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饮食血糖指数、血糖负荷与死亡率:日本基于公共卫生中心的前瞻性研究。

Dietary glycemic index, glycemic load and mortality: Japan Public Health Center-based prospective study.

机构信息

Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.

Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan.

出版信息

Eur J Nutr. 2021 Dec;60(8):4607-4620. doi: 10.1007/s00394-021-02621-0. Epub 2021 Jun 22.

Abstract

PURPOSE

Long-term associations of dietary glycemic index (GI) and glycemic load (GL) with mortality outcomes remain unclear.

METHODS

The present analysis included 72,783 participants of the Japan Public Health Center-based Prospective Study. Participants who responded to the 5-year follow-up questionnaire in 1995-1999 were followed-up until December 2015. We estimated the risk of total and cause-specific mortality associated with GI and GL using Cox proportional hazards regression models.

RESULTS

During 1,244,553 person years of follow-up, 7535 men and 4913 women died. GI was positively associated with all-cause mortality. As compared with the lowest quartile, the multivariable HR for those who had the highest quartile of GI was 1.14 (95% CI 1.08-1.20). The HRs for death comparing the highest with the lowest quartile were 1.28 (95% CI 1.14-1.42) for circulatory system diseases, 1.33 (95% CI 1.14-1.55) for heart disease, 1.32 (95% CI 1.11-1.57) for cerebrovascular disease, and 1.45 (95% CI 1.18-1.78) for respiratory diseases. GI was not associated with mortality risks of cancer and digestive diseases. GL showed a null association with all-cause mortality (highest vs lowest quartile; HR 1.04; 95% CI 0.96-1.12). However, among those who had the highest quartile of GL, the HRs for death from circulatory system diseases was 1.24 (95% CI 1.05-1.46), cerebrovascular disease was 1.34 (95% CI 1.03-1.74), and respiratory diseases was 1.35 (95% CI 1.00-1.82), as compared with the lowest quartile.

CONCLUSION

In this large prospective cohort study, dietary GI and GL were associated with mortality risks.

摘要

目的

长期以来,饮食血糖指数(GI)和血糖负荷(GL)与死亡率之间的关联仍不清楚。

方法

本分析纳入了日本公共卫生中心前瞻性研究的 72783 名参与者。1995-1999 年参加了 5 年随访问卷调查的参与者,随访至 2015 年 12 月。我们使用 Cox 比例风险回归模型估计 GI 和 GL 与总死亡率和特定原因死亡率相关的风险。

结果

在 1244553 人年的随访期间,7535 名男性和 4913 名女性死亡。GI 与全因死亡率呈正相关。与最低四分位相比,GI 最高四分位的多变量 HR 为 1.14(95%CI 1.08-1.20)。比较最高四分位与最低四分位,循环系统疾病的 HR 为 1.28(95%CI 1.14-1.42),心脏病为 1.33(95%CI 1.14-1.55),脑血管疾病为 1.32(95%CI 1.11-1.57),呼吸系统疾病为 1.45(95%CI 1.18-1.78)。GI 与癌症和消化系统疾病的死亡率风险无关。GL 与全因死亡率呈零关联(最高与最低四分位;HR 1.04;95%CI 0.96-1.12)。然而,在 GL 最高四分位的人群中,循环系统疾病死亡的 HR 为 1.24(95%CI 1.05-1.46),脑血管疾病为 1.34(95%CI 1.03-1.74),呼吸系统疾病为 1.35(95%CI 1.00-1.82),与最低四分位相比。

结论

在这项大型前瞻性队列研究中,饮食 GI 和 GL 与死亡率风险相关。

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