Bhavadharini Balaji, Dehghan Mahshid, Mente Andrew, Rangarajan Sumathy, Sheridan Patrick, Mohan Viswanathan, Iqbal Romaina, Gupta Rajeev, Lear Scott, Wentzel-Viljoen Edelweiss, Avezum Alvaro, Lopez-Jaramillo Patricio, Mony Prem, Varma Ravi Prasad, Kumar Rajesh, Chifamba Jephat, Alhabib Khalid F, Mohammadifard Noushin, Oguz Aytekin, Lanas Fernando, Rozanska Dorota, Bengtsson Bostrom Kristina, Yusoff Khalid, Tsolkile Lungiswa P, Dans Antonio, Yusufali Afzalhussein, Orlandini Andres, Poirier Paul, Khatib Rasha, Hu Bo, Wei Li, Yin Lu, Deeraili Ai, Yeates Karen, Yusuf Rita, Ismail Noorhassim, Mozaffarian Dariush, Teo Koon, Anand Sonia S, Yusuf Salim
Population Health Research Institute, Hamilton Health Sciences and McMaster University, Hamilton, Ontario, Canada.
Population Health Research Institute, Hamilton Health Sciences and McMaster University, Hamilton, Ontario, Canada
BMJ Open Diabetes Res Care. 2020 Apr;8(1). doi: 10.1136/bmjdrc-2019-000826.
Our aims were to assess the association of dairy intake with prevalence of metabolic syndrome (MetS) (cross-sectionally) and with incident hypertension and incident diabetes (prospectively) in a large multinational cohort study.
The Prospective Urban Rural Epidemiology (PURE) study is a prospective epidemiological study of individuals aged 35 and 70 years from 21 countries on five continents, with a median follow-up of 9.1 years. In the , we assessed the association of dairy intake with prevalent MetS and its components among individuals with information on the five MetS components (n=112 922). For , we examined the association of dairy with incident hypertension (in 57 547 individuals free of hypertension) and diabetes (in 131 481 individuals free of diabetes).
In cross-sectional analysis, higher intake of total dairy (at least two servings/day compared with zero intake; OR 0.76, 95% CI 0.71 to 0.80, p-trend<0.0001) was associated with a lower prevalence of MetS after multivariable adjustment. Higher intakes of whole fat dairy consumed alone (OR 0.72, 95% CI 0.66 to 0.78, p-trend<0.0001), or consumed jointly with low fat dairy (OR 0.89, 95% CI 0.80 to 0.98, p-trend=0.0005), were associated with a lower MetS prevalence. Low fat dairy consumed alone was not associated with MetS (OR 1.03, 95% CI 0.77 to 1.38, p-trend=0.13). In prospective analysis, 13 640 people with incident hypertension and 5351 people with incident diabetes were recorded. Higher intake of total dairy (at least two servings/day vs zero serving/day) was associated with a lower incidence of hypertension (HR 0.89, 95% CI 0.82 to 0.97, p-trend=0.02) and diabetes (HR 0.88, 95% CI 0.76 to 1.02, p-trend=0.01). Directionally similar associations were found for whole fat dairy versus each outcome.
Higher intake of whole fat (but not low fat) dairy was associated with a of MetS and most of its component factors, and with a of hypertension and diabetes. Our findings should be evaluated in large randomized trials of the effects of whole fat dairy on the risks of MetS, hypertension, and diabetes.
在一项大型跨国队列研究中，我们旨在评估乳制品摄入量与代谢综合征（MetS）患病率（横断面研究）以及与高血压发病率和糖尿病发病率（前瞻性研究）之间的关联。
城乡前瞻性流行病学（PURE）研究是一项针对来自五大洲21个国家、年龄在35至70岁之间个体的前瞻性流行病学研究，中位随访时间为9.1年。在本研究中，我们评估了在有五项MetS组分信息的个体（n = 112922）中，乳制品摄入量与MetS及其组分的现患情况之间的关联。对于前瞻性研究，我们考察了乳制品与高血压发病率（在57547名无高血压个体中）和糖尿病发病率（在131481名无糖尿病个体中）之间的关联。
在横断面分析中，多变量调整后，较高的总乳制品摄入量（每天至少两份与零摄入量相比；比值比[OR] 0.76，95%置信区间[CI] 0.71至0.80，P趋势<0.0001）与较低的MetS患病率相关。单独摄入较高量的全脂乳制品（OR 0.72，95% CI 0.66至0.78，P趋势<0.0001），或与低脂乳制品联合摄入（OR 0.89，95% CI 0.80至0.98，P趋势 = 0.0005），均与较低的MetS患病率相关。单独摄入低脂乳制品与MetS无关（OR 1.03，95% CI 0.77至1.38，P趋势 = 0.13）。在前瞻性分析中，记录到13640例高血压发病患者和5351例糖尿病发病患者。较高的总乳制品摄入量（每天至少两份与每天零份相比）与较低的高血压发病率（风险比[HR] 0.89，95% CI 0.82至0.97，P趋势 = 0.02）和糖尿病发病率（HR 0.88，95% CI 0.76至1.02，P趋势 = 0.01）相关。对于全脂乳制品与每种结局，发现了方向相似的关联。
较高的全脂（而非低脂）乳制品摄入量与较低的MetS及其大多数组分因素的患病率相关，也与较低的高血压和糖尿病发病率相关。我们的研究结果应在关于全脂乳制品对MetS、高血压和糖尿病风险影响的大型随机试验中进行评估。
