补充欧米伽-3脂肪酸与冠心病风险：随机对照临床试验的荟萃分析
Omega-3 Fatty Acid Supplementation and Coronary Heart Disease Risks: A Meta-Analysis of Randomized Controlled Clinical Trials.
作者信息
Shen ShiChun, Gong Chen, Jin KaiQin, Zhou Lei, Xiao Yin, Ma Likun
机构信息
Department of Cardiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China.
Department of Pediatrics, The First Affiliated Hospital of Anhui Medical University, Hefei, China.
出版信息
Front Nutr. 2022 Feb 3;9:809311. doi: 10.3389/fnut.2022.809311. eCollection 2022.
BACKGROUND
The clinical benefits of omega-3 fatty acids (FAs) supplementation in preventing and treating coronary heart disease (CHD) remain controversial. Therefore, this study aimed to investigate the clinical benefits of omega-3 FA supplementation, with special attention given to specific subgroups.
METHODS
Randomized controlled trials (RCTs) that compared the effects of omega-3 FA supplementation for CHD vs. a control group and including at least 1,000 patients were eligible for the inclusion in this meta-analysis. The relative risk (RR) of all-cause death, major adverse cardiovascular events (MACEs), cardiovascular death, myocardial infarction (MI), stroke, and revascularization were estimated. We analyzed the association between cardiovascular risk and omega-3 FA supplementation in the total subjects. We focused on the cardiovascular risk compared to omega-3 FA in subgroups with different development stages of CHD, omega-3 FA supplementation application dose, diabetes, and sex. PROSPERO Registration Number: CRD42021282459.
RESULTS
This meta-analysis included 14 clinical RCTs, including 1,35,291 subjects. Omega-3 FA supplementation reduced the risk of MACE (RR; 0.95; CI: 0.91-0.99; for heterogeneity 0.27; = 20%; = 0.03), cardiovascular death (RR; 0.94; CI: 0.89-0.99; for heterogeneity 0.21; = 25%; = 0.02), and MI (RR; 0.86; CI: 0.79-0.93; for heterogeneity 0.28; = 19%; < 0.01), but had no significant effect on all-cause death, stroke, and revascularization. In the subgroup analysis, omega-3 FA supplementation decreased the incidence of MACE and cardiovascular death in acute patients with MI, the risk of MI and stroke in patients with CHD, and the risk of MI in patients with high-risk CHD. 0.8-1.2 g omega-3 FA supplementation reduced the risk of MACE, cardiovascular death, and MI. It was revealed that gender and diabetes have no significant association between omega-3 FA supplementation and MACE risk.
CONCLUSIONS
Omega-3 FA supplementation had a positive effect in reducing the incidence of MACE, cardiovascular death, MI. Regardless of the stage of CHD, omega-3 FA supplementation can prevent the occurrence of MI. The 0.8-1.2 g omega-3 FA supplementation alleviated CHD risk more effectively than lower or higher doses.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero/, identifier CRD42021282459.
背景
补充ω-3脂肪酸（FAs）在预防和治疗冠心病（CHD）方面的临床益处仍存在争议。因此，本研究旨在探讨补充ω-3脂肪酸的临床益处，并特别关注特定亚组。
方法
比较补充ω-3脂肪酸对冠心病患者与对照组的影响且纳入至少1000例患者的随机对照试验（RCT）符合纳入本荟萃分析的条件。估计全因死亡、主要不良心血管事件（MACE）、心血管死亡、心肌梗死（MI）、中风和血运重建的相对风险（RR）。我们分析了全部受试者中心血管风险与补充ω-3脂肪酸之间的关联。我们重点关注了不同冠心病发展阶段、ω-3脂肪酸补充应用剂量、糖尿病和性别的亚组中与补充ω-3脂肪酸相比的心血管风险。国际前瞻性系统评价注册库注册号：CRD42021282459。
结果
本荟萃分析纳入了14项临床随机对照试验，包括135291名受试者。补充ω-3脂肪酸降低了MACE风险（RR；0.95；CI：0.91 - 0.99；异质性χ² = 0.27；I² = 20%；P = 0.03）、心血管死亡风险（RR；0.94；CI：0.89 - 0.99；异质性χ² = 0.21；I² = 25%；P = 0.02）和MI风险（RR；0.86；CI：0.79 - 0.93；异质性χ² = 0.28；I² = 19%；P < 0.01），但对全因死亡、中风和血运重建无显著影响。在亚组分析中，补充ω-3脂肪酸降低了急性心肌梗死患者的MACE和心血管死亡发生率、冠心病患者的MI和中风风险以及高危冠心病患者的MI风险。补充0.8 - 1.2克ω-3脂肪酸降低了MACE、心血管死亡和MI风险。结果显示，性别和糖尿病与补充ω-3脂肪酸和MACE风险之间无显著关联。
结论
补充ω-3脂肪酸在降低MACE、心血管死亡、MI发生率方面具有积极作用。无论冠心病处于何种阶段，补充ω-3脂肪酸均可预防MI的发生。补充0.8 - 1.2克ω-3脂肪酸比更低或更高剂量更有效地减轻了冠心病风险。
系统评价注册
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