中国神经再生研究(英文版)

中国神经再生研究(英文版) ›› 2019, Vol. 14 ›› Issue (12): 2156-2163.doi: 10.4103/1673-5374.262599

• 原著:退行性病与再生 • 上一篇    下一篇

高膳食脂肪摄入量和帕金森病发病风险的关系：一项meta分析

  

  • 出版日期:2019-12-15 发布日期:2019-12-15
  • 基金资助:

    国家自然科学基金(31200868)

Relationship between high dietary fat intake and Parkinson’s disease risk: a meta-analysis

Yan Qu 1 , Xi Chen 1 , Man-Man Xu 1 , Qiang Sun 2   

  1. 1 Department of Physiology, School of Basic Medicine, Qingdao University, Qingdao, Shandong Province, China
    2 Intensive Care Unit, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, China
  • Online:2019-12-15 Published:2019-12-15
  • Contact: Qiang Sun, Doctoral candidate, suncongrong@126.com.
  • Supported by:

     This study was supported by the National Natural Science Foundation of China, No. 31200868 (to XC).

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摘要：

目的：评估膳食脂肪是否会影响帕金森病的发病风险。
资料来源：系统地检索了Embase和PubMed数据库2018年10月之前发表的相关文章。主要检索词为(“Paralysis Agitans” OR “Parkinson disease” OR “Parkinson” OR “Parkinson’s” OR “Parkinson’s disease”) AND (“fat” OR “dietary fat” OR “dietary fat intake”).
资料选择：纳入的研究包括暴露因素为膳食脂肪摄入量，帕金森病的发病风险是暴露因素的结局的临床研究文章。用文献质量评价量表(NOS)对纳入的文献进行质量分析。使用Stata V12.0软件进行数据统计分析。
结局评价指标：主要结局指标包括高总能量摄入，高总脂肪摄入量与帕金森病发病风险的关系。次要结局指标包括不同种类的脂肪酸与帕金森病发病风险的关系。
结果：共有9篇符合要求纳入标准的研究被纳入本研究中，NOS分析结果均为高质量研究(4篇7分，5篇9分)。Meta结果显示，(1)总能量高摄入与帕金森病风险升高有关(P=0.000, OR=1.49, 95%CI: 1.26-1.75)，而总脂肪高摄入与帕金森病风险无关(P=0.123, OR=1.07, 95%CI：0.91-1.25)。(2)亚组分析结果显示，多不饱和脂肪酸 (P=0.010, OR=1.03, 95%CI: 0.88-1.20)能够降低帕金森病发病风险，花生四烯酸(P=0.026, OR=1.15, 95%CI: 0.97-1.37)和胆固醇(P=0.002, OR=1.09, 95%CI: 0.92-1.29)能够升高帕金森病发病风险。(3) 亚组分析结果还显示，尽管检测P值无显著性意义，但n-3多不饱和脂肪酸(P=0.071, OR=0.88, 95%CI: 0.73-1.05), α-亚麻酸(P=0.06, OR:0.86, 95%CI: 0.72-1.02)和n-3：n-6多不饱和脂肪酸摄入比(P=0.458, OR=0.89, 95%CI: 0.75-1.06)表现出降低帕金森病风险的趋势，单不饱和脂肪酸(P=0.450, OR=1.06, 95%CI: 0.91-1.23)、n-6多不饱和脂肪酸(P=0.100, OR=1.15, 95%CI: 0.96-1.36)和亚油酸(P=0.053, OR=1.11, 95%CI: 0.94-1.32)表现出升高帕金森病风险的趋势，而饱和脂肪酸(P=0.619, OR=1.01, 95%CI: 0.87-1.18)与帕金森病的发病风险无关。
结论：膳食脂肪摄入量影响帕金森病的发病风险主要取决于不同种类的脂肪酸亚型，较高的多不饱和脂肪酸可能降低帕金森病发病风险，较高的胆固醇和花生四烯酸摄入可能增加帕金森病发病风险，但文章结果还需要进一步的随机对照临床研究证据来验证。

orcid: 0000-0002-9356-5005(Qiang Sun)

关键词: 膳食脂肪, 帕金森病风险, meta分析, 总能量摄入, 多不饱和脂肪酸, 花生四烯酸, 胆固醇, &alpha, -亚麻酸, 亚油酸, n-3, n-6多不饱和脂肪酸比值, 单不饱和脂肪酸, 神经再生

Abstract:

OBJECTIVE: To assess whether dietary fat intake influences Parkinson’s disease risk.
DATA SOURCES: We systematically surveyed the Embase and PubMed databases, reviewing manuscripts published prior to October 2018. The following terms were used: (“Paralysis agitans” OR “Parkinson disease” OR “Parkinson” OR “Parkinson’s” OR “Parkinson’s disease”) AND (“fat” OR “dietary fat” OR “dietary fat intake”).
DATA SELECTION: Included studies were those with both dietary fat intake and Parkinson’s disease risk as exposure factors. The Newcastle-Ottawa Scale was adapted to investigate the quality of included studies. Stata V12.0 software was used for statistical analysis.
OUTCOME MEASURES: The primary outcomes included the relationship between high total energy intake, high total fat intake, and Parkinson’s disease risk. The secondary outcomes included the relationship between different kinds of fatty acids and Parkinson’s disease risk.
RESULTS: Nine articles met the inclusion criteria and were incorporated into this meta-analysis. Four studies scored 7 and the other five studies scored 9 on the Newcastle-Ottawa Scale, meaning that all studies were of high quality. Meta-analysis results showed that high total energy intake was associated with an increased risk of Parkinson’s disease (P = 0.000, odds ratio (OR) = 1.49, 95% confidence interval (CI): 1.26–1.75); in contrast, high total fat intake was not associated with Parkinson’s disease risk (P = 0.123, OR = 1.07, 95% CI: 0.91–1.25). Subgroup analysis revealed that polyunsaturated fatty acid intake (P = 0.010, OR = 1.03, 95% CI: 0.88–1.20) reduced the risk of Parkinson’s disease, while arachidonic acid (P = 0.026, OR = 1.15, 95% CI: 0.97–1.37) and cholesterol (P = 0.002, OR = 1.09, 95% CI: 0.92–1.29) both increased the risk of Parkinson’s disease. Subgroup analysis also demonstrated that, although the results were not significant, consumption of n-3 polyunsaturated fatty acids (P = 0.071, OR = 0.88, 95% CI: 0.73–1.05), α-linolenic acid (P = 0.06, OR = 0.86, 95% CI: 0.72–1.02), and the n-3 to n-6 ratio (P = 0.458, OR = 0.89, 95% CI: 0.75–1.06) were all linked with a trend toward reduced Parkinson’s disease risk. Monounsaturated fatty acid (P = 0.450, OR = 1.06, 95% CI: 0.91–1.23), n-6 polyunsaturated fatty acids (P = 0.100, OR = 1.15, 95% CI: 0.96–1.36) and linoleic acid (P = 0.053, OR = 1.11, 95% CI: 0.94–1.32) intakes were associated with a non-significant trend toward higher PD risk. Saturated fatty acid (P = 0.619, OR = 1.01, 95% CI: 0.87–1.18) intake was not associated with Parkinson’s disease.
CONCLUSION: Dietary fat intake affects Parkinson’s disease risk, although this depends on the fatty acid subtype. Higher intake of polyunsaturated fatty acids may reduce the risk of Parkinson’s disease, while higher cholesterol and arachidonic acid intakes may elevate Parkinson’s disease risk. However, further studies and evidence are needed to validate any link between dietary fat intake and Parkinson’s disease.

Key words: nerve regeneration, dietary fat, Parkinson’s disease risk, meta-analysis, total energy intake, polyunsaturated fatty acids, arachidonic acid, cholesterol, α-linolenic acid, linoleic acid, n-3/n-6 polyunsaturated fatty acid intake ratio, monounsaturated fatty acids, neural regeneration