Fresh Fruit Consumption and Major Cardiovascular Disease in China.
Fresh Fruit Consumption and Major Cardiovascular Disease in China.
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中国的新鲜水果消费和主要的心血管疾病。
DOI：
10.1056/nejmoa1501451
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发表时间：
2016-04-07
期刊：
影响因子：
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通讯作者：
China Kadoorie Biobank Study
中科院分区：
文献类型：
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作者：
Du H;Li L;Bennett D;Guo Y;Key TJ;Bian Z;Sherliker P;Gao H;Chen Y;Yang L;Chen J;Wang S;Du R;Su H;Collins R;Peto R;Chen Z;China Kadoorie Biobank Study
在西方人群中，高水平的水果消费与较低的心血管疾病风险相关，但在中国，人们对这种联系知之甚少，因为那里的水果消费水平较低，中风发生率较高。2004年至2008年，我们从中国的10个不同地区招募了512,891名成年人，年龄在30岁到79岁之间。在320万人年的跟踪调查中，在基线没有心血管疾病或抗高血压治疗病史的451,665名参与者中，有5173人死于心血管疾病，2551人发生重大冠状动脉事件(致命或非致命)，14579人中风，3523人脑出血。Cox回归得出调整后的风险比，将新鲜水果消费与患病率联系起来。总体而言，18.0%的参与者报告每天食用新鲜水果。与从不或很少食用新鲜水果的参与者(“非食用”类别)相比，每天食用新鲜水果的参与者的收缩压(降低4.0毫米汞柱)和血糖水平(每升降低0.5毫克[每升9.0毫克])更低(P<；两项比较的趋势均为0.001)。心血管死亡的调整危险比为0.60(95%可信区间，0.54~0.67)，发生重大冠状动脉事件、缺血性中风和出血性中风的调整危险比分别为0.66(95%可信区间，0.58~0.75)、0.75(95%可信区间，0.72~0.79)和0.64(95%可信区间，0.56~0.74)。每种结果的发生率与新鲜水果的消耗量之间存在强烈的对数线性剂量-反应关系。这些关联在10个研究区域和由基线特征定义的参与者亚组中是相似的。在中国成年人中，较高的水果摄入量与较低的血压和血糖水平相关，并且在很大程度上独立于这些和其他饮食和非饮食因素，显著降低重大心血管疾病的风险。(资金来自惠康信托和其他机构。)
In Western populations, a higher level of fruit consumption has been associated with a lower risk of cardiovascular disease, but little is known about such associations in China, where the consumption level is low and rates of stroke are high. Between 2004 and 2008, we recruited 512,891 adults, 30 to 79 years of age, from 10 diverse localities in China. During 3.2 million person-years of follow-up, 5173 deaths from cardiovascular disease, 2551 incident major coronary events (fatal or nonfatal), 14,579 ischemic strokes, and 3523 intracerebral hemorrhages were recorded among the 451,665 participants who did not have a history of cardiovascular disease or antihypertensive treatments at baseline. Cox regression yielded adjusted hazard ratios relating fresh fruit consumption to disease rates. Overall, 18.0% of participants reported consuming fresh fruit daily. As compared with participants who never or rarely consumed fresh fruit (the “nonconsumption” category), those who ate fresh fruit daily had lower systolic blood pressure (by 4.0 mm Hg) and blood glucose levels (by 0.5 mmol per liter [9.0 mg per deciliter]) (P<0.001 for trend for both comparisons). The adjusted hazard ratios for daily consumption versus nonconsumption were 0.60 (95% confidence interval [CI], 0.54 to 0.67) for cardiovascular death, and 0.66 (95% CI, 0.58 to 0.75), 0.75 (95% CI, 0.72 to 0.79), and 0.64 (95% CI, 0.56 to 0.74), respectively, for incident major coronary events, ischemic stroke, and hemorrhagic stroke. There was a strong loglinear dose–response relationship between the incidence of each outcome and the amount of fresh fruit consumed. These associations were similar across the 10 study regions and in subgroups of participants defined by baseline characteristics. Among Chinese adults, a higher level of fruit consumption was associated with lower blood pressure and blood glucose levels and, largely independent of these and other dietary and nondietary factors, with significantly lower risks of major cardiovascular diseases. (Funded by the Wellcome Trust and others.)