Radhika Ganesan, Van Dam Rob M, Sudha Vasudevan, Ganesan Anbazhagan, Mohan Viswanathan
Madras Diabetes Research Foundation, WHO Collaborating Centre for Non-Communicable diseases, Gopalapuram, Chennai 600 086, India.
Metabolism. 2009 May;58(5):675-81. doi: 10.1016/j.metabol.2009.01.008.
The objective of the study was to evaluate the association of refined grains consumption with insulin resistance and the metabolic syndrome in an urban south Indian population. The study population comprised 2042 individuals aged > or = 20 years randomly selected from the Chennai Urban Rural Epidemiology Study (CURES), a cross-sectional study on a representative population of Chennai, southern India. The metabolic syndrome was defined according to modified Adult Treatment Panel III guidelines; and insulin resistance, by the homeostasis assessment model. The mean refined grain intake was 333 g/d (46.9% of total calories) in this population. After adjustment for age, sex, body mass index, metabolic equivalent, total energy intake, and other dietary factors, higher refined grain intake was significantly associated with higher waist circumference (8% higher for the highest vs the lowest quartile, P for trend < .0001), systolic blood pressure (2.9%, P for trend < .0001), diastolic blood pressure (1.7%, P for trend = .03), fasting blood glucose (7.9%, P for trend = .007), serum triglyceride (36.5%, P for trend < .0001), low high-density lipoprotein cholesterol (-10.1%, P for trend < .0001), and insulin resistance (13.6%, P < .001). Compared with participants in the bottom quartile, participants who were in the highest quartile of refined grain intake were significantly more likely to have the metabolic syndrome (odds ratio, 7.83; 95% confidence interval, 4.72-12.99). Higher intake of refined grains was associated with insulin resistance and the metabolic syndrome in this population of Asian Indians who habitually consume high-carbohydrate diets.
本研究的目的是评估印度南部城市人群中精制谷物摄入量与胰岛素抵抗及代谢综合征之间的关联。研究人群包括从金奈城乡流行病学研究（CURES）中随机选取的2042名年龄≥20岁的个体，CURES是一项针对印度南部金奈代表性人群的横断面研究。代谢综合征根据修改后的成人治疗小组III指南定义；胰岛素抵抗则通过稳态评估模型定义。该人群中精制谷物的平均摄入量为333克/天（占总热量的46.9%）。在对年龄、性别、体重指数、代谢当量、总能量摄入和其他饮食因素进行调整后，较高的精制谷物摄入量与较高的腰围显著相关（最高四分位数与最低四分位数相比高8%，趋势P<0.0001）、收缩压（2.9%，趋势P<0.0001）、舒张压（1.7%，趋势P = 0.03）、空腹血糖（7.9%，趋势P = 0.007）、血清甘油三酯（36.5%，趋势P<0.0001）、低高密度脂蛋白胆固醇（-10.1%，趋势P<0.0001）和胰岛素抵抗（13.6%，P<0.001）。与最低四分位数的参与者相比，精制谷物摄入量最高四分位数的参与者患代谢综合征的可能性显著更高（比值比，7.83；95%置信区间，4.72 - 12.99）。在这个习惯性食用高碳水化合物饮食的亚洲印度人群中，较高的精制谷物摄入量与胰岛素抵抗及代谢综合征相关。
