食用富含欧米伽3多不饱和脂肪酸的鱼类可能会降低痛风发作风险

作者：Zhang M, et al.

摘要

目的：探讨欧米伽3多不饱和脂肪酸（n-3 PUFA）的摄入与痛风复发风险之间的关系。

方法：我们使用的资料来自于波士顿大学在线痛风研究，该研究是一项网络为基础的病例交叉研究。参与在在痛风复发（风险期）和痛风复发缓解后（对照期）完成问卷调查，记录包括复发前48小时内的饮食暴露情况。我们采用条件性逻辑回顾方式评估了自我报告的n-3 PUFA补充品和鱼摄入与痛风复发风险之间的关系，同时针对总的嘌呤摄入、利尿剂使用、其他降尿酸药或复发预防用药等因素进行了调整。

结果：724例参与者中，85%满足1977年ACR急性痛风分类标准。在痛风复发前的48小时内，22%的参与者报告了某种形式的n-3 PUFA的摄入（补充剂4.6%；摄入富含脂肪的鱼类：19%）。对于3种补充形式的综合调整后的比值比为1.01，而对于≥2种富含n-3 PUFA鱼摄入的比值比为0.74。

结论：当根据摄入总嘌呤情况进行调整时，发现食用富含n-3 PUFA的鱼类与痛风复发风险降低有关。而单纯补充n-3 PUFA没有发现类似效应。我们需要在临床试验进一步评估使用特定来源的n-3 PUFA和足够剂量的n-3 PUFA预防痛风发作的情况。

OBJECTIVE:To determine the relationship between omega-3 polyunsaturated fatty acid(n-3 PUFA) consumption (dietary or supplemental) and risk of gout flares.METHODS: We used data from the BostonUniversity Online Gout Study, an internet-based, case-crossover study conductedfrom 2003-2012. Participants completed questionnaires at times of gout flares(hazard periods) and during gout flare-free periods (control periods) regardingexposures (including supplements and diet) during the preceding 48 hours. Weexamined the relation of self-reported n-3 PUFA-rich supplements and fishintake to the risk of recurrent gout flares using conditional logistic regression,adjusting for total purine intake, diuretic use, and other urate-lowering orflare prophylactic medications (allopurinol, non-steroidal anti-inflammatorydrugs, colchicine).RESULTS: Ofthe 724 participants, 85% met the 1977 Preliminary ACR classification criteriafor acute gout. In the preceding48 hours, 22% of participants reported someform of n-3 PUFA consumption (supplements: 4.6%; dietary fatty fish: 19%). Theadjusted odds ratios (aOR) were 1.01 (95% CI, 0.63-1.60; p=0.98) for all threesupplement types combined and 0.74 (95% CI, 0.54-0.99; p=0.04) for ≥2≥2-richfish servings.CONCLUSIONS: Dietaryn-3 PUFA-rich fish consumption, when adjusted for total purine intake, wasassociated with lower risk of recurrent gout flares, whereas n-3 PUFA supplementationalone, as taken in a self-directed manner, was not. Consumption of specificsources and adequate doses of n-3 PUFA for gout flare prevention warrantsfurther study in an adequately powered clinical trial.

引自：Zhang M, Zhang Y, Terkeltaub R, Chen C, Neogi T.Effect of Dietary and Supplemental Omega-3Polyunsaturated Fatty Acids on Risk of Recurrent Gout Flares.ArthritisRheumatol.2019 Mar 25. doi: 10.1002/art.40896. [Epub ahead of print]