Iatan Iulia, Huang Kate, Vikulova Diana, Ranjan Shubhika, Brunham Liam R
Centre for Heart Lung Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada.
Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
JACC Adv. 2024 Mar 25;3(6):100924. doi: 10.1016/j.jacadv.2024.100924. eCollection 2024 Jun.
Low-carbohydrate high-fat (LCHF) diets have attracted interest for a variety of conditions. In some individuals, these diets trigger hypercholesterolemia. There are limited data on their effects on cardiovascular disease risk.
The purpose of this study was to investigate the association between LCHF dietary patterns, lipid levels, and incident major adverse cardiovascular events (MACE).
In a cohort from the UK Biobank, participants with ≥1 24-hour dietary questionnaire were identified. A LCHF diet was defined as <100 g/day and/or <25% total daily energy from carbohydrates/day and >45% total daily energy from fat, with participants on a standard diet (SD) not meeting these criteria. Each LCHF case was age- and sex-matched 1:4 to SD individuals.
Of the 2034 LCHF and 8136 SD identified participants, 305 LCHF and 1220 SD individuals completed an enrollment assessment concurrently with lipid collection. In this cohort, low-density lipoprotein-cholesterol (LDL-C) and apolipoprotein B levels were significantly increased in the LCHF vs SD group ( < 0.001). 11.1% of LCHF and 6.2% of SD individuals demonstrated severe hypercholesterolemia (LDL-C >5 mmol/L, < 0.001). After 11.8 years, 9.8% of LCHF vs 4.3% of SD participants experienced a MACE ( < 0.001). This difference remained significant after adjustment for cardiovascular risk factors (HR: 2.18, 95% CI: 1.39-3.43, < 0.001). Individuals with an elevated LDL-C polygenic risk score had the highest concentrations of LDL-C on a LCHF diet. Similar significant changes in lipid levels and MACE associations were confirmed in the entire cohort and in ≥2 dietary surveys.
Consumption of a LCHF diet was associated with increased LDL-C and apolipoprotein B levels, and an increased risk of incident MACE.
低碳水化合物高脂肪（LCHF）饮食因多种情况而受到关注。在一些个体中，这些饮食会引发高胆固醇血症。关于它们对心血管疾病风险影响的数据有限。
本研究的目的是调查LCHF饮食模式、血脂水平与主要不良心血管事件（MACE）发生率之间的关联。
在英国生物银行的一个队列中，识别出有≥1份24小时饮食问卷的参与者。LCHF饮食定义为每天碳水化合物摄入量<100克和/或碳水化合物提供的每日总能量<25%，脂肪提供的每日总能量>45%，标准饮食（SD）参与者不符合这些标准。每个LCHF病例按年龄和性别1:4与SD个体匹配。
在识别出的2034名LCHF参与者和8136名SD参与者中，305名LCHF和1220名SD个体在进行血脂采集的同时完成了入组评估。在该队列中，LCHF组与SD组相比，低密度脂蛋白胆固醇（LDL-C）和载脂蛋白B水平显著升高（P<0.001）。11.1%的LCHF个体和6.2%的SD个体表现出严重高胆固醇血症（LDL-C>5 mmol/L，P<0.001）。11.8年后，9.8%的LCHF参与者与4.3%的SD参与者发生了MACE（P<0.001）。在调整心血管危险因素后，这种差异仍然显著（HR：2.18，95%CI：1.39 - 3.43，P<0.001）。LDL-C多基因风险评分升高的个体在LCHF饮食中LDL-C浓度最高。在整个队列和≥2次饮食调查中证实了血脂水平和MACE关联的类似显著变化。
食用LCHF饮食与LDL-C和载脂蛋白B水平升高以及MACE发生风险增加有关。
