McKeown Nicola M, Meigs James B, Liu Simin, Saltzman Edward, Wilson Peter W F, Jacques Paul F
Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts 02111, USA.
Diabetes Care. 2004 Feb;27(2):538-46. doi: 10.2337/diacare.27.2.538.
The aim of this study was to examine the relation between carbohydrate-related dietary factors, insulin resistance, and the prevalence of the metabolic syndrome in the Framingham Offspring Cohort.
We examined cross-sectional associations between carbohydrate-related dietary factors, insulin resistance, and the prevalence of the metabolic syndrome in 2,834 subjects at the fifth examination (1991-1995) of the Framingham Offspring Study. Homeostasis model assessment of insulin resistance (HOMA-IR) was calculated using the following formula (fasting plasma insulin x plasma glucose)/22.5. The metabolic syndrome was defined using the National Cholesterol Education Program criteria.
After adjustment for potential confounding variables, intakes of total dietary fiber, cereal fiber, fruit fiber, and whole grains were inversely associated, whereas glycemic index and glycemic load were positively associated with HOMA-IR. The prevalence of the metabolic syndrome was significantly lower among those in the highest quintile of cereal fiber (odds ratio [OR] 0.62; 95% CI 0.45-0.86) and whole-grain (0.67; 0.48-0.91) intakes relative to those in the lowest quintile category after adjustment for confounding lifestyle and dietary factors. Conversely, the prevalence of the metabolic syndrome was significantly higher among individuals in the highest relative to the lowest quintile category of glycemic index (1.41; 1.04-1.91). Total carbohydrate, dietary fiber, fruit fiber, vegetable fiber, legume fiber, glycemic load, and refined grain intakes were not associated with prevalence of the metabolic syndrome.
Whole-grain intake, largely attributed to the cereal fiber, is inversely associated with HOMA-IR and a lower prevalence of the metabolic syndrome. Dietary glycemic index is positively associated with HOMA-IR and prevalence of the metabolic syndrome. Given that both a high cereal fiber content and lower glycemic index are attributes of whole-grain foods, recommendation to increase whole-grain intake may reduce the risk of developing the metabolic syndrome.
本研究旨在探讨碳水化合物相关饮食因素、胰岛素抵抗与弗雷明汉后代队列中代谢综合征患病率之间的关系。
我们在弗雷明汉后代研究的第五次检查（1991 - 1995年）中，对2834名受试者的碳水化合物相关饮食因素、胰岛素抵抗和代谢综合征患病率进行了横断面关联研究。胰岛素抵抗的稳态模型评估（HOMA - IR）使用以下公式计算：（空腹血浆胰岛素×血浆葡萄糖）/22.5。代谢综合征采用美国国家胆固醇教育计划标准进行定义。
在对潜在混杂变量进行调整后，总膳食纤维、谷物纤维、水果纤维和全谷物的摄入量与HOMA - IR呈负相关，而血糖指数和血糖负荷与HOMA - IR呈正相关。在对混杂的生活方式和饮食因素进行调整后，谷物纤维（优势比[OR] 0.62；95%可信区间0.45 - 0.86）和全谷物（0.67；0.48 - 0.91）摄入量最高五分位数组的受试者中，代谢综合征的患病率显著低于最低五分位数组。相反，血糖指数最高五分位数组的个体相对于最低五分位数组，代谢综合征的患病率显著更高（1.41；1.04 - 1.91）。总碳水化合物、膳食纤维、水果纤维、蔬菜纤维、豆类纤维、血糖负荷和精制谷物摄入量与代谢综合征患病率无关。
全谷物摄入量（主要归因于谷物纤维）与HOMA - IR呈负相关，且代谢综合征患病率较低。饮食血糖指数与HOMA - IR和代谢综合征患病率呈正相关。鉴于高谷物纤维含量和低血糖指数都是全谷物食品的特性，建议增加全谷物摄入量可能会降低患代谢综合征的风险。
