Jia Yuehui, Ma Shuli, Chen Xiaoting, Chen Zhe, Yang Xiaolei, Li Hongjie, Jiang Libo, Du Linlin, Liu Lei, Ge Jie
School of Public Health, Qiqihar Medical University, Qiqihar, 161000, China.
Sanitary Analysis Center, Scientific Research Office, Qiqihar Medical University, Qiqihar, 161000, China.
Eur J Nutr. 2024 Dec 16;64(1):47. doi: 10.1007/s00394-024-03567-9.
This study analyzed the relation of energy and macronutrient intake at dinner versus breakfast with the risk of hyperhomocysteinemia (Hhcy).
Up to 12,474 adults, in which 1,387 with Hhcy, completed a questionnaire about energy and macronutrient intake in the National Health and Nutrition Examination. The differences (Δ) in that between dinner and breakfast (Δ = dinner - breakfast) were categorized into quartiles. Logistic regression analyses or restrictive cubic spline regressions were conducted to determine the relation in Δ and the risk of Hhcy, as well as the change in risk when 5% energy at dinner was substituted with those at breakfast through isocaloric substitution models.
After adjusted the confounders, results showed that compared to the research objects in the lowest quartile, those in the highest quartile were more prone to get Hhcy (odds ratio (OR) = 1.26, 95% CI = 1.03-1.56; OR = 1.25, 95% CI = 1.01-1.55; OR = 1.22, 95% CI = 1.01-1.49, respectively). Isocalorically replacing 5% energy at dinner with energy at breakfast was related to 5% lower Hhcy risk. Replacing 5% of energy provided by protein at dinner with that by protein or PUFA at breakfast was related to 10% and 11% lower Hhcy risk, respectively. Replacing 5% energy provided by PUFA at dinner with that by protein or PUFA at breakfast were associated with 8% and 6% lower Hhcy risk, respectively.
The optimal intake period for energy, protein, and polyunsaturated fatty acid intake for reducing Hhcy risk in adults was the morning.
本研究分析晚餐与早餐时能量和宏量营养素摄入量与高同型半胱氨酸血症（Hhcy）风险之间的关系。
多达12474名成年人（其中1387名患有Hhcy）完成了美国国家健康与营养检查中关于能量和宏量营养素摄入量的问卷调查。晚餐与早餐摄入量的差异（Δ）（Δ = 晚餐摄入量 - 早餐摄入量）被分为四分位数。进行逻辑回归分析或限制性立方样条回归分析，以确定Δ与Hhcy风险之间的关系，以及通过等热量替代模型将晚餐5%的能量替换为早餐能量时风险的变化。
在调整混杂因素后，结果显示，与最低四分位数的研究对象相比，最高四分位数的研究对象更易患Hhcy（优势比（OR）分别为1.26，95%置信区间（CI）= 1.03 - 1.56；OR = 1.25，95% CI = 1.01 - 1.55；OR = 1.22，95% CI = 1.01 - 1.49）。将晚餐5%的能量等热量地替换为早餐能量与Hhcy风险降低5%相关。将晚餐由蛋白质提供的5%能量替换为早餐由蛋白质或多不饱和脂肪酸（PUFA）提供的能量分别与Hhcy风险降低10%和11%相关。将晚餐由PUFA提供的5%能量替换为早餐由蛋白质或PUFA提供的能量分别与Hhcy风险降低8%和6%相关。
对于降低成年人Hhcy风险而言，能量、蛋白质和多不饱和脂肪酸的最佳摄入时段是早晨。
