鱼类的摄入与心血管疾病死亡风险的Meta分析
发布时间：2019-02-13 14:36
【摘要】：目的关于鱼类的摄入与心血管疾病的死亡风险的关联性有较多的争论,目前多项流行病学研究分析了鱼类的摄入与心血管疾病的死亡风险的关系,但是结果存在较多的争议,因此本研究对这些结果进行了Meta分析以及剂量反应分析来定量的分析他们二者之间的关系。方法检索PubMed、Web of Science、EMBASE、万方以及中国知网数据库,收集从建库至2016年9月所有有关鱼类摄入与心血管疾病死亡风险关系的中英文文献。根据制定的检索策略和文献纳入标准,选择纳入符合要求的文献,并对检索到的文献的参考文献进行手工检索,以期尽可能全面的搜索相关的文献。本研究采用固定效应模型计算合并效应结果,用限制性立方样条模型来计算剂量反应关系,用Q检验法来评价研究间的异质性,用I2定量评价异质性的大小,用敏感性分析来评价分析单项研究对总合并效应量的影响,用Egger法以及漏斗图法来判断各研究因素合并效应是否存在发表偏倚。结果有14篇队列研究包含了487442例研究对象符合纳入标准,包括了美洲和亚洲的人群。相对于低的鱼类摄入来说,高的鱼类摄入与心血管疾病死亡率之间的合并RR值是0.91(95%CI:0.85-0.96)。亚组分析结果显示:(1)按照研究所在大洲,只有亚洲亚组的合并结果有统计学意义(RR=0.91,95%CI:0.85-0.97)。(2)按照研究对象的性别,只有男性的亚组合并结果有统计学意义(RR=0.88,95%CI0.81-0.96)。(3)按照样本量大小,进行亚组分析发现样本量大于10 000的亚组合并结果与总结果是一致的(RR=0.91,95%CI:0.85-0.97)。(4)按照调整的混杂因素个数,调整混杂因素个数多于7个的研究的合并结果有统计学意义(RR=0.91,95%CI:0.86-0.98)。剂量反应关系结果显示两者之间存在非线性关系(Pnonlinearity=0.041)。每天鱼类摄入量在17.5克以上时,对CVD死亡风险有较明显的降低作用。影响性分析结果显示没有一项研究对合并效应值有显著影响。漏斗图目测基本对称,结果显示没有小样本效应。Egger法检验未发现有发表偏倚(P=0.670)。结论增加鱼类摄入可以降低CVD的死亡风险,鱼类的摄入与心血管疾病死亡风险呈非线性剂量反应关系。在心血管疾病的预防中可以鼓励人们增加鱼类摄入,以降低心血管疾病的死亡风险。
[Abstract]:Objective there is much debate about the relationship between fish intake and cardiovascular disease death risk. At present, many epidemiological studies have analyzed the relationship between fish intake and cardiovascular disease death risk, but the results are controversial. Therefore, Meta analysis and dose response analysis were performed to quantitatively analyze the relationship between these results. Methods the database of PubMed,Web of Science,EMBASE, Wanfang and China KnowledgeNet was searched, and the Chinese and English literatures on the relationship between fish intake and cardiovascular disease death risk were collected from the establishment of the database to September 2016. According to the retrieval strategy and the criteria of literature inclusion, the paper selects the documents that meet the requirements, and manually retrieves the references of the retrieved documents in order to search the relevant documents as comprehensively as possible. In this study, the combined effect results were calculated by a fixed effect model, a dose response relationship was calculated by a restricted cubic spline model, a Q test was used to evaluate the heterogeneity among the studies, and an I 2 quantitative evaluation was used to evaluate the heterogeneity. Sensitivity analysis was used to evaluate the effect of single study on the total combined effect, and Egger method and funnel chart method were used to judge whether the combination effect of each factor had publication bias. Results 14 cohort studies included 487442 subjects who met the inclusion criteria, including people in the Americas and Asia. The combined RR between high fish intake and cardiovascular disease mortality was 0. 91 (95%CI:0.85-0.96) compared with low fish intake. The results of subgroup analysis showed that: (1) only the Asian subgroup combined results were statistically significant (RR=0.91,95%CI:0.85-0.97). (2) according to the sex of the subjects. Only the male subgroup and the results were statistically significant (RR=0.88,95%CI0.81-0.96). (3) according to the size of the sample, Subgroup analysis showed that the subcombinations with sample size greater than 10 000 were consistent with the total results (RR=0.91,95%CI:0.85-0.97). (4) according to the adjusted number of confounding factors. The combined results of more than 7 adjusted confounding factors were statistically significant (RR=0.91,95%CI:0.86-0.98). The results of dose-response relationship showed that there was a nonlinear relationship (Pnonlinearity=0.041) between them. Fish intake above 17. 5 g per day significantly reduced the risk of CVD death. The results of impact analysis showed that none of the studies had a significant effect on the combined effect. The funnel graph was visually symmetrical and showed no small sample effect. No publication bias was found by Egger test (P0. 670). Conclusion increasing fish intake can reduce the risk of CVD death, and there is a nonlinear dose response relationship between fish intake and mortality risk of cardiovascular disease. Increased fish intake can be encouraged in cardiovascular disease prevention to reduce the risk of death from cardiovascular disease.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R54
本文编号：2421652
[Abstract]:Objective there is much debate about the relationship between fish intake and cardiovascular disease death risk. At present, many epidemiological studies have analyzed the relationship between fish intake and cardiovascular disease death risk, but the results are controversial. Therefore, Meta analysis and dose response analysis were performed to quantitatively analyze the relationship between these results. Methods the database of PubMed,Web of Science,EMBASE, Wanfang and China KnowledgeNet was searched, and the Chinese and English literatures on the relationship between fish intake and cardiovascular disease death risk were collected from the establishment of the database to September 2016. According to the retrieval strategy and the criteria of literature inclusion, the paper selects the documents that meet the requirements, and manually retrieves the references of the retrieved documents in order to search the relevant documents as comprehensively as possible. In this study, the combined effect results were calculated by a fixed effect model, a dose response relationship was calculated by a restricted cubic spline model, a Q test was used to evaluate the heterogeneity among the studies, and an I 2 quantitative evaluation was used to evaluate the heterogeneity. Sensitivity analysis was used to evaluate the effect of single study on the total combined effect, and Egger method and funnel chart method were used to judge whether the combination effect of each factor had publication bias. Results 14 cohort studies included 487442 subjects who met the inclusion criteria, including people in the Americas and Asia. The combined RR between high fish intake and cardiovascular disease mortality was 0. 91 (95%CI:0.85-0.96) compared with low fish intake. The results of subgroup analysis showed that: (1) only the Asian subgroup combined results were statistically significant (RR=0.91,95%CI:0.85-0.97). (2) according to the sex of the subjects. Only the male subgroup and the results were statistically significant (RR=0.88,95%CI0.81-0.96). (3) according to the size of the sample, Subgroup analysis showed that the subcombinations with sample size greater than 10 000 were consistent with the total results (RR=0.91,95%CI:0.85-0.97). (4) according to the adjusted number of confounding factors. The combined results of more than 7 adjusted confounding factors were statistically significant (RR=0.91,95%CI:0.86-0.98). The results of dose-response relationship showed that there was a nonlinear relationship (Pnonlinearity=0.041) between them. Fish intake above 17. 5 g per day significantly reduced the risk of CVD death. The results of impact analysis showed that none of the studies had a significant effect on the combined effect. The funnel graph was visually symmetrical and showed no small sample effect. No publication bias was found by Egger test (P0. 670). Conclusion increasing fish intake can reduce the risk of CVD death, and there is a nonlinear dose response relationship between fish intake and mortality risk of cardiovascular disease. Increased fish intake can be encouraged in cardiovascular disease prevention to reduce the risk of death from cardiovascular disease.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R54
【参考文献】
相关期刊论文 前1条
1 陈伟伟;高润霖;刘力生;朱曼璐;王文;王拥军;吴兆苏;李惠君;郑哲;蒋立新;胡盛寿;;《中国心血管病报告2014》概要[J];中国循环杂志;2015年07期
，本文编号：2421652
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