Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Box 210, 171 77 Stockholm, Sweden.
Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Box 210, 171 77 Stockholm, Sweden.
Clin Nutr. 2018 Apr;37(2):590-596. doi: 10.1016/j.clnu.2017.01.012. Epub 2017 Jan 28.
BACKGROUND & AIMS: The accumulated evidence supports an inverse association of fish consumption with cardiovascular disease and mortality, but data among patients with type 2 diabetes are sparse. We aimed to assess fish consumption in relation to myocardial infarction (MI), stroke and mortality among individuals with type 2 diabetes.
Women and men with diagnosed type 2 diabetes (n = 2225; aged 45-84 years) within two population-based cohorts (the Swedish Mammography Cohort and the Cohort of Swedish Men) were followed from 1998 through 2012. Cox proportional hazards models were used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs).
We identified 333 incident MI events, 321 incident stroke events and 771 deaths (154 with coronary heart disease [CHD] as underlying cause) during follow-up of up to 15 years. The multivariable HRs comparing >3 servings/week with ≤3 servings/month were 0.60 (95% CI, 0.39-0.92) for MI and 1.04 (95% CI, 0.66-1.64) for stroke. HRs for total mortality were lowest for moderate fish consumption of 1-<2 servings/week (0.82; 95% CI, 0.64-1.04) and 2-3 servings/week (0.79; 95% CI, 0.61-1.01) compared with ≤3 servings/month. The corresponding HRs for CHD-related mortality were 0.53; 95% CI, 0.32-0.90 and 0.75; 95% CI, 0.45-1.27.
Fish consumption was associated with lower MI incidence among individuals with type 2 diabetes, whereas no association was observed with stroke. Our data further indicated an association with lower mortality, particularly for CHD-related deaths. These findings support the current general advice on regular fish consumption also in the high risk group of type 2 diabetes patients.
越来越多的证据表明，吃鱼与心血管疾病和死亡率呈负相关，但 2 型糖尿病患者的数据却很少。我们旨在评估 2 型糖尿病患者的鱼类摄入量与心肌梗死（MI）、中风和死亡率之间的关系。
在两个基于人群的队列（瑞典乳腺 X 线摄影队列和瑞典男性队列）中，患有已确诊 2 型糖尿病的女性和男性（n=2225；年龄 45-84 岁）从 1998 年随访至 2012 年。使用 Cox 比例风险模型估计风险比（HR）及其 95%置信区间（CI）。
在长达 15 年的随访期间，共发生 333 例 MI 事件、321 例中风事件和 771 例死亡（154 例为冠心病[CHD]为根本死因）。与每周≤3 份相比，每周>3 份的多变量 HR 分别为 0.60（95%CI，0.39-0.92）和 1.04（95%CI，0.66-1.64）。总死亡率的 HR 最低，为中等鱼类摄入量（每周 1-<2 份）和每周 2-3 份（0.82；95%CI，0.64-1.04 和 0.79；95%CI，0.61-1.01），与每月≤3 份相比。CHD 相关死亡率的相应 HR 为 0.53；95%CI，0.32-0.90 和 0.75；95%CI，0.45-1.27。
鱼类摄入量与 2 型糖尿病患者的 MI 发生率降低有关，而与中风无关。我们的数据进一步表明，与死亡率降低有关，特别是与 CHD 相关的死亡。这些发现支持目前关于定期吃鱼的一般建议，即使在 2 型糖尿病高危人群中也是如此。
