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饮食血糖指数和血糖负荷与缺血性脑卒中患者颈动脉粥样硬化狭窄及心血管危险因素的关系。

Dietary Glycemic Index and Glycemic Load in Relation to Atherosclerotic Stenosis of Carotid and Cardiovascular Risk Factors in Ischemic Stroke Patients.

机构信息

Department of Neurology, Jinling Hospital, Medical School of Nanjing University.

Department of Neurology, Jinling Hospital, Jinling Clinical College of Nanjing Medical University.

出版信息

J Atheroscler Thromb. 2020 Nov 1;27(11):1152-1159. doi: 10.5551/jat.53843. Epub 2020 Mar 7.

Abstract

AIM

Glycemic index (GI) and glycemic load (GL) influence postprandi al glucose concentrations and insulin responses. This study aims to ascertain the connection between GI, GL, and carotid atherosclerotic stenosis and cardiovascular disease (CVD) risk factors.

METHODS

A total of 669 patients with ischemic stroke within 7 days were enrolled. GI and GL were assessed with a validated food frequency questionnaire from patients. Computed tomography angiography (CTA) was used for the evaluation of carotid atherosclerotic stenosis. Traditional risk factors such as total cholesterol, triglycerides, LDL-C, HDL-C, C-reactive protein, homocysteine, neutrophil to lymphocyte ratio (NLR), fasting plasma glucose, and hemoglobin A1c were measured. GI/GL and its association with CVD risk factors and carotid stenosis were explored with Spearman analysis and multivariable logistic regression, respectively.

RESULTS

The prevalence of carotid stenosis was 63.2% of all 669 participants. The mean value of GI/GL was 49.3/137. Spearman test did not detect significant relationships between GI/GL and CVD risk factors. In multivariable regression models, GI (4 vs. 1 quartile, OR=2.11; 95% CI, 1.30-3.42) and GL (4 vs. 1 quartile, OR=1.82; 95% CI, 1.12-2.96) were observed a significant association with carotid stenosis after adjustment for major confounding factors. The association between GL and carotid stenosis became more pronounced among yo ungers (4 vs. 1 quartile, OR=2.42; 95% CI, 1.13-4.76) and women (4 vs. 1 quartile, OR=3.81; 95% CI, 1.45-5.05).

CONCLUSION

Higher GI and GL were positively associated with a higher degree of carotid stenosis in these Chinese cerebral infarction patients, especially in younger patients and women.

摘要

目的

血糖指数(GI)和血糖负荷(GL)会影响餐后血糖浓度和胰岛素反应。本研究旨在确定 GI、GL 与颈动脉粥样硬化狭窄和心血管疾病(CVD)危险因素之间的关系。

方法

共纳入 669 例发病 7 天内的缺血性脑卒中患者。通过患者验证后的食物频率问卷评估 GI 和 GL。采用计算机断层血管造影术(CTA)评估颈动脉粥样硬化狭窄。检测总胆固醇、甘油三酯、LDL-C、HDL-C、C 反应蛋白、同型半胱氨酸、中性粒细胞与淋巴细胞比值(NLR)、空腹血糖和糖化血红蛋白等传统危险因素。采用 Spearman 分析和多变量逻辑回归分别探讨 GI/GL 与 CVD 危险因素和颈动脉狭窄的关系。

结果

669 名参与者中颈动脉狭窄的患病率为 63.2%。GI/GL 的平均值为 49.3/137。Spearman 检验未发现 GI/GL 与 CVD 危险因素之间存在显著相关性。在多变量回归模型中,经主要混杂因素调整后,GI(4 与 1 四分位间距相比,OR=2.11;95%CI,1.30-3.42)和 GL(4 与 1 四分位间距相比,OR=1.82;95%CI,1.12-2.96)与颈动脉狭窄显著相关。GL 与颈动脉狭窄的相关性在年轻患者(4 与 1 四分位间距相比,OR=2.42;95%CI,1.13-4.76)和女性(4 与 1 四分位间距相比,OR=3.81;95%CI,1.45-5.05)中更为显著。

结论

在这些中国脑梗死患者中,较高的 GI 和 GL 与颈动脉狭窄程度较高呈正相关,尤其是在年轻患者和女性中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d4bc/7803829/701b34c22278/jat-27-1152-g001.jpg

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