Ehsani Behnaz, Moslehi Nazanin, Mirmiran Parvin, Ramezani Tehrani Fahimeh, Tahmasebinejad Zhale, Azizi Fereidoun
Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Clin Nutr. 2016 Oct;35(5):1181-7. doi: 10.1016/j.clnu.2015.10.007. Epub 2015 Nov 25.
BACKGROUND & AIMS: Visceral adiposity index (VAI), an indicator of visceral adiposity, has been found to be associated with cardiometabolic disturbances in women with polycystic ovary syndrome (PCOS). The association of dietary intakes with VAI, and subsequently cardiometabolic variables is still unclear. The aims of this study were to identify a dietary pattern associated with VAI and to investigate whether this pattern is associated with cardiometabolic variables in PCOS women.
The study was conducted on 53 PCOS women, aged 18-45 years, diagnosed according to National Institutes of Health (NIH) criteria, and 167 age-matched normo-ovulatory women who were recruited from the Tehran Lipid and Glucose Study. Reduced rank regression was applied to determine a dietary pattern that explains the maximum variation of the VAI. Associations between the dietary pattern and cardiometabolic profiles were investigated using linear and logistic regression, adjusted for age and BMI.
A VAI dietary pattern was identified characterized by high consumption of fried vegetables, vegetable oils (except olive oil), salty snacks, legumes, eggs, fast foods and low consumption of traditional sweets, high and low fat dairy, cruciferous vegetables, sugars and honey. A one standard deviation (SD) increase in dietary pattern score was significantly associated with higher triglycerides (TGs) (βcontrol = 0.22, p = 0.003; βcase = 0.48, p = 0.001) and TGs/HDL-C ratio (βcontrol = 0.23, p = 0.002; βcase = 0.52, p = 0.001) in both groups. After adjusting for age and BMI, a 1-SD increase in dietary pattern score was associated with increased risk of VAD in PCOS (OR 2.77; 95% CI 1.15, 6.66) and control groups (OR 2.41; 95% CI 1.41-4.12). In the control group, the risk of hypercholesterolemia, hypertriglyceridemia, high LDL-C, low HDL-C, hyperglycemia and IGT + IFG increased significantly per 1-SD increase in dietary pattern score, which all remained significant after adjusting for age and BMI, except for the risk of high LDL-C. Among the cardiometabolic abnormalities, only the risk of hypertriglyceridemia was significantly associated with dietary pattern score in women with PCOS, which lost its significance after adjusting for age and BMI.
The VAI dietary pattern affects most cardiometabolic variables in controls, but to a lesser extent in PCOS women. Our study suggests that relationships between diet and cardiometabolic risk profiles may be modified by PCOS status.
内脏脂肪指数（VAI）是内脏脂肪的一个指标，已发现其与多囊卵巢综合征（PCOS）女性的心脏代谢紊乱有关。饮食摄入与VAI以及随后的心脏代谢变量之间的关联仍不清楚。本研究的目的是确定一种与VAI相关的饮食模式，并调查这种模式是否与PCOS女性的心脏代谢变量相关。
本研究对53名年龄在18 - 45岁、根据美国国立卫生研究院（NIH）标准诊断的PCOS女性以及167名年龄匹配的正常排卵女性进行，这些女性来自德黑兰脂质与葡萄糖研究。应用降秩回归来确定一种能解释VAI最大变异的饮食模式。使用线性和逻辑回归研究饮食模式与心脏代谢指标之间的关联，并对年龄和BMI进行了调整。
确定了一种VAI饮食模式，其特点是大量食用油炸蔬菜、植物油（橄榄油除外）、咸味小吃、豆类、鸡蛋、快餐，以及少量食用传统甜食、高脂肪和低脂肪乳制品、十字花科蔬菜、糖和蜂蜜。饮食模式评分每增加一个标准差（SD），两组的甘油三酯（TGs）（对照组β = 0.22，p = 0.003；病例组β = 0.48，p = 0.001）和TGs/HDL - C比值（对照组β = 0.23，p = 0.002；病例组β = 0.52，p = 0.001）均显著升高。在调整年龄和BMI后，饮食模式评分每增加1个标准差，PCOS组（OR 2.77；95%CI 1.15，6.66）和对照组（OR 2.41；95%CI 1.41 - 4.12）患VAD的风险增加。在对照组中，饮食模式评分每增加1个标准差，高胆固醇血症、高甘油三酯血症、高LDL - C、低HDL - C、高血糖和IGT + IFG的风险显著增加，除高LDL - C风险外，在调整年龄和BMI后所有这些风险仍显著。在心脏代谢异常中，只有PCOS女性的高甘油三酯血症风险与饮食模式评分显著相关，在调整年龄和BMI后这种相关性消失。
VAI饮食模式对对照组的大多数心脏代谢变量有影响，但对PCOS女性的影响较小。我们的研究表明，饮食与心脏代谢风险特征之间的关系可能因PCOS状态而改变。
