Mohammadifard Noushin, Mansourian Marjan, Sajjadi Firouzeh, Maghroun Maryam, Pourmoghaddas Ali, Yazdekhasti Narges, Sarrafzadegan Nizal
Isfahan Cardiovascular Research Centre, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
Hypertension Research Centre, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
Nutr Diet. 2017 Feb;74(1):61-66. doi: 10.1111/1747-0080.12288. Epub 2016 Jul 12.
There is controversy around the clinical effects of the dietary glycaemic index (GI) and glycaemic load (GL) on cardiovascular diseases risk factors such as metabolic syndrome (MetS). So, the present study was performed to evaluate the relationship between GI or GL and metabolic syndrome in an Iranian adult population in 2007.
The study was based on data from a sub-sample of the Isfahan Healthy Heart Program (IHHP), collected across three cities in central Iran, in the year 2007. This was a cross-sectional survey of 1618 randomly selected adults aged ≥19 years. Nutritional assessment was conducted by a single 24-hour recall questionnaire. Fasting serum lipids, anthropometric indicators and blood pressure were measured by standard methods. Analysis of covariance was used to compare metabolic syndrome components according to energy-adjusted GI and GL levels. To expose the effect of potential confounders, hierarchical logistic regression models were utilised to determine adjusted odds ratios (OR) and 95% CI.
After adjustment for age, gender, body mass index and energy intake, high GI was found to be significantly associated with MetS (OR 95% CI) (1.46 (1.01-2.12)). This was attenuated marginally by excluding the confounding effects of dietary fibre intake (1.29 (1.01-1.74)). All hierarchical models illustrated no significant association between energy-adjusted GL and the risk of MetS adjusted for confounders.
There is a positive relationship between dietary GI, but not GL, and the presence of MetS after adjustment for potential confounders. However, studies with long duration of follow up and experimental studies are still required to confirm this relationship.
饮食血糖生成指数（GI）和血糖负荷（GL）对心血管疾病风险因素如代谢综合征（MetS）的临床影响存在争议。因此，本研究于2007年在伊朗成年人群中进行，以评估GI或GL与代谢综合征之间的关系。
该研究基于2007年在伊朗中部三个城市收集的伊斯法罕健康心脏项目（IHHP）子样本的数据。这是一项对1618名年龄≥19岁的随机选择成年人的横断面调查。通过单一的24小时回顾问卷进行营养评估。采用标准方法测量空腹血脂、人体测量指标和血压。使用协方差分析根据能量调整后的GI和GL水平比较代谢综合征组分。为了揭示潜在混杂因素的影响，利用分层逻辑回归模型确定调整后的比值比（OR）和95%置信区间（CI）。
在对年龄、性别、体重指数和能量摄入进行调整后，发现高GI与MetS显著相关（OR 95%CI）（1.46（1.01 - 2.12））。通过排除膳食纤维摄入的混杂效应，这种相关性略有减弱（1.29（1.01 - 1.74））。所有分层模型均表明，能量调整后的GL与调整混杂因素后的MetS风险之间无显著关联。
在调整潜在混杂因素后，饮食GI与MetS的存在呈正相关，而GL与MetS无此关联。然而，仍需要长期随访研究和实验研究来证实这种关系。
