Low-Carbohydrate Diet Score and Coronary Artery Calcium Progression: Results From the CARDIA Study.
Low-Carbohydrate Diet Score and Coronary Artery Calcium Progression: Results From the CARDIA Study.
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低碳水化合物饮食评分和冠状动脉钙进展：CARDIA 研究结果
DOI：
10.1161/atvbaha.120.314838
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发表时间：
2021-01
期刊：
影响因子：
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通讯作者：
Liu (刘品明) PM
中科院分区：
文献类型：
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作者：
Gao (高静伟) JW;Hao (郝卿鋆) QY;Zhang (张海峰) HF;Li (李雄志) XZ;Yuan (袁智敏) ZM;Guo (郭颖) Y;Wang (王景峰) JF;Zhang (张少玲) SL;Liu (刘品明) PM
补充数字内容可在文本中找到。研究低碳水化合物饮食（LCD）是否与冠状动脉钙化（CAC）进展相关。我们纳入了在2000年至2001年（第15年）完成基线CAC计算机断层扫描评估和随访（第20年或第25年）以及在CARDIA研究（年轻人冠状动脉风险发展）中完成食物频率问卷（第0年、第7年和第20年）的参与者。CAC进展定义为基线CAC为0的受试者随访时CAC >0，0<基线CAC<100或基线CAC≥100的受试者年变化10或百分比变化≥10%。在纳入的2226例受试者中（年龄：40.4±3.5岁; 45.4%为男性），碳水化合物摄入占总能量的47.8±6.5%，204例（9.2%）在基线（第15年）时患有CAC。在平均8.3年的随访中，591名（26.5%）参与者发生CAC进展。校正传统心血管危险因素和其他饮食因素后，碳水化合物摄入量占总能量的百分比与CAC进展风险呈负相关（风险比，0.731 [95%CI，0.552-0.968]; P=0.029）。此外，基于动物而非基于植物的LCD评分与CAC进展的高风险显著相关（动物LCD评分：风险比，1.456 [95% CI，1.015-2.089]; P=0.041;植物LCD评分：风险比，1.016 [95% CI，0.821-1.257]; P=0.884;两者都比较极端的群体）。在年轻时开始的LCD与随后CAC进展的风险增加有关，特别是当选择动物蛋白或脂肪代替碳水化合物时。URL：https://www.clinicaltrials.gov;唯一标识符：NCT 00005130。
Supplemental Digital Content is available in the text. To investigate whether low-carbohydrate diets (LCDs) were associated with coronary artery calcium (CAC) progression. We included the participants who completed computed tomography assessment of baseline CAC in 2000 to 2001 (year 15) and follow-up (year 20 or 25) and food frequency questionnaire (years 0, 7, and 20) in the CARDIA study (Coronary Artery Risk Development in Young Adults). CAC progression was defined as CAC >0 at follow-up among participants with baseline CAC of 0 and an annualized change of 10 or percent change of ≥10% for those with 0<baseline CAC<100 or baseline CAC≥100, respectively. Among 2226 included participants (age, 40.4±3.5 years; 45.4% men), the carbohydrate intake accounted for 47.8±6.5% of total energy, and 204 (9.2%) had CAC at baseline (year 15). Over a mean follow-up of 8.3 years, 591 (26.5%) participants had CAC progression. After adjustment for traditional cardiovascular risk factors and other dietary factors, carbohydrate intake as a percentage of total energy was inversely associated with the risk of CAC progression (hazard ratio, 0.731 [95% CI, 0.552–0.968]; P=0.029). Furthermore, the animal-based but not plant-based LCD score was significantly associated with a higher risk of CAC progression (animal-based LCD score: hazard ratio, 1.456 [95% CI, 1.015–2.089]; P=0.041; plant-based LCD score: hazard ratio, 1.016 [95% CI, 0.821–1.257]; P=0.884; both comparing extreme groups). LCDs starting at a young age are associated with an increased risk of subsequent CAC progression, particularly when animal protein or fat are chosen to replace carbohydrates. URL: https://www.clinicaltrials.gov; Unique identifier: NCT00005130.