含糖饮料、遗传易感性与心房颤动事件：一项前瞻性队列研究。
Sweetened Beverages, Genetic Susceptibility, and Incident Atrial Fibrillation: A Prospective Cohort Study.
机构信息
Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, China (Y.S., B.Y., Y.Y., B.W., Y.L., K.Z., N.W.).
School of Public Health, Zhejiang University, Hangzhou, China (X.T.).
出版信息
Circ Arrhythm Electrophysiol. 2024 Mar;17(3):e012145. doi: 10.1161/CIRCEP.123.012145. Epub 2024 Mar 5.
BACKGROUND
An association between sweetened beverages and several cardiometabolic diseases has been reported, but their association with atrial fibrillation (AF) is unclear. We aimed to investigate the associations between consumption of sugar-sweetened beverages (SSB), artificially sweetened beverages (ASB), and pure fruit juice (PJ) and risk of consumption with AF risk and further evaluate whether genetic susceptibility modifies these associations.
METHODS
A total of 201 856 participants who were free of baseline AF, had genetic data available, and completed a 24-hour diet questionnaire were included. Cox proportional hazard models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs).
RESULTS
During a median follow-up of 9.9 years, 9362 incident AF cases were documented. Compared with nonconsumers, individuals who consumed >2 L/wk of SSB or ASB had an increased risk of AF (HR, 1.10 [95% CI, 1.01-1.20] and HR, 1.20 [95% CI, 1.10-1.31]) in the multivariable-adjusted model. A negative association was observed between the consumption of ≤1 L/wk of PJ and the risk of AF (HR, 0.92 [95% CI, 0.87-0.97]). The highest HRs (95% CIs) of AF were observed for participants at high genetic risk who consumed >2 L/wk of ASB (HR, 3.51 [95% CI, 2.94-4.19]), and the lowest HR were observed for those at low genetic risk who consumed ≤1 L/wk of PJ (HR, 0.77 [95% CI, 0.65-0.92]). No significant interactions were observed between the consumption of SSB, ASB, or PJ and genetic predisposition to AF.
CONCLUSIONS
Consumption of SSB and ASB at >2 L/wk was associated with an increased risk for AF. PJ consumption ≤1 L/wk was associated with a modestly lower risk for AF. The association between sweetened beverages and AF risk persisted after adjustment for genetic susceptibility to AF. This study does not demonstrate that consumption of SSB and ASB alters AF risk but rather that the consumption of SSB and ASB may predict AF risk beyond traditional risk factors.
背景
已有研究报道，加糖饮料与多种心血管代谢疾病之间存在关联，但它们与心房颤动（AF）的关系尚不清楚。我们旨在研究糖饮料（SSB）、人工加糖饮料（ASB）和纯果汁（PJ）的摄入量与 AF 风险之间的关系，并进一步评估遗传易感性是否会改变这些关系。
方法
共有 201856 名参与者在基线时无 AF，具有可用的遗传数据，并完成了 24 小时饮食问卷。使用 Cox 比例风险模型来估计危险比（HR）和 95%置信区间（CI）。
结果
在中位随访 9.9 年期间，共记录到 9362 例新发 AF 病例。与非饮用者相比，在多变量调整模型中，每周饮用 >2 L/周的 SSB 或 ASB 的个体患 AF 的风险增加（HR，1.10[95%CI，1.01-1.20]和 HR，1.20[95%CI，1.10-1.31]）。每周饮用 ≤1 L/周的 PJ 与 AF 风险呈负相关（HR，0.92[95%CI，0.87-0.97]）。每周饮用 >2 L/周的 ASB 且遗传风险高的参与者的 AF 最高 HR（95%CI）最高（HR，3.51[95%CI，2.94-4.19]），而遗传风险低的参与者每周饮用 ≤1 L/周的 PJ 的 HR 最低（HR，0.77[95%CI，0.65-0.92]）。未观察到 SSB、ASB 或 PJ 摄入与 AF 遗传易感性之间存在显著的交互作用。
结论
每周饮用 >2 L/周的 SSB 和 ASB 与 AF 风险增加有关。每周饮用 ≤1 L/周的 PJ 与 AF 风险适度降低有关。在调整 AF 遗传易感性后，甜饮料与 AF 风险之间的关联仍然存在。本研究并未表明 SSB 和 ASB 的摄入会改变 AF 风险，而是表明 SSB 和 ASB 的摄入可能会在传统危险因素之外预测 AF 风险。
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