欧米茄-3多不和脂肪酸补充剂和心血管疾病结果:随机对照试验的系统审查和元分析
Xue Qi1, Hechen Zhu2, Ru Ya1
1Department of Critical Rehabilitation, Shanghai Third Rehabilitation Hospital, 200436 Shanghai, China.
欧米茄-3脂肪酸补充剂对主要心血管事件没有显著的益处,但可能会降低心血管死亡率和再血管化. 然而,它们增加了心房的风险,需要仔细考虑风险和益处.
科学领域:
- 心血管医学 心血管医学
- 营养科学 营养科学
- 临床试验 临床试验
背景情况:
- 关于心血管疾病 (CVD) 的omega-3补充剂的元分析和RCT存在相互矛盾的结果.
- 以前的元分析可能遗漏了Omega-3脂肪酸和心血管疾病的关键随机对照试验 (RCT).
研究的目的:
- 对评价omega-3多不和脂肪酸 (PUFA) 在预防心血管事件中的有效性进行RCT的综合元分析.
- 评估欧米茄-3 PUFA 补充剂对各种心血管疾病结果的整体影响,并确定潜在的风险.
主要方法:
- 在PubMed,EMBASE,Cochrane图书馆和Web of Science系统搜索符合条件的RCT.
- 使用随机效应模型进行元分析,以计算相关结果的危险比率 (HR) 和95%置信区间 (95% CI).
- 进行了子组和敏感性分析,以解决异质性和探索特定的人口特征.
主要成果:
- 包括19个RCT,其中有116,498名参与者. 补充欧米茄-3PUFA并没有显著改善主要不良心血管事件,心肌梗塞,冠心病,中风,心脏突然死亡或全因死亡率的结果.
- 观察到重血管化 (HR:0.90,95% CI:0.81-1.00) 和心血管死亡率 (HR:0.91,95% CI:0.85-0.97) 的显著降低.
- 然而,欧米茄-3 PUFA 补充剂显著增加了心房 (AF) 的风险 (HR: 1.56,95% CI: 1.27-1.91).
结论:
- 欧米茄-3 PUFA 补充剂显示出双重效应:降低心血管死亡率和重血管化,同时增加心房的发生率.
- 对于其他主要心血管疾病结局,没有发现显著的益处.
- 在考虑在高风险患者或人群中使用Omega-3 PUFA时,平衡潜在的心血管益处与增加的AF风险至关重要.
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