Boden Institute of Obesity, Nutrition, Exercise, and Eating Disorders, Charles Perkins Centre, Sydney Medical School, University of Sydney, Sydney, Australia.
Adv Nutr. 2018 Mar 1;9(2):99-104. doi: 10.1093/advances/nmx012.
Precision medicine refers to treatment or prevention strategies in a group of individuals identified by their phenotype or genotype. Dietary components or patterns may play an important role in precision medicine. There is emerging evidence to support a role for n-3 (ω-3) fatty acids in lowering blood pressure and reducing the extent of subclinical atherosclerosis in people born with impaired fetal growth, a group at increased risk of coronary artery disease partly due to an increased risk of hypertensive disorders. The evidence linking n-3 fatty acid intake with less atherosclerosis and lower blood pressure in people with impaired fetal growth has been derived from studies in young children, adolescents, and adults and has included dietary assessments by questionnaires and circulating biomarkers. Furthermore, results appear to be similar for shorter chain n-3 fatty acids from plant sources and long-chain n-3 fatty acids from marine sources. The general framework used to develop this evidence, consisting of hypothesis-driven analyses from observational studies and post hoc analyses of a randomized clinical trial, before a priori testing as a primary outcome in randomized trials, is presented and proposed as a potential model for the identification and development of dietary precision medicine strategies.
精准医学是指针对通过表型或基因型鉴定的特定人群的治疗或预防策略。饮食成分或模式可能在精准医学中发挥重要作用。越来越多的证据表明，n-3（ω-3）脂肪酸在降低血压和减少亚临床动脉粥样硬化程度方面具有作用，这些人在胎儿生长受损的情况下出生，由于高血压疾病风险增加，他们患冠状动脉疾病的风险增加。在胎儿生长受损的人群中，n-3 脂肪酸摄入量与较少的动脉粥样硬化和较低的血压相关的证据来自对幼儿、青少年和成年人的研究，并包括通过问卷调查和循环生物标志物进行的饮食评估。此外，来自植物源的短链 n-3 脂肪酸和来自海洋源的长链 n-3 脂肪酸的结果似乎相似。提出了用于开发该证据的一般框架，该框架由来自观察性研究的假设驱动分析和随机临床试验的事后分析组成，然后在随机临床试验中作为主要结果进行了预先测试，该框架被提出作为鉴定和开发饮食精准医学策略的潜在模型。
