Institute of Environmental Medicine, Karolinska Institutet, Box 210, SE-171 77 Stockholm, Sweden.
Department of Biomedical Science and Veterinary Public Health, Swedish University of Agricultural Sciences, Box 7028, SE-750 07 Uppsala, Sweden.
Environ Int. 2019 May;126:1-6. doi: 10.1016/j.envint.2019.01.069. Epub 2019 Feb 15.
Beneficial effects of fish consumption on heart failure (HF) may be modified by contaminants in fish. Polychlorinated biphenyls (PCBs) are of particular concern as they have been associated with well-established risk factors of HF, but current data are limited.
We aimed to assess the association between dietary PCB exposure and risk of HF, accounting for dietary intake of long-chain omega-3 fish fatty acids.
We used the prospective population-based research structure SIMPLER (previously the Swedish Mammography Cohort and Cohort of Swedish Men) comprising 32,952 women and 36,546 men, free from cancer, cardiovascular disease and diabetes at baseline in 1997. Validated estimates of dietary PCBs and long-chain omega-3 fish fatty acids [eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA)] were obtained via a food frequency questionnaire at baseline. Incident cases of HF were ascertained through register linkage.
During an average of 12 years of follow-up, we ascertained 2736 and 3128 incident cases of HF in women and men, respectively. In multivariable-adjusted models, mutually adjusted for PCBs and EPA-DHA, the relative risk (RR) for dietary PCB exposure was 1.48 (95% CI 1.12-1.96) in women and 1.42 (95% CI 1.08-1.86) in men, comparing extreme quintiles. Corresponding RRs for EPA-DHA intake were 0.71 (95% CI 0.54-0.93) and 0.82 (95% CI 0.63-1.07), respectively.
Dietary exposure to PCBs was associated with an increased risk of HF in both women and men. EPA-DHA intake was associated with a lower risk of HF in women, with a similar tendency in men.
鱼类消费对心力衰竭（HF）的有益影响可能会因鱼类中的污染物而改变。多氯联苯（PCBs）特别令人关注，因为它们与 HF 的既定风险因素有关，但目前的数据有限。
我们旨在评估饮食 PCB 暴露与 HF 风险之间的关联，同时考虑长链 ω-3 鱼类脂肪酸的饮食摄入量。
我们使用前瞻性人群为基础的研究结构 SIMPLER（前身为瑞典乳腺摄影队列和瑞典男性队列），该研究包括 32952 名女性和 36546 名男性，在 1997 年基线时无癌症、心血管疾病和糖尿病。通过基线时的食物频率问卷获得了饮食 PCBs 和长链 ω-3 鱼类脂肪酸[二十碳五烯酸（EPA）和二十二碳六烯酸（DHA）]的有效估计值。通过登记链接确定 HF 的新发病例。
在平均 12 年的随访期间，我们分别在女性和男性中确定了 2736 例和 3128 例 HF 新发病例。在多变量调整模型中，对于 PCBs 和 EPA-DHA 进行相互调整，饮食 PCB 暴露的相对风险（RR）在女性中为 1.48（95%CI 1.12-1.96），在男性中为 1.42（95%CI 1.08-1.86），比较极端五分位数。EPA-DHA 摄入量的相应 RR 分别为 0.71（95%CI 0.54-0.93）和 0.82（95%CI 0.63-1.07）。
饮食中 PCB 的暴露与女性和男性 HF 风险的增加有关。EPA-DHA 的摄入量与女性 HF 的风险降低有关，男性也有类似的趋势。
