O'Neil Carol E, Nicklas Theresa A, Saab Rabab, Fulgoni Victor L
LSU Agricultural Center Professor Emeritus, Baton Rouge, LA, USA.
USDA/ARS/CNRC, Baylor College of Medicine, Houston, TX, USA.
AIMS Public Health. 2020 Jul 1;7(3):450-468. doi: 10.3934/publichealth.2020037. eCollection 2020.
Consumption of added sugars (AS) has been associated with increased risk for liver disease and risk factors for cardiovascular disease. The objective of this study was to further understand the relationship of AS intake with liver enzymes and risk factors for cardiovascular disease in adults (n = 29,687) participating in the National Health and Nutrition Examination Survey (NHANES) 2001-2012.
Individual usual intake (IUI) of AS was estimated using the Markov Chain Monte Carlo ratio method using two days of 24-hour dietary recalls gathered using standardized protocols. Subjects were separated into six consumption groups: 0 to <5%, 5 to <10%, 10 to <15%, 15 to <20%, 20 to <25% and ≥25% of energy as added sugars. Linear and group trends were determined using regression analyses for liver enzymes, cardiovascular risk factors, weight parameters, glucose, metabolic syndrome, and C-reactive protein. Logistic regression calculated odds ratios for these biomarkers above established risk levels (p < 0.01).
There was an inverse group trend association with AS IUI for lower body mass index (beta = -0.12 kg/m across AS intake groups); % overweight/obese or % obese also showed inverse group trend (-1.44, -0.77, % units across AS intake groups, respectively). Liver enzymes did not show a significant association with AS IUI. Mean plasma glucose levels (mg/dL) showed an inverse linear (beta = -0.13 mg/dL per AS intake); and group association with energy from AS IUI (beta = -0.71mg/d L across AS intake groups). There was no association of AS intake with the risk of elevated uric acid levels; however, the odds of reduced uric acid levels was 17% lower with increasing intake of energy from AS IUI in group trend analysis only (0.83; 0.72-0.95 [99 CI]).
Although it is sensible to consume AS in moderation, results suggested that higher intakes of AS were not consistently associated with physiologic parameters. Since the data were cross-sectional, they cannot be used to assess cause and effect. Thus, additional studies are warranted to confirm these findings with more rigorous study designs.
添加糖（AS）的摄入与肝脏疾病风险增加以及心血管疾病风险因素相关。本研究的目的是进一步了解参与2001 - 2012年美国国家健康与营养检查调查（NHANES）的成年人（n = 29,687）中，AS摄入量与肝脏酶以及心血管疾病风险因素之间的关系。
使用马尔可夫链蒙特卡罗比率法，根据采用标准化方案收集的两天24小时饮食回忆数据，估算个体AS的通常摄入量（IUI）。受试者被分为六个消费组：以添加糖形式摄入的能量占比分别为0至<5%、5至<10%、10至<15%、15至<20%、20至<25%以及≥25%。通过对肝脏酶、心血管风险因素、体重参数、血糖、代谢综合征和C反应蛋白进行回归分析，确定线性和组间趋势。逻辑回归计算这些生物标志物高于既定风险水平（p < 0.01）时的比值比。
较低体重指数与AS的IUI呈反向组间趋势关联（在各AS摄入组中，β = -0.12 kg/m²）；超重/肥胖百分比或肥胖百分比也呈现反向组间趋势（在各AS摄入组中分别为-1.44、-0.77个百分点）。肝脏酶与AS的IUI未显示出显著关联。平均血浆葡萄糖水平（mg/dL）呈现反向线性关系（每增加AS摄入量，β = -0.13 mg/dL）；并且与来自AS的IUI能量呈组间关联（在各AS摄入组中，β = -0.71mg/dL）。AS摄入量与尿酸水平升高风险无关联；然而，仅在组间趋势分析中，随着来自AS的IUI能量摄入量增加，尿酸水平降低的几率降低了17%（0.83；0.72 - 0.95 [99%置信区间]）。
尽管适量摄入AS是合理的，但结果表明，较高的AS摄入量并非始终与生理参数相关。由于数据是横断面的，不能用于评估因果关系。因此，有必要进行更多研究，采用更严格的研究设计来证实这些发现。
