Finley Carrie E, Barlow Carolyn E, Halton Thomas L, Haskell William L
The Cooper Institute, Dallas, TX, USA.
J Am Diet Assoc. 2010 Dec;110(12):1820-9. doi: 10.1016/j.jada.2010.09.016.
Previous research examining the relationships among glycemic index, glycemic load, and the metabolic syndrome has resulted in inconsistent findings. The objective of this study was to examine whether glycemic index and glycemic load are associated with prevalent metabolic syndrome and its components after adjustment for cardiorespiratory fitness, an objective measure of physical activity habitus.
Cross-sectional study.
SUBJECTS/SETTING: Women (n=1,775) and men (n=9,137) who completed a comprehensive medical examination between October 1987 and March 1999, including maximal treadmill exercise test and 3-day dietary records at the Cooper Clinic, Dallas, TX.
Metabolic syndrome and its components, defined by the revised Adult Treatment Panel III criteria.
Multiple logistic regression models were used to estimate sex-specific odds ratios and 95% confidence intervals to evaluate the associations among glycemic index, glycemic load, and prevalent metabolic syndrome and its components, while adjusting for potential confounding variables.
Prevalence of metabolic syndrome was 24% in men and 9% in women. A positive association across quintiles of glycemic index and metabolic syndrome, elevated triglycerides, and low high-density lipoprotein cholesterol (HDL-C) in men was observed in the fully adjusted model (P for trend<0.05). In women, glycemic index was positively associated with large waist girth, low HDL-C, and elevated triglycerides (P for trend<0.05 for all) after multivariate adjustment including cardiorespiratory fitness. Glycemic load was positively associated with elevated triglycerides and low HDL-C (P for trend<0.0001) and inversely associated with prevalence of large waist girth and elevated glucose (P for trend<0.0001) in men. Among women, glycemic load was positively associated with elevated triglycerides (P for trend=0.04) and low HDL-C (P for trend<0.0001) in the multivariate model including cardiorespiratory fitness.
A lifestyle that includes a low glycemic diet can improve metabolic risk profiles in men and women. Prospective studies examining glycemic index, glycemic load, and metabolic syndrome that control for cardiorespiratory fitness are needed.
以往关于血糖指数、血糖负荷与代谢综合征之间关系的研究结果并不一致。本研究的目的是在调整心肺适能（一种身体活动习惯的客观指标）后，检验血糖指数和血糖负荷是否与普遍存在的代谢综合征及其组成成分相关。
横断面研究。
研究对象/地点：1987年10月至1999年3月期间在德克萨斯州达拉斯市库珀诊所完成全面医学检查的女性（n = 1775）和男性（n = 9137），检查包括最大跑步机运动试验和3天饮食记录。
根据修订的成人治疗小组III标准定义的代谢综合征及其组成成分。
使用多元逻辑回归模型估计特定性别的比值比和95%置信区间，以评估血糖指数、血糖负荷与普遍存在的代谢综合征及其组成成分之间的关联，同时调整潜在的混杂变量。
男性代谢综合征患病率为24%，女性为9%。在完全调整模型中，观察到男性血糖指数五分位数与代谢综合征、甘油三酯升高和高密度脂蛋白胆固醇（HDL-C）降低呈正相关（趋势P<0.05）。在女性中，在包括心肺适能的多变量调整后，血糖指数与大腰围、低HDL-C和甘油三酯升高呈正相关（所有趋势P<0.05）。男性中，血糖负荷与甘油三酯升高和HDL-C降低呈正相关（趋势P<0.0001），与大腰围患病率和血糖升高呈负相关（趋势P<0.0001）。在女性中，在包括心肺适能的多变量模型中，血糖负荷与甘油三酯升高（趋势P = 0.04）和HDL-C降低（趋势P<0.0001）呈正相关。
包括低血糖饮食的生活方式可以改善男性和女性的代谢风险状况。需要进行前瞻性研究，以控制心肺适能来检验血糖指数、血糖负荷与代谢综合征之间的关系。
