Division of Human Nutrition, Wageningen University, 6700 EV, Wageningen, The Netherlands.
J Nutr. 2010 May;140(5):1023-8. doi: 10.3945/jn.109.119271. Epub 2010 Mar 24.
We assessed the dose-response relations within a low range of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) and fish intake on fatal coronary heart disease (CHD) and nonfatal myocardial infarction (MI). In a Dutch population-based cohort study, EPA+DHA and fish intake were assessed at baseline among 21,342 participants aged 20-65 y with no history of MI or stroke. Hazard ratios were calculated with Cox proportional-hazard models. During 9-14 y of follow-up (mean 11.3 y), 647 participants (3%) died, of which 82 of CHD. Fatal CHD mainly comprised MI (64 cases). In total, 252 participants survived an MI. Median intakes in quartiles of EPA+DHA were 40, 84, 151, and 234 mg/d. Medians of fish consumption in quartiles were 1.1, 4.2, 10.7, and 17.3 g/d. Compared with the lowest quartile of EPA+DHA, participants in the top quartile had a 49% lower risk of fatal CHD (95% CI: 6-73%) and a 62% lower risk of fatal MI (95% CI: 23-81%). We observed inverse dose-response relations for EPA+DHA intake and fatal CHD (P-trend = 0.05) and fatal MI (P-trend = 0.01). Results were similar for fish consumption. Nonfatal MI was not associated with EPA+DHA or fish intake. In conclusion, in populations with a low fish consumption, EPA+DHA and fish may lower fatal CHD and MI risk in a dose-responsive manner. Low intakes of EPA+DHA or fish do not seem to protect against nonfatal MI.
我们评估了在二十碳五烯酸（EPA）和二十二碳六烯酸（DHA）以及鱼类摄入量的低范围内的剂量反应关系，这些因素与致命性冠心病（CHD）和非致命性心肌梗死（MI）有关。在一项荷兰基于人群的队列研究中，在 21342 名年龄在 20-65 岁、无 MI 或中风病史的参与者中，在基线时评估了 EPA+DHA 和鱼类摄入量。使用 Cox 比例风险模型计算危险比。在 9-14 年的随访期间（平均随访 11.3 年），有 647 名参与者（3%）死亡，其中 82 名死于 CHD。致命性 CHD 主要由 MI（64 例）组成。共有 252 名参与者幸存 MI。EPA+DHA 四分位数的中位数摄入量分别为 40、84、151 和 234mg/d。四分位数的鱼类消费量中位数分别为 1.1、4.2、10.7 和 17.3g/d。与 EPA+DHA 最低四分位数相比，最高四分位数的参与者致命性 CHD 的风险降低了 49%（95%CI：6-73%），致命性 MI 的风险降低了 62%（95%CI：23-81%）。我们观察到 EPA+DHA 摄入量与致命性 CHD（P-trend=0.05）和致命性 MI（P-trend=0.01）之间呈负相关剂量反应关系。鱼类消费的结果相似。非致命性 MI 与 EPA+DHA 或鱼类摄入量无关。总之，在鱼类摄入量低的人群中，EPA+DHA 和鱼类可能以剂量反应的方式降低致命性 CHD 和 MI 的风险。EPA+DHA 或鱼类的低摄入量似乎不能预防非致命性 MI。
