儿童和青少年中含糖甜味饮料（SSB）与血脂谱之间的关联：横断面研究的系统评价和剂量反应荟萃分析。

The association between Sugars Sweetened Beverages (SSBs) and lipid profile among children and youth: A systematic review and dose-response meta-analysis of cross-sectional studies.

作者信息

Nikniaz Leila, Abbasalizad-Farhangi Mahdieh, Vajdi Mahdi, Nikniaz Zeinab

机构信息

Tabriz Health Services Management Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran.

Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.

出版信息

Pediatr Obes. 2021 Jul;16(7):e12782. doi: 10.1111/ijpo.12782. Epub 2021 Feb 24.

DOI:10.1111/ijpo.12782

PMID:33629539

Abstract

BACKGROUND

The relationship between sugar-sweetened beverages (SSBs) intake and serum lipids among children and youth has been reported in several studies, but the results are still controversial.

OBJECTIVE

In the current study, we summarized the results of studies that assessed the relationship between SSBs consumption and serum lipids among children and youth in a systematic review and dose-response meta-analysis.

METHODS

The PubMed, Web of Sciences, Cochrane and Scopus electronic databases were searched for observational studies reporting an association between SSBs intake and serum lipids among children and youth that were published before May 2020. For data extracted from cohort studies, only cross-sectional baseline data were included in the current meta-analysis. The Random effects model was used to estimate the pooled weighted mean difference (WMD) and 95% confidence intervals (CI). Heterogeneity was assessed with the Cochran Q test and I statistics.

RESULTS

In our search, 1845 studies were retrieved of which 13 studies (two cohorts and eleven cross-sectional) were included. High SSB consumption was associated with 1.21 mg/dL increase in low-density lipoprotein cholesterol (LDL-C; pooled WMD: 1.21 mg/dL; 95% CI: 0.23, 2.20; P = .01), 1.45 mg/dL decrease in high-density lipoprotein cholesterol (HDL-C, pooled WMD: -1.46 mg/dL; 95% CI, -2.25, -0.67; P < .0001) and 2.49 mg/dL decrease in total cholesterol (TC, pooled WMD: -2.49 mg/dL; 95% CI, -2.89, -2.10; P < .0001). In dose-response meta-analysis, there was an evidence of departure from linearity in the relationship between SSB consumption and change in LDL-C (P- = .03) and TC (P- = .01). However, no departure from linearity was observed between SSB intake and change in HDL-C (P- = .56) or triglyceride (TG) values (P- = .85).

CONCLUSION

According to our results, high SSB consumption was significantly associated with higher LDL-C and lower HDL-C and TC among children and youth. However, owing to the limited number of the included studies, further well-designed interventional studies are needed to better elucidate causality.

摘要

背景

多项研究报告了儿童和青少年摄入含糖饮料（SSB）与血脂之间的关系，但结果仍存在争议。

目的

在本研究中，我们通过系统评价和剂量反应荟萃分析总结了评估儿童和青少年饮用SSB与血脂之间关系的研究结果。

方法

检索了PubMed、Web of Sciences、Cochrane和Scopus电子数据库，以查找2020年5月之前发表的关于儿童和青少年摄入SSB与血脂之间关联的观察性研究。对于从队列研究中提取的数据，本次荟萃分析仅纳入横断面基线数据。采用随机效应模型估计合并加权平均差（WMD）和95%置信区间（CI）。用Cochran Q检验和I统计量评估异质性。

结果

在我们的检索中，共检索到1845项研究，其中纳入了13项研究（2项队列研究和11项横断面研究）。高糖饮料摄入量与低密度脂蛋白胆固醇（LDL-C）升高1.21mg/dL相关（合并WMD：1.21mg/dL；95%CI：0.23，2.20；P = 0.01），高密度脂蛋白胆固醇（HDL-C）降低1.45mg/dL（合并WMD：-1.46mg/dL；95%CI，-2.25，-0.67；P < 0.0001），总胆固醇（TC）降低2.49mg/dL（合并WMD：-2.49mg/dL；95%CI，-2.89，-2.10；P < 0.0001）。在剂量反应荟萃分析中，有证据表明饮用SSB与LDL-C（P = 0.03）和TC（P = 0.01）变化之间的关系偏离线性。然而，未观察到饮用SSB与HDL-C（P = 0.56）或甘油三酯（TG）值变化（P = 0.85）之间存在线性偏离。