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[对ω-3脂肪酸作用的困惑:考虑ω-3指数的研究数据思考]

[Confusion about the effects of omega-3 fatty acids : Contemplation of study data taking the omega-3 index into consideration].

作者信息

von Schacky C

机构信息

Präventive Kardiologie, Medizinische Klinik I, Ludwig-Maximilians-Universität München, Ziemssenstr. 1, 80336, München, Deutschland.

出版信息

Internist (Berl). 2019 Dec;60(12):1319-1327. doi: 10.1007/s00108-019-00687-x.

DOI:10.1007/s00108-019-00687-x
PMID:31591673
Abstract

BACKGROUND

Confusion reigns about omega‑3 fatty acids and their effects. Scientific investigations did not appear to clarify the issue. Guidelines and regulatory authorities contradict each other.

OBJECTIVE

This article provides clarity by considering not intake but levels of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) in erythrocytes as a percentage of all fatty acids measured (omega‑3 index).

CURRENT DATA

The largest database of all methods of fatty acid analyses has been generated with the standardized HS-Omega‑3 Index® (Omegametrix, Martinsried, Deutschland). The omega‑3 index assesses the in EPA+DHA status of a person, has a minimum of 2%, a maximum of 20%, and is optimal between 8% and 11%. In many western countries but not in Japan or South Korea, mean levels are suboptimal. Suboptimal levels correlate with increased total mortality, sudden cardiac death, fatal and non-fatal myocardial infarction, other cardiovascular diseases, cognitive impairment, major depression, premature birth and other health issues. Interventional studies on surrogate and intermediary parameters demonstrated many positive effects, correlating with the omega‑3 index when measured. Due to issues in methodology that became apparent from the perspective of the omega‑3 index many, even large interventional trials with clinical endpoints were not positive, which is reflected in pertinent meta-analyses. In contrast, interventional trials without issues in methodology the clinical endpoints mentioned were reduced.

CONCLUSION

All humans have levels of EPA+DHA that if methodologically correctly assessed in erythrocytes, are optimal between 8% and 11%. Deficits can cause serious health issues that can be prevented by optimal levels.

摘要

背景

关于ω-3脂肪酸及其作用,目前存在诸多混淆。科学研究似乎并未澄清这一问题。指南和监管机构的观点相互矛盾。

目的

本文通过考虑红细胞中二十碳五烯酸(EPA)和二十二碳六烯酸(DHA)的水平占所测全部脂肪酸的百分比(ω-3指数)来厘清这一问题。

当前数据

通过标准化的HS-Omega-3 Index®(德国马丁斯里德的Omegametrix公司)生成了所有脂肪酸分析方法中最大的数据库。ω-3指数评估一个人的EPA+DHA状态,最低为2%,最高为20%,最佳范围在8%至11%之间。在许多西方国家,但日本和韩国并非如此,平均水平未达最佳。次优水平与总死亡率增加、心源性猝死、致命和非致命性心肌梗死、其他心血管疾病、认知障碍、重度抑郁症、早产及其他健康问题相关。关于替代和中间参数的干预性研究显示出许多积极影响,测量时与ω-3指数相关。由于从ω-3指数角度来看方法学上存在问题,许多甚至大型的有临床终点的干预试验结果并不乐观,这在相关的荟萃分析中有所体现。相比之下,方法学无问题的干预试验能降低上述提及的临床终点。

结论

所有人红细胞中EPA+DHA的水平,如果在方法学上能正确评估,最佳范围在8%至11%之间。缺乏这些脂肪酸会导致严重健康问题,而最佳水平可预防这些问题。

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本文引用的文献

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ESPEN guideline on clinical nutrition in liver disease.ESPEN 临床肝病营养指南。
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ω-3指数低且心率变异性降低的双相情感障碍患者补充ω-3脂肪酸:“BIPO-3”试验
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