Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece.
Circulation. 2012 Nov 20;126(21):2456-64. doi: 10.1161/CIRCULATIONAHA.112.114058. Epub 2012 Oct 23.
BACKGROUND: A nutrient-wide approach may be useful to comprehensively test and validate associations between nutrients (derived from foods and supplements) and blood pressure (BP) in an unbiased manner. METHODS AND RESULTS: Data from 4680 participants aged 40 to 59 years in the cross-sectional International Study of Macro/Micronutrients and Blood Pressure (INTERMAP) were stratified randomly into training and testing sets. US National Health and Nutrition Examination Survey (NHANES) four cross-sectional cohorts (1999-2000, 2001-2002, 2003-2004, 2005-2006) were used for external validation. We performed multiple linear regression analyses associating each of 82 nutrients and 3 urine electrolytes with systolic and diastolic BP in the INTERMAP training set. Significant findings were validated in the INTERMAP testing set and further in the NHANES cohorts (false discovery rate <5% in training, P<0.05 for internal and external validation). Among the validated nutrients, alcohol and urinary sodium-to-potassium ratio were directly associated with systolic BP, and dietary phosphorus, magnesium, iron, thiamin, folacin, and riboflavin were inversely associated with systolic BP. In addition, dietary folacin and riboflavin were inversely associated with diastolic BP. The absolute effect sizes in the validation data (NHANES) ranged from 0.97 mm Hg lower systolic BP (phosphorus) to 0.39 mm Hg lower systolic BP (thiamin) per 1-SD difference in nutrient variable. Inclusion of nutrient intake from supplements in addition to foods gave similar results for some nutrients, though it attenuated the associations of folacin, thiamin, and riboflavin intake with BP. CONCLUSIONS: We identified significant inverse associations between B vitamins and BP, relationships hitherto poorly investigated. Our analyses represent a systematic unbiased approach to the evaluation and validation of nutrient-BP associations.
背景:全面测试和验证营养素(来源于食物和补充剂)与血压(BP)之间的关联,采用营养广泛的方法可能会很有用。
方法和结果:横断面国际宏/微量营养素与血压研究(INTERMAP)中 4680 名年龄在 40 至 59 岁的参与者的数据按比例随机分为训练集和测试集。使用美国国家健康和营养调查(NHANES)的四个横断面队列(1999-2000、2001-2002、2003-2004、2005-2006)进行外部验证。我们在 INTERMAP 训练集中进行了多元线性回归分析,将 82 种营养素和 3 种尿液电解质中的每一种与收缩压和舒张压相关联。在 INTERMAP 测试集中验证了显著发现,并在 NHANES 队列中进一步验证(训练中错误发现率<5%,P<0.05 用于内部和外部验证)。在所验证的营养素中,酒精和尿钠/钾比与收缩压呈正相关,而饮食磷、镁、铁、硫胺素、叶酸和核黄素与收缩压呈负相关。此外,饮食叶酸和核黄素与舒张压呈负相关。验证数据(NHANES)中的绝对效应大小范围从 0.97mmHg 收缩压降低(磷)到 0.39mmHg 收缩压降低(硫胺素),每个营养素变量的标准差差异。除了食物外,还包括补充剂的营养素摄入量,对某些营养素的结果相似,尽管它减弱了叶酸、硫胺素和核黄素摄入量与 BP 的关联。
结论:我们发现 B 族维生素与 BP 之间存在显著的负相关关系,这些关系以前研究甚少。我们的分析代表了一种系统的、无偏的评估和验证营养素与 BP 关联的方法。
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