Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA.
Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA.
Am J Clin Nutr. 2020 Jul 1;112(1):150-167. doi: 10.1093/ajcn/nqz349.
Current evidence on associations between intakes of linoleic acid (LA), the predominant n-6 (ω-6) fatty acid, and mortality is inconsistent and has not been summarized by a systematic review and meta-analysis.
The aim was to perform a systematic review and meta-analysis of prospective cohort studies to examine associations between LA intake and mortality.
We conducted a comprehensive search of MEDLINE and EMBASE databases through 31 July 2019 for prospective cohort studies reporting associations of LA (assessed by dietary surveys and/or LA concentrations in adipose tissue or blood compartments) with mortality from all causes, cardiovascular disease (CVD), and cancer. Multivariable-adjusted RRs were pooled using random-effects meta-analysis.
Thirty-eight studies reporting 44 prospective cohorts were identified; these included 811,069 participants with dietary intake assessment (170,076 all-cause, 50,786 CVD, and 59,684 cancer deaths) and 65,411 participants with biomarker measurements (9758 all-cause, 6492 CVD, and 1719 cancer deaths). Pooled RRs comparing extreme categories of dietary LA intake (high vs low) were 0.87 (95% CI: 0.81, 0.94; I2 = 67.9%) for total mortality, 0.87 (95% CI: 0.82, 0.92; I2 = 3.7%) for CVD mortality, and 0.89 (95% CI: 0.85, 0.93; I2 = 0%) for cancer mortality. Pooled RRs for each SD increment in LA concentrations in adipose tissue/blood compartments were 0.91 (95% CI: 0.87, 0.95; I2 = 64.1%) for total mortality, 0.89 (95% CI: 0.85, 0.94; I2 = 28.9%) for CVD mortality, and 0.91 (95% CI: 0.84, 0.98; I2 = 26.3%) for cancer mortality. Meta-regressions suggested baseline age and dietary assessment methods as potential sources of heterogeneity for the association between LA and total mortality.
In prospective cohort studies, higher LA intake, assessed by dietary surveys or biomarkers, was associated with a modestly lower risk of mortality from all causes, CVD, and cancer. These data support the potential long-term benefits of PUFA intake in lowering the risk of CVD and premature death.
目前关于亚油酸（LA）摄入量与死亡率之间关联的证据不一致，且尚未通过系统评价和荟萃分析进行总结。LA 是主要的 n-6（ω-6）脂肪酸。
本研究旨在通过系统评价和荟萃分析前瞻性队列研究，检验 LA 摄入量与死亡率之间的关联。
我们通过 MEDLINE 和 EMBASE 数据库检索，截至 2019 年 7 月 31 日，以获取评估 LA（通过膳食调查和/或脂肪组织或血液成分中 LA 浓度评估）与全因、心血管疾病（CVD）和癌症死亡率相关性的前瞻性队列研究。使用随机效应荟萃分析汇总多变量调整后的 RR。
共确定了 38 项研究报告的 44 项前瞻性队列研究；这些研究共纳入了 811069 名接受膳食摄入量评估的参与者（170076 例全因死亡、50786 例 CVD 死亡和 59684 例癌症死亡）和 65411 名接受生物标志物测量的参与者（9758 例全因死亡、6492 例 CVD 死亡和 1719 例癌症死亡）。比较饮食中 LA 摄入量最高和最低两个极端类别（高 vs 低）的 RR 分别为：全因死亡率为 0.87（95%CI：0.81，0.94；I2=67.9%）、CVD 死亡率为 0.87（95%CI：0.82，0.92；I2=3.7%）和癌症死亡率为 0.89（95%CI：0.85，0.93；I2=0%）。脂肪组织/血液成分中 LA 浓度每增加 1 个 SD 的 RR 分别为：全因死亡率为 0.91（95%CI：0.87，0.95；I2=64.1%）、CVD 死亡率为 0.89（95%CI：0.85，0.94；I2=28.9%）和癌症死亡率为 0.91（95%CI：0.84，0.98；I2=26.3%）。荟萃回归分析表明，基线年龄和膳食评估方法可能是 LA 与全因死亡率之间关联的异质性来源。
在前瞻性队列研究中，通过膳食调查或生物标志物评估的 LA 摄入量较高与全因、CVD 和癌症死亡率的风险降低适度相关。这些数据支持摄入多不饱和脂肪酸（PUFA）可能具有长期益处，可降低 CVD 和过早死亡的风险。
