Department of Nutrition, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China.
Department of Cardiology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China.
Nutrients. 2022 Apr 20;14(9):1713. doi: 10.3390/nu14091713.
The evidence regarding the impact of the scores on healthy eating indices on the risk of cardiovascular events among patients with type 2 diabetes (T2D) is limited. As such, in this study, we examined the associations of adherence to the Chinese and American dietary guidelines and the risk of cardiovascular disease (CVD) among Chinese individuals with T2D. We conducted a 1:1 age- and sex-matched case−control study based on a Chinese population. We used a structured questionnaire and a validated 79-item food-frequency questionnaire to collect general information and dietary intake information, and calculated the Chinese Healthy Eating Index (CHEI) and the Healthy Eating Index-2015 (HEI-2015). As participants, we enrolled a total of 419 pairs of hospital-based CVD cases and controls, all of whom had T2D. We found a significant inverse association between diet quality scores on the CHEI and HEI-2015 and the risk of CVD. The adjusted odds ratios (95% confidence interval) per five-score increment were 0.68 (0.61, 0.76) in the CHEI and 0.60 (0.52, 0.70) in the HEI-2015. In stratified analyses, the protective associations remained significant in the subgroups of sex, BMI, smoking status, tea-drinking, hypertension state, dyslipidemia state, T2D duration, and medical nutrition therapy knowledge (all p < 0.05). These findings suggest that a higher CHEI or HEI-2015 score, representing a higher-quality diet relative to the most recent Chinese or American dietary guidelines, was associated with a decreased risk of CVD among Chinese patients with T2D.
关于评分对 2 型糖尿病（T2D）患者的健康饮食指数的影响对心血管事件风险的影响的证据是有限的。因此，在这项研究中，我们研究了中国人群中 T2D 患者对中国和美国饮食指南的依从性与心血管疾病（CVD）风险之间的关联。我们进行了一项基于中国人群的 1:1 年龄和性别匹配的病例对照研究。我们使用结构化问卷和经过验证的 79 项食物频率问卷来收集一般信息和饮食摄入信息，并计算了中国健康饮食指数（CHEI）和健康饮食指数-2015（HEI-2015）。作为参与者，我们共纳入了 419 对基于医院的 CVD 病例和对照，所有患者均患有 T2D。我们发现 CHEI 和 HEI-2015 的饮食质量评分与 CVD 风险呈显著负相关。每五分递增的调整后比值比（95%置信区间）分别为 CHEI 中的 0.68（0.61，0.76）和 HEI-2015 中的 0.60（0.52，0.70）。在分层分析中，在性别、BMI、吸烟状况、饮茶、高血压状态、血脂异常状态、T2D 病程和医学营养治疗知识的亚组中，保护相关性仍然显著（所有 p < 0.05）。这些发现表明，相对于最近的中国或美国饮食指南，更高的 CHEI 或 HEI-2015 评分代表更高质量的饮食，与中国 T2D 患者 CVD 风险降低相关。
