Wu Yihua, Qian Yufeng, Pan Yiwen, Li Peiwei, Yang Jun, Ye Xianhua, Xu Geng
Department of Epidemiology and Health Statistics, Zhejiang University School of Public Health, Hangzhou, 310058, China.
Department of Cardiology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, China.
Clin Nutr. 2015 Aug;34(4):603-11. doi: 10.1016/j.clnu.2014.05.009. Epub 2014 May 28.
BACKGROUND & AIMS: The association between coronary heart disease (CHD) and dietary fiber intake is not consistent, especially for the subtypes of dietary fiber. The aim of our study was to conduct a meta-analysis of existing cohort published studies assessing the association between dietary fiber intake and risk of CHD, and quantitatively estimating their dose-response relationships.
We searched PubMed and EMBASE before May 2013. Random-effect model was used to calculate the pool relative risk (RRs) for the incidence and mortality of CHD. Dose-response, subgroup analyses based on fiber subtypes, heterogeneity and publication bias were also carried out.
Eighteen studies involving 672,408 individuals were finally included in the present study. The pooled-adjusted RRs of coronary heart disease for the highest versus lowest category of fiber intake were 0.93 (95% confidence interval (CI), 0.91-0.96, P < 0.001) for incidence of all coronary events and 0.83 (95% CI, 0.76-0.91, P < 0.001) for mortality. Further subgroup analyses based on fiber subtypes (cereal, fruit, and vegetable fiber), indicated that RRs were 0.92 (95% CI, 0.85-0.99, P = 0.032), 0.92 (95% CI, 0.86-0.98, P = 0.01), 0.95 (95% CI, 0.89-1.01, P = 0.098) respectively for all coronary event and 0.81 (95% CI, 0.72-0.92, P = 0.001), 0.68 (95% CI, 0.43-1.07, P = 0.094), 0.91 (95% CI, 0.74-1.12, P = 0.383) for mortality. In addition, a significant dose-response relationship was observed between fiber intake and the incidence and mortality of CHD (P < 0.001).
Our results indicate that consumption of dietary fiber is inversely associated with risk of coronary heart disease, especially for fiber from cereals and fruits. Besides, soluble and insoluble fibers have the similar effect. A significant dose-response relationship is also observed between fiber intake and CHD risk.
冠心病（CHD）与膳食纤维摄入量之间的关联并不一致，尤其是对于膳食纤维的亚型而言。我们研究的目的是对已发表的队列研究进行荟萃分析，评估膳食纤维摄入量与冠心病风险之间的关联，并定量估计它们的剂量反应关系。
我们检索了2013年5月之前的PubMed和EMBASE数据库。采用随机效应模型计算冠心病发病和死亡的合并相对风险（RRs）。还进行了剂量反应分析、基于纤维亚型的亚组分析、异质性分析和发表偏倚分析。
本研究最终纳入了18项涉及672408人的研究。纤维摄入量最高组与最低组相比，所有冠心病事件发病的合并调整RRs为0.93（95%置信区间（CI），0.91 - 0.96，P < 0.001），死亡的合并调整RRs为0.83（95%CI，0.76 - 0.91，P < 0.001）。基于纤维亚型（谷物、水果和蔬菜纤维）的进一步亚组分析表明，所有冠心病事件的RRs分别为0.92（95%CI，0.85 - 0.99，P = 0.032）、0.92（95%CI，0.86 - 0.98，P = 0.01）、0.95（95%CI，0.89 - 1.01，P = 0.098），死亡的RRs分别为0.81（95%CI，0.72 - 0.92，P = 0.001）、0.68（95%CI，0.43 - 1.07，P = 0.094）、0.91（95%CI，0.74 - 1.12，P = 0.383）。此外，观察到纤维摄入量与冠心病的发病和死亡之间存在显著的剂量反应关系（P < 0.001）。
我们的结果表明，膳食纤维的摄入与冠心病风险呈负相关，尤其是谷物和水果中的纤维。此外，可溶性纤维和不溶性纤维具有相似的作用。在纤维摄入量与冠心病风险之间也观察到显著的剂量反应关系。
