膳食血糖负荷和血糖指数与荷兰男女冠心病和中风风险的关系：EPIC-MORGEN 研究。
Dietary glycemic load and glycemic index and risk of coronary heart disease and stroke in Dutch men and women: the EPIC-MORGEN study.
机构信息
National Institute for Public Health and the Environment, Bilthoven, The Netherlands.
出版信息
PLoS One. 2011;6(10):e25955. doi: 10.1371/journal.pone.0025955. Epub 2011 Oct 5.
BACKGROUND
The associations of glycemic load (GL) and glycemic index (GI) with the risk of cardiovascular diseases (CVD) are not well-established, particularly in men, and may be modified by gender.
OBJECTIVE
To assess whether high dietary GL and GI increase the risk of CVD in men and women.
METHODS
A large prospective cohort study (EPIC-MORGEN) was conducted within the general Dutch population among 8,855 men and 10,753 women, aged 21-64 years at baseline (1993-1997) and free of diabetes and CVD. Dietary intake was assessed with a validated food-frequency questionnaire and GI and GL were calculated using Foster-Powell's international table of GI. Information on morbidity and mortality was obtained through linkage with national registries. Cox proportional hazards analysis was performed to estimate hazard ratios (HRs) for incident coronary heart disease (CHD) and stroke, while adjusting for age, CVD risk factors, and dietary factors.
RESULTS
During a mean follow-up of 11.9 years, 581 CHD cases and 120 stroke cases occurred among men, and 300 CHD cases and 109 stroke cases occurred among women. In men, GL was associated with an increased CHD risk (adjusted HR per SD increase, 1.17 [95% CI, 1.02-1.35]), while no significant association was found in women (1.09 [0.89-1.33]). GI was not associated with CHD risk in both genders, while it was associated with increased stroke risk in men (1.27 [1.02-1.58]) but not in women (0.96 [0.75-1.22]). Similarly, total carbohydrate intake and starch intake were associated with a higher CHD risk in men (1.23 [1.04-1.46]; and 1.24 [1.07-1.45]), but not in women.
CONCLUSION
Among men, high GL and GI, and high carbohydrate and starch intake, were associated with increased risk of CVD.
背景
血糖负荷（GL）和血糖指数（GI）与心血管疾病（CVD）风险的关联尚未得到很好的确立，尤其是在男性中，并且可能因性别而异。
目的
评估高膳食 GL 和 GI 是否会增加男性和女性患 CVD 的风险。
方法
在一般荷兰人群中进行了一项大型前瞻性队列研究（EPIC-MORGEN），纳入了 8855 名男性和 10753 名女性，基线时年龄为 21-64 岁（1993-1997 年），且无糖尿病和 CVD。膳食摄入量通过经过验证的食物频率问卷进行评估，GI 和 GL 使用 Foster-Powell 的国际 GI 表进行计算。通过与国家登记册的链接获得发病率和死亡率信息。使用 Cox 比例风险分析来估计发病率冠心病（CHD）和中风的风险比（HRs），同时调整年龄、CVD 危险因素和膳食因素。
结果
在平均 11.9 年的随访期间，男性中发生了 581 例 CHD 病例和 120 例中风病例，女性中发生了 300 例 CHD 病例和 109 例中风病例。在男性中，GL 与 CHD 风险增加相关（每增加一个标准差的调整 HR，1.17[95%CI，1.02-1.35]），而在女性中则没有显著关联（1.09[0.89-1.33]）。在两性中，GI 与 CHD 风险无关，而与男性中风风险增加相关（1.27[1.02-1.58]），但与女性无关（0.96[0.75-1.22]）。同样，总碳水化合物摄入量和淀粉摄入量与男性的 CHD 风险增加相关（1.23[1.04-1.46]；和 1.24[1.07-1.45]），但与女性无关。
结论
在男性中，高 GL 和 GI，以及高碳水化合物和淀粉摄入量与 CVD 风险增加有关。
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