Owen Alice J, Magliano Dianna J, O'Dea Kerin, Barr Elizabeth L M, Shaw Jonathan E
Department of Epidemiology and Preventive Medicine, Monash University, 6th Floor, The Alfred Centre, 99 Commercial Rd, Melbourne, 3004, Australia.
Baker IDI Heart and Diabetes Institute, Melbourne, Australia.
Eur J Nutr. 2016 Jun;55(4):1605-13. doi: 10.1007/s00394-015-0979-x. Epub 2015 Jul 23.
The aim of this study was to examine the relationship between polyunsaturated fatty acids (PUFA) intake (n-6 and n-3) and mortality in a population-based sample with a low fish intake.
Cox regression was used to examine the relationships between dietary PUFA intake and all-cause or CVD mortality in the Australian Diabetes, Obesity and Lifestyle Study (AusDiab) cohort, a population of 11,247 Australians aged ≥25 years recruited in 1999/2000 and followed until 2012. Demographic, lifestyle and behavioural information were collected by questionnaire and fasting blood tests undertaken. Dietary intake was collected by a 121-item food frequency questionnaire. Vital status and causes of death were collected by death registry linkage.
Those in the highest quintile of n-6 PUFA intake had lower risk of CVD mortality (HR 0.57, 95 % CI 0.38-0.86) after age and sex adjustment, but this failed to retain significance after further risk factor adjustment. Consumption of ≥1 serves/week of non-fried fish was associated with reduced risk of CVD mortality (HR 0.64, 95 % CI 0.45-0.91, p = 0.013) compared to those eating less than 1 serve/month, after sex and age adjustment, but did not retain significance after further adjustment. However, long-chain n-3 intake was not associated with CVD mortality, and those in the highest quintile of n-3 intake had a higher risk of all-cause mortality.
These findings do not support previous suggestions that n-6 PUFA have adverse effects on CVD risk. Greater intake of non-fried fish was associated with lower risk of CVD mortality, but those with the highest total n-3 intake were at slightly increased risk of all-cause mortality.
本研究旨在探讨在鱼类摄入量较低的人群样本中，多不饱和脂肪酸（PUFA，包括n-6和n-3）摄入量与死亡率之间的关系。
采用Cox回归分析澳大利亚糖尿病、肥胖与生活方式研究（AusDiab）队列中膳食PUFA摄入量与全因死亡率或心血管疾病（CVD）死亡率之间的关系。该队列由1999/2000年招募的11247名年龄≥25岁的澳大利亚人组成，随访至2012年。通过问卷调查收集人口统计学、生活方式和行为信息，并进行空腹血液检测。通过121项食物频率问卷收集膳食摄入量。通过与死亡登记处链接收集生命状态和死亡原因。
在调整年龄和性别后，n-6 PUFA摄入量处于最高五分位数的人群CVD死亡率风险较低（风险比[HR]为0.57，95%置信区间[CI]为0.38 - 0.86），但在进一步调整风险因素后，该结果不再具有统计学意义。与每月食用鱼类少于1份的人群相比，每周食用≥1份非油炸鱼的人群在调整性别和年龄后CVD死亡率风险降低（HR为0.64，95% CI为0.45 - 0.91，p = 0.013），但在进一步调整后该结果不再具有统计学意义。然而，长链n-3摄入量与CVD死亡率无关，n-3摄入量处于最高五分位数的人群全因死亡率风险较高。
这些研究结果不支持之前关于n-6 PUFA对CVD风险有不利影响的观点。更多地摄入非油炸鱼与较低的CVD死亡率风险相关，但n-3总摄入量最高的人群全因死亡率风险略有增加。
