Evans Charlotte El, Greenwood Darren C, Threapleton Diane E, Gale Chris P, Cleghorn Christine L, Burley Victoria J
Nutritional Epidemiology Group, School of Food Science and Nutrition, and
Leeds Institute for Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, United Kingdom; and.
Am J Clin Nutr. 2017 May;105(5):1176-1190. doi: 10.3945/ajcn.116.143685. Epub 2017 Apr 12.
High blood pressure is a strong risk factor for cardiovascular disease. The aim of this study was to determine the associations of dietary glycemic index (GI) and glycemic load (GL) with systolic blood pressure (SBP) and diastolic blood pressure (DBP) in healthy individuals. A systematic review and meta-analysis of randomized controlled trials (RCTs) was carried out. Databases were searched for eligible RCTs in 2 phases. MEDLINE, Embase, CAB Abstracts, BIOSIS, ISI Web of Science, and the Cochrane Library were searched from January 1990 to December 2009. An updated search was undertaken with the use of MEDLINE and Embase from January 2010 to September 2016. Trials were included if they reported author-defined high- and low-GI or -GL diets and blood pressure, were of ≥6 wk duration, and comprised healthy participants without chronic conditions. Data were extracted and analyzed with the use of Stata statistical software. Pooled estimates and 95% CIs were calculated with the use of weighted mean differences and random-effects models. Data were extracted from 14 trials comprising 1097 participants. Thirteen trials provided information on differences in GI between control and intervention arms. A median reduction in GI of 10 units reduced the overall pooled estimates for SBP and DBP by 1.1 mm Hg (95% CI: -0.3, 2.5 mm Hg; = 0.11) and 1.3 mm Hg (95% CI: 0.2 mm Hg, 2.3; = 0.02), respectively. Nine trials reported information on differences in GL between arms. A median reduction in GL of 28 units reduced the overall pooled estimates for SBP and DBP by 2.0 mm Hg (95% CI: 0.2, 3.8 mm Hg; = 0.03) and 1.4 mm Hg (95% CI: 0.1, 2.6 mm Hg; = 0.03), respectively. This review of healthy individuals indicated that a lower glycemic diet may lead to important reductions in blood pressure. However, many of the trials included in the analysis reported important sources of bias. This trial was registered at PROSPERO as CRD42016049026.
高血压是心血管疾病的一个重要风险因素。本研究的目的是确定健康个体的膳食血糖生成指数（GI）和血糖负荷（GL）与收缩压（SBP）和舒张压（DBP）之间的关联。我们对随机对照试验（RCT）进行了系统评价和荟萃分析。分两个阶段检索数据库以查找符合条件的RCT。检索了1990年1月至2009年12月期间的MEDLINE、Embase、CAB文摘、BIOSIS、ISI科学网和Cochrane图书馆。2010年1月至2016年9月期间，使用MEDLINE和Embase进行了更新检索。如果试验报告了作者定义的高GI或GL饮食以及血压，试验持续时间≥6周，且参与者为无慢性病的健康人，则纳入试验。使用Stata统计软件提取和分析数据。使用加权平均差和随机效应模型计算合并估计值和95%置信区间（CI）。从14项试验中提取数据，这些试验包括1097名参与者。13项试验提供了对照臂和干预臂之间GI差异的信息。GI中位数降低10个单位，SBP和DBP的总体合并估计值分别降低1.1毫米汞柱（95%CI：-0.3，2.5毫米汞柱；P = 0.11）和1.3毫米汞柱（95%CI：0.2毫米汞柱，2.3；P = 0.02）。9项试验报告了各臂之间GL差异的信息。GL中位数降低28个单位，SBP和DBP的总体合并估计值分别降低2.0毫米汞柱（95%CI：0.2，3.8毫米汞柱；P = 0.03）和1.4毫米汞柱（95%CI：0.1，2.6毫米汞柱；P = 0.03）。对健康个体的这项综述表明，较低的血糖生成饮食可能会使血压显著降低。然而，分析中纳入的许多试验报告了重要的偏倚来源。该试验在PROSPERO注册为CRD42016049026。
