Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada; Division of Clinical Epidemiology, Research Institute of McGill University Health Centre, Montreal, Quebec, Canada.
Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada.
Am J Med. 2014 Sep;127(9):848-57.e2. doi: 10.1016/j.amjmed.2014.04.016. Epub 2014 May 4.
Findings on the association between fish consumption and acute coronary syndrome are inconsistent. We assessed the role of fish consumption in acute coronary syndrome by conducting a dose-response meta-analysis.
We conducted a literature search of MEDLINE and Embase databases from 1966 to June 2013 for prospective cohort and case-control studies that evaluated the association between fish consumption and acute coronary syndrome among general populations without cardiovascular disease history. Additional studies were identified via hand search of references of relevant articles. Estimates of relative risk (RR) were pooled using random-effects model. Sex and age effects were also evaluated.
Our search retrieved 11 prospective cohort and 8 case-control studies, totaling 408,305 participants. Among prospective cohort studies, the highest category of fish consumption (ie, ≥4 times per week) was associated with the greatest risk reduction in acute coronary syndrome (RR 0.79; 95% confidence interval [CI], 0.70-0.89). In dose-response analysis, each additional 100-g serving of fish per week was associated with a 5% reduced risk (RR per serving 0.95; 95% CI, 0.92-0.97). Subgroup analysis and meta-regression suggested that the risk reduction did not differ across sex or age groups. No heterogeneity was observed among prospective cohort (P = .73) and case-control (P = .29) studies. There was no evidence of publication bias.
Our meta-analysis demonstrated that there is an inverse association between fish consumption and the risk of acute coronary syndrome. Fish consumption appears beneficial in the primary prevention of acute coronary syndrome, and higher consumption is associated with greater protection.
关于鱼类摄入与急性冠状动脉综合征之间关联的研究结果并不一致。我们通过进行剂量反应荟萃分析评估了鱼类摄入在急性冠状动脉综合征中的作用。
我们对 1966 年至 2013 年 6 月期间 MEDLINE 和 Embase 数据库进行了文献检索，以评估无心血管疾病病史的一般人群中鱼类摄入与急性冠状动脉综合征之间的关联。通过对相关文章参考文献的手工搜索，确定了其他研究。使用随机效应模型汇总相对风险（RR）的估计值。还评估了性别和年龄的影响。
我们的搜索共检索到 11 项前瞻性队列研究和 8 项病例对照研究，总计 408305 名参与者。在前瞻性队列研究中，鱼类摄入量最高的类别（即每周≥4 次）与急性冠状动脉综合征风险的最大降低相关（RR 0.79；95%置信区间 [CI]，0.70-0.89）。在剂量反应分析中，每周额外摄入 100 克鱼类与降低 5%的风险相关（每摄入 100 克 RR 0.95；95%CI，0.92-0.97）。亚组分析和荟萃回归表明，这种风险降低在性别或年龄组之间没有差异。前瞻性队列（P=0.73）和病例对照（P=0.29）研究之间没有观察到异质性。没有发表偏倚的证据。
我们的荟萃分析表明，鱼类摄入与急性冠状动脉综合征风险之间存在负相关。鱼类摄入似乎对急性冠状动脉综合征的一级预防有益，并且摄入较高与更大的保护作用相关。
