Masley Steven C, Roetzheim Richard, Masley Lucas V, McNamara Timothy, Schocken Douglas D
a Masley Optimal Health Center , St. Petersburg , Florida.
J Am Coll Nutr. 2015;34(2):100-7. doi: 10.1080/07315724.2014.916238. Epub 2015 Mar 9.
Cardiovascular disease (CVD) remains the number one cause of mortality in the Western world. This study aims to determine which lifestyle factors are associated with mean carotid intima media thickness (IMT), a safe and reliable predictor of future CVD risk.
A prospective cross-sectional analysis of 592 subjects. Measures were made of body composition, anthropometric measures, fitness, diet (measured with a 3-day food diary), laboratory results, and mean carotid IMT. Multivariate analyses show that higher mean IMT values are associated with increasing age (p < 0.0001), male gender (p = 0.0002), higher systolic blood pressure (BP; p = 0.0008), higher body mass index (BMI; p = 0.0005), and lower intake of zinc (p = 0.0001). Bivariate analyses controlling for age and gender, with and without statin use, showed that higher mean IMT scores were statistically associated with higher diastolic BP (p = 0.007), higher total cholesterol/high-density lipoprotein (HDL) ratio (p < 0.0001), higher triglyceride/HDL ratio (p = 0.0001), lower aerobic capacity measures (p = 0.0007), higher body fat percentage and waist circumference (p < 0.0001), higher fasting glucose level (p = 0.028), and lower intake of magnesium (p = 0.019), fish (p = 0.007), and fiber (p = 0.02). Other factors that were not associated with mean IMT include total cholesterol, low-density lipoprotein cholesterol (LDL-C), and high-sensitivity C-reactive protein (hs-CRP); intake of saturated fat, potassium, calcium, sodium, or vitamin K; percentage of calories from protein, fat, or carbohydrate; measures of strength (assessed with push-up and sit-up testing); and reported exercise.
Aerobic fitness and dietary intake of fiber, fish, magnesium, and zinc are inversely associated with carotid IMT scores. Of the traditional CVD risk factors, only systolic BP, fasting glucose, body composition, and total cholesterol/HDL ratio have a direct relationship with mean carotid IMT.
心血管疾病（CVD）仍是西方世界的首要死因。本研究旨在确定哪些生活方式因素与平均颈动脉内膜中层厚度（IMT）相关，IMT是未来CVD风险的一个安全可靠的预测指标。
对592名受试者进行前瞻性横断面分析。测量了身体成分、人体测量指标、体能、饮食（通过3天食物日记测量）、实验室检查结果以及平均颈动脉IMT。多变量分析显示，较高的平均IMT值与年龄增长（p < 0.0001）、男性（p = 0.0002）、较高的收缩压（BP；p = 0.0008）、较高的体重指数（BMI；p = 0.0005）以及较低的锌摄入量（p = 0.0001）相关。在控制年龄和性别、使用和不使用他汀类药物的双变量分析中，较高的平均IMT评分与较高的舒张压（p = 0.007）、较高的总胆固醇/高密度脂蛋白（HDL）比值（p < 0.0001）、较高的甘油三酯/HDL比值（p = 0.0001）、较低的有氧能力指标（p = 0.0007）、较高的体脂百分比和腰围（p < 0.0001）、较高的空腹血糖水平（p = 0.028）以及较低的镁（p = 0.019）、鱼类（p = 0.007）和纤维摄入量（p = 0.02）具有统计学关联。其他与平均IMT无关的因素包括总胆固醇、低密度脂蛋白胆固醇（LDL-C）和高敏C反应蛋白（hs-CRP）；饱和脂肪、钾、钙、钠或维生素K的摄入量；蛋白质、脂肪或碳水化合物提供的卡路里百分比；力量指标（通过俯卧撑和仰卧起坐测试评估）以及报告的运动量。
有氧体能以及纤维、鱼类、镁和锌的饮食摄入量与颈动脉IMT评分呈负相关。在传统的CVD危险因素中，只有收缩压、空腹血糖、身体成分和总胆固醇/HDL比值与平均颈动脉IMT有直接关系。
