高膳食血糖负荷和血糖指数增加中年女性患心血管疾病的风险：一项基于人群的随访研究。

High dietary glycemic load and glycemic index increase risk of cardiovascular disease among middle-aged women: a population-based follow-up study.

作者信息

Beulens Joline W J, de Bruijne Leonie M, Stolk Ronald P, Peeters Petra H M, Bots Michiel L, Grobbee Diederick E, van der Schouw Yvonne T

机构信息

Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.

出版信息

J Am Coll Cardiol. 2007 Jul 3;50(1):14-21. doi: 10.1016/j.jacc.2007.02.068. Epub 2007 Jun 18.

DOI:10.1016/j.jacc.2007.02.068

PMID:17601539

Abstract

OBJECTIVES

The goal of this work was to assess whether high dietary glycemic load and glycemic index are associated with an increased risk of cardiovascular disease (CVD).

BACKGROUND

The associations of dietary glycemic index and glycemic load with risk of CVD are not well established, particularly in populations consuming modest glycemic load diets. Moreover, risk may differ between lean and overweight subjects.

METHODS

Associations of glycemic index and glycemic load with incident CVD were examined in a prospective cohort of 15,714 Dutch women age 49 to 70 years without diabetes or CVD. Dietary glycemic index and glycemic load were calculated using the glycemic index, carbohydrate content, and frequency of intake of individual foods.

RESULTS

During 9 +/- 2 years of follow-up, 556 cases of coronary heart disease (CHD) and 243 cases of cerebrovascular accident (CVA) occurred. Dietary glycemic load (mean = 100; SD = 17) was associated with increased risk of CVD, adjusted for CVD risk factors and dietary variables, with a hazard ratio (HR) for the highest against lowest quartile of 1.47 (95% confidence interval [CI] 1.04 to 2.09; p(trend) = 0.03). Similar results were observed for dietary glycemic index with a corresponding HR of 1.33 (95% CI 1.07 to 1.67; p(trend) = 0.02). Glycemic load tended to be associated with both CHD (HR 1.44; 95% CI 0.95 to 2.19; p(trend) = 0.14) and CVA (HR 1.55; 95% CI 0.81 to 2.97; p(trend) = 0.10), but glycemic index only with CHD (HR 1.44; 95% CI 1.10 to 1.89; p(trend) = 0.01). Among overweight women (body mass index >25 kg/m2), glycemic load was associated with CVD (1.78; 95% CI 1.11 to 2.85; p(trend) = 0.04), but not among normal weight women (p(interaction) = 0.19). Body mass index did not modify the association of glycemic index with CVD.

CONCLUSIONS

Among women consuming modest glycemic load diets, high dietary glycemic load and glycemic index increase the risk of CVD, particularly for overweight women.

摘要

目的

本研究旨在评估高膳食血糖负荷和血糖指数是否与心血管疾病（CVD）风险增加相关。

背景

膳食血糖指数和血糖负荷与CVD风险之间的关联尚未明确确立，尤其是在食用适度血糖负荷饮食的人群中。此外，瘦人和超重者的风险可能有所不同。

方法

在一个由15714名年龄在49至70岁之间、无糖尿病或CVD的荷兰女性组成的前瞻性队列中，研究了血糖指数和血糖负荷与新发CVD之间的关联。膳食血糖指数和血糖负荷通过血糖指数、碳水化合物含量以及个体食物的摄入频率来计算。

结果

在9±2年的随访期间，发生了556例冠心病（CHD）和243例脑血管意外（CVA）。在对CVD风险因素和膳食变量进行调整后，膳食血糖负荷（均值 = 100；标准差 = 17）与CVD风险增加相关，最高四分位数与最低四分位数的风险比（HR）为1.47（95%置信区间[CI] 1.04至2.09；p趋势 = 0.03）。膳食血糖指数也有类似结果，相应的HR为1.33（95% CI 1.07至1.67；p趋势 = 0.02）。血糖负荷与CHD（HR 1.44；95% CI 0.95至2.19；p趋势 = 0.14）和CVA（HR 1.55；95% CI 0.81至2.97；p趋势 = 0.10）均有一定关联趋势，但血糖指数仅与CHD相关（HR 1.44；95% CI 1.10至1.89；p趋势 = 0.01）。在超重女性（体重指数>25 kg/m²）中，血糖负荷与CVD相关（1.78；95% CI 1.11至2.85；p趋势 = 0.04），但在正常体重女性中无此关联（p交互作用 = 0.19）。体重指数并未改变血糖指数与CVD之间的关联。