期刊
JAMA INTERNAL MEDICINE
卷 176, 期 8, 页码 1155-1166出版社
AMER MEDICAL ASSOC
DOI: 10.1001/jamainternmed.2016.2925
关键词
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资金
- National Heart, Lung, and Blood Institute [HHSN268201100005C, HHSN268201100006C, HHSN268201100007C, HHSN268201100008C, HHSN268201100009C, HHSN268201100010C, HHSN268201100011C, HHSN268201100012C, R01HL087641, R01HL59367, R01HL086694, HHSN268201200036C, HHSN268200800007C, N01HC55222, N01HC85079, N01HC85080]
- National Human Genome Research Institute [U01HG004402]
- National Institutes of Health [HHSN268200625226C, R01HL081549, UM1 CA167552, R01 HL35464, AA11181, HL35464, CA55075, HL60712, P30 DK46200, UM1 CA186107, R01 CA49449, R01 HL034594, P01CA87969, R01HL034594, R01HL088521, UM1 CA182876, R01CA 144034, UL1RR025005]
- National Institute on Aging [R01AG023629]
- Dutch Ministry of Health
- Cancer Research Switzerland [AKT76]
- Swiss National Science Foundation [32-9257-87]
- Medical Research Council
- Medical Research Council Epidemiology Unit [MC_UU_12015/5]
- Intramural Research Program of the National Institutes of Health [N01-AG-916413, N01-AG821336, 263 MD 9164 13, 263 MD 821336]
- Academy of Finland, Helsinki, Finland [1041086, 41471]
- VicHealth
- Australia's National Health and Medical Research Council [209057, 251553, 504711]
- Swedish Cancer Society
- Swedish Research Council
- National Cancer Institute [R21 HL088081, CA-34944, CA-40360, CA-097193]
- Fondation pour la Recherche Medicale
- Caisse Nationale Maladie des Travailleurs Salaries
- Direction Generale de la Sante
- Institut de la Longevite
- Conseils Regionaux d'Aquitaine et Bourgogne
- Fondation de France
- Ministry of Research-Institut National de la Sante et de la Recherche Medicale Programme Cohortes et collections de donnees biologiques
- grant COGINUT from the Agence Nationale de la Recherche [ANR-06-PNRA-005]
- grant FCS from the Fondation Plan Alzheimer
- Caisse Nationale pour la Solidarite et l'Autonomie
- Scottish Health Department Chief Scientist Organization
- British Heart Foundation
- FP Fleming Trust
- Singapore National Medical Research Council [NMRC 1270/2010]
- Swedish Research Council for Health, Working Life and Welfare
- Uppsala City Council
- National Institutes of Health Roadmap for Medical Research
- National Institute of Neurological Disorders and Stroke
- Commission of the European Communities
- Cancer Research UK
- Italian Ministry of Health [ICS 110.1\RS97.71]
- Cancer Council Victoria
- MGEN
- Fondation Plan Alzheimer
- [N01HC85082]
- [N01HC85083]
- [N01HC85086]
- [U01HL080295]
- [N01-HC-95159]
- [N01-HC-95160]
- [N01-HC-95161]
- [N01-HC-95162]
- [N01-HC-95163]
- [N01-HC-95164]
- [N01-HC-95165]
- [N01-HC-95166]
- [N01-HC-95167]
- [N01-HC-95168]
- [N01-HC-95169]
- [UL1-TR-001079]
- [UL1-TR000040]
- [N02-HL-64278]
- [HL-34595]
- [HL-26490]
- [N01HC85081]
- Medical Research Council [MC_UU_12015/5, G0401527, MR/N003284/1, G1000143] Funding Source: researchfish
- National Institute for Health Research [NF-SI-0512-10114] Funding Source: researchfish
- MRC [MR/N003284/1, MC_UU_12015/5] Funding Source: UKRI
IMPORTANCE The role of omega-3 polyunsaturated fatty acids for primary prevention of coronary heart disease (CHD) remains controversial. Most prior longitudinal studies evaluated self-reported consumption rather than biomarkers. OBJECTIVE To evaluate biomarkers of seafood-derived eicosapentaenoic acid (EPA; 20: 5 omega-3), docosapentaenoic acid (DPA; 22: 5 omega-3), and docosahexaenoic acid (DHA; 22: 6 omega-3) and plant-derived alpha-linolenic acid (ALA; 18: 3 omega-3) for incident CHD. DATA SOURCES A global consortium of 19 studies identified by November 2014. STUDY SELECTION Available prospective (cohort, nested case-control) or retrospective studies with circulating or tissue omega-3 biomarkers and ascertained CHD. DATA EXTRACTION AND SYNTHESIS Each study conducted standardized, individual-level analysis using harmonized models, exposures, outcomes, and covariates. Findings were centrally pooled using random-effects meta-analysis. Heterogeneity was examined by age, sex, race, diabetes, statins, aspirin, omega-6 levels, and FADS desaturase genes. MAIN OUTCOMES AND MEASURES Incident total CHD, fatal CHD, and nonfatal myocardial infarction (MI). RESULTS The 19 studies comprised 16 countries, 45 637 unique individuals, and 7973 total CHD, 2781 fatal CHD, and 7157 nonfatal MI events, with omega-3 measures in total plasma, phospholipids, cholesterol esters, and adipose tissue. Median age at baseline was 59 years (range, 18-97 years), and 28 660 (62.8%) were male. In continuous (per 1-SD increase) multivariable-adjusted analyses, the omega-3 biomarkers ALA, DPA, and DHA were associated with a lower risk of fatal CHD, with relative risks (RRs) of 0.91 (95% CI, 0.84-0.98) for ALA, 0.90 (95% CI, 0.85-0.96) for DPA, and 0.90 (95% CI, 0.84-0.96) for DHA. Although DPA was associated with a lower risk of total CHD (RR, 0.94; 95% CI, 0.90-0.99), ALA (RR, 1.00; 95% CI, 0.95-1.05), EPA (RR, 0.94; 95% CI, 0.87-1.02), and DHA (RR, 0.95; 95% CI, 0.91-1.00) were not. Significant associations with nonfatal MI were not evident. Associations appeared generally stronger in phospholipids and total plasma. Restricted cubic splines did not identify evidence of nonlinearity in dose responses. CONCLUSIONS AND RELEVANCE On the basis of available studies of free-living populations globally, biomarker concentrations of seafood and plant-derived omega-3 fatty acids are associated with a modestly lower incidence of fatal CHD.
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