Sonestedt Emily, Hellstrand Sophie, Schulz Christina-Alexandra, Wallström Peter, Drake Isabel, Ericson Ulrika, Gullberg Bo, Hedblad Bo, Orho-Melander Marju
Diabetes and Cardiovascular Disease-Genetic Epidemiology, Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden.
Nutritional Epidemiology, Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden.
PLoS One. 2015 Apr 21;10(4):e0126104. doi: 10.1371/journal.pone.0126104. eCollection 2015.
It is still unclear whether carbohydrate consumption is associated with cardiovascular disease (CVD) risk. Genetic susceptibility might modify the associations between dietary intakes and disease risk.
The aim was to examine the association between the consumption of carbohydrate-rich foods (vegetables, fruits and berries, juice, potatoes, whole grains, refined grains, cookies and cakes, sugar and sweets, and sugar-sweetened beverages) and the risk of incident ischemic CVD (iCVD; coronary events and ischemic stroke), and whether these associations differ depending on genetic susceptibility to dyslipidemia.
Among 26,445 individuals (44-74 years; 62% females) from the Malmö Diet and Cancer Study cohort, 2,921 experienced an iCVD event during a mean follow-up time of 14 years. At baseline, dietary data were collected using a modified diet history method, and clinical risk factors were measured in 4,535 subjects. We combined 80 validated genetic variants associated with triglycerides and HDL-C or LDL-C, into genetic risk scores and examined the interactions between dietary intakes and genetic risk scores on the incidence of iCVD.
Subjects in the highest intake quintile for whole grains had a 13% (95% CI: 3-23%; p-trend: 0.002) lower risk for iCVD compared to the lowest quintile. A higher consumption of foods rich in added sugar (sugar and sweets, and sugar-sweetened beverages) had a significant cross-sectional association with higher triglyceride concentrations and lower HDL-C concentrations. A stronger positive association between a high consumption of sugar and sweets on iCVD risk was observed among those with low genetic risk score for triglycerides (p-interaction=0.05).
In this prospective cohort study that examined food sources of carbohydrates, individuals with a high consumption of whole grains had a decreased risk of iCVD. No convincing evidence of an interaction between genetic susceptibility for dyslipidemia, measured as genetic risk scores of dyslipidemia-associated variants, and the consumption of carbohydrate-rich foods on iCVD risk was observed.
碳水化合物的摄入量与心血管疾病（CVD）风险之间是否存在关联仍不明确。遗传易感性可能会改变饮食摄入量与疾病风险之间的关联。
旨在研究富含碳水化合物的食物（蔬菜、水果和浆果、果汁、土豆、全谷物、精制谷物、饼干和蛋糕、糖和甜食以及含糖饮料）的摄入量与缺血性CVD（iCVD；冠心病事件和缺血性中风）发病风险之间的关联，以及这些关联是否因血脂异常的遗传易感性而异。
在马尔默饮食与癌症研究队列的26445名个体（44 - 74岁；62%为女性）中，2921人在平均14年的随访期内发生了iCVD事件。在基线时，使用改良的饮食史方法收集饮食数据，并在4535名受试者中测量临床风险因素。我们将80个与甘油三酯和高密度脂蛋白胆固醇（HDL-C）或低密度脂蛋白胆固醇（LDL-C）相关的经过验证的基因变异合并为遗传风险评分，并研究饮食摄入量与遗传风险评分对iCVD发病率的相互作用。
与摄入量最低的五分位数相比，全谷物摄入量最高的五分位数的受试者发生iCVD的风险降低了13%（95%置信区间：3% - 23%；p趋势：0.002）。高糖食物（糖和甜食以及含糖饮料）的较高摄入量与较高的甘油三酯浓度和较低的HDL-C浓度存在显著的横断面关联。在甘油三酯遗传风险评分较低的人群中，糖和甜食的高摄入量与iCVD风险之间观察到更强的正相关（p相互作用 = 0.05）。
在这项研究碳水化合物食物来源的前瞻性队列研究中，全谷物摄入量高的个体发生iCVD的风险降低。未观察到以血脂异常相关变异的遗传风险评分衡量的血脂异常遗传易感性与富含碳水化合物食物的摄入量对iCVD风险的相互作用有令人信服的证据。
