Department of Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan 2nd Road, Guangzhou, 510080, China.
Department of Cardiology, Guangdong Cardiovascular Institute, Hypertension Research Laboratory, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan 2nd Road, Guangzhou, 510080, China.
Eur J Prev Cardiol. 2022 Oct 20;29(14):1911-1920. doi: 10.1093/eurjpc/zwac192.
Mixed effects of fish oil supplementation on the risks of atrial fibrillation (AF) were observed in several large-scale randomized controlled trials. Whether this relationship would be modified by genetic AF risk, baseline cardiovascular disease (CVD) status and background oily fish consumption are unknown.
We included 468 665 participants without AF at baseline from the UK Biobank cohort. The association between fish oil supplementation and the AF risk was assessed in the study cohort and in several subgroups, including genetic AF predisposition, baseline CVD status, and background oily fish consumption. During a median follow-up of 11.1 years, fish oil users had a higher rate of incident AF (6.2% vs. 5.2%, adjusted hazard ratio of 1.10, and 95% confidence interval of 1.07, 1.13). Compared with non-users, fish oil users had a higher rate of incident AF in the low (3.7% vs. 3.0%, P= 0.02), intermediate (5.8% vs. 4.8%, P < 0.0001), and high (9.8% vs. 8.1%, P < 0.0001) genetic AF risk groups. In participants without CVD at baseline, fish oil users had a higher rate of incident AF (5.3% vs. 4.1%, P < 0.0001), which was not observed in participants with CVD at baseline (11.6% vs. 11.1%, P = 0.56), with significant interaction (P-interaction < 0.0001). The association between fish oil supplementation and the AF risk was not modified by background oily fish consumption (P-interaction = 0.62).
Habitual fish oil supplementation was associated with the risk of incident AF, regardless of genetic AF predisposition and background oily fish consumption. This association was observed only in individuals without CVD at baseline.
几项大规模随机对照试验观察到，鱼油补充剂对心房颤动（AF）风险的影响是混合的。尚不清楚这种关系是否会因 AF 遗传风险、基线心血管疾病（CVD）状况和背景油性鱼摄入而改变。
我们纳入了 UK Biobank 队列中基线时无 AF 的 468665 名参与者。在研究队列和包括 AF 遗传易感性、基线 CVD 状况和背景油性鱼摄入在内的几个亚组中，评估了鱼油补充剂与 AF 风险之间的关联。在中位随访 11.1 年期间，鱼油使用者的 AF 发生率较高（6.2% vs. 5.2%，调整后的风险比为 1.10，95%置信区间为 1.07，1.13）。与非使用者相比，AF 遗传风险低（3.7% vs. 3.0%，P=0.02）、中（5.8% vs. 4.8%，P < 0.0001）和高（9.8% vs. 8.1%，P < 0.0001）组的鱼油使用者 AF 发生率较高。在基线时无 CVD 的参与者中，鱼油使用者的 AF 发生率较高（5.3% vs. 4.1%，P < 0.0001），而基线时患有 CVD 的参与者中则未见这种情况（11.6% vs. 11.1%，P = 0.56），且存在显著的交互作用（P 交互 < 0.0001）。鱼油补充剂与 AF 风险之间的关联不受背景油性鱼摄入的影响（P 交互 = 0.62）。
习惯性服用鱼油与新发 AF 风险相关，无论 AF 遗传易感性和背景油性鱼摄入如何。这种关联仅在基线时无 CVD 的个体中观察到。
