Suzhou Wujiang District Hospital of Traditional Chinese Medicine (Suzhou Wujiang District Second People's Hospital).
Affiliated Hospital of Nanjing University of Traditional Chinese Medicine.
Nutr Hosp. 2022 Aug 25;39(4):924-935. doi: 10.20960/nh.04148.
Background: in recent years, n-3 PUFAs have been confirmed to be associated with cardiovascular and cerebrovascular diseases, but the link between n-3 PUFAs and stroke remains controversial. Objective: this study aimed to evaluate the association between n-3 PUFAs and stroke. Methods: we performed a comprehensive search of the following electronic databases: PubMed, Embase, Cochrane Library, Web of Science and CNKI. Literature screening and quality assessment were performed according to inclusion and exclusion criteria. Cochrane's tool was used to assess the methodological components of each study, and the Stata 15.1 software was used to perform the meta-analysis. Results: a total of 18 RCTs were included, and the meta-analysis showed no differences in vascular disease-related death between the n-3 PUFA and control groups (RR, 0.95, 95 % CI: 0.89 to 1.01, p = 0.114 > 0.05). However, there was a significant difference in the lower n-3 PUFA dose subgroup (RR, 0.93, 95 % CI: 0.87 to 0.99, p = 0.034 < 0.05). Oral administration of n-3 PUFAs did not significantly reduce the risk of the following cerebrovascular accidents: stroke (RR = 1.00, 95 % CI: 0.93 to 1.07, p = 0.983 > 0.05), ischemic stroke (RR = 0.99, 95 % CI: 0.896 to 1.094, p = 0.841 > 0.05), hemorrhagic stroke (RR = 1.249, 95 % CI: 0.939 to 1.662, p = 0.127 > 0.05) and TIA (RR = 1.016, 95 % CI: 0.882 to 1.170, p = 0.824 > 0.05). The levels of TC (SMD, -0.167, 95 % CI: -0.193 to -0.141, p = 0 < 0.05) and TG (SMD, -0.065, 95 % CI: -0.087 to -0.042, p = 0 < 0.05) in the n-3 PUFA group were significantly decreased, but no significant improvement in the LDL (SMD, 0.022, 95 % CI: 0.005 to 0.040, p = 0.889 > 0.05) and HDL (SMD, 0.008, 95 % CI: -0.009 to 0.025, p = 0.368 > 0.05) levels was observed. Conclusion: this systematic review and meta-analysis suggests that treatment with low-dose n-3 PUFAs can reduce cerebrovascular disease-related death. After the oral administration of n-3 PUFAs, the levels of TC and TG decreased significantly, but n-3 PUFAs did not prevent the occurrence of cerebrovascular accidents or improve LDL or HDL levels.
近年来，n-3 多不饱和脂肪酸已被证实与心脑血管疾病有关，但 n-3 多不饱和脂肪酸与中风之间的联系仍存在争议。目的：本研究旨在评估 n-3 多不饱和脂肪酸与中风的关系。方法：我们全面检索了以下电子数据库：PubMed、Embase、Cochrane 图书馆、Web of Science 和中国知网。根据纳入和排除标准进行文献筛选和质量评估。采用 Cochrane 工具评估每项研究的方法学组成部分，使用 Stata 15.1 软件进行荟萃分析。结果：共纳入 18 项 RCTs，荟萃分析显示 n-3 多不饱和脂肪酸组与对照组在血管疾病相关死亡方面无差异（RR，0.95，95 % CI：0.89 至 1.01，p = 0.114 ＞0.05）。然而，在低剂量 n-3 多不饱和脂肪酸亚组中存在显著差异（RR，0.93，95 % CI：0.87 至 0.99，p = 0.034 ＜0.05）。口服 n-3 多不饱和脂肪酸并不能显著降低以下脑血管意外的风险：中风（RR = 1.00，95 % CI：0.93 至 1.07，p = 0.983 ＞0.05）、缺血性中风（RR = 0.99，95 % CI：0.896 至 1.094，p = 0.841 ＞0.05）、出血性中风（RR = 1.249，95 % CI：0.939 至 1.662，p = 0.127 ＞0.05）和 TIA（RR = 1.016，95 % CI：0.882 至 1.170，p = 0.824 ＞0.05）。n-3 多不饱和脂肪酸组的 TC（SMD，-0.167，95 % CI：-0.193 至 -0.141，p = 0 ＜0.05）和 TG（SMD，-0.065，95 % CI：-0.087 至 -0.042，p = 0 ＜0.05）水平显著降低，但 LDL（SMD，0.022，95 % CI：0.005 至 0.040，p = 0.889 ＞0.05）和 HDL（SMD，0.008，95 % CI：-0.009 至 0.025，p = 0.368 ＞0.05）水平无明显改善。结论：本系统评价和荟萃分析表明，低剂量 n-3 多不饱和脂肪酸治疗可降低脑血管疾病相关死亡。口服 n-3 多不饱和脂肪酸后，TC 和 TG 水平显著下降，但 n-3 多不饱和脂肪酸不能预防脑血管意外的发生，也不能改善 LDL 或 HDL 水平。
