膳食模式与动脉粥样硬化关系的多种族研究

The Multi-Ethnic Study of Dietary Pattern and Atherosclerosis

目的人们对膳食模式、代谢紊乱与左心室功能的关系研究报道不多,本研究旨在探讨膳食模式和左心室功能之间的关系以及代谢紊乱与动脉粥样硬化的关系。方法膳食模式采用降秩回归(reduced rankregression,RRR)方法构建;左室重量、心搏量和左室射血分数采用磁共振成像测量;膳食模式和左室指数之间的关系采用横断面分析法。结果选用4 601例45～84岁、无临床心血管疾病受试者,RRR膳食模式得分数与高血糖指数、高脂肉类、奶酪、加工食品的摄入量呈正相关,而与蔬菜、大豆、水果、绿茶、黑茶、低脂甜点、种子、坚果和鱼肉的低摄入量呈负相关。多变量分析显示,RRR膳食模式得分增加1个单位,左室重量/体表面积就增加0.32g/m2,心博量减少0.43mL/m2,左室射血分数则减少0.21%。调整代谢综合征组分后,RRR膳食模式得分与左室重量和心搏指数之间的相关性减低,变为差异有统计学意义(P<0.05)。结论 RRR膳食模式、代谢紊乱与左室功能紊乱有关。本研究属于横断面研究,结果的可靠性有待前瞻性研究进一步证实。

Objective Background Little is known about the relations between dietary patterns, metabolic dysfunction,and left ventricular（LV）function. The objective was to examine associations of dietary patterns with LV mass and function and to explore the potential role of metabolic dysfunction in the association between diet and LV function. Methods Dietary patterns that maximally explained the variation in metabolic syndrome （MetSyn） components were derived by using reduced rank regression（RRR）. LV mass,stroke volume and LV ejection fraction （LVEF）were measured by magnetic resonance imaging. Associations between dietary pattern and LV indexes were analyzed cross-sectionally. Results A total of 4 601 participants aged 45-84 y and free of clinical cardiovascular disease were studied. The primary RRR dietary pattern score was positively correlated with intake of foods with a high glycemic index, high-fat meats, cheese and processed foods and negatively correlated with low intakes of vegetables,soy, fruit, green and black tea, low-fat dairy desserts, seeds and nuts, and fish. Multivariate analyses showed that each 1-unit increase in the RRR dietary pattern score was associated with a 0.32 g/㎡ increase in LVmass/body surface area,a 0.43 mL/㎡ decrease in stroke volume/body surface area,and a 0.21% decrease in LVEF. The associations of the RRR dietary pattern score with LV mass and stroke indexes were attenuated and became significant after adjustment for all MetSyn components（P〈0. 05）. Conclusion The results suggest that the RRR dietary pattern is significantly associated with unfavorable LV function, and this association might be mediated by metabolic dysfunction. Given the cross-sectional nature of our study, these results must be confirmed with the use of longitudinal data.