Glycemic index, glycemic load, and chronic disease risk - a metaanalysis of observational studies
Glycemic index, glycemic load, and chronic disease risk - a metaanalysis of observational studies
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DOI：
10.1093/ajcn/87.3.627
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发表时间：
2008-03-01
影响因子：
7.1
通讯作者：
Brand-Miller, Jennie C.
中科院分区：
文献类型：
--
作者：
Barclay, Alan W.;Petocz, Peter;Brand-Miller, Jennie C.
背景资料：观察性研究的不一致结果延长了关于饮食血糖指数（GI）和血糖负荷（GL）对某些慢性病风险影响的争议。目的：目的是使用荟萃分析技术评估GI、GL和慢性病风险之间的关联。设计：对已发表报告的系统性综述共确定了37项GI和GL以及慢性疾病风险的前瞻性队列研究。根据用于评估饮食摄入的工具的有效性，对研究进行进一步分层。率比（RRs）估计在考克斯比例风险模型，并结合使用random-effects model.Results：从4至20年的后续跨研究，共确定了40 129例事件。对于GI和GL的最高和最低分位数之间的比较，在2型糖尿病验证研究的完全校正模型中发现了显著的正相关性（GI RR = 1.40，95% CI：1.23，1.59; GL RR = 1.27，95% CI：1.12，1.45），冠心病（GI RR = 1.25，95% CI：1.00，1.56），胆囊疾病（GI RR = 1.26，95% CI：1.13，1.40; GL RR = 1.41，95% CI：1.25，1.60），乳腺癌（GI RR = 1.08，95%CI：1.02，1.16），所有疾病合并（GI RR = 1.14，95%CI：1.09，1.19; GL RR = 1.09，95%CI：1.04，1.15）。低GI和/或低GL饮食与某些慢性疾病的风险降低独立相关。在糖尿病和心脏病中，这种保护作用与全谷物和高纤维摄入量相当。这些发现支持了这一假设，即餐后血糖升高是疾病进展的普遍机制。
Background: Inconsistent findings from observational studies have prolonged the controversy over the effects of dietary glycemic index (GI) and glycemic load (GL) on the risk of certain chronic diseases.Objective: The objective was to evaluate the association between GI, GL, and chronic disease risk with the use of meta-analysis techniques.Design: A systematic review of published reports identified a total of 37 prospective cohort studies of GI and GL and chronic disease risk. Studies were stratified further according to the validity of the tools used to assess dietary intake. Rate ratios (RRs) were estimated in a Cox proportional hazards model and combined by using a random-effects model.Results: From 4 to 20 y of follow-up across studies, a total of 40 129 incident cases were identified. For the comparison between the highest and lowest quantiles of GI and GL, significant positive associations were found in fully adjusted models of validated studies for type 2 diabetes (GI RR = 1.40,95% Cl: 1.23, 1.59; GL RR = 1.27, 95% Cl: 1.12, 1.45), coronary heart disease (GI RR = 1.25, 95% CI: 1.00, 1.56), gallbladder disease (GI RR = 1.26, 95% CI: 1.13, 1.40; GL RR = 1.41, 95% CI: 1.25, 1.60), breast cancer (GI RR = 1.08, 95% CI: 1.02,1.16), and all diseases combined (GI RR = 1.14,95% Cl: 1.09, 1.19; GL RR = 1.09, 95% CI: 1.04, 1.15).Conclusions: Low-GI and/or low-GL diets are independently associated with a reduced risk of certain chronic diseases. In diabetes and heart disease, the protection is comparable with that seen for whole grain and high fiber intakes. The findings support the hypothesis that higher postprandial glycemia is a universal mechanism for disease progression.