欧米茄-3 多不饱和脂肪酸摄入量与血压:随机对照试验的剂量-反应元分析》(A Dose-Response Meta-Analysis of Randomized Controlled Trials)。

IF 4 3区 经济学 Q1 ECONOMICS
Economic Change and Restructuring Pub Date : 2022-06-07 Epub Date: 2022-06-01 DOI:10.1161/JAHA.121.025071
Xin Zhang, Jennifer A Ritonja, Na Zhou, Bingshu E Chen, Xinzhi Li
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引用次数: 0

摘要

背景 目前的证据可能支持使用ω-3脂肪酸(最好是二十二碳六烯酸和二十碳五烯酸)来降低血压(BP),但剂量-反应关系的强度和形式仍不清楚。方法与结果 本研究纳入了 2021 年 5 月 7 日之前发表的随机对照试验,这些试验涉及年龄≥18 岁的参与者,研究了欧米伽-3 脂肪酸(二十二碳六烯酸、二十碳五烯酸或两者)与血压之间的关系。我们采用随机效应 1 级立方样条回归模型来预测每日欧米伽-3 脂肪酸摄入量与血压变化之间的平均剂量-反应关系。我们还进行了分层分析,以研究预设亚组的差异。共纳入 71 项试验,涉及 4973 人,其中二十二碳六烯酸+二十碳五烯酸的联合剂量为 2.8 克/天(四分位间范围为 1.3 克/天至 3.6 克/天)。在总体或大多数亚组中发现了非线性关联,描述为 J 型剂量-反应曲线。2 克/天(收缩压,-2.61 [95% CI,-3.57 至-1.65];舒张压,-1.64 [95% CI,-2.29 至-0.99])和 3 克/天(收缩压,-2.61 [95% CI,-3.52 至-1.69];舒张压,-1.80 [95% CI,-2.38 至-1.23])之间的中等剂量可使收缩压和舒张压降低(毫米汞柱)达到最佳摄入量。亚组研究显示,在高血压、高脂血症和老年人群中,剂量-反应关系更强,且近似线性。结论 该剂量-反应荟萃分析表明,ω-3 脂肪酸降低血压的最佳综合摄入量可能在 2 克/天和 3 克/天之间。在心血管疾病高危人群中,ω-3 脂肪酸摄入量超过推荐的 3 克/天,可能会对降低血压有额外的益处。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Omega-3 Polyunsaturated Fatty Acids Intake and Blood Pressure: A Dose-Response Meta-Analysis of Randomized Controlled Trials.

Background Current evidence might support the use of omega-3 fatty acids (preferably docosahexaenoic acid and eicosapentaenoic acid) for lowering blood pressure (BP), but the strength and shape of the dose-response relationship remains unclear. Methods and Results This study included randomized controlled trials published before May 7, 2021, that involved participants aged ≥18 years, and examined an association between omega-3 fatty acids (docosahexaenoic acid, eicosapentaenoic acid, or both) and BP. A random-effects 1-stage cubic spline regression model was used to predict the average dose-response association between daily omega-3 fatty acid intake and changes in BP. We also conducted stratified analyses to examine differences by prespecified subgroups. Seventy-one trials were included, involving 4973 individuals with a combined docosahexaenoic acid+eicosapentaenoic acid dose of 2.8 g/d (interquartile range, 1.3 g/d to 3.6 g/d). A nonlinear association was found overall or in most subgroups, depicted as J-shaped dose-response curves. The optimal intake in both systolic BP and diastolic BP reductions (mm Hg) were obtained by moderate doses between 2 g/d (systolic BP, -2.61 [95% CI, -3.57 to -1.65]; diastolic BP, -1.64 [95% CI, -2.29 to -0.99]) and 3 g/d (systolic BP, -2.61 [95% CI, -3.52 to -1.69]; diastolic BP, -1.80 [95% CI, -2.38 to -1.23]). Subgroup studies revealed stronger and approximately linear dose-response relations among hypertensive, hyperlipidemic, and older populations. Conclusions This dose-response meta-analysis demonstrates that the optimal combined intake of omega-3 fatty acids for BP lowering is likely between 2 g/d and 3 g/d. Doses of omega-3 fatty acid intake above the recommended 3 g/d may be associated with additional benefits in lowering BP among groups at high risk for cardiovascular diseases.

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来源期刊
CiteScore
4.80
自引率
6.50%
发文量
78
期刊介绍: Economic Change and Restructuring has been accepted for SSCI and will get its first Impact Factor in 2020!Since the early 1990s fundamental changes in the world economy, under the auspices of increasing globalisation, have taken place On one hand, the disappearance of the centrally planned economies and the progressive formation of market-oriented economies, have brought about countless systematic changes, where new economic structures, institutions, competences and skills involve complex processes, changes which are still underway and which necessitate adaptation and restructuring to form competitive market economies. On the other hand, many developing economies are making great strides as regards economic reform and liberalisation, and are emerging as new global players. They show an innovative capacity to position themselves in the global economy and to compete with industrialised countries, which are generally believed to be witnessing the rapid erosion of their established positions. These developments are accompanied by the exacerbation of the world competition. Both processes involve transition and the emerging economies, in searching for a new role and scope for public policies and for a new balance between public and private partnership, seem to currently be converging, especially with respect to the policies needed to create appropriate and effective market institutions and integrated reform policies, and to increase the standards of the population''s education levels. Thus, liberalisation and development policies, in attempting to strike a difficult balance between social and environmental needs, must be integrated more coherently. This complexity calls for new analytical and empirical approaches that can explain these new phenomena, which often go beyond the over-simplified facts and conventional ''wisdom'' that emerged at the start of the transition in the early 1990s. Economic Change and Restructuring (formerly ''Economics of Planning''), by keeping abreast of developments affecting both transitional and emerging economies, is aimed to attract original empirical and policy analysis contributions that are focused on various issues, including macroeconomic analysis, fiscal issues, finance and banking, industrial and trade development, and regional and local development issues. The journal aspires to publish cutting edge research and to serve as a forum for economists and policymakers working in these fields.Officially cited as: Econ Change Restruct
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