魚類的攝入與心血管疾病死亡風(fēng)險(xiǎn)的Meta分析
發(fā)布時(shí)間：2019-02-13 14:36
【摘要】：目的關(guān)于魚類的攝入與心血管疾病的死亡風(fēng)險(xiǎn)的關(guān)聯(lián)性有較多的爭論,目前多項(xiàng)流行病學(xué)研究分析了魚類的攝入與心血管疾病的死亡風(fēng)險(xiǎn)的關(guān)系,但是結(jié)果存在較多的爭議,因此本研究對這些結(jié)果進(jìn)行了Meta分析以及劑量反應(yīng)分析來定量的分析他們二者之間的關(guān)系。方法檢索PubMed、Web of Science、EMBASE、萬方以及中國知網(wǎng)數(shù)據(jù)庫,收集從建庫至2016年9月所有有關(guān)魚類攝入與心血管疾病死亡風(fēng)險(xiǎn)關(guān)系的中英文文獻(xiàn)。根據(jù)制定的檢索策略和文獻(xiàn)納入標(biāo)準(zhǔn),選擇納入符合要求的文獻(xiàn),并對檢索到的文獻(xiàn)的參考文獻(xiàn)進(jìn)行手工檢索,以期盡可能全面的搜索相關(guān)的文獻(xiàn)。本研究采用固定效應(yīng)模型計(jì)算合并效應(yīng)結(jié)果,用限制性立方樣條模型來計(jì)算劑量反應(yīng)關(guān)系,用Q檢驗(yàn)法來評價(jià)研究間的異質(zhì)性,用I2定量評價(jià)異質(zhì)性的大小,用敏感性分析來評價(jià)分析單項(xiàng)研究對總合并效應(yīng)量的影響,用Egger法以及漏斗圖法來判斷各研究因素合并效應(yīng)是否存在發(fā)表偏倚。結(jié)果有14篇隊(duì)列研究包含了487442例研究對象符合納入標(biāo)準(zhǔn),包括了美洲和亞洲的人群。相對于低的魚類攝入來說,高的魚類攝入與心血管疾病死亡率之間的合并RR值是0.91(95%CI:0.85-0.96)。亞組分析結(jié)果顯示:(1)按照研究所在大洲,只有亞洲亞組的合并結(jié)果有統(tǒng)計(jì)學(xué)意義(RR=0.91,95%CI:0.85-0.97)。(2)按照研究對象的性別,只有男性的亞組合并結(jié)果有統(tǒng)計(jì)學(xué)意義(RR=0.88,95%CI0.81-0.96)。(3)按照樣本量大小,進(jìn)行亞組分析發(fā)現(xiàn)樣本量大于10 000的亞組合并結(jié)果與總結(jié)果是一致的(RR=0.91,95%CI:0.85-0.97)。(4)按照調(diào)整的混雜因素個(gè)數(shù),調(diào)整混雜因素個(gè)數(shù)多于7個(gè)的研究的合并結(jié)果有統(tǒng)計(jì)學(xué)意義(RR=0.91,95%CI:0.86-0.98)。劑量反應(yīng)關(guān)系結(jié)果顯示兩者之間存在非線性關(guān)系(Pnonlinearity=0.041)。每天魚類攝入量在17.5克以上時(shí),對CVD死亡風(fēng)險(xiǎn)有較明顯的降低作用。影響性分析結(jié)果顯示沒有一項(xiàng)研究對合并效應(yīng)值有顯著影響。漏斗圖目測基本對稱,結(jié)果顯示沒有小樣本效應(yīng)。Egger法檢驗(yàn)未發(fā)現(xiàn)有發(fā)表偏倚(P=0.670)。結(jié)論增加魚類攝入可以降低CVD的死亡風(fēng)險(xiǎn),魚類的攝入與心血管疾病死亡風(fēng)險(xiǎn)呈非線性劑量反應(yīng)關(guān)系。在心血管疾病的預(yù)防中可以鼓勵(lì)人們增加魚類攝入,以降低心血管疾病的死亡風(fēng)險(xiǎn)。
[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.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R54
本文編號：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.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R54
【參考文獻(xiàn)】
相關(guān)期刊論文 前1條
1 陳偉偉;高潤霖;劉力生;朱曼璐;王文;王擁軍;吳兆蘇;李惠君;鄭哲;蔣立新;胡盛壽;;《中國心血管病報(bào)告2014》概要[J];中國循環(huán)雜志;2015年07期
，本文編號：2421652
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