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Long-chain omega-3 polyunsaturated fatty acids and risk of stroke: a meta-analysis

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Abstract

Prospective studies of long-chain omega-3 polyunsaturated fatty acids (PUFA) in relation to stroke have yielded inconsistent results. The authors conducted a meta-analysis of prospective studies to summarize available evidence regarding the relation between long-chain omega-3 PUFA intake and stroke. Pertinent studies were identified by searching PubMed and Embase databases to November 1, 2012 and by reviewing the reference lists of relevant publications. Prospective studies that provided relative risks (RRs) with 95 % confidence intervals (CIs) for the association between dietary long-chain omega-3 PUFA intake and stroke were eligible. A random-effects model was used to combine study-specific results. Eight prospective studies, with 5238 stroke events among 242,076 participants, were included in the meta-analysis. The combined RR of total stroke was 0.90 (95 % CI, 0.81–1.01) for the highest versus lowest category of long-chain omega-3 PUFA intake, without heterogeneity among studies (P = 0.32). Results were similar for ischemic (RR, 0.82; 95 % CI, 0.71–0.94) and hemorrhagic stroke (RR, 0.80; 95 % CI, 0.55–1.15). A statistically significant reduction in total stroke risk was observed in women (RR, 0.80; 95 % CI, 0.65–0.99). This meta-analysis showed no overall association between omega-3 PUFA intake and stroke, but suggests that women might benefit from a higher intake of these PUFAs.

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References

  1. Mozaffarian D, Wu JH. Omega-3 fatty acids and cardiovascular disease: effects on risk factors, molecular pathways, and clinical events. J Am Coll Cardiol. 2011;58(20):2047–67.

    Article  PubMed  CAS  Google Scholar 

  2. Rizos EC, Ntzani EE, Bika E, Kostapanos MS, Elisaf MS. Association between omega-3 fatty acid supplementation and risk of major cardiovascular disease events: a systematic review and meta-analysis. JAMA. 2012;308(10):1024–33.

    Article  PubMed  CAS  Google Scholar 

  3. Larsson SC, Orsini N. Fish consumption and the risk of stroke: a dose-response meta-analysis. Stroke. 2011;42(12):3621–3.

    Article  PubMed  Google Scholar 

  4. Stroup DF, Berlin JA, Morton SC, Olkin I, Williamson GD, Rennie D, Moher D, Becker BJ, Sipe TA, Thacker SB. Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of observational studies in epidemiology (MOOSE) group. JAMA. 2000;283(15):2008–12.

    Article  PubMed  CAS  Google Scholar 

  5. Wells GA, Shea B, O’Connell D, Petersen J, Welch V, Losos M, Tugwell P. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomized studies in meta-analyses. Department of Epidemiology and Community Medicine, University of Ottawa, Canada; Available at http://www.ohri.ca/programs/clinical_epidemiology/oxford.htm. Accessed October 29, 2012.

  6. DerSimonian R, Laird N. Meta-analysis in clinical trials. Control Clin Trials. 1986;7(3):177–88.

    Article  PubMed  CAS  Google Scholar 

  7. Greenland S, Longnecker MP. Methods for trend estimation from summarized dose-response data, with applications to meta-analysis. Am J Epidemiol. 1992;135(11):1301–9.

    PubMed  CAS  Google Scholar 

  8. Orsini N, Bellocco R, Greenland S. Generalized least squares for trend estimation of summarized dose-response data. Stat J 2006;6(40–57).

    Google Scholar 

  9. Harrell FE Jr, Lee KL, Pollock BG. Regression models in clinical studies: determining relationships between predictors and response. J Natl Cancer Inst. 1988;80(15):1198–202.

    Article  PubMed  Google Scholar 

  10. Higgins JP, Thompson SG. Quantifying heterogeneity in a meta-analysis. Stat Med. 2002;21(11):1539–58.

    Article  PubMed  Google Scholar 

  11. Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ. 1997;315(7109):629–34.

    Article  PubMed  CAS  Google Scholar 

  12. Morris MC, Manson JE, Rosner B, Buring JE, Willett WC, Hennekens CH. Fish consumption and cardiovascular disease in the physicians’ health study: a prospective study. Am J Epidemiol. 1995;142(2):166–75.

    PubMed  CAS  Google Scholar 

  13. Yuan JM, Ross RK, Gao YT, Yu MC. Fish and shellfish consumption in relation to death from myocardial infarction among men in Shanghai. China Am J Epidemiol. 2001;154(9):809–16.

    Article  CAS  Google Scholar 

  14. Iso H, Rexrode KM, Stampfer MJ, Manson JE, Colditz GA, Speizer FE, Hennekens CH, Willett WC. Intake of fish and omega-3 fatty acids and risk of stroke in women. JAMA. 2001;285(3):304–12.

    Article  PubMed  CAS  Google Scholar 

  15. He K, Rimm EB, Merchant A, Rosner BA, Stampfer MJ, Willett WC, Ascherio A. Fish consumption and risk of stroke in men. JAMA. 2002;288(24):3130–6.

    Article  PubMed  CAS  Google Scholar 

  16. Montonen J, Järvinen R, Reunanen A, Knekt P. Fish consumption and the incidence of cerebrovascular disease. Br J Nutr. 2009;102(5):750–6.

    Article  PubMed  CAS  Google Scholar 

  17. Larsson SC, Virtamo J, Wolk A. Dietary fats and dietary cholesterol and risk of stroke in women. Atherosclerosis. 2012;221(1):282–6.

    Article  PubMed  CAS  Google Scholar 

  18. Wallström P, Sonestedt E, Hlebowicz J, Ericson U, Drake I, Persson M, Gullberg B, Hedblad B, Wirfält E. Dietary fiber and saturated fat intake associations with cardiovascular disease differ by sex in the Malmo Diet and Cancer Cohort: a prospective study. PLoS ONE. 2012;7(2):e31637.

    Article  PubMed  Google Scholar 

  19. de Goede J, Verschuren WM, Boer JM, Kromhout D, Geleijnse JM. Gender-specific associations of marine n-3 fatty acids and fish consumption with 10-year incidence of stroke. PLoS ONE. 2012;7(4):e33866.

    Article  PubMed  Google Scholar 

  20. Geleijnse JM, Giltay EJ, Grobbee DE, Donders AR, Kok FJ. Blood pressure response to fish oil supplementation: metaregression analysis of randomized trials. J Hypertens. 2002;20(8):1493–9.

    Article  PubMed  CAS  Google Scholar 

  21. Eslick GD, Howe PR, Smith C, Priest R, Bensoussan A. Benefits of fish oil supplementation in hyperlipidemia: a systematic review and meta-analysis. Int J Cardiol. 2009;136(1):4–16.

    Article  PubMed  Google Scholar 

  22. Egert S, Stehle P. Impact of n-3 fatty acids on endothelial function: results from human interventions studies. Curr Opin Clin Nutr Metab Care. 2011;14(2):121–31.

    Article  PubMed  CAS  Google Scholar 

  23. Park Y, Park S, Yi H, Kim HY, Kang SJ, Kim J, Ahn H. Low level of n-3 polyunsaturated fatty acids in erythrocytes is a risk factor for both acute ischemic and hemorrhagic stroke in Koreans. Nutr Res. 2009;29(12):825–30.

    Article  PubMed  CAS  Google Scholar 

  24. De Goede J, Verschuren WM, Boer JM, Kromhout D, Geleijnse JM. N-6 and n-3 fatty acid cholesteryl esters in relation to incident stroke in a Dutch adult population: A nested case-control study. Nutr Metab Cardiovasc Dis 2012.

  25. Wennberg M, Bergdahl IA, Stegmayr B, Hallmans G, Lundh T, Skerfving S, Strömberg U, Vessby B, Jansson JH. Fish intake, mercury, long-chain n-3 polyunsaturated fatty acids and risk of stroke in northern Sweden. Br J Nutr. 2007;98(5):1038–45.

    Article  PubMed  CAS  Google Scholar 

  26. Ikeya Y, Fukuyama N, Kitajima W, Ogushi Y, Mori H. Comparison of eicosapentaenoic acid concentrations in plasma between patients with ischemic stroke and control subjects. Nutrition 2012.

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Acknowledgments

This study was supported by a research grant from the Swedish Council for Working Life and Social Research (FAS). The funding source had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; or preparation, review, or approval of the manuscript.

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Authors and Affiliations

  1. Division of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Box 210, SE-17177, Stockholm, Sweden

    Susanna C. Larsson, Nicola Orsini & Alicja Wolk

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  1. Susanna C. Larsson
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  2. Nicola Orsini
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  3. Alicja Wolk
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Correspondence to Susanna C. Larsson.

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Larsson, S.C., Orsini, N. & Wolk, A. Long-chain omega-3 polyunsaturated fatty acids and risk of stroke: a meta-analysis. Eur J Epidemiol 27, 895–901 (2012). https://doi.org/10.1007/s10654-012-9748-9

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  • DOI: https://doi.org/10.1007/s10654-012-9748-9

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