Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4741, Tehran, Iran.
Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.
BMC Public Health. 2020 Oct 2;20(1):1496. doi: 10.1186/s12889-020-09586-5.
The present study was conducted to investigate the association of dietary insulin index(II), insulin load(IL), glycemic index(GI), and glycemic load(GL) with the risk of cardiovascular disease(CVD).
This cohort study was conducted within the framework of the Tehran Lipid and Glucose Study on 2198 subjects, aged≥19 years old, who were followed-up for a median (IQR) 6.7 (6.1-7.1) years. Dietary GI, GL, II, and IL were calculated using a food frequency questionnaire at the baseline. Multivariate Cox proportional hazard regression models were used to estimate the risk of CVD across quartiles of dietary insulin and glycemic indices.
Mean ± SD age of the subjects(44.9% men) was 38.3 ± 13.4 years. During a mean of 2406 ± 417 person-years of follow-up, 76(3.5%) new cases of the CVD were ascertained. The mean ± SD of II, IL, GI, and GL of participants were 51.7 ± 6.5, 235.8 ± 90.2, 61.9 ± 7.8, and 202.2 ± 78.1, respectively. After adjusting for the variables of age, sex, smoking, physical activity, daily energy intake, body mass index, diabetes, and hypertension, the hazard ratio (HR) of the highest quartile of dietary GL was 2.77(95%CI:1.00-7.69,P for trend:0.033) compared to the lowest one. Also, each one SD increase in the GL score was associated with a higher risk of CVD[(RR:1.46;CI:1.00-2.16),P-value = 0.047]. However, there was no significant association between the dietary GI, II, and IL and risk for CVD incidence.
Our results suggested that a high GL diet can increase the incidence of CVD, whereas high dietary II and IL were not associated with the risk of CVD among adults.
本研究旨在探讨饮食胰岛素指数(II)、胰岛素负荷(IL)、血糖指数(GI)和血糖负荷(GL)与心血管疾病(CVD)风险的关系。
本队列研究在德黑兰血脂和血糖研究中进行，纳入了 2198 名年龄≥19 岁的受试者，中位(四分位距)随访时间为 6.7(6.1-7.1)年。在基线时使用食物频率问卷计算膳食 GI、GL、II 和 IL。采用多变量 Cox 比例风险回归模型估计膳食胰岛素和血糖指数四分位数与 CVD 风险的关系。
受试者的平均(±标准差)年龄(44.9%为男性)为 38.3(±13.4)岁。在平均 2406(±417)人年的随访期间，76 例(3.5%)新发生 CVD。参与者的 II、IL、GI 和 GL 的平均值(±标准差)分别为 51.7(±6.5)、235.8(±90.2)、61.9(±7.8)和 202.2(±78.1)。在校正年龄、性别、吸烟、体力活动、每日能量摄入、体重指数、糖尿病和高血压等变量后，与最低四分位相比，膳食 GL 的最高四分位的 HR 为 2.77(95%CI：1.00-7.69，P 趋势：0.033)。此外，GL 评分每增加 1 个标准差，CVD 风险就会增加[(RR：1.46；CI：1.00-2.16)，P 值=0.047]。然而，饮食 GI、II 和 IL 与 CVD 发生率之间没有显著关联。
我们的研究结果表明，高 GL 饮食可增加 CVD 的发病风险，而高膳食 II 和 IL 与成年人 CVD 风险无关。
