Unidad Clínica y de Investigación en Lípidos y Arteriosclerosis, Hospital Universitario Miguel Servet, Instituto de Investigación Sanitaria Aragón (IIS Aragón), Universidad de Zaragoza, CIBERCV, Zaragoza, Spain.
Fundación Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain.
J Clin Lipidol. 2017 Nov-Dec;11(6):1372-1382.e4. doi: 10.1016/j.jacl.2017.08.007. Epub 2017 Aug 24.
The Mediterranean diet (MeDi) is known to prevent cardiovascular events but the mechanisms mediating this association are not fully understood.
The objective of the study was to examine the association between MeDi adherence and the presence and extent of atherosclerotic plaques in carotid, femoral, and aorta territories and its relationship with risk factors in asymptomatic middle-aged adults.
Cross-sectional analysis of the Aragon Workers' Health Study, a cohort of 2588 subjects (94.9% men aged 51.3 ± 3.89 years) without previous cardiovascular history. Participants underwent carotid, femoral, and aorta ultrasound for the quantification of number and thickness of plaques and intima-media thickness. To estimate the participant's adherence to MeDi, we computed the Alternative MEDiterranean index (aMED).
The overall aMED score was 4.19 ± 1.70, representing a moderate adherence to MeDi. aMED score was associated with the presence of plaque in femoral arteries (odds ratio highest vs lowest aMED score quartile: 0.63; 95% confidence interval: 0.48-0.83; P trend = .045) independently of risk factors and mediators. The strongest association between aMED quartiles and presence of plaque was found among smokers, both in femoral (0.39 [0.22-0.69]; P trend = .001) and in any territory (0.33 [0.14-0.79], P trend = .008). aMED was inversely associated with the number of plaques in all territories except for carotids.
MeDi adherence showed a dose-dependent protective association with the presence, number, and thickness of plaques independent of other risk factors. The association was strongest for femoral arteries and among smokers.
地中海饮食（MeDi）已被证实可预防心血管事件，但介导这种关联的机制尚不完全清楚。
本研究旨在探讨 MeDi 依从性与颈动脉、股动脉和主动脉区域动脉粥样硬化斑块的存在和程度及其与无症状中年人群危险因素的关系。
对阿罗工人健康研究（Aragon Workers' Health Study）的横断面分析，该队列纳入了 2588 名受试者（94.9%为男性，年龄 51.3±3.89 岁），均无既往心血管病史。参与者接受颈动脉、股动脉和主动脉超声检查，以定量斑块数量和厚度以及内膜中层厚度。为了评估参与者对 MeDi 的依从性，我们计算了替代地中海饮食指数（aMED）。
总体而言，aMED 评分（4.19±1.70）为中等程度的 MeDi 依从性。aMED 评分与股动脉斑块的存在相关（最高与最低 aMED 评分四分位数的比值比：0.63；95%置信区间：0.48-0.83；P 趋势=0.045），独立于危险因素和中介因素。在吸烟者中，aMED 四分位数与斑块存在之间的相关性最强，无论是在股动脉（0.39[0.22-0.69]；P 趋势=0.001）还是在任何部位（0.33[0.14-0.79]，P 趋势=0.008）。aMED 与除颈动脉外所有部位的斑块数量呈负相关。
MeDi 依从性与斑块的存在、数量和厚度呈剂量依赖性保护关联，与其他危险因素无关。这种相关性在股动脉最强，在吸烟者中最强。
