Inverse association of dietary fat with development of ischemic stroke in men.
Inverse association of dietary fat with development of ischemic stroke in men.
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DOI：
10.1001/jama.1997.03550240035030
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发表时间：
1997-12
期刊：
影响因子：
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通讯作者：
M. Gillman;L. Cupples;B. Millen;R. Ellison;P. Wolf
中科院分区：
文献类型：
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作者：
M. Gillman;L. Cupples;B. Millen;R. Ellison;P. Wolf
在亚洲人群中进行的一些生态学和队列研究表明，脂肪和饱和脂肪的摄入与中风风险呈负相关。然而，西方人群的数据很少。目的：在20年的随访中，研究美国中年男性中风发病率与脂肪摄入量和脂肪类型的关系。设计与背景：一项以人群为基础的队列研究。研究对象：832名男性，年龄45 ~ 65岁，基线（1966-1969年）无心血管疾病。测量和数据分析：每名受试者的饮食在基线时通过单次24小时饮食回忆进行评估，从中估计能量和常量营养素的摄入量。在Kaplan-Meier分析中，我们计算了年龄校正的卒中累积发病率。使用考克斯回归，我们估计了20年随访期间卒中发病率的相对风险。主要观察指标：随访期间61例受试者发生缺血性卒中的发生率。结果平均摄入量为10975 kJ的能量; 114克（39%的能量）的总脂肪; 44克（15%）的饱和脂肪; 46克（16%）的单不饱和脂肪;和16克（5%）的多不饱和脂肪。缺血性卒中的风险随着总脂肪（对数秩趋势P= 0.008）、饱和脂肪（P= 0.002）和单不饱和脂肪（P= 0.008）的增加而下降，但多不饱和脂肪（P= 0.33）没有下降。总脂肪每增加3%的能量，经年龄和能量调整的相对风险为0.85（95%置信区间[CI]，0.78-0.94）;饱和脂肪每增加1%，0.91（95% CI，0.85-0.98）;单不饱和脂肪每增加1%，0.89（95% CI，0.83-0.96）。调整吸烟，葡萄糖耐受不良，体重指数，血压，血液胆固醇水平，体力活动，蔬菜和水果的摄入量和酒精没有实质性的改变结果。出血性卒中病例太少（n=14），无法进行推断。结论：脂肪、饱和脂肪和单不饱和脂肪的摄入与男性缺血性卒中风险降低相关。
CONTEXT A few ecological and cohort studies in Asian populations suggest an inverse association of the intake of both fat and saturated fat with risk of stroke. However, data among western populations are scant. OBJECTIVE To examine the association of stroke incidence with intake of fat and type of fat among middle-aged US men during 20 years of follow-up. DESIGN AND SETTING The Framingham Heart Study, a population-based cohort study. PARTICIPANTS A total of 832 men, aged 45 through 65 years, who were free of cardiovascular disease at baseline (1966-1969). MEASUREMENTS AND DATA ANALYSIS: The diet of each subject was assessed at baseline by a single 24-hour dietary recall, from which intakes of energy and macronutrients were estimated. In Kaplan-Meier analyses, we calculated age-adjusted cumulative incidence rates of stroke. Using Cox regression, we estimated stroke incidence relative risks during 20 years of follow-up. MAIN OUTCOME MEASURE Incidence of ischemic stroke, which occurred in 61 subjects during the follow-up period. RESULTS Mean intakes were 10975 kJ for energy; 114 g (39% of energy) for total fat; 44 g (15%) for saturated fat; 46 g (16%) for monounsaturated fat; and 16 g (5%) for polyunsaturated fat. Risk of ischemic stroke declined across the increasing quintile of total fat (log-rank trend P=.008), saturated fat (P=.002), and monounsaturated fat (P=.008) but not polyunsaturated fat (P=.33). The age- and energy-adjusted relative risk for each increment of 3% of energy from total fat was 0.85 (95% confidence interval [CI], 0.78-0.94); for an increment of 1% from saturated fat, 0.91 (95% CI, 0.85-0.98); and for 1% from monounsaturated fat, 0.89 (95% CI, 0.83-0.96). Adjustment for cigarette smoking, glucose intolerance, body mass index, blood pressure, blood cholesterol level, physical activity, and intake of vegetables and fruits and alcohol did not materially change the results. Too few cases of hemorrhagic stroke (n=14) occurred to draw inferences. CONCLUSION Intakes of fat, saturated fat, and monounsaturated fat were associated with reduced risk of ischemic stroke in men.