Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, Suzhou, 215123, China.
DSM Nutritional Products, Human Nutrition and Health, 4303, Kaiseraugst, Switzerland.
Eur J Clin Nutr. 2018 Jun;72(6):805-817. doi: 10.1038/s41430-017-0052-3. Epub 2017 Dec 28.
Elevated resting heart rate (HR) has emerged as a new risk factor for all-cause and cardiovascular mortality. The effect of marine-derived omega-3 long-chain polyunsaturated fatty acid (n-3 LCPUFAs) supplementation on HR was investigated as an outcome in many clinical trials. The present study was to provide an updated meta-analysis on the HR-slowing effect of n-3 LCPUFAs, and to differentiate the chronotropic effect between eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).
PubMed and Cochrane databases were searched for relevant articles examining the effects of n-3 PUFAs on HR through May 2017. A random-effects model was used to generate the pooled effect sizes and 95% confidence intervals (CIs). The pooled effect sizes were presented as weighted mean differences (WMDs).
A total of 51 randomized controlled trials (RCTs) with approximately 3000 participants were included in this meta-analysis. Compared to placebo, n-3 PUFA supplementation mildly but significantly reduced HR (-2.23 bpm; 95% CI: -3.07, -1.40 bpm). Moderate evidence of heterogeneity was observed among included trials (I = 49.1%, P heterogeneity < 0.001). When DHA and EPA were separately administered, modest HR reduction was observed in trials that supplemented with DHA (-2.47 bpm; 95% CI: -3.47, -1.46 bpm), but not in trials with EPA.
The present meta-analysis provides strong clinical evidence demonstrating the effect of heart rate reduction by n-3 LCPUFA supplementation. When DHA or EPA administered alone, heart rate was slowed by DHA rather than by EPA.
静息心率（HR）升高已成为全因和心血管死亡率的一个新的危险因素。许多临床试验都将海洋衍生的ω-3 长链多不饱和脂肪酸（n-3 LCPUFA）补充作为心率的结果进行了研究。本研究旨在提供 n-3 LCPUFA 减慢心率作用的最新荟萃分析，并区分二十碳五烯酸（EPA）和二十二碳六烯酸（DHA）的变时作用。
通过 2017 年 5 月，在 PubMed 和 Cochrane 数据库中搜索了关于 n-3 PUFAs 对 HR 影响的相关文章。使用随机效应模型生成汇总效应大小和 95％置信区间（CI）。汇总效应大小以加权均数差值（WMD）表示。
本荟萃分析共纳入了 51 项随机对照试验（RCT），约有 3000 名参与者。与安慰剂相比，n-3 PUFA 补充剂可轻度但显著降低 HR（-2.23 bpm；95％CI：-3.07，-1.40 bpm）。纳入试验存在中度异质性（I = 49.1％，P 异质性 < 0.001）。当分别给予 DHA 和 EPA 时，补充 DHA 的试验观察到适度的 HR 降低（-2.47 bpm；95％CI：-3.47，-1.46 bpm），而 EPA 试验则没有。
本荟萃分析提供了有力的临床证据，证明了 n-3 LCPUFA 补充剂可降低心率。当单独给予 DHA 或 EPA 时，DHA 可减慢心率，而 EPA 则不能。
