Department of Epidemiology, School of Public Health, Soochow University, Suzhou, China.
Eur J Clin Nutr. 2013 Jan;67(1):96-100. doi: 10.1038/ejcn.2012.158. Epub 2012 Oct 17.
BACKGROUND/OBJECTIVES: Epidemiological studies have suggested that dietary fiber intake may be associated with a decreased risk of stroke, but the findings have been inconsistent. We aimed to assess this association by conducting a meta-analysis of prospective cohort studies.
SUBJECTS/METHODS: We performed a literature search on PubMed database through July 2012 to identify prospective studies of dietary fiber intake in relation to risk of stroke. We also comprehensively reviewed the reference lists of the retrieved articles to identify additional studies. We used a random-effects model to compute the summary risk estimates.
Six prospective cohort studies containing a total of 314 864 subjects and 8920 stroke cases were included. The summary relative risk (RR) of stroke for the highest vs lowest category of dietary fiber intake was 0.87 (95% confidence interval (CI), 0.77-0.99). The corresponding RR in the subgroup analyses for men and women was 0.95 (95% CI, 0.83-1.08) and 0.80 (95% CI, 0.66-0.96), respectively; and for ischemic stroke and hemorrhagic stroke was 0.83(95% CI, 0.72-0.96) and 0.86 (95% CI, 0.70-1.06), respectively. Meta-regression indicated no significant difference between gender (P-interaction=0.18), or stroke subtypes (P-interaction =0.85). The dose-response analysis suggested a 12% (RR=0.88; 95% CI, 0.79-0.97) reduction in risk of stroke for each 10 g per day increment in dietary fiber intake. Moderate heterogeneity emerged in some of analyses, but disappeared after removing one study substantially contributing to the heterogeneity. Little evidence of publication bias was detected.
Findings of this meta-analysis indicate a significant inverse dose-response relationship between dietary fiber intake and risk of stroke.
背景/目的：流行病学研究表明，膳食纤维的摄入量可能与中风的风险降低有关，但结果并不一致。我们旨在通过对前瞻性队列研究进行荟萃分析来评估这种相关性。
对象/方法：我们通过 2012 年 7 月在 PubMed 数据库中进行文献检索，以确定膳食纤维摄入量与中风风险相关的前瞻性研究。我们还全面审查了检索到的文章的参考文献列表，以确定其他研究。我们使用随机效应模型计算综合风险估计。
纳入了 6 项前瞻性队列研究，共包含 314864 名受试者和 8920 例中风病例。膳食纤维摄入量最高与最低组之间中风的相对风险（RR）为 0.87（95%置信区间（CI），0.77-0.99）。男性和女性亚组分析的相应 RR 分别为 0.95（95% CI，0.83-1.08）和 0.80（95% CI，0.66-0.96）；缺血性中风和出血性中风的 RR 分别为 0.83（95% CI，0.72-0.96）和 0.86（95% CI，0.70-1.06）。Meta 回归表明，性别（P 交互=0.18）或中风亚型（P 交互=0.85）之间无显著差异。剂量-反应分析表明，膳食纤维摄入量每天增加 10g，中风风险降低 12%（RR=0.88；95% CI，0.79-0.97）。一些分析中出现了中度异质性，但在去除一项对异质性有较大贡献的研究后，异质性消失。未发现明显的发表偏倚证据。
这项荟萃分析的结果表明，膳食纤维摄入量与中风风险之间存在显著的负相关剂量反应关系。
