Yang Bo, Ren Xiao-Li, Huang Hong, Guo Xiao-Juan, Ma Ai-Guo, Li Duo
School of Public Health, Qingdao University, Qingdao, China.
Key Laboratory of Watershed Science and Health of Zhejiang Province, School of Public Health, Wenzhou Medical University, Wenzhou, China.
Oncotarget. 2017 Jul 25;8(48):83781-83791. doi: 10.18632/oncotarget.19530. eCollection 2017 Oct 13.
Circulating long-chain (LC) n-3 polyunsaturated fatty acid (PUFA) can provide objective measures that reflect both dietary consumption and relevant biological processes. Nevertheless, prospective cohort studies on circulating LC n-3 PUFA in relation to incidence of stroke have yielded inconsistent results. We therefore conducted a meta-analysis to quantitatively evaluate the association.
A total of 2,836 stroke events occurred among 20,460 individuals aged 35-79 yr from 10 prospective cohort studies. Circulating LC n-3 PUFA was significantly associated with reduced risk of stroke (RR: 0.86; 95% CI: 0.76, 0.98; = 0.00%), especially 22:5n-3 (RR: 0.74; 95% CI: 0.60, 0.92) and 22:6n-3 (RR: 0.78; 95% CI: 0.65, 0.94). The associations were more pronounced with ischemic stroke (RR: 0.81; 95% CI: 0.68, 0.96), but not with hemorrhagic stroke (RR: 0.95; 95% CI: 0.60, 1.49). A 1% increment of 22:5n-3 and 22:6n-3 proportions in circulating blood was associated with 25% (RR: 0.75; 95% CI: 0.64, 0.87) and 11% (RR: 0.89; 95% CI: 0.83, 0.95) reduced risk of stroke, respectively.
Pertinent studies were identified from Cochrane Library, PubMed and EMBASE database through June 2017. Multivariate-adjusted risk ratios (RRs) with 95% confidence interval (CI) for incident stroke when comparing the top with the bottom tertiles of baseline LC n-3 PUFA proportions in blood were pooled using a random-effect model.
Circulating LC n-3 PUFAs were linearly associated with reduced risk of stroke, especially 22:5n-3 and 22:6n-3. Such findings highlight the importance of circulating LC n-3 PUFA in the development of ischemic stroke.
循环长链（LC）n-3多不饱和脂肪酸（PUFA）能够提供反映饮食摄入和相关生物学过程的客观指标。然而，关于循环LC n-3 PUFA与中风发病率关系的前瞻性队列研究结果并不一致。因此，我们进行了一项荟萃分析以定量评估这种关联。
来自10项前瞻性队列研究的20460名35 - 79岁个体中，共发生了2836例中风事件。循环LC n-3 PUFA与中风风险降低显著相关（风险比：0.86；95%置信区间：0.76，0.98；P = 0.00%），尤其是22:5n-3（风险比：0.74；95%置信区间：0.60，0.92）和22:6n-3（风险比：0.78；95%置信区间：0.65，0.94）。这种关联在缺血性中风中更为明显（风险比：0.81；95%置信区间：0.68，0.96），但在出血性中风中不明显（风险比：0.95；95%置信区间：0.60，1.49）。循环血液中22:5n-3和22:6n-3比例每增加1%，中风风险分别降低25%（风险比：0.75；95%置信区间：0.64，0.87）和11%（风险比：0.89；95%置信区间：0.83，0.95）。
通过检索截至2017年6月的Cochrane图书馆、PubMed和EMBASE数据库来确定相关研究。使用随机效应模型汇总比较血液中基线LC n-3 PUFA比例最高与最低三分位数时，发生中风的多变量调整风险比（RRs）及其95%置信区间（CI）。
循环LC n-3 PUFAs与中风风险降低呈线性相关，尤其是22:5n-3和22:6n-3。这些发现突出了循环LC n-3 PUFA在缺血性中风发生发展中的重要性。
