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生活方式因素调节餐后高甘油三酯血症:来自 CORDIOPREV 研究。

Lifestyle factors modulate postprandial hypertriglyceridemia: From the CORDIOPREV study.

机构信息

Lipids and Atherosclerosis Unit, Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Córdoba, Spain.

CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Córdoba, Spain; Endocrinology and Nutrition Unit, Biomedical Research Institute of Malaga (IBIMA), Virgen de la Victoria University Hospital, Malaga, Spain.

出版信息

Atherosclerosis. 2019 Nov;290:118-124. doi: 10.1016/j.atherosclerosis.2019.09.025. Epub 2019 Sep 28.

Abstract

BACKGROUND AND AIMS

Recent evidence suggests that postprandial hypertriglyceridemia (PPT) is associated with the incidence of CVD. Several non-modifiable factors (genetics, age, gender) and lifestyle factors (physical activity, smoking, regular alcohol) have shown their ability to modulate PPT. We evaluate the influence of regular alcohol intake, physical activity and smoking habit modulating PPT in the CORDIOPREV study (NCT00924937).

METHODS

1002 patients were subject to an oral fat load test meal and serial blood samples were drawn at 0, 1, 2, 3 and 4 h during postprandial state. A PPT concentration above 2.5 mmol/L (220 mg/dL) at any time point has been established as a detrimental response. Alcohol consumption was defined as non-drinkers, moderate and severe intake; regular physical activity exceeding than or lower than 1000 MET/week; smoking habit was classified in current, never, recent ex-smokers and long-term ex-smokers.

RESULTS

The prevalence of undesirable PPT response was 68% in current, 58% in recent ex-smokers, 49% in long-term ex-smokers and 48% in never smokers (p < 0.001). Current and recent ex-smokers displayed higher PPT response as well as a greater area under the curve (AUC) and higher incremental (iAUC) of triglycerides (TG) compared with long-term ex-smokers and never smokers (p < 0.05), without differences among these subgroups. No differences were observed in the magnitude of PPT according to regular physical activity or alcohol intake habits.

CONCLUSIONS

Smoking is an independent risk factor modulating the magnitude of PPT. However, after tobacco cessation, ex-smokers show a progressive decrease on their PPT to reach levels similar to those of never smokers.

摘要

背景与目的

最近的证据表明,餐后高甘油三酯血症(PPT)与 CVD 的发生有关。一些不可改变的因素(遗传、年龄、性别)和生活方式因素(体力活动、吸烟、规律饮酒)已显示出其调节 PPT 的能力。我们评估了规律饮酒、体力活动和吸烟习惯对 CORDIOPREV 研究(NCT00924937)中 PPT 的影响。

方法

1002 例患者接受口服脂肪负荷试验餐,在餐后状态下,分别在 0、1、2、3 和 4 小时抽取系列血样。任何时间点 PPT 浓度超过 2.5mmol/L(220mg/dL)被定义为有害反应。饮酒定义为不饮酒者、中度和重度饮酒者;每周体力活动超过或低于 1000MET;吸烟习惯分为当前吸烟者、从不吸烟者、近期戒烟者和长期戒烟者。

结果

当前吸烟者、近期戒烟者、长期戒烟者和从不吸烟者不良 PPT 反应的发生率分别为 68%、58%、49%和 48%(p<0.001)。与长期戒烟者和从不吸烟者相比,当前吸烟者和近期戒烟者的 PPT 反应更高,曲线下面积(AUC)和甘油三酯(TG)增量(iAUC)更高(p<0.05),但这些亚组之间无差异。根据规律体力活动或饮酒习惯,PPT 的幅度无差异。

结论

吸烟是调节 PPT 幅度的独立危险因素。然而,戒烟后,戒烟者的 PPT 逐渐下降,达到与从不吸烟者相似的水平。

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