Supplementary Material for: Higher Frequency of Fish Intake May Be Associated with a Lower Neutrophil/Lymphocyte Ratio: Anti-Atherosclerotic Effects of Fish Consumption

Background: Higher fish consumption has been reported to be associated with a lower incidence of coronary artery disease (CAD). An elevated neutrophil/lymphocyte ratio (NLR), a marker of systemic inflammation, is reportedly associated with the development of adverse CAD events. We hypothesized that a higher fish intake was associated with a lower NLR. Methods and Results: This cross-sectional study was conducted in a cohort of 8,237 Japanese subjects who had no history of atherosclerotic cardiovascular disease registered at the Health Planning Center of Nihon University Hospital between April 2018 and March 2019. The average weekly frequency of fish intake was 2.32 ± 1.31 days. The NLR decreased significantly as the weekly frequency of fish intake (0 day, 1–2 days, 3–4 days, or 5–7 days) increased (p = 0.001). A multiple stepwise regression analysis identified the weekly frequency of fish intake (β = −0.045, p < 0.0001) and habitual alcohol intake (β = −0.051, p < 0.0001) as significant but weak, negative, and independent determinants of the NLR. Conversely, the presence of metabolic syndrome (β = 0.046, p < 0.0001), the presence of treatment for diabetes mellitus (β = 0.054, p < 0.0001), and the presence of treatment for hypertension (β = 0.043, p < 0.0001) were significant positive and independent determinants of the NLR. Conclusions: The present results suggest that a higher frequency of fish intake appears to be associated with a lower NLR, suggesting an anti-systemic inflammation effect. This association may partially explain the preventive effects of a higher fish intake on CAD events.背景：已有研究表明，较高的鱼类摄入量与较低的冠状动脉粥样硬化性心脏病（coronary artery disease, CAD）发病率相关。中性粒细胞/淋巴细胞比值（neutrophil/lymphocyte ratio, NLR）作为全身炎症标志物，其水平升高与不良CAD事件的发生密切相关。本研究假设鱼类摄入量越高，NLR水平越低。 方法与结果：本横断面研究于2018年4月至2019年3月间，在日本大学医院健康计划中心登记的8237名无动脉粥样硬化性心血管疾病病史的日本受试者队列中开展。受试者平均每周鱼类摄入频次为2.32±1.31天。随着每周鱼类摄入频次（0天、1~2天、3~4天、5~7天）增加，NLR水平显著降低（p=0.001）。多重逐步回归分析显示，每周鱼类摄入频次（β=-0.045，p<0.0001）与习惯性饮酒摄入（β=-0.051，p<0.0001）为NLR水平的显著但微弱的负向独立影响因素。反之，合并代谢综合征（β=0.046，p<0.0001）、接受糖尿病治疗（β=0.054，p<0.0001）以及接受高血压治疗（β=0.043，p<0.0001）均为NLR水平的显著正向独立影响因素。 结论：本研究结果显示，较高的鱼类摄入频次与较低的NLR水平相关，提示鱼类摄入具有全身性抗炎效应。这一关联或可部分解释较高鱼类摄入量对CAD事件的预防作用。