He Miao, Guo Zaogeng, Lu Zuxun, Wei Sheng, Wang Zhihong
Department of Epidemiology and Biostatistics, School of Public Health,Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Health Science Center, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, China.
Int J Cardiol Hypertens. 2020 May 12;5:100031. doi: 10.1016/j.ijchy.2020.100031. eCollection 2020 Jun.
Carotid atherosclerosis (CA) can reflect atherosclerotic status of systemic vessels, and is associated with ischemic stroke and cognitive impairment. Milk consumption is growing in China, and data are limited on the association between milk and CA risk.
Participants aged ≥40 years in China National Stroke Prevention Project were recruited for carotid ultrasound examination, and those with carotid endarterectomy, carotid stenting stroke or coronary heart disease were excluded. Participants were defined as having CA when intima-media thickness (IMT) ≥1 mm or plaques were detected by ultrasonography. For milk consumption, though contents were not analyzed, people were divided into high consumption (≥200 ml/day and ≥5 day/week) and low consumption (occasional or never) groups. Multivariate logistics regression analyses were done in both full and propensity score-matched population to identify the association between milk consumption and CA.
84880 participants were included in the final analysis. After being adjusted by age, gender, living location, smoking habits, drinking habits, physical activity, obesity, hypertension, diabetes, and dyslipidemia, high milk consumption is associated with CA in both full population (odds ratio [OR] = 1.26, 95% confidence interval [CI] 1.19-1.33) and propensity score-matched population (OR = 1.25, 95%CI 1.17-1.34). High milk consumption is also a risk factor for IMT thickening (OR = 1.15, 95%CI 1.08-1.23), carotid plaque formation (OR = 1.17, 95%CI 1.09-1.25) and carotid stenosis over 50% (OR = 1.52, 95%CI 1.10-2.14) in the propensity score-matched population.
High milk consumption is related to CA in middle and old-aged Chinese population. More cautious advice on milk intake should be given in this population for prevention of atherosclerosis.
颈动脉粥样硬化(CA)可反映全身血管的动脉粥样硬化状况,并与缺血性中风和认知障碍相关。在中国,牛奶消费量不断增加,但关于牛奶与CA风险之间关联的数据有限。
在中国国家脑卒中预防项目中招募年龄≥40岁的参与者进行颈动脉超声检查,排除接受颈动脉内膜切除术、颈动脉支架置入术、中风或冠心病的患者。当内膜中层厚度(IMT)≥1毫米或超声检查发现斑块时,参与者被定义为患有CA。对于牛奶消费,尽管未分析其成分,但人们被分为高消费组(≥200毫升/天且≥5天/周)和低消费组(偶尔或从不饮用)。在全人群和倾向得分匹配人群中进行多变量逻辑回归分析,以确定牛奶消费与CA之间的关联。
84880名参与者纳入最终分析。在调整年龄、性别、居住地点、吸烟习惯、饮酒习惯、身体活动、肥胖、高血压、糖尿病和血脂异常后,高牛奶消费在全人群(比值比[OR]=1.26,95%置信区间[CI]1.19-1.33)和倾向得分匹配人群(OR=1.25,95%CI 1.17-1.34)中均与CA相关。在倾向得分匹配人群中,高牛奶消费也是IMT增厚(OR=1.15,95%CI 1.08-1.23)、颈动脉斑块形成(OR=1.17,95%CI 1.09-1.25)和颈动脉狭窄超过50%(OR=1.52,95%CI 1.10-2.14)的危险因素。
高牛奶消费与中国中老年人群的CA相关。对于该人群预防动脉粥样硬化,应给出更谨慎的牛奶摄入量建议。