From Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA (DJA, SB, CM, HMD); Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA (SB); Rush Medical College, Rush University, Chicago, IL (MP); Pritzker School of Medicine, University of Chicago, Chicago, IL (IL-H); Podiatric Residency Program, Tower Health, West Reading, PA (GV-A).
J Am Board Fam Med. 2022 Jul-Aug;35(4):656-667. doi: 10.3122/jabfm.2022.04.210413.
There is considerable interest in the association between food insecurity (FIS) and various cardiovascular risk factors such as dyslipidemia. Although the association between FIS and dyslipidemia has been studied across various methodologies and populations, there is no comprehensive systematic review and meta-analysis of these data.
A systematic literature search was conducted. Cross-sectional peer-review studies assessing the association between FIS and dyslipidemia were identified. Data extracted included population characteristics, study sizes, covariates explored, and laboratory assessments of dyslipidemia. Effect sizes were extracted or calculated, then synthesized across studies using a random effect model, and the heterogeneity, publication bias, and subgroup dependence for each meta-analysis were assessed.
For adults, meta-analysis demonstrated no significantly elevated odds for FIS individuals to have a concomitant abnormal lipid measurement. Covariate-unadjusted analysis of standardized mean differences showed no significant differences in lipid measurements between food-insecure and food-secure individuals. In contrast to quantitative laboratory results, food-insecure patients were more likely to self-report previous diagnoses of dyslipidemia.
Although current data do not suggest an association between FIS and dyslipidemia, more longitudinal studies and studies targeting women, children, the elderly, and patients with chronic diseases such as diabetes are needed to further address this issue.
人们对食品不安全(FIS)与各种心血管风险因素(如血脂异常)之间的关联非常感兴趣。尽管已经有许多研究使用不同的方法和人群对 FIS 和血脂异常之间的关联进行了研究,但目前还没有对这些数据进行全面的系统综述和荟萃分析。
进行了系统的文献检索。确定了评估 FIS 和血脂异常之间关联的横断面同行评审研究。提取的数据包括人口特征、研究规模、探索的协变量以及血脂异常的实验室评估。提取或计算了效应大小,然后使用随机效应模型对研究进行综合,并评估了每个荟萃分析的异质性、发表偏倚和亚组依赖性。
对于成年人,荟萃分析表明,食品不安全个体发生异常脂质测量的可能性并没有显著增加。未调整协变量的标准化均数差值分析显示,食品不安全和食品安全个体之间的脂质测量值没有显著差异。与定量实验室结果相反,食品不安全的患者更有可能自我报告以前诊断为血脂异常。
尽管目前的数据并未表明 FIS 与血脂异常之间存在关联,但需要更多的纵向研究和针对女性、儿童、老年人以及患有糖尿病等慢性病患者的研究来进一步解决这个问题。