Sieri Sabina, Krogh Vittorio, Berrino Franco, Evangelista Alberto, Agnoli Claudia, Brighenti Furio, Pellegrini Nicoletta, Palli Domenico, Masala Giovanna, Sacerdote Carlotta, Veglia Fabrizio, Tumino Rosario, Frasca Graziella, Grioni Sara, Pala Valeria, Mattiello Amalia, Chiodini Paolo, Panico Salvatore
Nutritional Epidemiology Unit, Fondazione IRCCS (Istituto di Ricovero e Cura a Carattere Scientifico) Istituto Nazionale Tumori, Milan, Italy.
Arch Intern Med. 2010 Apr 12;170(7):640-7. doi: 10.1001/archinternmed.2010.15.
Dietary glycemic load (GL) and glycemic index (GI) in relation to cardiovascular disease have been investigated in a few prospective studies with inconsistent results, particularly in men. The present EPICOR study investigated the association of GI and GL with coronary heart disease (CHD) in a large and heterogeneous cohort of Italian men and women originally recruited to the European Prospective Investigation into Cancer and Nutrition study.
We studied 47 749 volunteers (15 171 men and 32 578 women) who completed a dietary questionnaire. Multivariate Cox proportional hazards modeling estimated adjusted relative risks (RRs) of CHD and 95% confidence intervals (CIs).
During a median of 7.9 years of follow-up, 463 CHD cases (158 women and 305 men) were identified. Women in the highest carbohydrate intake quartile had a significantly greater risk of CHD than did those in the lowest quartile (RR, 2.00; 95% CI, 1.16-3.43), with no association found in men (P = .04 for interaction). Increasing carbohydrate intake from high-GI foods was also significantly associated with greater risk of CHD in women (RR, 1.68; 95% CI, 1.02-2.75), whereas increasing the intake of low-GI carbohydrates was not. Women in the highest GL quartile had a significantly greater risk of CHD than did those in the lowest quartile (RR, 2.24; 95% CI, 1.26-3.98), with no significant association in men (P = .03 for interaction).
In this Italian cohort, high dietary GL and carbohydrate intake from high-GI foods increase the overall risk of CHD in women but not men.
在一些前瞻性研究中已对饮食血糖负荷（GL）和血糖指数（GI）与心血管疾病的关系进行了调查，但结果不一致，尤其是在男性中。目前的EPICOR研究在最初招募参加欧洲癌症与营养前瞻性调查研究的大量异质性意大利男性和女性队列中，调查了GI和GL与冠心病（CHD）的关联。
我们研究了47749名完成饮食问卷的志愿者（15171名男性和32578名女性）。多变量Cox比例风险模型估计了冠心病的调整相对风险（RRs）和95%置信区间（CIs）。
在中位7.9年的随访期间，共确定了463例冠心病病例（158名女性和305名男性）。碳水化合物摄入量处于最高四分位数的女性患冠心病的风险显著高于最低四分位数的女性（RR，2.00；95%CI，1.16 - 3.43），而在男性中未发现关联（交互作用P = 0.04）。从高GI食物中增加碳水化合物摄入量也与女性患冠心病的风险显著增加相关（RR，1.68；95%CI，1.02 - 2.75），而增加低GI碳水化合物的摄入量则不然。GL处于最高四分位数的女性患冠心病的风险显著高于最低四分位数的女性（RR，2.24；95%CI，1.26 - 3.98），在男性中无显著关联（交互作用P = 0.03）。
在这个意大利队列中，高饮食GL和来自高GI食物的碳水化合物摄入量增加了女性而非男性患冠心病的总体风险。
