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膳食镁摄入量与心血管疾病死亡率之间的剂量反应关系:前瞻性研究的系统评价和基于剂量的meta回归分析

Dose-response relationship between dietary magnesium intake and cardiovascular mortality: A systematic review and dose-based meta-regression analysis of prospective studies.

作者信息

Fang Xin, Liang Chun, Li Mei, Montgomery Scott, Fall Katja, Aaseth Jan, Cao Yang

机构信息

Unit of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, 17177 Stockholm, Sweden.

Department of Cardiology, Shanghai Changzheng Hospital, Second Military Medical University, 200003 Shanghai, China.

出版信息

J Trace Elem Med Biol. 2016 Dec;38:64-73. doi: 10.1016/j.jtemb.2016.03.014. Epub 2016 Mar 29.

Abstract

BACKGROUND

Although epidemiology studies have reported the relationship, including a dose-response relationship, between dietary magnesium intake and risk of cardiovascular disease (CVD), the risk for CVD mortality is inconclusive and the evidence for a dose-response relationship has not been summarized.

OBJECTIVE

We conducted a systematic review and meta-analysis of prospective studies to summarize the evidence regarding the association of dietary magnesium intake with risk of CVD mortality and describe their dose-response relationship.

DESIGN

We identified relevant studies by searching major scientific literature databases and grey literature resources from their inception to August 2015, and reviewed references lists of retrieved articles. We included population-based studies that reported mortality risks, i.e. relative risks (RRs), odds ratios (ORs) or hazard ratios (HRs) of CVD mortality or cause-specific CVD death. Linear dose-response relationships were assessed using random-effects meta-regression. Potential nonlinear associations were evaluated using restricted cubic splines.

RESULTS

Out of 3002 articles, 9 articles from 8 independent studies met the eligibility criteria. These studies comprised 449,748 individuals and 10,313 CVD deaths. Compared with the lowest dietary magnesium consumption group in the population, the risk of CVD mortality was reduced by 16% in women and 8% in men. No significant linear dose-response relationship was found between increment in dietary magnesium intake and CVD mortality across all the studies. After adjusting for age and BMI, the risk of CVD mortality was reduced by 24-25% per 100mg/d increment in dietary magnesium intake in women of all the participants and in all the US participants.

CONCLUSION

Although the combined data confirm the role of dietary magnesium intake in reducing CVD mortality, the dose-response relationship was only found among women and in US population.

摘要

背景

尽管流行病学研究报告了膳食镁摄入量与心血管疾病(CVD)风险之间的关系,包括剂量反应关系,但CVD死亡率的风险尚无定论,且剂量反应关系的证据尚未得到总结。

目的

我们对前瞻性研究进行了系统评价和荟萃分析,以总结膳食镁摄入量与CVD死亡率风险之间关联的证据,并描述它们的剂量反应关系。

设计

我们通过检索主要科学文献数据库和从其创刊至2015年8月的灰色文献资源来识别相关研究,并查阅检索到的文章的参考文献列表。我们纳入了报告死亡率风险的基于人群的研究,即CVD死亡率或特定病因CVD死亡的相对风险(RRs)、比值比(ORs)或风险比(HRs)。使用随机效应荟萃回归评估线性剂量反应关系。使用受限立方样条评估潜在的非线性关联。

结果

在3002篇文章中,来自8项独立研究的9篇文章符合纳入标准。这些研究包括449,748名个体和10,313例CVD死亡。与人群中膳食镁摄入量最低的组相比,女性CVD死亡率风险降低了16%,男性降低了8%。在所有研究中,膳食镁摄入量增加与CVD死亡率之间未发现显著的线性剂量反应关系。在调整年龄和BMI后,所有参与者中的女性以及所有美国参与者中,膳食镁摄入量每增加100mg/d,CVD死亡率风险降低24 - 25%。

结论

尽管综合数据证实了膳食镁摄入量在降低CVD死亡率中的作用,但剂量反应关系仅在女性和美国人群中发现。

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