含糖饮料摄入与高血压事件的关联。
Association of sweetened beverage intake with incident hypertension.
机构信息
Division of Nephrology, University of Maryland Medical Center, Baltimore, MD, USA.
出版信息
J Gen Intern Med. 2012 Sep;27(9):1127-34. doi: 10.1007/s11606-012-2069-6. Epub 2012 Apr 27.
BACKGROUND
Consumption of sugar-sweetened beverages (SSBs) is associated with an increased risk of hypertension in cross-sectional studies. However, prospective data are limited.
OBJECTIVE
To examine the associations between SSBs and artificially sweetened beverages (ASBs) with incident hypertension.
DESIGN AND SETTING
Prospective analysis using Cox proportional hazards regression to examine the association between SSBs and ASBs with incident hypertension in three large, prospective cohorts, the Nurses' Health Studies I (n = 88,540 women) and II (n = 97,991 women) and the Health Professionals' Follow-Up Study (n = 37,360 men).
MEASUREMENTS
Adjusted hazard ratios for incident clinically diagnosed hypertension.
RESULTS
Higher SSB and ASB intake was associated with an increased risk of developing hypertension in all three cohorts. In a pooled analysis, participants who consumed at least one SSB daily had an adjusted HR for incident hypertension of 1.13 (95 % CI, 1.09-1.17) compared with those who did not consume SSBs; for persons who drank at least one ASB daily, the adjusted HR was 1.14 (95 % CI, 1.09-1.18). The association between sweetened beverage intake and hypertension was stronger for carbonated beverages versus non-carbonated beverages, and for cola-containing versus non-cola beverages in the NHS I and NHS II cohorts only. Higher fructose intake from SSBs as a percentage of daily calories was associated with increased hypertension risk in NHS I and NHS II (p-trend = 0.001 in both groups), while higher fructose intake from sources other than SSBs was associated with a decrease in hypertension risk in NHS II participants (p-trend = 0.006).
LIMITATIONS
Residual confounding factors may interfere with the interpretation of results.
CONCLUSIONS
SSBs and ASBs are independently associated with an increased risk of incident hypertension after controlling for multiple potential confounders. These associations may be mediated by factors common to both SSBs and ASBs (e.g., carbonation or cola), but are unlikely to be due to fructose.
背景
横断面研究表明，饮用含糖饮料（SSB）会增加患高血压的风险。然而，前瞻性数据有限。
目的
研究 SSB 和人工加糖饮料（ASB）与新发高血压的相关性。
设计和设置
使用 Cox 比例风险回归对 3 个大型前瞻性队列（护士健康研究 I（n=88540 名女性）和 II（n=97991 名女性）和健康专业人员随访研究（n=37360 名男性）中的 SSB 和 ASB 与新发高血压的相关性进行前瞻性分析。
测量
对新确诊高血压的发病率进行调整后的风险比。
结果
在所有 3 个队列中，较高的 SSB 和 ASB 摄入量与高血压发病风险增加相关。在汇总分析中，与不饮用 SSB 的参与者相比，每天至少饮用一种 SSB 的参与者发生高血压的调整后 HR 为 1.13（95%CI，1.09-1.17）；对于每天至少饮用一种 ASB 的人，调整后的 HR 为 1.14（95%CI，1.09-1.18）。仅在 NHS I 和 NHS II 队列中，与饮用非碳酸 SSB 相比，饮用碳酸 SSB 与高血压的相关性更强；与饮用不含可乐的 SSB 相比，饮用含可乐的 SSB 与高血压的相关性更强。在 NHS I 和 NHS II 中，SSB 中果糖摄入量占每日卡路里的百分比与高血压风险增加相关（两组的 P 趋势均=0.001），而 SSB 以外的其他来源的果糖摄入量与 NHS II 参与者的高血压风险降低相关（P 趋势=0.006）。
局限性
残留的混杂因素可能会干扰结果的解释。
结论
在控制了多个潜在混杂因素后，SSB 和 ASB 与新发高血压的风险增加独立相关。这些相关性可能是由 SSB 和 ASB 共有的因素介导的（例如碳酸化或可乐），但不太可能是由于果糖。
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