Third Department of Internal Medicine, General University Hospital, Prague, Czech Republic.
Physiol Res. 2009;58 Suppl 1:S19-S26. doi: 10.33549/physiolres.931860.
There is a large body of evidence documenting the effects of long-chain polyunsaturated fatty acids with the first double bond at the third position from methyl-terminal (so called omega-3 fatty acids (FAs)) on different components of cardiovascular disease (CVD) risk. However, it may seem the more answers on the topic we learn, the more questions remain to be elucidated. There are three levels of evidence documenting the impact of fish omega-3 FAs on CVD risk. Epidemiological data have shown unequivocally the increased intake of fish is associated with lower CVD morbidity and mortality. Numerous experimental studies have shown (almost always) positive effects of omega-3 FAs on lipoprotein metabolism, coagulation and platelet function, endothelial function, arterial stiffness etc. Most importantly, there are a few prospective clinical endpoint trials (DART, JELIS, GISSI Prevenzione and GISSI-HF) that have examined the impact of omega-3 FAs supplementation on cardiovascular outcomes in different patient populations. Recent meta-analyses of these and other clinical studies have yielded somewhat conflicting results. In this review we will summarize current evidence of omega-3 FAs effects on cardiovascular risk focusing on new data from recent clinical trials as well as possible practical implications for clinical practice.
有大量证据表明，第一个双键位于甲基末端第三个位置的长链多不饱和脂肪酸（所谓的ω-3 脂肪酸（FA））对心血管疾病（CVD）风险的不同成分有影响。然而，似乎我们对这个主题了解得越多，就会有更多的问题需要阐明。有三个层次的证据证明了鱼类 ω-3 FA 对 CVD 风险的影响。流行病学数据明确表明，增加鱼类的摄入量与降低 CVD 发病率和死亡率有关。许多实验研究表明（几乎总是）ω-3 FA 对脂蛋白代谢、凝血和血小板功能、内皮功能、动脉僵硬度等有积极影响。最重要的是，有几项前瞻性临床终点试验（DART、JELIS、GISSI Prevenzione 和 GISSI-HF）研究了 ω-3 FA 补充剂对不同患者群体心血管结局的影响。最近对这些和其他临床研究的荟萃分析得出了一些相互矛盾的结果。在这篇综述中，我们将总结 ω-3 FA 对心血管风险影响的最新证据，重点关注来自最近临床试验的新数据以及对临床实践的可能实际影响。
