Toeller M, Buyken A E, Heitkamp G, Scherbaum W A, Krans H M, Fuller J H
Clinical Department, Diabetes Research Institute at the Heinrich-Heine-University, Düsseldorf, Germany.
Exp Clin Endocrinol Diabetes. 1999;107(8):512-21. doi: 10.1055/s-0029-1232560.
The EURODIAB IDDM Complications Study, a cross-sectional, clinic-based study examined the fat and cholesterol intakes of European individuals with type 1 diabetes for possible relations to serum lipid levels (total cholesterol, HDL- and LDL-cholesterol, fasting triglycerides) and to the prevalence of cardiovascular disease (past history or electrocardiogram abnormalities). Fat intake (total fat, saturated fat, cholesterol) from 2,868 subjects with type 1 diabetes (mean age 32.9 +/- 10.2 years (range: 14-61 years), mean diabetes duration 14.7 +/- 9.4 years (range: 1-56 years)) was assessed by a standardized 3-day dietary record at the Nutrition Co-Ordinating Centre (Düsseldorf). Serum lipid levels were determined in the central laboratory (London) by standard enzymatic methods. Energy-adjusted total and LDL-cholesterol levels increased significantly with higher intakes of total fat, saturated fat and cholesterol. However, these relations were largely explained by concomitant decreases in dietary fibre intake. For levels of HDL-cholesterol and triglycerides no independent associations were observed with fat or cholesterol intake. Increased intakes of total fat, saturated fat and cholesterol were also related to higher prevalences of cardiovascular disease. These associations were, however, no longer significant after adjustment for dietary fibre intake for which we previously demonstrated independent associations with the serum cholesterol pattern and CVD. Since higher fat intakes are commonly accompanied by lower carbohydrate and fibre intakes we conclude that restricted intakes of cholesterol, saturated fat and total fat combined with higher fibre intakes beneficially affect both the levels of total and LDL-cholesterol and the risk for cardiovascular disease in European individuals with type 1 diabetes.
欧洲糖尿病研究（EURODIAB IDDM Complications Study）是一项基于诊所的横断面研究，调查了欧洲1型糖尿病患者的脂肪和胆固醇摄入量，以探究其与血脂水平（总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、空腹甘油三酯）以及心血管疾病患病率（既往病史或心电图异常）之间的可能关系。通过在营养协调中心（杜塞尔多夫）采用标准化的3天饮食记录，评估了2868名1型糖尿病患者（平均年龄32.9±10.2岁（范围：14 - 61岁），平均糖尿病病程14.7±9.4岁（范围：1 - 56岁））的脂肪摄入量（总脂肪、饱和脂肪、胆固醇）。血清脂质水平在中央实验室（伦敦）采用标准酶法测定。能量调整后的总胆固醇和低密度脂蛋白胆固醇水平随着总脂肪、饱和脂肪和胆固醇摄入量的增加而显著升高。然而，这些关系在很大程度上可以通过膳食纤维摄入量的相应减少来解释。对于高密度脂蛋白胆固醇和甘油三酯水平，未观察到与脂肪或胆固醇摄入量有独立关联。总脂肪、饱和脂肪和胆固醇摄入量的增加也与心血管疾病的较高患病率相关。然而，在对膳食纤维摄入量进行调整后，这些关联不再显著，我们之前已证明膳食纤维摄入量与血清胆固醇模式和心血管疾病存在独立关联。由于较高的脂肪摄入量通常伴随着较低的碳水化合物和膳食纤维摄入量，我们得出结论，限制胆固醇、饱和脂肪和总脂肪的摄入量并增加膳食纤维的摄入量，对欧洲1型糖尿病患者的总胆固醇和低密度脂蛋白胆固醇水平以及心血管疾病风险均有有益影响。
