Choe Hansaem, Hwang Ji-Yun, Yun Jin A, Kim Ji-Myung, Song Tae-Jin, Chang Namsoo, Kim Yong-Jae, Kim Yuri
Department of Nutritional Science and Food Management, Ewha Womans University, 52 Ewhayeodae-gil, Seodaemun-gu, Seoul 03760, Korea.
Department of Foodservice Management and Nutrition, Sangmyung University, Seoul 03016, Korea.
Nutr Res Pract. 2016 Oct;10(5):516-523. doi: 10.4162/nrp.2016.10.5.516. Epub 2016 Jul 28.
BACKGROUND/OBJECTIVES: This study was conducted to examine relationships between dietary habits and intakes of antioxidants and B vitamins and the risk of ischemic stroke, and to compare dietary factors according to the presence of cerebral artery atherosclerosis and stroke subtypes.
SUBJECTS/METHODS: A total of 147 patients and 144 control subjects were recruited consecutively in the metropolitan area of Seoul, Korea. Sixty participants each in the case and control groups were included in analyses after 1:1 frequency matching. In addition, 117 acute ischemic stroke patients were classified into subtypes according to the Trial of Org 10172 in Acute Stroke Treatment (TOAST) guidelines. Dietary intake was measured using a semi-quantitative food frequency questionnaire composed of 111 food items and plasma lipid and homocysteine levels were analyzed.
When compared with control subjects, stroke patients had unfavorable dietary behaviors and lower intakes of fruits (73.1 ± 83.2 g vs. 230.9 ± 202.1 g, < 0.001), vegetables (221.1 ± 209.0 g vs. 561.7 ± 306.6 g, < 0.001), and antioxidants, including vitamins C, E, B, β-carotene, and folate. The intakes of fruits, vegetables, vitamin C, and folate were inversely associated with the risk of ischemic stroke after adjusting for confounding factors. Intakes of vegetables, vitamins C, B, B, and folate per 1,000 kcal were lower in ischemic stroke with cerebral atherosclerosis than in those without. Overall vitamin B intake per 1,000 kcal differed according to the TOAST classification ( = 0.004), but no differences among groups existed based on the post-hoc test.
When compared with control subjects, ischemic stroke patients, particularly those with cerebral atherosclerosis, had unfavorable dietary intake, which may have contributed to the development of ischemic stroke. These results indicate that proper dietary recommendations are important for the prevention of ischemic stroke.
背景/目的：本研究旨在探讨饮食习惯、抗氧化剂和B族维生素摄入量与缺血性中风风险之间的关系，并根据脑动脉粥样硬化的存在情况和中风亚型比较饮食因素。
对象/方法：在韩国首尔大都市区连续招募了147例患者和144例对照者。病例组和对照组各60名参与者在进行1:1频率匹配后纳入分析。此外，117例急性缺血性中风患者根据急性中风治疗中组织纤溶酶原激活剂10172试验（TOAST）指南分为不同亚型。使用由111种食物组成的半定量食物频率问卷测量饮食摄入量，并分析血浆脂质和同型半胱氨酸水平。
与对照者相比，中风患者有不良的饮食行为，水果（73.1±83.2克对230.9±202.1克，<0.001）、蔬菜（221.1±209.0克对561.7±306.6克，<0.001）以及包括维生素C、E、B、β-胡萝卜素和叶酸在内的抗氧化剂摄入量较低。在调整混杂因素后，水果、蔬菜、维生素C和叶酸的摄入量与缺血性中风风险呈负相关。每1千卡中蔬菜、维生素C、B、B和叶酸的摄入量在伴有脑动脉粥样硬化的缺血性中风患者中低于无脑动脉粥样硬化的患者。每1千卡的总体维生素B摄入量根据TOAST分类有所不同（=0.004），但事后检验各组之间无差异。
与对照者相比，缺血性中风患者，尤其是伴有脑动脉粥样硬化的患者，饮食摄入不良，这可能导致了缺血性中风的发生。这些结果表明，适当的饮食建议对预防缺血性中风很重要。
