Department of Medicine, Skellefteå Hospital, Skellefteå, Sweden.
Am J Clin Nutr. 2011 Jan;93(1):27-36. doi: 10.3945/ajcn.2010.29408. Epub 2010 Nov 3.
A beneficial role of fish consumption on the risk of myocardial infarction (MI) has been reported and is mostly ascribed to n-3 (omega-3) fatty acids. However, fish also contains methylmercury, which may increase the risk of MI.
The objective was to determine how fish consumption and erythrocyte concentrations of mercury (Ery-Hg) and selenium (Ery-Se) are related to the risk of MI and whether n-3 fatty acids (eicosapentaenoic and docosahexaenoic acids) in plasma phospholipids (P-EPA+DHA) are protective.
This was a case-control study nested within the northern Sweden cohort, in which data and samples were collected prospectively. The study included 431 cases with an MI after data and sample collection, including 81 sudden cardiac deaths (SCDs) and 499 matched controls. Another 69 female cases with controls from a breast cancer screening registry were included in sex-specific analyses.
Odds ratios for the third compared with the first tertile were 0.65 (95% CI: 0.46, 0.91) for Ery-Hg, 0.75 (95% CI: 0.53, 1.06) for Ery-Se, and 0.78 (95% CI: 0.54, 1.11) for P-EPA+DHA. Ery-Hg and P-EPA+DHA were intercorrelated (Spearman's R = 0.34). No association was seen for reported fish consumption. Multivariate modeling did not change these associations significantly. Sex-specific analyses showed no differences in risk associations. High concentrations of Ery-Se were associated with an increased risk of SCD.
The biomarker results indicate a protective effect of fish consumption. No harmful effect of mercury was indicated in this low-exposed population in whom Ery-Hg and P-EPA+DHA were intercorrelated.
有研究报道称，食用鱼类对心肌梗死（MI）的风险有有益影响，这主要归因于 n-3（ω-3）脂肪酸。然而，鱼类也含有甲基汞，这可能会增加 MI 的风险。
本研究旨在确定鱼类摄入量和红细胞汞（Ery-Hg）及红细胞硒（Ery-Se）浓度与 MI 风险的关系，以及血浆磷脂中 n-3 脂肪酸（二十碳五烯酸和二十二碳六烯酸）（P-EPA+DHA）是否具有保护作用。
这是一项嵌套在瑞典北部队列研究中的病例对照研究，数据和样本是前瞻性收集的。该研究纳入了 431 例数据和样本采集后发生 MI 的病例，其中包括 81 例心源性猝死（SCD）和 499 例匹配对照。另外，还纳入了来自乳腺癌筛查登记处的 69 例女性病例和对照组，进行了性别特异性分析。
与第一三分位相比，第三三分位的 Ery-Hg、Ery-Se 和 P-EPA+DHA 的比值比（OR）分别为 0.65（95%可信区间：0.46，0.91）、0.75（95%可信区间：0.53，1.06）和 0.78（95%可信区间：0.54，1.11）。Ery-Hg 和 P-EPA+DHA 呈正相关（Spearman 相关系数 r = 0.34）。报告的鱼类摄入量与这两种标志物均无关联。多变量模型分析并未显著改变这些关联。性别特异性分析显示，风险关联无差异。高浓度的 Ery-Se 与 SCD 风险增加相关。
生物标志物结果表明鱼类摄入具有保护作用。在该低暴露人群中，未发现汞的有害影响，且 Ery-Hg 和 P-EPA+DHA 呈正相关。
