Low-Carbohydrate Diets and Risk of Incident Atrial Fibrillation: A Prospective Cohort Study
Low-Carbohydrate Diets and Risk of Incident Atrial Fibrillation: A Prospective Cohort Study
复制标题
低碳水化合物饮食和心房颤动的风险：一项前瞻性队列研究
DOI：
10.1161/jaha.119.011955
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发表时间：
2019
影响因子：
5.4
通讯作者：
Liao Xinxue
中科院分区：
文献类型：
--
作者：
Zhang Shaozhao;Zhuang Xiaodong;Lin Xiaoyu;Zhong Xiangbin;Zhou Huimin;Sun Xiuting;Xiong Zhenyu;Huang Yiquan;Fan Yongqiang;Guo Yue;Du Zhimin;Liao Xinxue
低碳水化合物饮食对心血管疾病的影响存在争议。很少有研究探讨碳水化合物摄入量与房颤（AF）风险的关系。我们的目的是评估碳水化合物的摄入量和事件AF的风险之间的关联ARIC（动脉粥样硬化风险在社区）Study.Methods和ResultsWe包括13 385名参与者（年龄，54.2±5.8岁; 45.1%的男性和74.7%的白色）谁完成了饮食调查问卷在基线（1987-1989年）在ARIC研究。主要结局为AF事件，通过研究检查期间进行的ECG、出院代码和死亡证明确定。我们使用多变量考克斯风险回归模型来评估碳水化合物摄入量与AF事件之间的关联。我们进一步探讨了在低碳水化合物摄入量环境中用于替代碳水化合物摄入量的特定食物来源（动物与植物）的影响。在中位随访22.4年期间，发生了1808例（13.5%）AF。调整传统AF风险因素和其他饮食因素后，与碳水化合物摄入量占能量摄入量百分比增加1-SD（9.4%）相关的AF事件风险比为0.82（95% CI，0.72-0.94）。当个体按碳水化合物摄入量四分位数分类时，结果相似（风险比，0.64; 95%CI，0.49-0.84;比较极端四分位数）。未发现用于替代碳水化合物的蛋白质或脂肪类型与AF发生风险之间存在关联。结论低碳水化合物饮食与AF发生风险增加相关，无论用于替代碳水化合物的蛋白质或脂肪类型如何。
BackgroundThe influences of low‐carbohydrate diets in cardiovascular disease are controversial. Few studies have examined the relationship of carbohydrate intake and risk of incident atrial fibrillation (AF). We aimed to evaluate the association between carbohydrate intake and the risk of incident AF in the ARIC (Atherosclerosis Risk in Communities) Study.Methods and ResultsWe included 13 385 participants (age, 54.2±5.8 years; 45.1% men and 74.7% white) who completed a dietary questionnaire at baseline (1987–1989) in the ARIC Study. The primary outcome was incident AF, which was identified by ECG performed during study examinations, hospital discharge codes, and death certificates. We used multivariable Cox hazard regression models to assess the association between carbohydrate intake and incident AF. We further explored the effects of specific food source (animal versus plant based) used to replace carbohydrate intake in the low‐carbohydrate intake setting. During a median follow‐up of 22.4 years, 1808 cases (13.5%) of AF occurred. The hazard ratio for incident AF associated with a 1‐SD (9.4%) increase in carbohydrate intake as a percentage of energy intake was 0.82 (95% CI, 0.72–0.94), after adjustment for traditional AF risk factors and other diets factors. Results were similar when individuals were categorized by carbohydrate intake quartiles (hazard ratio, 0.64; 95% CI, 0.49–0.84; comparing extreme quartiles). No association was found between the type of protein or fat used to replace the carbohydrate and risk of incident AF.ConclusionsLow‐carbohydrate diets were associated with increased risk of incident AF, regardless of the type of protein or fat used to replace the carbohydrate.