Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, University of Groningen, 9713GZ Groningen, The Netherlands.
Department of Internal Medicine, University Medical Center Groningen, University of Groningen, 9713GZ Groningen, The Netherlands.
Nutrients. 2018 Oct 3;10(10):1419. doi: 10.3390/nu10101419.
Marine-derived omega-3 polyunsaturated fatty acids (-3 PUFAs) are inversely associated with cardiovascular and all-cause mortality in renal transplant recipients (RTRs). Recommendations to increase marine-derived -3 PUFAs by increasing fish intake may have a drawback in concomitant stimulation of mercury intake, which could lead to higher circulating mercury concentrations and mitigation of otherwise beneficial effects of -3 PUFAs. We aimed to monitor circulating mercury concentrations, and to prospectively evaluate whether it counteracts the potential association between fish intake and cardiovascular and all-cause mortality in a cohort of RTRs ( = 604, 53 ± 13 years-old, 57% men) with long-term follow-up (median of 5.4 years; 121 deaths). Circulating mercury concentration (median 0.30 (IQR 0.14⁻0.63) µg/L) positively associated with fish intake (std. β = 0.21, < 0.001). Multivariable-adjusted Cox-proportional hazards regression analyses showed that prior to, and after additional adjustment for circulating mercury concentrations, fish intake was inversely associated with both cardiovascular (HR 0.75, 95% CI 0.58⁻0.96; and, HR 0.75, 95% CI 0.58⁻0.97, respectively) and all-cause mortality (HR 0.84, 95% CI 0.72⁻0.97; and, HR 0.86, 95% CI 0.74⁻0.99, respectively). Secondary analyses accounting for marine-derived -3 PUFAs intake revealed associations of similar magnitude. In conclusion, we found no evidence of a counteracting effect conferred by circulating mercury concentrations on the associations between fish and marine-derived -3 PUFAs intake and the risks of cardiovascular and all-cause mortality in RTRs.
海产 ω-3 多不饱和脂肪酸（ω-3 PUFA）与肾移植受者（RTR）的心血管和全因死亡率呈负相关。通过增加鱼类摄入量来增加海产 ω-3 PUFA 的建议可能存在缺点，因为这会同时刺激汞的摄入，从而导致循环汞浓度升高，并减轻 ω-3 PUFA 的有益影响。我们旨在监测循环汞浓度，并前瞻性评估它是否会抵消鱼类摄入量与心血管和全因死亡率之间的潜在关联，该研究队列包括 604 名 RTR（=604，53±13 岁，57%为男性），随访时间较长（中位数为 5.4 年；121 人死亡）。循环汞浓度（中位数 0.30（IQR 0.14⁻0.63）µg/L）与鱼类摄入量呈正相关（标准 β=0.21， < 0.001）。多变量调整的 Cox 比例风险回归分析表明，在调整循环汞浓度之前和之后，鱼类摄入量与心血管疾病（HR 0.75，95%CI 0.58⁻0.96；和 HR 0.75，95%CI 0.58⁻0.97）和全因死亡率（HR 0.84，95%CI 0.72⁻0.97；和 HR 0.86，95%CI 0.74⁻0.99）均呈负相关。考虑到海产 ω-3 PUFAs 摄入量的二次分析显示出相似的关联程度。总之，我们没有发现循环汞浓度对鱼类和海产 ω-3 PUFAs 摄入量与 RTR 心血管和全因死亡率风险之间关联的拮抗作用的证据。
