Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
J Intern Med. 2014 Sep;276(3):248-59. doi: 10.1111/joim.12194. Epub 2014 Mar 17.
The potentially beneficial effects of fish consumption on stroke may be modified by major food contaminants in fish. Polychlorinated biphenyls (PCBs) in particular are proposed to play a role in the aetiology of stroke. The aim of this study was to assess the association between dietary PCB exposure and stroke risk with the intake of long-chain omega-3 fish fatty acids and fish consumption.
The prospective population-based Swedish Mammography Cohort was examined. It was comprised of 34,591 women free of cardiovascular diseases and cancer at baseline in 1997 and followed up for 12 years. Validated estimates of dietary PCB exposure were obtained via a food frequency questionnaire at baseline. Incident cases of stroke were ascertained through register linkage.
During 12 years of follow-up (397,309 person-years), there were 2015 incident cases of total stroke (1532 ischaemic strokes, 216 intracerebral haemorrhages, 94 subarachnoid haemorrhages and 173 unspecified strokes). Multivariable-adjusted relative risks (RR), controlled for known stroke risk factors and fish consumption, were 1.67 [95% confidence interval (CI), 1.29-2.17] for total stroke, 1.61 (95% CI, 1.19-2.17) for ischaemic stroke and 2.80 (95% CI, 1.42-5.55) for haemorrhagic stroke for women in the highest quartile of dietary PCB exposure (median 288 ng day(-1) ) compared with women in the lowest quartile (median 101 ng day(-1) ).
Dietary exposure to PCBs was associated with an increased stroke risk in women, especially haemorrhagic stroke. The results provide important information regarding the risk-benefit analysis of fish consumption, particularly for cerebrovascular disease prevention.
鱼类消费对中风的潜在有益影响可能会受到鱼类中主要食物污染物的影响。多氯联苯（PCBs）尤其被认为在中风的病因学中发挥作用。本研究旨在评估膳食 PCB 暴露与中风风险与长链欧米伽-3 鱼类脂肪酸和鱼类摄入量的关系。
研究对象为基于人群的瑞典乳腺 X 线摄影队列。它由 34591 名在 1997 年基线时无心血管疾病和癌症的女性组成，随访 12 年。通过基线时的食物频率问卷获得膳食 PCB 暴露的有效估计值。通过登记链接确定中风的发病情况。
在 12 年的随访期间（397309 人年），共有 2015 例总中风病例（1532 例缺血性中风、216 例颅内出血、94 例蛛网膜下腔出血和 173 例未明确的中风）。多变量调整后的相对风险（RR），控制了已知的中风危险因素和鱼类的摄入，在膳食 PCB 暴露最高四分位的女性中，总中风的 RR 为 1.67（95%置信区间[CI]，1.29-2.17），缺血性中风为 1.61（95% CI，1.19-2.17），出血性中风为 2.80（95% CI，1.42-5.55），而膳食 PCB 暴露最低四分位的女性 RR 为 1.00（95% CI，0.81-1.24）。
女性膳食 PCBs 暴露与中风风险增加有关，尤其是出血性中风。这些结果为鱼类消费的风险效益分析提供了重要信息，特别是对预防脑血管疾病。
