Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, CEI UAM+CSIC, Madrid, Spain.
J Intern Med. 2020 Feb;287(2):197-209. doi: 10.1111/joim.12995. Epub 2019 Nov 8.
Co-exposure to environmental contaminants present in fish could mitigate the beneficial effects of fish consumption and possibly explain the lack of association observed for mortality in some geographical regions.
To assess the independent associations of dietary exposure to polychlorinated biphenyls (PCBs) and long-chain omega-3 fish fatty acids intake with cardiovascular and cancer mortality.
We used the prospective population-based Swedish Mammography Cohort and the Cohort of Swedish Men comprising 32 952 women and 36 545 men, free from cancer, cardiovascular disease and diabetes at baseline in 1998. Validated estimates of dietary PCBs and long-chain omega-3 fish fatty acids [i.e. eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)] intake were obtained via a food frequency questionnaire at baseline. Information on death was ascertained through register linkage.
During a mean follow-up of 15.5 years, we ascertained 16 776 deaths. We observed for cardiovascular mortality, comparing extreme quintiles in multivariable models mutually adjusted for PCBs and EPA-DHA, dose-dependent associations for dietary PCB exposure, hazard ratio (HR) 1.31 (CI 95%: 1.08 to 1.57; P-trend 0.005) and for dietary EPA-DHA intake, HR 0.79 (CI 95%: 0.66 to 0.95; P-trend 0.041). For cancer mortality, no clear associations were discerned.
The beneficial effect of fish consumption on the cardiovascular system seems compromised by co-exposure to PCBs - one likely explanation for the inconsistent associations observed between fish consumption and mortality.
鱼类中存在的环境污染物共同暴露可能会降低鱼类消费的有益影响，并可能解释在某些地理区域观察到的死亡率缺乏关联的原因。
评估膳食中多氯联苯 (PCBs) 和长链欧米伽-3 鱼类脂肪酸暴露与心血管疾病和癌症死亡率的独立关联。
我们使用前瞻性基于人群的瑞典乳腺 X 线摄影队列和瑞典男性队列，该队列包括 32952 名女性和 36545 名男性，在 1998 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膳食 PCBs 和长链欧米伽-3 鱼类脂肪酸（即二十碳五烯酸 (EPA) 和二十二碳六烯酸 (DHA)) 摄入的有效估计值。通过登记链接确定死亡信息。
在平均 15.5 年的随访期间，我们确定了 16776 例死亡。在多变量模型中，比较了多变量模型中极端五分位数的心血管死亡率，发现膳食 PCB 暴露呈剂量依赖性，危险比 (HR) 为 1.31 (95%CI：1.08 至 1.57；P 趋势=0.005)，膳食 EPA-DHA 摄入的 HR 为 0.79 (95%CI：0.66 至 0.95；P 趋势=0.041)。对于癌症死亡率，没有明显的关联。
鱼类消费对心血管系统的有益影响似乎因与 PCBs 的共同暴露而受到损害——这可能是解释鱼类消费与死亡率之间不一致关联的一个原因。
