Frankenfeld Cara L
Department of Global and Community Health, George Mason University, Fairfax, VA
J Nutr. 2014 Sep;144(9):1445-53. doi: 10.3945/jn.114.190512. Epub 2014 Jun 25.
The study objective was to evaluate independent and interactive associations of dietary fiber intake and high urinary enterolignans with cardiometabolic risk factors. The analysis included 2260 adults (≥20 y of age) from the 2003-2010 NHANES. Logistic regression models were used to evaluate obesity and clinically defined cardiometabolic risk factors in relation to dietary fiber intake and urinary enterolignan concentrations. Three sets of models were created: 1) independent associations, 2) mutually adjusted associations, and 3) interactions. Models were adjusted for age, gender, race/ethnicity, education, smoking status, and energy intake. High concentrations were considered to be above the 90th percentile of urinary enterolignan concentrations. Increasing dietary fiber intake was associated with high blood pressure (P = 0.02) and low serum HDL cholesterol (P-trend = 0.03). High urinary enterodiol concentration was not associated with obesity or cardiometabolic risk factors. High urinary enterolactone concentration was inversely associated with obesity (OR: 0.44; 95% CI: 0.29, 0.66), abdominal obesity (OR: 0.58; 95% CI: 0.39, 0.87), high serum C-reactive protein (CRP; OR: 0.52; 95% CI: 0.37, 0.74), high serum triglycerides (OR: 0.39; 95% CI: 0.23, 0.61), low serum HDL cholesterol (OR: 0.37; 95% CI: 0.23, 0.61), and metabolic syndrome (OR: 0.47; 95% CI: 0.30, 0.74). In mutually adjusted models, enterolactone associations observed in independent models remained similar, but associations for dietary fiber intake were attenuated, with the exception of blood pressure. In interaction models, there were 2 significant interactions: between high urinary enterodiol concentration and dietary fiber intake for high serum CRP (P = 0.04) and high plasma glucose (P = 0.04). Overall, being in the highest 10% of urinary enterolactone concentration was associated with cardiometabolic risk factors, independent of dietary fiber intake and enterodiol concentration. Future studies are warranted to evaluate physiologic actions of enterolactone or aspects of the gut microbial profile responsible for lignan metabolism to enterolactone.
本研究的目的是评估膳食纤维摄入量和高尿木脂素与心血管代谢危险因素之间的独立关联和交互作用。分析纳入了2003 - 2010年美国国家健康与营养检查调查（NHANES）中的2260名成年人（年龄≥20岁）。采用逻辑回归模型评估与膳食纤维摄入量和尿木脂素浓度相关的肥胖及临床定义的心血管代谢危险因素。创建了三组模型：1）独立关联模型；2）相互调整关联模型；3）交互作用模型。模型根据年龄、性别、种族/民族、教育程度、吸烟状况和能量摄入进行了调整。高浓度被定义为高于尿木脂素浓度的第90百分位数。膳食纤维摄入量增加与高血压（P = 0.02）和低血清高密度脂蛋白胆固醇（HDL - C）（P趋势 = 0.03）相关。高尿雌马酚浓度与肥胖或心血管代谢危险因素无关。高尿肠内酯浓度与肥胖呈负相关（比值比：0.44；95%置信区间：0.29，0.66）、腹型肥胖（比值比：0.58；95%置信区间：0.39，0.87）、高血清C反应蛋白（CRP；比值比：0.52；95%置信区间：0.37，0.74）、高血清甘油三酯（比值比：0.39；95%置信区间：0.23，0.61）、低血清HDL - C（比值比：0.37；95%置信区间：0.23，0.61）和代谢综合征（比值比：0.47；95%置信区间：0.30，0.74）相关。在相互调整模型中，独立模型中观察到的肠内酯关联仍然相似，但膳食纤维摄入量的关联有所减弱，血压除外。在交互作用模型中，有两个显著的交互作用：高尿雌马酚浓度与膳食纤维摄入量之间对高血清CRP（P = 0.04）和高血糖（P = 0.04）的交互作用。总体而言，尿肠内酯浓度处于最高10%与心血管代谢危险因素相关，与膳食纤维摄入量和雌马酚浓度无关。未来有必要开展研究评估肠内酯的生理作用或负责木脂素代谢为肠内酯的肠道微生物谱方面的情况。
