反式脂肪酸对冠心病危险性的Meta分析

Meta-analysis of risk of trans fatty acids on coronary heart diseases

目的采用Meta分析法评价反式脂肪酸对冠心病危险性的影响。方法以'trans fatty acids''sudden cardiac death''myo-cardial infarction''coronary heart disease''反式脂肪酸''冠心病猝死''心肌梗塞'和'冠心病'等为关键词,通过Medline、EMBASE、Cochrane图书馆、中国期刊全文数据库、重庆维普数据库和万方数据库等工具进行文献检索,以多重校正后的相对危险度(RR)或比值比(OR)及其95%可信区间(CI)为效应值,经异质性检验后采用固定效应模型对纳入文献进行Meta分析。结果共纳入9篇文献,包括6项队列研究和3项病例对照研究。反式脂肪酸摄入量与冠心病和冠心病死亡的合并RR分别为1.234(95%CI 1.117~1.363,P=0.000)和1.307(95%CI 1.113~1.535,P=0.001);皮下脂肪中反式脂肪酸水平与首次心肌梗死的合并OR为1.560(95%CI 1.119~2.175,P=0.009)。敏感性分析显示本研究结果具有良好的稳定性。结论反式脂肪酸是冠心病的危险因素之一。

Objective To evaluate the risk of trans fatty acids on coronary heart diseases by Meta-analysis. MethodsRelated literatures were searched with subject words including'trans fatty acids','sudden cardiac death','myocardial infarction' and 'coronary heart disease' from electronic databases of Medline,EMBASE,Cochrane Library,China National Knowledge Infrastructure,Chongqing VIP Database and Wanfang Data,etc.With multivariate adjusted relative ratio(RR) or odds ratio(OR) and their 95% confidence interval(CI) as parameters,literatures included were analysed by fixed effect model of Meta-analysis after heterogeneity inspection. Results A total of 9 literatures were selected,including 6 cohort studies and 3 case-control studies.Combined RR between trans fatty acids intake and coronary heart disease events and between trans fatty acids intake and fatal coronary heart diseases were 1.234(95%CI 1.117-1.363,P=0.000) and 1.307(95%CI 1.113-1.535,P=0.001),respectively.Combined OR between trans fatty acids in subcutaneous fat and first myocardial infarction events was 1.560(95%CI 1.119-2.175,P=0.009).Sensitivity analysis revealed that the results of this Meta-analysis were stable. Conclusion Trans fatty acids may be a risk factor for coronary heart diseases.