NEJM:补充n-3脂肪酸,无法预防糖尿病患者的心血管事件

创作:MP 审核:沈志勋 09月02日
将15,480例(>40岁)无动脉粥样硬化的糖尿病患者随机分组,分别服用n-3脂肪酸(460mg EPA和 380mg DHA))或橄榄油(安慰剂)胶囊。随访7.4年,随访率76%。
脂肪酸组的严重血管事件,综合严重血管事件、血管再生率、全因死亡率(8.9%,11.4%,9.7%)与安慰剂组(9.2%,11.5%和10.2%)无显著差异。
补充n-3脂肪酸对无心血管疾病证据的糖尿病患者的严重血管事件无影响;
结合早期随机研究,本文不支持膳食补充n-3脂肪酸来预防血管事件。
延伸阅读

Effects of n-3 Fatty Acid Supplements in Diabetes Mellitus

n-3脂肪酸补充剂对糖尿病的作用

10-18, Article, 10.1056/NEJMoa1804989more

Abstract:
BACKGROUND: Increased intake of n-3 fatty acids has been associated with a reduced risk of cardiovascular disease in observational studies, but this finding has not been confirmed in randomized trials. It remains unclear whether n-3 (also called omega-3) fatty acid supplementation has cardiovascular benefit in patients with diabetes mellitus.
METHODS: We randomly assigned 15,480 patients with diabetes but without evidence of atherosclerotic cardiovascular disease to receive 1-g capsules containing either n-3 fatty acids (fatty acid group) or matching placebo (olive oil) daily. The primary outcome was a first serious vascular event (i.e., nonfatal myocardial infarction or stroke, transient ischemic attack, or vascular death, excluding confirmed intracranial hemorrhage). The secondary outcome was a first serious vascular event or any arterial revascularization.
RESULTS: During a mean follow-up of 7.4 years (adherence rate, 76%), a serious vascular event occurred in 689 patients (8.9%) in the fatty acid group and in 712 (9.2%) in the placebo group (rate ratio, 0.97; 95% confidence interval [CI], 0.87 to 1.08; P=0.55). The composite outcome of a serious vascular event or revascularization occurred in 882 patients (11.4%) and 887 patients (11.5%), respectively (rate ratio, 1.00; 95% CI, 0.91 to 1.09). Death from any cause occurred in 752 patients (9.7%) in the fatty acid group and in 788 (10.2%) in the placebo group (rate ratio, 0.95; 95% CI, 0.86 to 1.05). There were no significant between-group differences in the rates of nonfatal serious adverse events.
CONCLUSIONS: Among patients with diabetes without evidence of cardiovascular disease, there was no significant difference in the risk of serious vascular events between those who were assigned to receive n-3 fatty acid supplementation and those who were assigned to receive placebo. (Funded by the British Heart Foundation and others; Current Controlled Trials number, ISRCTN60635500 ; ClinicalTrials.gov number, NCT00135226 .).

First Authors:
ASCEND Study Collaborative Group

Correspondence Authors:
ASCEND Study Collaborative Group

All Authors:
ASCEND Study Collaborative Group