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通过心理幸福感和肥胖程度对高血压的相对碳水化合物摄入的因果效应:一项孟德尔随机化研究。

Causal Effect of Relative Carbohydrate Intake on Hypertension through Psychological Well-Being and Adiposity: A Mendelian Randomization Study.

机构信息

Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.

Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.

出版信息

Nutrients. 2023 Nov 17;15(22):4817. doi: 10.3390/nu15224817.

Abstract

Observations of the association between carbohydrate intake and hypertension are inconsistent, with mediating pathways unclear. We aimed to investigate the causal effect of relative carbohydrate intake on hypertension and the mediating roles of psychological well-being and adiposity. Using summary-level statistics of genome-wide association studies of European ancestry, we conducted univariable and multivariable Mendelian randomization (MR) to estimate the bidirectional causal association between relative carbohydrate intake (total energy-adjusted, mean: 42-51%) and hypertension (FinnGen: 42,857 cases/162,837 controls; UK Biobank: 77,723 cases/330,366 controls) and two-step MR to assess the mediating effects of psychological well-being indicators and adiposity traits on the association. MR estimates of hypertension from FinnGen and UK Biobank were meta-analyzed using the fixed-effect model given no heterogeneity. Meta-analyses of multivariable MR estimates from FinnGen and UK Biobank indicated that each one-SD higher relative carbohydrate intake was associated with 71% (odds ratio: 0.29; 95% confidence interval: 0.11-0.79) lower risk of hypertension, independently of other dietary macronutrients. Hypertension showed no reverse effect on carbohydrate intake. Five psychological well-being indicators and four adiposity traits causally mediated the association between relative carbohydrate intake and hypertension, including body mass index (mediation proportion: 51.37%), waist circumference (40.54%), waist-to-hip ratio (35.00%), hip circumference (24.77%), major depressive disorder (23.37%), positive affect (17.08%), depressive symptoms (16.52%), life satisfaction (16.05%), and neuroticism (11.22%). Higher relative carbohydrate intake was causally associated with lower hypertension risk, substantially mediated by better psychological well-being and less adiposity. Our findings inform causal targets and pathways for the prevention and intervention of hypertension.

摘要

关于碳水化合物摄入量与高血压之间的关联,观察结果并不一致,其中的中介途径尚不清楚。我们旨在研究相对碳水化合物摄入量对高血压的因果效应,以及心理幸福感和肥胖在其中的中介作用。我们使用欧洲血统全基因组关联研究的汇总统计数据,进行了单变量和多变量孟德尔随机化(MR)分析,以估计相对碳水化合物摄入量(总能量调整后,平均值为 42-51%)与高血压(FinnGen:42857 例/162837 例对照;英国生物库:77723 例/330366 例对照)之间的双向因果关联,并进行了两步 MR 分析以评估心理幸福感指标和肥胖特征对该关联的中介作用。鉴于无异质性,使用固定效应模型对 FinnGen 和 UK Biobank 的高血压 MR 估计值进行了荟萃分析。使用 FinnGen 和 UK Biobank 的多变量 MR 估计值的荟萃分析表明,相对碳水化合物摄入量每增加一个标准差,高血压的风险就会降低 71%(比值比:0.29;95%置信区间:0.11-0.79),这与其他膳食宏量营养素无关。高血压对碳水化合物摄入量没有反向影响。五个心理幸福感指标和四个肥胖特征可导致相对碳水化合物摄入量与高血压之间的关联,包括体重指数(中介比例:51.37%)、腰围(40.54%)、腰臀比(35.00%)、臀围(24.77%)、重性抑郁症(23.37%)、积极情绪(17.08%)、抑郁症状(16.52%)、生活满意度(16.05%)和神经质(11.22%)。相对较高的碳水化合物摄入量与较低的高血压风险有因果关系,主要通过更好的心理幸福感和较低的肥胖程度来介导。我们的研究结果为高血压的预防和干预提供了因果目标和途径。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1658/10674610/3d6c72ce4855/nutrients-15-04817-g001.jpg

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