Ashfield-Watt Pauline Al, Clark Zoë E, Breay Pat, Zotos Paul C, Cale Sara B, Burr Michael L, McDowell Ian F W
Department of Medical Biochemistry and Centre for Applied Public Health Medicine, Wales Heart Research Institute, University of Wales College of Medicine, Heath Park, Cardiff, UK.
Public Health Nutr. 2002 Feb;5(1):47-53. doi: 10.1079/PHN2001250.
To study the effect of advice to increase dietary soluble fibre, including fruit and vegetables, on plasma folate and homocysteine in men with angina.
Data were collected on a subset of subjects from the Diet and Angina Randomised Trial (DART II). In a randomised (2 x 2) factorial design, subjects received advice on either, neither or both interventions to: (1) increase soluble fibre intake to 8.0 g day(-1) (fruit, vegetables and oats); (2) increase oily fish intake to 2 portions week(-1). Those who received soluble fibre advice were compared with those who did not. Subjects were genotyped for C677T variant 5,10-methylenetetrahydrofolate reductase (MTHFR).
SETTING/SUBJECTS: Seven hundred and fifty-three male angina patients were recruited from general practice.
Plasma homocysteine concentrations were at the upper end of the normal range (median 11.5, 25% 9.4, 75% 14.0 micromol l(-1)). Baseline intake of fruit and vegetables was positively correlated with plasma folate (r(s) = 0.29, P < 0.01). Smokers had lower intakes of fruit and vegetables, lower plasma folate and higher homocysteine (all P < 0.01). Homozygotes for variant MTHFR had higher homocysteine concentrations at low plasma folate (P < 0.01). Reported intakes of fruit and vegetables and estimated dietary folate increased in the intervention group (ca. +75 g day(-1), P < 0.01 and ca. +20 g day(-1), P < 0.05, respectively). However, neither plasma folate (baseline/follow-up 4.5 vs. 4.4 microg l(-1), P = 0.40) nor homocysteine (baseline/follow-up 11.7 vs. 11.7 micromol l(-1), P = 0.31) changed.
Plasma homocysteine, a cardiovascular risk factor, is influenced by MTHFR genotype, plasma folate and smoking status. Dietary advice successfully led to changes in fruit and vegetable intake, but not to changes in plasma folate or homocysteine, possibly because the fruits and vegetables that were chosen were not those richest in folate.
研究增加包括水果和蔬菜在内的膳食可溶性纤维的建议对心绞痛男性患者血浆叶酸和同型半胱氨酸的影响。
数据收集自饮食与心绞痛随机试验（DART II）的部分受试者。采用随机（2×2）析因设计，受试者接受以下一种、两种或不接受任何干预措施的建议：（1）将可溶性纤维摄入量增加至8.0克/天（水果、蔬菜和燕麦）；（2）将油性鱼类摄入量增加至每周2份。将接受可溶性纤维建议的受试者与未接受该建议的受试者进行比较。对受试者进行5,10-亚甲基四氢叶酸还原酶（MTHFR）C677T变体基因分型。
背景/受试者：从全科医疗中招募了753名男性心绞痛患者。
血浆同型半胱氨酸浓度处于正常范围的上限（中位数11.5，第25百分位数9.4，第75百分位数14.0微摩尔/升）。水果和蔬菜的基线摄入量与血浆叶酸呈正相关（斯皮尔曼相关系数r(s)=0.29，P<0.01）。吸烟者的水果和蔬菜摄入量较低，血浆叶酸水平较低，同型半胱氨酸水平较高（均P<0.01）。MTHFR变体纯合子在血浆叶酸水平较低时同型半胱氨酸浓度较高（P<0.01）。干预组报告的水果和蔬菜摄入量以及估计的膳食叶酸摄入量增加（分别约增加75克/天，P<0.01和约20克/天，P<0.05）。然而，血浆叶酸（基线/随访：4.5对4.4微克/升，P=0.40）和同型半胱氨酸（基线/随访：11.7对11.7微摩尔/升，P=0.31）均未改变。
血浆同型半胱氨酸作为一种心血管危险因素，受MTHFR基因型、血浆叶酸和吸烟状况的影响。饮食建议成功导致了水果和蔬菜摄入量的改变，但未导致血浆叶酸或同型半胱氨酸的改变，可能是因为所选择的水果和蔬菜并非叶酸含量最丰富的种类。
