less effect (0.7-bpm reduction; P=0.27) in trials with duration <12 weeks (P for interaction=0.07). HR reduction with fish oil intake did not significantly vary by fish oil dose (range, 0.81 to 15 g/d), type of HR measure, population age, population health, parallel versus crossover design, type of control oil, or study quality by Delphi criteria (P for interaction >0.25 for each).

CONCLUSIONS

In randomized controlled trials in humans, fish oil reduces HR, particularly in those with higher baseline HR or longer treatment duration. These findings provide firm evidence that fish oil consumption directly or indirectly affects cardiac electrophysiology in humans. Potential mechanisms such as effects on the sinus node, ventricular efficiency, or autonomic function deserve further investigation.

摘要

背景

鱼油对心率（HR）这一猝死主要危险因素的影响尚未明确。我们通过对人类随机、双盲、安慰剂对照试验的荟萃分析来计算这种影响。

方法与结果

通过MEDLINE（1966年至2005年1月）、手工检索参考文献以及与研究者联系获取未发表结果，来识别评估心率的鱼油随机试验。两名研究者独立提取试验数据。通过随机效应荟萃分析计算合并估计值。使用预定义的分层荟萃分析和荟萃回归来探讨潜在的异质性。在197篇已识别的文章中，30篇符合纳入标准。不存在发表偏倚的证据。在总体合并估计中，与安慰剂相比，鱼油使心率降低了1.6次/分钟（95%可信区间，0.6至2.5；P = 0.002）。试验间异质性明显（Q检验，P < 0.001）。在基线心率≥69次/分钟（中位数）的试验中，鱼油使心率降低2.5次/分钟（P < 0.001），但在基线心率<69次/分钟的试验中影响很小（降低0.04次/分钟；P = 0.56）（交互作用P = 0.03）。在持续时间≥12周的试验中，鱼油使心率降低2.5次/分钟（P <0.001），但在持续时间<12周的试验中影响较小（降低0.7次/分钟；P = 0.27）（交互作用P = 0.07）。摄入鱼油导致的心率降低在鱼油剂量（范围，0.81至15克/天）、心率测量类型、人群年龄、人群健康状况、平行设计与交叉设计、对照油类型或根据德尔菲标准的研究质量方面均无显著差异（各交互作用P>0.25）。