Department of Preventive Medicine, College of Medicine, The University of Tennessee Health Science Center, Memphis.
Department of Epidemiology, College of Public Health, University of Iowa, Iowa City.
JAMA Netw Open. 2021 Nov 1;4(11):e2136367. doi: 10.1001/jamanetworkopen.2021.36367.
Although seafood is known to contain heart-healthy omega-3 fatty acids, many people choose to limit their seafood consumption because of fear of mercury exposure from seafood. It is imperative to clarify the potential health effects of current mercury exposure in contemporary populations.
To examine the association of seafood consumption and mercury exposure with all-cause and cardiovascular disease (CVD)-related mortality in the US general population.
DESIGN, SETTING, AND PARTICIPANTS: This prospective cohort study included adults 20 years or older who participated in the 2003 to 2012 cycles of the National Health and Nutrition Examination Survey; data were linked to mortality records through December 31, 2015. Data analysis was performed from January to March 10, 2021.
Seafood consumption was assessed through two 24-hour dietary recalls, and mercury exposure was assessed by blood mercury levels.
All-cause and CVD-related mortality. Multivariable Cox proportional hazards regression was used to estimate hazard ratios (HRs) and 95% CIs of mortality associated with usual seafood consumption and blood mercury concentration quartiles.
This study included 17 294 participants (mean [SD] age, 45.9 [17.1] years; 9217 [53.3%] female) with a mean (SD) blood mercury concentration of 1.62 (2.46) μg/L. During 131 276 person-years of follow-up, 1076 deaths occurred, including 181 deaths from CVD. The multivariable-adjusted HR for an increase in seafood consumption of 1 oz equivalent per day and all-cause mortality was 0.84 (95% CI, 0.66-1.07) and for CVD-related mortality was 0.89 (95% CI, 0.54-1.47). Blood mercury level was not associated with all-cause or CVD-related mortality. Comparing the highest with the lowest quartile of blood mercury concentration, the multivariable-adjusted HRs were 0.82 (95% CI, 0.66-1.05) for all-cause mortality and 0.90 (95% CI, 0.53-1.52) for CVD-related mortality.
In this cohort study of US adults, seafood consumption and mercury exposure with the current seafood consumption level were not significantly associated with the risk of all-cause or CVD-related mortality. These findings may inform future public health guidelines regarding mercury exposure, seafood consumption, and cardiovascular health promotion.
尽管海鲜富含对心脏有益的欧米伽-3 脂肪酸，但许多人选择限制海鲜的摄入量，因为担心从海鲜中摄入汞。澄清当前人群中汞暴露的潜在健康影响至关重要。
在美国普通人群中，研究海鲜摄入和汞暴露与全因和心血管疾病（CVD）相关死亡率之间的关系。
设计、地点和参与者：本前瞻性队列研究纳入了 20 岁或以上参加了 2003 年至 2012 年全国健康与营养调查周期的成年人；数据通过 2015 年 12 月 31 日与死亡率记录相关联。数据分析于 2021 年 1 月至 3 月 10 日进行。
通过两次 24 小时膳食回忆评估海鲜摄入量，通过血液汞水平评估汞暴露情况。
全因和 CVD 相关死亡率。多变量 Cox 比例风险回归用于估计与常规海鲜摄入量和血液汞浓度四分位值相关的死亡率的危险比（HRs）和 95%置信区间（CIs）。
这项研究纳入了 17294 名参与者（平均[标准差]年龄 45.9[17.1]岁；9217[53.3%]为女性），平均（标准差）血液汞浓度为 1.62（2.46）μg/L。在 131276 人年的随访期间，有 1076 人死亡，包括 181 人死于 CVD。多变量调整后的 HR 显示，每天增加 1 盎司相当的海鲜摄入量与全因死亡率相关为 0.84（95%CI，0.66-1.07），与 CVD 相关的死亡率相关为 0.89（95%CI，0.54-1.47）。血液汞水平与全因或 CVD 相关死亡率无关。与血液汞浓度最低四分位组相比，最高四分位组的多变量调整 HR 分别为全因死亡率为 0.82（95%CI，0.66-1.05）和 CVD 相关死亡率为 0.90（95%CI，0.53-1.52）。
在这项对美国成年人的队列研究中，海鲜摄入和汞暴露与当前的海鲜摄入水平与全因或 CVD 相关死亡率的风险无显著相关性。这些发现可能为未来有关汞暴露、海鲜消费和心血管健康促进的公共卫生指南提供信息。
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