News Release 4-Mar-2020

Further studies should explore what dose is needed to achieve a clinically meaningful effect

BMJ

Regular use of fish oil supplements may be linked to a lower risk of death and cardiovascular disease (CVD) events, such as heart attack and stroke, suggests an analysis of data from the UK Biobank study, published in The BMJ today.

Further studies should explore what dose is needed to achieve a clinically meaningful effect, say the researchers.

Fish oil is a popular dietary supplement in the UK and other developed countries. Some evidence suggests that omega-3 fatty acids in fish oil may help prevent cardiovascular disease and reduce mortality, but conclusive evidence is still lacking.

To explore these potential associations further, a team of researchers based in China and the US drew on data from the UK Biobank – a large population based study of more than half a million British men and women.

Their analysis included 427,678 men and women aged between 40 and 69 years old, without CVD or cancer, who were enrolled in the study from 2006 to 2010 and completed a questionnaire on supplement use, including fish oil.

Death certificates and hospital records were used to monitor deaths from any cause (“all-cause mortality”), CVD deaths, and CVD events, such as heart attack and stroke, through to 2018.

Almost a third (31%) of participants reported taking regular fish oil supplements at the start of the study.

The researchers found that fish oil supplements were associated with a 13% lower risk of all-cause mortality, a 16% lower risk of CVD mortality, and a 7% lower risk of CVD events (388 fewer all-cause deaths, 124 fewer CVD deaths, and 295 fewer CVD events per 100,000 people in a median follow-up of 9 years).

The association between fish oil use and CVD events appeared to be stronger among those with high blood pressure.

These favourable associations remained after taking account of traditional risk factors, such as age, sex, lifestyle habits, diet, medication and other supplement use.

Results were also unchanged after further analyses, suggesting that the findings withstand scrutiny.

Several mechanisms could explain these results, say the researchers. For example, omega-3 fatty acid supplements have shown beneficial effects on blood pressure, cholesterol levels, and heart rate, all of which would exert a protective effect against the development of CVD events.

Despite the large sample size, this is an observational study, so can’t establish cause, and the researchers point to some limitations, such as lack of information on dose, duration, and side effects of fish oil use.

But they conclude that habitual fish oil use “is associated with a lower risk of all-cause and CVD mortality and a marginal benefit against CVD events among the general population.

Future studies are needed to address the extent to which the dose of fish oil supplements influences the ability to achieve a clinically meaningful effect,” they add.

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2880/5000今日在《英国医学杂志》（BMJ）上发表的UK Biobank研究数据分析表明，定期使用鱼油补充剂可能与降低死亡和心血管疾病（CVD）事件（例如心脏病发作和中风）的风险有关。

研究人员说，进一步的研究应探索达到临床意义的效果所需的剂量。

鱼油是在英国和其他发达国家流行的膳食补充剂。一些证据表明，鱼油中的omega-3脂肪酸可能有助于预防心血管疾病并降低死亡率，但仍缺乏确凿的证据。

为了进一步探讨这些潜在的关联，来自中国和美国的一组研究人员借鉴了英国生物库的数据。英国生物库是一项基于人口的大型研究，涉及超过50万英国男女。

他们的分析包括2006年至2010年参与研究的427,678名年龄在40至69岁之间，没有CVD或癌症的男女，并完成了包括鱼油在内的补充剂使用调查表。

死亡证明和医院记录被用来监测任何原因导致的死亡（“全因死亡率”），CVD死亡以及直到2018年的CVD事件，例如心脏病发作和中风。

近三分之一（31％）的参与者报告在研究开始时服用常规鱼油补充剂。

研究人员发现，鱼油补充剂可使全因死亡率降低13％，CVD死亡率降低16％，CVD事件降低7％（全因死亡减少388个，CVD减少124个）在9年的中位随访期内，每10万人中的死亡人数和CVD事件减少了295次）。

在高血压人群中，鱼油使用与CVD事件之间的相关性似乎更强。

考虑到传统的风险因素，例如年龄，性别，生活方式，饮食，药物和其他补充剂使用后，这些有利的关联仍然存在。

经过进一步分析，结果也没有变化，表明该结果可以接受仔细检查。

研究人员说，几种机制可以解释这些结果。例如，omega-3脂肪酸补充剂对血压，胆固醇水平和心率显示出有益的作用，所有这些都会对CVD事件的发展起到保护作用。

尽管样本量很大，但这是一项观察性研究，因此无法确定原因，研究人员指出了一些局限性，例如缺乏有关鱼油的剂量，持续时间和副作用的信息。

但是他们得出结论，习惯性使用鱼油“与全因和CVD死亡的风险较低以及普通人群中针对CVD事件的边际收益有关。

鱼油补充剂的剂量在多大程度上影响达到临床上有意义的效果的能力，还需要进一步的研究。”