Balk Ethan M, Lichtenstein Alice H, Chung Mei, Kupelnick Bruce, Chew Priscilla, Lau Joseph
Tufts-New England Medical Center Evidence-based Practice Center, Institute for Clinical Research and Health Policy Studies, Tufts-New England Medical Center, NEMC #63, Boston, MA 02111, USA.
Atherosclerosis. 2006 Nov;189(1):19-30. doi: 10.1016/j.atherosclerosis.2006.02.012. Epub 2006 Mar 10.
Greater fish oil consumption has been associated with reduced CVD risk, although the mechanisms are unclear. Plant-source oil omega-3 fatty acids (ALA) have also been studied regarding their cardiovascular effect. We conducted a systematic review of randomized controlled trials that evaluated the effect of consumption of fish oil and ALA on commonly measured serum CVD risk factors, performing meta-analyses when appropriate. Combining 21 trials evaluating lipid outcomes, fish oil consumption resulted in a summary net change in triglycerides of -27 (95% CI -33, -20)mg/dL, in HDL cholesterol of +1.6 (95% CI +0.8, +2.3)mg/dL, and in LDL cholesterol of +6 (95% CI +3, +8)mg/dL. There was no effect of fish oil on total cholesterol. Across studies, higher fish oil dose and higher baseline levels were associated with greater reductions in serum triglycerides. Overall, the 27 fish oil trials evaluating Hgb A(1c) or FBS found small non-significant net increases compared to control oils. Five studies of ALA were inconsistent in their effects on lipids, Hgb A(1c) or FBS. Four studies investigating the effects of omega-3 fatty acids on hs-CRP were also inconsistent and non-significant. The evidence supports a dose-dependent beneficial effect of fish oil on serum triglycerides, particularly among people with more elevated levels. Fish oil consumption also modestly improves HDL cholesterol, increases LDL cholesterol levels, but does not appear to adversely affect glucose homeostasis. The evidence regarding the effects of omega-3 fatty acids on hs-CRP is inconclusive, as are data on ALA.
尽管机制尚不清楚，但摄入更多的鱼油与降低心血管疾病（CVD）风险相关。植物源油中的ω-3脂肪酸（ALA）也已就其心血管效应进行了研究。我们对评估鱼油和ALA摄入对常见血清CVD危险因素影响的随机对照试验进行了系统评价，并在适当的时候进行荟萃分析。综合21项评估血脂结果的试验，摄入鱼油导致甘油三酯的汇总净变化为-27（95%CI -33，-20）mg/dL，高密度脂蛋白胆固醇为+1.6（95%CI +0.8，+2.3）mg/dL，低密度脂蛋白胆固醇为+6（95%CI +3，+8）mg/dL。鱼油对总胆固醇没有影响。在各项研究中，较高的鱼油剂量和较高的基线水平与血清甘油三酯的更大降幅相关。总体而言，27项评估糖化血红蛋白（Hgb A(1c)）或空腹血糖（FBS）的鱼油试验发现，与对照油相比，净增加幅度较小且无统计学意义。五项关于ALA的研究在其对血脂、Hgb A(1c)或FBS的影响方面并不一致。四项研究ω-3脂肪酸对超敏C反应蛋白（hs-CRP）影响的试验也不一致且无统计学意义。证据支持鱼油对血清甘油三酯具有剂量依赖性的有益作用，尤其是在水平较高的人群中。摄入鱼油还适度改善高密度脂蛋白胆固醇，提高低密度脂蛋白胆固醇水平，但似乎不会对葡萄糖稳态产生不利影响。关于ω-3脂肪酸对hs-CRP影响的证据尚无定论，关于ALA的数据也是如此。
