Department of Food and Nutrition, Chung-Ang University, Gyeonggi-do, Korea.
Department of Food and Nutrition, Chung-Ang University, Gyeonggi-do, Korea.
J Acad Nutr Diet. 2021 Jul;121(7):1242-1257.e2. doi: 10.1016/j.jand.2020.08.090. Epub 2020 Nov 3.
Identifying dietary patterns that contribute to dyslipidemia development can inform prevention, nutritional counseling, and other treatment recommendations.
This study aimed to identify major dietary patterns and examine the association between these dietary patterns and dyslipidemia incidence by sex among Koreans.
The Health Examinees (HEXA) study is a community-based prospective cohort study. The baseline and follow-up surveys were conducted in 2004-2013, and 2012-2016, respectively, at 38 health examination centers and training hospitals located in eight regions in Korea. Dietary intake data were collected using a web-based, validated semiquantitative food frequency questionnaire (FFQ) at baseline.
PARTICIPANTS/SETTING: Among 65,642 participants who completed the baseline and follow-up survey, data from 38,170 participants without dyslipidemia and other related chronic diseases at baseline were analyzed.
Incidence of dyslipidemia and its components (hypercholesterolemia, hyper-low-density lipoprotein [LDL] cholesterolemia, hypo-high-density lipoprotein [HDL] cholesterolemia, and hypertriglyceridemia) after baseline but before the follow-up examination was examined.
Factor analysis was conducted on data from the semiquantitative FFQ to identify major dietary patterns for Korean adults. Cox proportional hazards regression analysis was performed to estimate the relative risk (RR) and 95% confidence interval (CI) according to the quintiles of three dietary pattern scores, after adjusting for potential confounders by sex.
Of the three identified dietary patterns, the higher "prudent" pattern score was associated with a lower incidence of dyslipidemia (RR, 0.90; 95% CI, 0.82-0.99; P = .02) after adjusting for potential confounders in women. Higher "flour-based food and meats" pattern score was associated with a higher incidence of hypercholesterolemia (men: RR, 1.63; 95% CI, 1.21-2.20; P = .003; women: RR, 1.47; 95% CI, 1.30-1.67; P < .001), hyper-LDL cholesterolemia (men: RR, 1.45; 95% CI, 1.03-2.04, P = .06; women: RR, 1.35; 95% CI, 1.16-1.58, P < .001), and dyslipidemia (men: RR, 1.30; 95% CI, 1.09-1.54; P = .009; women: RR, 1.28; 95% CI, 1.16-1.42; P < .001) in both men and women. The "white rice" pattern score was associated with a lower incidence of hypo-HDL cholesterolemia (RR, 0.75; 95% CI, 0.58-0.96; P = .01) and dyslipidemia (RR, 0.90; 95% CI, 0.81-0.99; P = .07) in women.
Adherence to the "prudent" and "white rice" patterns was associated with a lower dyslipidemia risk in Korean women, whereas adherence to the "flour-based food and meats" pattern was associated with increased risks of dyslipidemia and its components (hypercholesterolemia and hyper-LDL cholesterolemia) in both Korean men and women.
确定导致血脂异常发展的饮食模式可以为预防、营养咨询和其他治疗建议提供信息。
本研究旨在鉴定主要的饮食模式，并检查这些饮食模式与韩国人群血脂异常发生率之间的关联。
HEXA 研究是一项基于社区的前瞻性队列研究。基线和随访调查分别于 2004-2013 年和 2012-2016 年在韩国八个地区的 38 个健康检查中心和培训医院进行。在基线时使用基于网络的、经过验证的半定量食物频率问卷（FFQ）收集饮食摄入数据。
参与者/设置：在完成基线和随访调查的 65642 名参与者中，分析了基线时无血脂异常和其他相关慢性疾病的 38170 名参与者的数据。
基线后但随访前血脂异常及其成分（高胆固醇血症、低 LDL 胆固醇血症、低 HDL 胆固醇血症和高甘油三酯血症）的发生率。
对半定量 FFQ 数据进行因子分析，以确定韩国成年人的主要饮食模式。采用 Cox 比例风险回归分析，根据三种饮食模式评分的五分位数，调整性别等潜在混杂因素后，估计相对风险（RR）和 95%置信区间（CI）。
在所确定的三种饮食模式中，较高的“谨慎”模式评分与女性血脂异常发生率降低相关（RR，0.90；95%CI，0.82-0.99；P=0.02），调整潜在混杂因素后。较高的“基于面粉的食物和肉类”模式评分与胆固醇血症（男性：RR，1.63；95%CI，1.21-2.20；P=0.003；女性：RR，1.47；95%CI，1.30-1.67；P<0.001）、高 LDL 胆固醇血症（男性：RR，1.45；95%CI，1.03-2.04，P=0.06；女性：RR，1.35；95%CI，1.16-1.58，P<0.001）和血脂异常（男性：RR，1.30；95%CI，1.09-1.54；P=0.009；女性：RR，1.28；95%CI，1.16-1.42；P<0.001）的发生率较高，无论男女。“白米饭”模式评分与女性低 HDL 胆固醇血症（RR，0.75；95%CI，0.58-0.96；P=0.01）和血脂异常（RR，0.90；95%CI，0.81-0.99；P=0.07）的发生率降低相关。
在韩国女性中，遵循“谨慎”和“白米饭”模式与血脂异常风险降低相关，而在韩国男性和女性中，遵循“基于面粉的食物和肉类”模式与血脂异常及其成分（高胆固醇血症和高 LDL 胆固醇血症）的风险增加相关。
