Research Institute of Public Health, School of Public Health and Clinical Nutrition, University of Kuopio, Kuopio, Finland.
Circulation. 2009 Dec 8;120(23):2315-21. doi: 10.1161/CIRCULATIONAHA.109.852657. Epub 2009 Nov 23.
Atrial fibrillation (AF) is a common cardiac arrhythmia. Regular fish consumption has been shown to reduce the risk of AF in some but not all studies. Long-chain n-3 polyunsaturated fatty acids (PUFAs) from fish have been suggested to account for these beneficial effects. We tested this hypothesis by studying the association between the serum long-chain n-3 PUFAs eicosapentaenoic acid, docosapentaenoic acid, and docosahexaenoic acid and risk of AF in men.
A total of 2174 men from the prospective population-based Kuopio Ischemic Heart Disease Risk Factor Study, 42 to 60 years old and free of AF at baseline in 1984 to 1989, were studied. During the average follow-up time of 17.7 years, 240 AF events occurred. In the Cox proportional hazards model, the multivariable-adjusted hazard ratio in the highest (>5.33%) versus the lowest (<3.61%) quartile of eicosapentaenoic acid plus docosapentaenoic acid plus docosahexaenoic acid was 0.65 (95% confidence interval 0.44 to 0.96, P for trend=0.07). Evaluated individually, only serum docosahexaenoic acid was associated with the risk of AF (hazard ratio in the highest versus the lowest quartile 0.62, 95% confidence interval 0.42 to 0.92, P for trend=0.02). Exclusion of subjects (n=233) with myocardial infarction or congestive heart failure either at baseline or that preceded the AF event during follow-up slightly strengthened the associations. Serum intermediate chain-length n-3 PUFA, alpha-linolenic acid, or hair methylmercury concentration were not associated with the risk.
An increased concentration of long-chain n-3 PUFAs in serum, a marker of fish or fish oil consumption, may protect against AF. Serum docosahexaenoic acid concentration had the greatest impact.
心房颤动（AF）是一种常见的心律失常。一些研究表明，经常食用鱼类可以降低 AF 的风险，但并非所有研究都如此。鱼类中的长链 n-3 多不饱和脂肪酸（PUFA）被认为是这些有益影响的原因。我们通过研究血清长链 n-3 PUFAs 二十碳五烯酸、二十二碳五烯酸和二十二碳六烯酸与男性 AF 风险之间的关系来检验这一假设。
共纳入 2174 名来自前瞻性人群基础的库奥皮奥缺血性心脏病风险因素研究的男性，年龄在 42 至 60 岁之间，在 1984 年至 1989 年基线时无 AF。在平均 17.7 年的随访期间，发生了 240 例 AF 事件。在 Cox 比例风险模型中，最高（>5.33%）与最低（<3.61%）四分位数的二十碳五烯酸加二十二碳五烯酸加二十二碳六烯酸的多变量调整后的风险比为 0.65（95%置信区间 0.44 至 0.96，趋势 P 值=0.07）。单独评估时，只有血清二十二碳六烯酸与 AF 风险相关（最高四分位与最低四分位的风险比为 0.62，95%置信区间为 0.42 至 0.92，趋势 P 值=0.02）。排除基线时患有心肌梗死或充血性心力衰竭或在随访期间发生 AF 事件之前患有这些疾病的患者（n=233），略微加强了这些关联。血清中链长 n-3 PUFA、α-亚麻酸或头发甲基汞浓度与风险无关。
血清长链 n-3 PUFAs 浓度升高，即鱼类或鱼油摄入的标志物，可能有助于预防 AF。血清二十二碳六烯酸浓度的影响最大。
