Erkkilä A T, Sarkkinen E S, Lehto S, Pyörälä K, Uusitupa M I
Department of Clinical Nutrition, University of Kuopio, Finland.
Prev Med. 1999 Jun;28(6):558-65. doi: 10.1006/pmed.1998.0478.
Diet-lipid associations established in clinical trials have in general been weak or nonexistent in cross-sectional studies within a population. Our objective was to analyze the dietary associates of serum lipids in patients with coronary heart disease (CHD) not using lipid-lowering medication.
Patients with coronary bypass grafting (n = 49), balloon angioplasty (n = 46), acute myocardial infarction (n = 79), and acute myocardial ischemia (n = 79) participated in a survey (EUROASPIRE). Patients were selected from hospital records at least 6 months after hospitalization. Diet was assessed by a food record, a short questionnaire, and fatty acid composition of serum cholesteryl esters (CE).
Neither the intake of total fat nor that of saturated, monounsaturated, or polyunsaturated fatty acids was associated with serum lipids. Use of soft margarine on bread (though not in cooking or baking) and high intake of fiber and cereal products were associated with low total cholesterol. Linoleic acid in CE was inversely associated with total cholesterol and triglycerides, and eicosapentaenoic acid was inversely associated with triglycerides and positively associated with HDL cholesterol.
In the present study use of soft margarine on bread (though not in cooking or baking) and high intake of fiber and cereal products were associates of lowered serum cholesterol concentrations in CHD patients. Fatty acid composition of CE reflected dietary fatty acid intake involved in cholesterol lowering better than food records.
在临床试验中确定的饮食与脂质的关联，在人群横断面研究中总体上较弱或不存在。我们的目的是分析未使用降脂药物的冠心病（CHD）患者血清脂质的饮食相关因素。
接受冠状动脉搭桥术（n = 49）、球囊血管成形术（n = 46）、急性心肌梗死（n = 79）和急性心肌缺血（n = 79）的患者参与了一项调查（EUROASPIRE）。患者从住院至少6个月后的医院记录中选取。通过食物记录、简短问卷和血清胆固醇酯（CE）的脂肪酸组成来评估饮食。
总脂肪摄入量以及饱和、单不饱和或多不饱和脂肪酸摄入量均与血清脂质无关。在面包上使用软人造黄油（而非用于烹饪或烘焙）以及高纤维和谷物产品摄入量与低总胆固醇相关。CE中的亚油酸与总胆固醇和甘油三酯呈负相关，二十碳五烯酸与甘油三酯呈负相关，与高密度脂蛋白胆固醇呈正相关。
在本研究中，在面包上使用软人造黄油（而非用于烹饪或烘焙）以及高纤维和谷物产品摄入量是冠心病患者血清胆固醇浓度降低的相关因素。CE的脂肪酸组成比食物记录更好地反映了参与降低胆固醇的饮食脂肪酸摄入量。
