Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box 19395-4763, Tehran 1985717413, Iran.
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, P.O. Box 19395-4741, Tehran 19816-19573, Iran.
Nutrients. 2017 Aug 21;9(8):872. doi: 10.3390/nu9080872.
The relationship between fructose and cardiovascular disease (CVD) remains controversial. In this study, we aimed to assess possible association of dietary intakes of fructose with the risk of CVD events in a prospective population-based study. Participants without CVD ( = 2369) were recruited from the Tehran Lipid and Glucose Study and followed a mean of 6.7 years. Dietary data were collected using a validated 168 item semi-quantitative food frequency questionnaire. Dietary total fructose (TF) intake was calculated by sum of natural fructose (NF) in fruits and vegetables and added fructose (AF) in commercial foods. Multivariate Cox proportional hazard regression models, adjusted for potential confounders, were used to estimate the risk of CVD across tertiles of dietary fructose. Linear regression models were used to indicate association of fructose intakes with changes of CVD risk factors over the study period. The mean age of participants (43.5% men) was 38.1 ± 13.3 years at baseline. During an average of 6.7 ± 1.4 years of follow-up, 79 participants experienced CVD outcomes. The mean daily intake of TF was 6.4 ± 3.7% of total energy (3.6 ± 2.0 from AF and 2.7 ± 1.8 from NF). Higher consumption of TF (≥7.4% vs. <4.5% of total energy) was accompanied with an increased risk of CVD (HR = 1.81, 95% CI = 1.04-3.15); higher energy intake from AF was also related to incidence of CVD (HR = 1.80, 95% CI = 1.04-3.12), whereas NF was not associated with the risk of CVD outcomes. Both AF and TF were also related to changes of systolic and diastolic blood pressures, waist circumference, serum insulin and creatinine levels, as well as HDL-C. Our data provides further evidence regarding undesirable effects of fructose intake in relation to risk of CVD events.
果糖与心血管疾病（CVD）之间的关系仍存在争议。在这项研究中，我们旨在评估饮食中果糖的摄入量与前瞻性人群研究中 CVD 事件风险之间可能存在的关联。无 CVD 的参与者（= 2369）是从德黑兰血脂和血糖研究中招募的，随访平均 6.7 年。使用经过验证的 168 项半定量食物频率问卷收集饮食数据。饮食总果糖（TF）摄入量通过水果和蔬菜中的天然果糖（NF）和商业食品中的添加果糖（AF）的总和计算。多变量 Cox 比例风险回归模型，调整了潜在混杂因素，用于估计饮食果糖三分位的 CVD 风险。线性回归模型用于指示果糖摄入量与研究期间 CVD 危险因素变化的关联。参与者的平均年龄（43.5%为男性）在基线时为 38.1 ± 13.3 岁。在平均 6.7 ± 1.4 年的随访期间，79 名参与者发生了 CVD 结局。TF 的平均日摄入量为总能量的 6.4 ± 3.7%（3.6 ± 2.0 来自 AF，2.7 ± 1.8 来自 NF）。TF 摄入量较高（≥7.4% vs. <4.5%的总能量）与 CVD 风险增加相关（HR = 1.81，95%CI = 1.04-3.15）；AF 的能量摄入较高也与 CVD 的发生相关（HR = 1.80，95%CI = 1.04-3.12），而 NF 与 CVD 结局无关。AF 和 TF 与收缩压和舒张压、腰围、血清胰岛素和肌酐水平以及 HDL-C 的变化也有关。我们的数据提供了更多关于果糖摄入与 CVD 事件风险之间不良影响的证据。
