Division of Epidemiology, University of Texas School of Public Health, Houston, TX 77225, USA.
Ann Epidemiol. 2010 Aug;20(8):610-6. doi: 10.1016/j.annepidem.2010.05.008.
In this study we examined whether high glycemic index (GI) and glycemic load (GL) diets are associated with increased risk of developing coronary heart disease (CHD) in Whites and African Americans with and without type 2 diabetes.
Data on 13,051 patients ages 45 to 64 years from the Atherosclerosis Risk in Communities study were analyzed. The ARIC food frequency questionnaire baseline data provided GI and GL indices. A propensity score was created to estimate the effect of a patient's covariates on energy-adjusted GI or GL. During a maximum of 17 years of follow-up, 1683 cases of CHD (371 with diabetes and 1312 without diabetes) were recorded.
For every 5-units increase in GI, there was a 1.16-fold (95% confidence interval [95% CI], 1.01-1.33) increased risk of incident CHD in African Americans. For every 30-units increase in GL, there was a 1.11-fold (95% CI, 1.01-1.21) increased risk of incident CHD in Whites. High GL was an especially important CHD risk factor for Whites without diabetes (per 30-units increase; hazard ratio, 1.14; 95% CI, 1.02-1.26). However, these relationships were not seen in individuals with diabetes.
Nutritional advice to reduce the GI and GL in diets of African Americans and Whites subjects (without diabetes) may play a role in reducing CHD risk.
本研究旨在探讨高血糖指数（GI）和血糖负荷（GL）饮食是否与白人及非裔美国人 2 型糖尿病患者和非糖尿病患者发生冠心病（CHD）的风险增加相关。
对动脉粥样硬化风险社区研究（Atherosclerosis Risk in Communities study）中年龄在 45 至 64 岁的 13051 名患者的数据进行了分析。ARIC 食物频率问卷基线数据提供了 GI 和 GL 指数。创建了一个倾向评分，以估计患者协变量对能量调整后的 GI 或 GL 的影响。在最长 17 年的随访期间，记录了 1683 例 CHD（371 例合并糖尿病，1312 例无糖尿病）。
GI 每增加 5 个单位，非裔美国人发生 CHD 的风险增加 1.16 倍（95%置信区间[95%CI]，1.01-1.33）。GL 每增加 30 个单位，白人发生 CHD 的风险增加 1.11 倍（95%CI，1.01-1.21）。对于无糖尿病的白人，高 GL 是 CHD 的一个重要危险因素（每增加 30 个单位；风险比，1.14；95%CI，1.02-1.26）。然而，这些关系在糖尿病患者中并未出现。
对于非裔美国人和白人（无糖尿病），减少饮食中的 GI 和 GL 可能有助于降低 CHD 风险。
