Journal Information
Vol. 7. Issue 38.
Pages 228-236 (September - October 1993)
Vol. 7. Issue 38.
Pages 228-236 (September - October 1993)
Open Access
Consumo de pescado y mortalidad coronaria en la población general: meta-análisis de estudios de cohorte
Fish Intake And Coronary Mortality in the General Population: Meta-Analysis of Cohort Studies
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Eliseo Guallar Castillón1,*, F. Javier Jiménez Jiménez2,3, Mónica Tafalla García2,3, José M. Martín-Moreno1
1 Departamento de Epidemiología y Bioestadística
2 Programa Superior de Salud Pública 1992, Escuela Nacional de Sanidad. Madrid
3 Servicio de Medicina Preventiva, Hospital Universitario “San Carlos”, Madrid
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Resumen

Con objeto de estimar el efecto del consumo de pescado sobre la mortalidad por cardiopatía isquémica en la población general, se ha realizado un meta-análisis de los estudios epidemiológicos publicados sobre el tema que incluían individuos inicialmente as intomáticos. De los siete estudios publicados hasta la fecha, todos ellos de cohorte, sólo cinco presentaban los resultados con el detalle suficiente como para poder ser utilizados en un meta-análisis formal. En éstos, participaron un total de 27.656 personas, con un seguimiento medio que varió de 7,5 a 25 años, y un número total de muertes por cardiopatía isquémica de 1.731. El estimador combinado del riesgo relativo para un consumo de 30 g/día de pescado frente al no consumo fue de 0,96 (IC al 95%: 0,93–1,00; P=0,058). Dada la presencia de heterogeneidad significativa entre los estudios, no explicada por factores a priori, se procedió a combinar los estudios utilizando un modelo de efectos aleatorios, obteniendo un estimador combinado de riesgo relativo de 0,92 (IC al 95%: 0,84–1,01; P=0,090). Estos resultados, considerados junto con los del único ensayo clínico realizado de consumo de pescado en pacientes que se habían recuperado de un infarto de miocardio, en el que el consumo de 200 a 400 g/semana de pescado graso redujo la mortalidad subsiguiente en un 29% (riesgo relativo del consumo frente al no consumo de 0,71; IC al 95%; 0,54–0,93), sugieren un moderado efecto protector del consumo de pescado en relación a la cardiopatía isquémica.

Palabras clave:
Meta-análisis
Enfermedad coronaria
Dieta
Pescado
Summary

In order to estimate the effect of fish intake on ischemic heart disease mortality in the general population, we performed a meta-analysis of the epidemiologic studies involving participants free of disease at baseline published on the topic. All of the 7 studies published to date were cohort studies; however, only 5 of them reported the results with enough detail to be used in a formal meta-analysis. The total number of participants in these studies was 27,656, with an average follow-up in each study between 7.5 and 25 years and a total of 1,731 coronary deaths. The combined estimate of the relative risk for an intake of 30 g/day of fish compared to no intake was 0.96 (95% Cl: 0.93-1.00; P= 0.058). Due to the presence of statistically significant heterogeneity among the studies, unexplained by a priori factors, we combined the studies assuming a random effects model, obtaining a relative risk estimate of 0.92 (95% Cl: 0.84-1.01; P= 0.090). These results, together with the results of the only clinical trial of fish intake performed in post-myocardial infarction patients, in which an intake of 200–400 g/week of fatty fish reduced total mortality by 29% (relative risk of intake compared to no intake 0.71; 95% Cl: 0.54–0.93), suggest a moderate beneficial effect of fish intake on coronary mortality.

Key words:
Meta-analysis
Coronary disease
Diet
Fish
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