dos Santos Ana Luiza Teixeira, Weiss Tanara, Duarte Camila Kümmel, Gross Jorge Luiz, de Azevedo Mirela Jobim, Zelmanovitz Themis
Endocrine Division, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2350/ Prédio 12, 4° andar, CEP 90035-003 Porto Alegre, RS, Brazil.
Atherosclerosis. 2014 Sep;236(1):31-8. doi: 10.1016/j.atherosclerosis.2014.06.014. Epub 2014 Jun 25.
To evaluate associations of dietary fat composition with the development of cardiac events in patients with type 2 diabetes, without ischemic heart disease who were followed for at least 12 months.
In this prospective cohort study the usual diet of patients was retrospectively assessed by a 3-day weighed diet record (WDR). Compliance with the WDR technique was assessed by comparing protein intake estimated from 3-day WDR and 24-h urinary nitrogen output. The following were considered cardiac events: myocardial infarction, myocardial revascularization procedures, congestive heart failure, new-onset angina pectoris, and sudden death.
A total of 227 patients with type 2 diabetes (aged 59 ± 10 years; 46.0% male), were followed during 4.6 years. In a multivariate Cox regression analysis, the intake of polyunsaturated fatty acids had a protective effect for cardiac events (HR = 0.31, 95% CI: 0.11-0.89; P = 0.03) adjusted for age, gender, duration of diabetes, smoking, compliance with WDR, using hypolipidemic agents, and the presence of hypertension and diabetic nephropathy. When the fat intake was divided into quartiles, the highest intake of α-linolenic acid (>1.25% of energy) was negatively associated with cardiac events (HR = 0.58, 95% CI: 0.39-0.85; P = 0.006), adjusted for the same covariates..
In patients with type 2 diabetes without ischemic heart disease, a high intake of polyunsaturated fatty acids, especially alpha linolenic acid, was protective for the development of cardiac events..
评估2型糖尿病且无缺血性心脏病患者的饮食脂肪成分与心脏事件发生之间的关联，这些患者至少随访了12个月。
在这项前瞻性队列研究中，通过3天称重饮食记录（WDR）对患者的日常饮食进行回顾性评估。通过比较3天WDR估算的蛋白质摄入量和24小时尿氮排出量来评估WDR技术的依从性。以下被视为心脏事件：心肌梗死、心肌血运重建术、充血性心力衰竭、新发心绞痛和猝死。
共有227例2型糖尿病患者（年龄59±10岁；男性占46.0%），随访了4.6年。在多变量Cox回归分析中，调整年龄、性别、糖尿病病程、吸烟、WDR依从性、使用降脂药物以及高血压和糖尿病肾病的存在情况后，多不饱和脂肪酸的摄入对心脏事件有保护作用（HR=0.31，95%CI：0.11-0.89；P=0.03）。当将脂肪摄入量分为四分位数时，最高的α-亚麻酸摄入量（>能量的1.25%）与心脏事件呈负相关（HR=0.58，95%CI：0.39-0.85；P=0.006），同样调整了上述协变量。
在无缺血性心脏病的2型糖尿病患者中，高摄入多不饱和脂肪酸，尤其是α-亚麻酸，对心脏事件的发生具有保护作用。
