BMJ:新的数据教你认清饱和同反式不饱和脂肪酸的摄入对健康的影响

2015-08-12 崔倩 译 MedSci原创

    该系统回顾和荟萃分析。研究的目的是系统地调查摄入饱和脂肪和反式不饱和脂肪与全因死亡率,心血管疾病(CVD)及相关的死亡率,冠状动脉心脏疾病(CHD)及相关的死亡率,缺血性中风,2型糖尿病之间的关联。       该研究的数据来自于MEDLINE,EMBASE,临床对照试验中心注册数据库,循证医学全文数据库,以及CINAHL从成立到

这是一个系统回顾和荟萃分析研究。研究的目的是系统地调查摄入饱和脂肪和反式不饱和脂肪与全因死亡率,心血管疾病(CVD)及相关的死亡率,冠状动脉心脏疾病(CHD)及相关的死亡率,缺血性中风,2型糖尿病之间的关联。
   
该研究的数据来自于MEDLINE,EMBASE,临床对照试验中心注册数据库,循证医学全文数据库,以及CINAHL从成立到2015年5月1日的数据,辅以检索文章和以往的参考文献进行分析。

观察性研究报告了饱和脂肪和/反式不饱和脂肪(总,工业生产的,或来自于反刍动物)与全死因死亡率,CHD/ CVD死亡,总CHD事件,缺血性中风,或2型糖尿病的联系。

两名评价者独立提取数据和评估研究风险的偏差。多变量相对风险进行了汇总。并且对异质性进行了评估和量化。对潜在的发表偏差进行了评估,并进行了亚组分析。GRADE方法被来评估证据的质量和结论的确定性。

对于饱和脂肪,3至12个前瞻性队列研究汇集了每个联系的数据(对1790501-339090名参与者进行了5-17种比较)。饱和脂肪摄入量与全因死亡率(相对风险0.99,95%置信区间 0.91-1.09),CVD死亡率(0.97,0.84-1.12),总CHD事件(1.06,0.95-1.17),缺血性卒中(1.02,0.90-1.15),或2型糖尿病(0.95,0.88-1.03)无关。还没有令人信服的数据表明饱和脂肪和CHD死亡率之间的关联(1.15,0.97-1.36;P=0.10)。对于反式不饱和脂肪,1-6个前瞻性队列研究汇集了每个联系的数据(对12942-230135名参与者进行了2-7种比较)。总反式脂肪的摄入量与全因死亡率(1.34,1.16-1.56),CHD死亡率(1.28,1.09-1.50),和总CHD事件(1.21,1.10-1.33)相关,但不与缺血性脑卒中(1.07,0.88-1.28)或2型糖尿病(1.10,0.95-1.27)相关。工业,但非反刍的反式脂肪均与CHD死亡率(1.18(1.04-1.33) vs 1.01(0.71-1.43))和CHD(1.42(1.05〜1.92) vs 0.93(0.73〜1.18))相关。反刍动物的反式棕榈烯酸与2型糖尿病(0.58,0.46至0.74)呈负相关。饱和脂肪和所有结果的之间关联的确定性是“非常低”。反式脂肪与CHD预后的关联是“温和的”,对于其他的联系是“非常低”到“低”的。
    
饱和脂肪与全因死亡率,CVD,CHD,缺血性中风,或2型糖尿病无关,但证据是局限性方法异质的方法。反式脂肪与全因死亡率,总CHD事件和CHD死亡率相关,可能是因为摄取的工业反式脂肪比反刍动物的反式脂肪的量高。膳食指南必须认真考虑选择替代营养素来代替反式脂肪和饱和脂肪对健康的影响的建议。

原始出处:

Russell J de Souza, assistant professor, Andrew Mente, associate professor, Adriana Maroleanu, research volunteer et al,Intake of saturated and trans unsaturated fatty acids and risk of all cause mortality, cardiovascular disease, and type 2 diabetes,BMJ,2015.8.12

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    2016-05-27 gaoxiaoe
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