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Published in: European Journal of Epidemiology 12/2012

01-12-2012 | META-ANALYSIS

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

Authors: Susanna C. Larsson, Nicola Orsini, Alicja Wolk

Published in: European Journal of Epidemiology | Issue 12/2012

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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.
Literature
1.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
2.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
3.
go back to reference Larsson SC, Orsini N. Fish consumption and the risk of stroke: a dose-response meta-analysis. Stroke. 2011;42(12):3621–3.PubMedCrossRef Larsson SC, Orsini N. Fish consumption and the risk of stroke: a dose-response meta-analysis. Stroke. 2011;42(12):3621–3.PubMedCrossRef
4.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
6.
7.
go back to reference 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 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
8.
go back to reference Orsini N, Bellocco R, Greenland S. Generalized least squares for trend estimation of summarized dose-response data. Stat J 2006;6(40–57). Orsini N, Bellocco R, Greenland S. Generalized least squares for trend estimation of summarized dose-response data. Stat J 2006;6(40–57).
9.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
10.
go back to reference Higgins JP, Thompson SG. Quantifying heterogeneity in a meta-analysis. Stat Med. 2002;21(11):1539–58.PubMedCrossRef Higgins JP, Thompson SG. Quantifying heterogeneity in a meta-analysis. Stat Med. 2002;21(11):1539–58.PubMedCrossRef
11.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
12.
go back to reference 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 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
13.
go back to reference 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.CrossRef 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.CrossRef
14.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
15.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
16.
go back to reference Montonen J, Järvinen R, Reunanen A, Knekt P. Fish consumption and the incidence of cerebrovascular disease. Br J Nutr. 2009;102(5):750–6.PubMedCrossRef Montonen J, Järvinen R, Reunanen A, Knekt P. Fish consumption and the incidence of cerebrovascular disease. Br J Nutr. 2009;102(5):750–6.PubMedCrossRef
17.
go back to reference Larsson SC, Virtamo J, Wolk A. Dietary fats and dietary cholesterol and risk of stroke in women. Atherosclerosis. 2012;221(1):282–6.PubMedCrossRef Larsson SC, Virtamo J, Wolk A. Dietary fats and dietary cholesterol and risk of stroke in women. Atherosclerosis. 2012;221(1):282–6.PubMedCrossRef
18.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
19.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
20.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
21.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
22.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
23.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
24.
go back to reference 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. 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.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
26.
go back to reference 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. 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.
Metadata
Title
Long-chain omega-3 polyunsaturated fatty acids and risk of stroke: a meta-analysis
Authors
Susanna C. Larsson
Nicola Orsini
Alicja Wolk
Publication date
01-12-2012
Publisher
Springer Netherlands
Published in
European Journal of Epidemiology / Issue 12/2012
Print ISSN: 0393-2990
Electronic ISSN: 1573-7284
DOI
https://doi.org/10.1007/s10654-012-9748-9

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