Schröder Helmut, Marrugat Jaume, Elosua Roberto, Covas Maribel I
Lipids and Cardiovascular Epidemiology Unit, Institut Municipal d'Investigació Mèdica, IMIM and Department of Nutrition, Sports Medicine Barcelona, Barcelona, Spain.
Br J Nutr. 2003 Aug;90(2):431-9. doi: 10.1079/bjn2003899.
The aim of the present study was to determine the relationship of BMI with other cardiovascular risk factors, leisure-time physical activity and diet. Participants were recruited in a cross-sectional population-based survey in a southern-Europe Mediterranean population (Spain); cardiovascular risk factors were measured, and leisure-time physical activity and diet intake were evaluated. Linear regression analysis adjusted for several confounders showed a significant, direct association of BMI and total cholesterol (P<0.005) and LDL-cholesterol (P<0.006), in men. HDL-cholesterol was inversely related to BMI in both sexes (P<0.0001). Higher BMI was more frequent in less-active men (P<0.04) but not in women. BMI increased significantly (P<0.0001) by 1.92 kg/m(2) with each 4.18 MJ consumed in men but not in women. Dietary intakes of carbohydrate (P<0.03), total fat (P<0.03) and saturated fatty acids (P<0.02) were directly associated with BMI in men but not in women, in whom protein intake was correlated (P<0.001) with BMI. Linear regression models including dietary components explained up to 10.6 and 21.1 % of BMI variability in men and women, respectively. Sex differences in the association of BMI with total cholesterol, and LDL-cholesterol, may account for the lower risk for CHD in women compared with men of similar BMI reported in the literature for the southern-Europe Mediterranean region. An increases of BMI may be more deleterious in populations in which it is accompanied by other risk factors such as a higher intake of total fat and, particularly, of saturated fatty acids, or lower leisure-time physical activity.
本研究的目的是确定体重指数（BMI）与其他心血管危险因素、休闲时间身体活动及饮食之间的关系。在一项基于人群的横断面调查中，我们招募了来自南欧地中海地区（西班牙）的参与者；测量了心血管危险因素，并评估了休闲时间身体活动及饮食摄入量。经对多个混杂因素进行校正的线性回归分析显示，在男性中，BMI与总胆固醇（P<0.005）及低密度脂蛋白胆固醇（LDL-胆固醇，P<0.006）呈显著正相关。高密度脂蛋白胆固醇（HDL-胆固醇）在男女两性中均与BMI呈负相关（P<0.0001）。在活动较少的男性中，较高的BMI更为常见（P<0.04），但在女性中并非如此。男性每摄入4.18兆焦耳能量，BMI显著增加（P<0.0001）1.92千克/米²，而女性则不然。男性饮食中碳水化合物摄入量（P<0.03）、总脂肪摄入量（P<0.03）及饱和脂肪酸摄入量（P<0.02）与BMI呈正相关，而女性并非如此，女性蛋白质摄入量与BMI相关（P<0.001）。包含饮食成分的线性回归模型分别解释了男性和女性BMI变异性的10.6%和21.1%。BMI与总胆固醇及LDL-胆固醇之间关联的性别差异，可能解释了在南欧地中海地区文献报道中，与BMI相似的男性相比，女性冠心病风险较低的原因。在伴有其他危险因素（如总脂肪尤其是饱和脂肪酸摄入量较高或休闲时间身体活动较少）的人群中，BMI升高可能更具危害性。
