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研究饮食模式与代谢性心血管疾病风险因素之间的关联:结构方程模型的一种新应用。

Examining associations between dietary patterns and metabolic CVD risk factors: a novel use of structural equation modelling.

作者信息

Castro Michelle Alessandra, Baltar Valéria Troncoso, Marchioni Dirce Maria, Fisberg Regina Mara

机构信息

1Department of Nutrition,School of Public Health,University of São Paulo,PO Box 01246-904,715 São Paulo,Brazil.

2Department of Epidemiology and Biostatistics,Institute of Collective Health,Federal Fluminense University,PO Box 24030210,303 Niterói,Rio de Janeiro,Brazil.

出版信息

Br J Nutr. 2016 May;115(9):1586-97. doi: 10.1017/S0007114516000556. Epub 2016 Mar 2.

Abstract

The association between dietary patterns and metabolic cardiovascular risk factors has long been addressed but there is a lack of evidence towards the effects of the overall diet on the complex net of biological inter-relationships between risk factors. This study aimed to derive dietary patterns and examine their associations with metabolic cardiovascular risk factors following a theoretic model for the relationship between them. Participants included 417 adults of both sexes, enrolled to the cross-sectional population-based study performed in Brazil. Body weight, waist circumference, high-sensitivity C-reactive protein, blood pressure, total cholesterol:HDL-cholesterol ratio, TAG:HDL-cholesterol ratio, fasting plasma glucose and serum leptin were evaluated. Food consumption was assessed by two non-consecutive 24-h dietary recalls adjusted for the within-person variation of intake. A total of three dietary patterns were derived by exploratory structural equation modelling: 'Traditional', 'Prudent' and 'Modern'. The 'Traditional' pattern had a negative and direct effect on obesity indicators (serum LEP, body weight and waist circumference) and negative indirect effects on total cholesterol:HDL-cholesterol ratio, TAG:HDL-cholesterol ratio and fasting plasma glucose. The 'Prudent' pattern had a negative and direct effect on systolic blood pressure. No association was observed for the 'Modern' pattern and metabolic risk factors. In conclusion, the 'Traditional' and 'Prudent' dietary patterns were negatively associated with metabolic cardiovascular risk factors among Brazilian adults. Their apparent protective effects against obesity and high blood pressure may be important non-pharmacological strategies for the prevention and control of obesity-related metabolic disorders and CVD.

摘要

饮食模式与代谢性心血管危险因素之间的关联早已得到探讨,但缺乏证据表明整体饮食对危险因素之间复杂的生物相互关系网络有何影响。本研究旨在根据它们之间关系的理论模型推导饮食模式,并研究其与代谢性心血管危险因素的关联。研究对象包括417名成年男女,他们参与了在巴西进行的基于人群的横断面研究。评估了体重、腰围、高敏C反应蛋白、血压、总胆固醇与高密度脂蛋白胆固醇比值、甘油三酯与高密度脂蛋白胆固醇比值、空腹血糖和血清瘦素。通过两次非连续的24小时饮食回忆法评估食物摄入量,并针对个体内摄入量的变化进行了调整。通过探索性结构方程模型共推导出三种饮食模式:“传统型”、“谨慎型”和“现代型”。“传统型”模式对肥胖指标(血清瘦素、体重和腰围)有直接负面影响,对总胆固醇与高密度脂蛋白胆固醇比值、甘油三酯与高密度脂蛋白胆固醇比值和空腹血糖有间接负面影响。“谨慎型”模式对收缩压有直接负面影响。未观察到“现代型”模式与代谢危险因素之间存在关联。总之,“传统型”和“谨慎型”饮食模式与巴西成年人的代谢性心血管危险因素呈负相关。它们对肥胖和高血压的明显保护作用可能是预防和控制肥胖相关代谢紊乱和心血管疾病的重要非药物策略。

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