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血糖指数高的饮食增加重大心血管疾病和死亡的风险
作者:小柯机器人 发布时间:2021/2/26 16:00:45

加拿大营养科学部David J.A. Jenkins研究了血糖指数和血糖负荷与心血管疾病和死亡率的相关性。2021年2月24日,该研究发表在《新英格兰医学杂志》上。

大多数关于血糖指数和心血管疾病之间关系的数据来自高收入的西方人群,很少有来自中低收入非西方国家的信息。为了填补这一空白,需要从大量的、地理上不同的人口中获取数据。

这项分析包括生活在五大洲的137851名年龄在35岁至70岁之间的参与者,平均随访时间为9.5年。研究组使用国家特定食物频率问卷来确定膳食摄入量,并根据七类碳水化合物食物的消费量估计血糖指数和血糖负荷。研究组使用多变量Cox脆弱性模型计算风险比。主要结局是重大心血管事件(心血管死亡、非致命性心肌梗死、中风和心力衰竭)或全因死亡。

随访期间共发生8780例死亡和8252例重大心血管事件。在对血糖指数最低和最高的五分位数进行广泛校正后,研究组发现血糖指数高的饮食与重大心血管事件或死亡的风险增加相关,这在既往有或没有心血管疾病的受试者中都存在,风险比分别为1.51和1.21。在主要结局的组成部分中,高血糖指数也与心血管原因导致的死亡风险增加有关。关于血糖负荷的结果与基线时心血管疾病参与者的血糖指数结果相似,但在既往无心血管疾病的参与者中相关性不显著。

研究结果表明,血糖指数高的饮食与心血管疾病和死亡的风险增加有关。

附:英文原文

Title: Glycemic Index, Glycemic Load, and Cardiovascular Disease and Mortality

Author: David J.A. Jenkins, M.D., Ph.D.,, Mahshid Dehghan, Ph.D.,, Andrew Mente, Ph.D.,, Shrikant I. Bangdiwala, Ph.D.,, Sumathy Rangarajan, M.Sc.,, Kristie Srichaikul, M.D.,, Viswanathan Mohan, D.Sc.,, Alvaro Avezum, M.D.,, Rafael Díaz, M.D.,, Annika Rosengren, M.D.,, Fernando Lanas, M.D.,, Patricio Lopez-Jaramillo, M.D.,, Wei Li, Ph.D.,, Aytekin Oguz, M.D.,, Rasha Khatib, Ph.D.,, Paul Poirier, M.D., Ph.D.,, Noushin Mohammadifard, Ph.D.,, Andrea Pepe, M.Sc.,, Khalid F. Alhabib, M.B., B.S.,, Jephat Chifamba, D.Phil.,, Afzal Hussein Yusufali, M.D.,, Romaina Iqbal, Ph.D.,, Karen Yeates, M.D.,, Khalid Yusoff, M.D.,, Noorhassim Ismail, M.D.,, Koon Teo, M.B., B.Ch.,, Sumathi Swaminathan, Ph.D.,, Xiaoyun Liu, Ph.D.,, Katarzyna Zatońska, M.D.,, Rita Yusuf, Ph.D.,, and Salim Yusuf, D.Phil.

Issue&Volume: 2021-02-24

Abstract:

Background

Most data regarding the association between the glycemic index and cardiovascular disease come from high-income Western populations, with little information from non-Western countries with low or middle incomes. To fill this gap, data are needed from a large, geographically diverse population.

Methods

This analysis includes 137,851 participants between the ages of 35 and 70 years living on five continents, with a median follow-up of 9.5 years. We used country-specific food-frequency questionnaires to determine dietary intake and estimated the glycemic index and glycemic load on the basis of the consumption of seven categories of carbohydrate foods. We calculated hazard ratios using multivariable Cox frailty models. The primary outcome was a composite of a major cardiovascular event (cardiovascular death, nonfatal myocardial infarction, stroke, and heart failure) or death from any cause.

Results

In the study population, 8780 deaths and 8252 major cardiovascular events occurred during the follow-up period. After performing extensive adjustments comparing the lowest and highest glycemic-index quintiles, we found that a diet with a high glycemic index was associated with an increased risk of a major cardiovascular event or death, both among participants with preexisting cardiovascular disease (hazard ratio, 1.51; 95% confidence interval [CI], 1.25 to 1.82) and among those without such disease (hazard ratio, 1.21; 95% CI, 1.11 to 1.34). Among the components of the primary outcome, a high glycemic index was also associated with an increased risk of death from cardiovascular causes. The results with respect to glycemic load were similar to the findings regarding the glycemic index among the participants with cardiovascular disease at baseline, but the association was not significant among those without preexisting cardiovascular disease.

Conclusions

In this study, a diet with a high glycemic index was associated with an increased risk of cardiovascular disease and death.

DOI: 10.1056/NEJMoa2007123

Source: https://www.nejm.org/doi/full/10.1056/NEJMoa2007123

 

期刊信息

The New England Journal of Medicine:《新英格兰医学杂志》,创刊于1812年。隶属于美国麻省医学协会,最新IF:70.67
官方网址:http://www.nejm.org/
投稿链接:http://www.nejm.org/page/author-center/home