School of Public Health, Faculty of Medicine, The University of Queensland, 266 Herston Rd, Herston, QLD 4006, Australia; UQ Poche Centre for Indigenous Health, Faculty of Health and Behavioural Sciences, The University of Queensland, 74 High Street, Toowong, QLD, 4066, Australia; Nutrition and Dietetics Department, Faculty of Public Health, Jimma University, Jimma, Ethiopia.
UQ Poche Centre for Indigenous Health, Faculty of Health and Behavioural Sciences, The University of Queensland, 74 High Street, Toowong, QLD, 4066, Australia; The ARC Centre of Excellence for Children and Families Over the Life Course, The University of Queensland, 80 Meiers Road, Indooroopilly, QLD 4068, Australia.
Nutr Metab Cardiovasc Dis. 2023 May;33(5):1007-1018. doi: 10.1016/j.numecd.2023.02.019. Epub 2023 Feb 27.
To examine a combined effect of dietary intakes, blood lipid and insulin resistance in young adulthood on the risk of predicted CVD through midlife.
Data of young adults from a birth cohort study in Australia were used. Reduced rank regression (RRR) and partial least squares (PLS) methods identified dietary patterns rich in meats, refined grains, processed and fried foods, and high-fat dairy and low in whole grains and low-fat dairy from dietary intakes obtained at 21-years, and blood lipids and measures of insulin resistance measured at 30-years of age. Using standard CVD risk factors measured at 30-years of age, the Framingham Heart Study risk-prediction algorithms were used to calculate the 30-year predicted Framingham CVD risk scores. The scores represent Hard CVD events; coronary death, myocardial infarction and stroke and Full CVD events; Hard CVD plus coronary insufficiency and angina pectoris, transient ischaemic attack, intermittent claudication, and congestive heart failure in midlife. Sex-specific upper quartiles of CVD risk scores were used to define high-risk groups. Modified Poisson regression models were used to estimate relative risks (RRs) with 95% CI. Greater adherence to the diet identified applying RRR in young adulthood was associated with higher risks of predicted Hard CVD (RR: 1.60; 1.14, 2.25) and Full CVD (RR: 1.46; 1.04, 2.05) events in midlife. The diet from PLS showed similar trend of association for the risk of predicted Hard CVD events (RR: 1.49; 1.03, 2.16) in adjusted models.
Dietary patterns associated with variations in blood lipids and insulin resistance in young adulthood are associated with increased risks of predicted CVD events in midlife. The findings suggest that diet induced altered blood lipids and insulin resistance in the life course of young adulthood could increase the risks of CVD events in later life.
本研究旨在探讨年轻人的饮食摄入、血脂和胰岛素抵抗情况，以及中年时期预测的心血管疾病（CVD）风险之间的综合影响。
本研究使用了澳大利亚一项出生队列研究中青年成年人的数据。通过简化秩回归（RRR）和偏最小二乘法（PLS）方法，从 21 岁时的饮食摄入中确定了富含肉类、精制谷物、加工和油炸食品以及高脂肪乳制品的饮食模式，以及 30 岁时的血脂和胰岛素抵抗测量值。使用 30 岁时的标准 CVD 风险因素，采用弗雷明汉心脏研究风险预测算法计算 30 年的预测弗雷明汉 CVD 风险评分。这些评分代表硬 CVD 事件，包括冠状动脉死亡、心肌梗死和中风；全 CVD 事件，包括硬 CVD 加上冠状动脉不足和心绞痛、短暂性脑缺血发作、间歇性跛行和充血性心力衰竭。使用 CVD 风险评分的性别特异性上四分位数来定义高危组。采用修正泊松回归模型估计相对风险（RR）及其 95%置信区间。在年轻成年人中，采用 RRR 确定的更严格的饮食依从性与预测的硬 CVD（RR：1.60；1.14，2.25）和全 CVD（RR：1.46；1.04，2.05）事件在中年时的发生风险较高相关。PLS 得出的饮食模式也显示出类似的趋势，即调整后的模型中预测的硬 CVD 事件的风险增加（RR：1.49；1.03，2.16）。
与年轻成年人的血脂和胰岛素抵抗变化相关的饮食模式与中年时期预测的 CVD 事件风险增加有关。这些发现表明，饮食引起的年轻成年人生活过程中血脂和胰岛素抵抗的改变可能会增加晚年 CVD 事件的风险。
