低碳水化合物饮食与血脂异常关系的横断面研究

ASSOCIATION BETWEEN LOW-CARBOHYDRATE DIETS AND DYSLIPIDEMIA: A POPULATION-BASED CROSS-SECTIONAL STUDY

目的 构建低碳水化合物饮食(low-carbohydrate diets,LCDs)依从性得分并研究LCDs与血脂异常的关系。方法 本研究基于安徽六安地区以人群为基础的横断面研究。膳食测量采用食物频度问卷。通过计算三大宏量营养素及其亚型占总能量的百分比构建LCDs得分。根据《中国成人血脂异常防治指南(2016年修订版)》定义血脂异常。采用多因素Logistic回归计算优势比(OR)及其95%可信区间(95%CI)。结果 调整体质指数(BMI)等协变量后,与最低四分位相比,植物性LCD得分最高四分位者血脂异常罹患风险降低了34%(OR=0.66, 95%CI:0.51-0.87, P=0.008);健康LCD与血脂异常风险OR为0.62(95%CI:0.48-0.79, P<0.001);而总LCD、动物性及不健康LCDs似乎与血脂异常无关(P均大于0.05);替代分析显示:用占5%供能比的植物蛋白质代替等能量的碳水化合物,罹患血脂异常风险降低了24%(OR=0.76, 95%CI:0.61-0.94)。结论 植物性LCD或健康LCD,或用植物蛋白质替代碳水化合物与血脂异常罹患风险降低有关。[营养学报,2022,44(5):442-448]

Objective To investigate the association between low-carbohydrate diets(LCDs) adherence-scores and the dyslipidemia risk. Methods This study was a population-based cross-sectional study in Lu’an, Anhui. Dietary intakes were assessed by food frequency questionnaires. LCDs scores were developed according to the percentages of energy from total and subtypes of carbohydrate, protein, and fat. Dyslipidemia was defined according to the 2016 Chinese guidelines for the management of dyslipidemia in adults. Logistic regression was used to estimate the odds ratios(ORs) and 95% confidence intervals(CIs). Results After adjusting for BMI and other covariables, compared with the lowest quartile of plant-based LCD scores, participants in the highest quartile had lower odds of dyslipidemia(OR=0.66, 95% CI: 0.51-0.87, P=0.008).Similarly, higher healthy LCD scores were inversely associated with the prevalence of dyslipidemia(OR=0.62, 95% CI:0.48-0.79, P<0.001). However, animal-based and unhealthy LCDs seemed not to be associated with the odds of dyslipidemia(all the P>0.05). Replacing 5% of energy from carbohydrate with plant protein was associated with 24%lower odds of dyslipidemia(OR=0.76, 95% CI: 0.61-0.94). Conclusion Greater adherence to plant-based and healthy LCD is associated with lower likelihood of dyslipidemia, and replacing carbohydrate with plant protein in diet was inversely associated with the odds of dyslipidemia. [ACTA NUTRIMENTA SINICA, 2022,44(5):442-448]