Dietary Fish and Long-Chain n-3 Polyunsaturated Fatty Acids Intake and Risk of Atrial Fibrillation: A Meta-Analysis
Abstract
:1. Introduction
2. Materials
2.1. Search Strategy
2.2. Inclusion Criteria
2.3. Data Extraction
2.4. Statistical Methods
3. Results
3.1. Study Characteristics
3.2. Fish Consumption and AF Risk
3.3. N-3 PUFAs Intake and AF Risk
3.4. Dose-Response Analysis
4. Discussion
5. Conclusions
Acknowledgments
Author Contributions
Conflicts of Interest
References
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Study, Country | Name | Duration (year) | Participants | No. of Cases | Age (year) | Exposure | Baseline Diseases Excluded | Adjustment for Confounding Factors | Score |
---|---|---|---|---|---|---|---|---|---|
Mozaffarian et al., 2004, USA [23] | CHS | 12 | 4815 men and women | 980 | 65–100 | Fish | AF | Age, BMI, diastolic blood pressure, education, exercise levels, race, sex, SBP, left ventricular systolic function at baseline, C-reactive protein, smoking, CHD, DM, hypertension, valvular heart disease, energy intake, intake of tuna/other fish, fried fish/fish sandwich, alcohol, beef/pork, cereal fiber, fruits, SFAs, and vegetables | 8 |
Gronroos et al., 2012, USA [7] | ARIC | 17.6 | 14,222 men and women | 1604 | 45–64 | Fish and n-3 PUFAs | AF | Age, BMI, center, education, exercise levels, race, sex, SBP, HDL and LDL cholesterol levels, smoking, cholesterol treatment, CHD, DM, hypertension, left ventricular hypertrophy, energy intake, and alcohol use | 8 |
Brouwer et al., 2006, Netherland [25] | RS | 6.4 | 2105 men and 3079 women | 312 | 67.4 | Fish and n-3 PUFAs | AF | Age, sex, HDL and total cholesterol levels, SBP, smoking, DM, MI, energy intake, intake of alcohol, and SFAs | 7 |
Berry et al., 2010, USA [38] | WHI | 6 | 44,720 women | 378 | 50–79 | Fish and n-3 PUFAs | AF | Age, BMI, education, race, SBP, smoking, DM, hypertension, cardiovascular disease, energy intake, intake of alcohol, fruit, fiber, and vegetable | 7 |
Rix et al., 2014, Denmark [8] | DCHCS | 13.6 | 55,246 men and women | 3284 | 50–64 | Fish and n-3 PUFAs | Cancer, AF and AFL | Age, BMI, education, sex, SBP, total serum cholesterol, waist circumference, smoking, angina pectoris, DM, hypertension, heart failure, MI, hypercholesterolaemia and/or cholesterol treatment, energy intake, intake of alcohol, fruits, vegetables, red meat, poultry, and fatty dairy products | 8 |
Shen et al., 2011, USA [37] | FHS | 4 | 4231 men and 5409 women | 296 | 62 | Fish and n-3 PUFAs | AF | Age, BMI, sex, SBP, electrocardiographic PR interval, hypertension, heart failure, and significant heart murmur | 7 |
Larsson et al., 2017, Sweden [17] | COSM, SMC | 12 | 38,960 men and 34,024 women | 6059 | 45–83 | Fish and n-3 PUFAs | Cancer, AF, ischemic heart disease and heart failure | Age, BMI, education, exercise levels, sex, smoking, DM, family history of MI, hypertension, energy intake, and alcohol use | 8 |
Subgroup | n | RR a (95% CI b) | Pheterogeneity | I2 |
---|---|---|---|---|
Sex | ||||
Male | 0 | - | - | - |
Female | 1 | 1.02 (0.94, 1.09) | - | - |
Both | 5 | 1.01 (0.93, 1.09) | 0.604 | 0.0% |
Region | ||||
North America | 4 | 0.99 (0.89, 1.11) | 0.645 | 0.0% |
Europe | 2 | 1.03 (0.93, 1.14) | 0.362 | 0.0% |
Range of intake | ||||
≥3 servings/week | 3 | 1.00 (0.91, 1.09) | 0.426 | 0.0% |
<3 servings/week | 3 | 1.05 (0.90, 1.22) | 0.689 | 0.0% |
Duration | ||||
≥10 years | 3 | 0.99 (0.91, 1.08) | 0.806 | 0.0% |
<10 years | 3 | 1.13 (0.94, 1.38) | 0.718 | 0.0% |
Mean/median age at baseline | ||||
≥60 years | 5 | 1.01 (0.93, 1.10) | 0.606 | 0.0% |
<60 years | 1 | 1.00 (0.81, 1.24) | - | - |
Quality scores | ||||
≥8 | 3 | 0.99 (0.91, 1.08) | 0.806 | 0.0% |
<8 | 3 | 1.13 (0.94, 1.38) | 0.718 | 0.0% |
Subgroup | n | RR a (95% CI b) | Pheterogeneity | I2 |
---|---|---|---|---|
Sex | ||||
Male | 0 | - | - | - |
Female | 1 | 1.02 (0.73, 1.44) | - | - |
Both | 5 | 1.03 (0.97, 1.10) | 0.437 | 0.0% |
Region | ||||
North America | 3 | 0.97 (0.85, 1.10) | 0.383 | 0.0% |
Europe | 3 | 1.05 (0.98, 1.12) | 0.713 | 0.0% |
Range of intake | ||||
≥0.3 mg/day | 3 | 1.05 (0.98, 1.12) | 0.765 | 0.0% |
<0.3 mg/day | 2 | 1.11 (0.89, 1.38) | 0.522 | 0.0% |
Duration | ||||
≥10 years | 3 | 1.02 (0.95, 1.09) | 0.330 | 9.9% |
<10 years | 3 | 1.13 (0.94, 1.36) | 0.778 | 0.0% |
Mean/median age at baseline | ||||
≥60 years | 4 | 1.05 (0.98, 1.14) | 0.758 | 0.0% |
<60 years | 2 | 0.99 (0.87, 1.13) | 0.179 | 44.6% |
Quality scores | ||||
≥8 | 3 | 1.02 (0.95, 1.09) | 0.330 | 9.9% |
<8 | 3 | 1.13 (0.94, 1.36) | 0.778 | 0.0% |
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Li, F.-R.; Chen, G.-C.; Qin, J.; Wu, X. Dietary Fish and Long-Chain n-3 Polyunsaturated Fatty Acids Intake and Risk of Atrial Fibrillation: A Meta-Analysis. Nutrients 2017, 9, 955. https://doi.org/10.3390/nu9090955
Li F-R, Chen G-C, Qin J, Wu X. Dietary Fish and Long-Chain n-3 Polyunsaturated Fatty Acids Intake and Risk of Atrial Fibrillation: A Meta-Analysis. Nutrients. 2017; 9(9):955. https://doi.org/10.3390/nu9090955
Chicago/Turabian StyleLi, Fu-Rong, Guo-Chong Chen, Jiabi Qin, and Xianbo Wu. 2017. "Dietary Fish and Long-Chain n-3 Polyunsaturated Fatty Acids Intake and Risk of Atrial Fibrillation: A Meta-Analysis" Nutrients 9, no. 9: 955. https://doi.org/10.3390/nu9090955