Fish intake may prevent cerebrovascular disease (CVD), yet the mechanisms are unclear, especially regarding its impact on subclinical damage. Assuming that fish may have pleiotropic effect on cerebrovascular health, we investigated the association of fish intake with global CVD burden based on brain MRI markers.

This cross-sectional analysis included participants from the Three-City Dijon population-based cohort (age ≥65 years) without dementia, stroke, or history of hospitalized cardiovascular disease who underwent brain MRI with automated assessment of white matter hyperintensities, visual detection of covert infarcts, and grading of dilated perivascular spaces. Fish intake was assessed through a frequency questionnaire, and the primary outcome measure was defined as the first component of a factor analysis of mixed data applied to MRI markers. The association of fish intake with the CVD burden indicator was studied with linear regressions.

In total, 1,623 participants (mean age 72.3 years, 63% women) were included. The first component of factor analysis (32.4% of explained variance) was associated with higher levels of all 3 MRI markers. Higher fish intake was associated with lower CVD burden. In a model adjusted for total intracranial volume, compared to participants consuming fish <1 time per week, those consuming fish 2 to 3 and ≥4 times per week had a β = –0.19 (95% confidence interval –0.37 to –0.01) and β = –0.30 (–0.57 to –0.03) lower indicator of CVD burden, respectively (p trend < 0.001). We found evidence of effect modification by age such that the association of fish to CVD was stronger in younger participants (65–69 years) and not significant in participants ≥75 years of age. For comparison, in the younger age group, consuming fish 2 to 3 times a week was roughly equivalent (in the opposite direction) to the effect of hypertension.

In this large population-based study, higher frequency of fish intake was associated with lower CVD burden, especially among participants <75 years of age, suggesting a beneficial effect on brain vascular health before manifestation of overt brain disease.

This study provides Class II evidence that in individuals without stroke or dementia, higher fish intake is associated with lower subclinical CVD on MRI.

鱼类摄入可预防脑血管疾病 (CVD)，但其机制尚不清楚，尤其是其对亚临床损伤的影响。假设鱼类可能对脑血管健康具有多效性，我们根据脑部 MRI 标志物调查了鱼类摄入量与全球 CVD 负担的关系。

这项横断面分析包括来自三城第戎人群队列（年龄≥65 岁）的参与者，他们没有痴呆、中风或住院心血管疾病史，他们接受了脑 MRI，自动评估白质高信号，视觉检测隐蔽梗塞和扩张的血管周围空间的分级。通过频率问卷评估鱼类摄入量，主要结果测量被定义为应用于 MRI 标记的混合数据的因素分析的第一个组成部分。使用线性回归研究了鱼类摄入量与 CVD 负担指标的关系。

总共包括 1,623 名参与者（平均年龄 72.3 岁，63% 为女性）。因子分析的第一个组成部分（解释方差的 32.4%）与所有 3 种 MRI 标记的较高水平相关。较高的鱼类摄入量与较低的 CVD 负担相关。在根据颅内总体积调整的模型中，与每周食用鱼 <1 次的参与者相比，每周食用鱼 2 到 3 次和≥4 次的参与者的 β = –0.19（95% 置信区间 –0.37 到 –0.01）和β = –0.30（–0.57 至 –0.03）分别是 CVD 负担的较低指标（p趋势 < 0.001)。我们发现了年龄效应改变的证据，因此鱼类与 CVD 的关联在年轻参与者（65-69 岁）中更强，而在 75 岁以上的参与者中不显着。作为比较，在较年轻的年龄组中，每周食用 2 至 3 次鱼与高血压的影响大致相当（相反方向）。

在这项以人群为基础的大型研究中，较高的鱼类摄入频率与较低的 CVD 负担相关，尤其是在 75 岁以下的参与者中，这表明在出现明显脑部疾病之前对脑血管健康有益。

这项研究提供了 II 类证据，表明在没有中风或痴呆症的个体中，较高的鱼类摄入量与 MRI 上较低的亚临床 CVD 相关。