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大量饮用人工甜味饮料与心血管事件风险的相关性:系统评价和荟萃分析。

High consumption of artificially sweetened beverages and associated risk of cardiovascular events: A systematic review and meta-analysis.

机构信息

Catholic University of Pernambuco, Recife, Brazil.

Redentor University Center, Itaperuna, Brazil.

出版信息

Curr Probl Cardiol. 2025 Jan;50(1):102837. doi: 10.1016/j.cpcardiol.2024.102837. Epub 2024 Nov 17.

Abstract

BACKGROUND

With the rising use of artificial sweeteners as sugar substitutes, concerns regarding their impact on cardiovascular health have emerged. Artificially sweetened beverages are the primary source of diet sweeteners, but despite approval by national food agencies, evidence of their association with cardiovascular events has not been conclusive. Our Meta-Analysis assessed the relationship between artificially sweetened beverage consumption and long-term outcomes of cardiovascular events in extended follow-up cohorts.

METHODS

Medline, Embase, and Cochrane databases were systematically searched for cohort studies investigating the incidence of all-cause mortality, cardiovascular mortality, stroke, and coronary heart disease among individuals with high consumption of ASB compared to minimal or no consumption. Pooled event hazard ratios with 95% confidence intervals were calculated using a random-effects model in R software, with heterogeneity assessed via I² statistics.

RESULTS

We included twelve prospective cohorts comprising 1,224,560 patients. Analyses were conducted on patient groups with data adjusted for co-founding, such as dietary factors and comorbidities. One or more daily dose of Artificially sweetened beverages was significantly associated with a higher risk of all-cause mortality (HR 1.14; 95% 1.03 to 1.26; p < 0.01;), Cardiovascular mortality (HR 1.29; 95% 1.1 to 1.53; p < 0.01), and stroke (HR 1.15; 95% 1.01 to 1.32; p = 0.04;).

CONCLUSION

In this meta-analysis, we found a significant association between high consumption of ASBs and increased incidence of ACM, CVD, and stroke, highlighting potential long-term cardiovascular implications.

摘要

背景

随着人工甜味剂作为糖替代品的使用日益增加,人们对其对心血管健康的影响产生了担忧。人工甜味饮料是饮食甜味剂的主要来源,但尽管得到了国家食品机构的批准,但其与心血管事件之间关联的证据尚无定论。我们的荟萃分析评估了人工甜味饮料消费与长期心血管事件结局在扩展随访队列中的关系。

方法

系统检索了 Medline、Embase 和 Cochrane 数据库,以寻找调查与高摄入量人工甜味饮料(ASB)相比,低摄入量或不摄入 ASB 人群的全因死亡率、心血管死亡率、卒中和冠心病发生率的队列研究。使用 R 软件中的随机效应模型计算具有 95%置信区间的汇总事件危险比,并通过 I² 统计评估异质性。

结果

我们纳入了 12 项前瞻性队列研究,共包括 1224560 名患者。对经过协变量调整(如饮食因素和合并症)的数据进行了患者组分析。每天摄入一份或多份人工甜味饮料与全因死亡率(HR 1.14;95% 1.03 至 1.26;p < 0.01)、心血管死亡率(HR 1.29;95% 1.1 至 1.53;p < 0.01)和卒中等风险显著相关(HR 1.15;95% 1.01 至 1.32;p = 0.04)。

结论

在这项荟萃分析中,我们发现高摄入量人工甜味饮料与 ACM、CVD 和卒中等发生率增加之间存在显著关联,强调了其对长期心血管的潜在影响。

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