Associations of glycemic index and load with coronary heart disease events: a systematic review and meta-analysis of prospective cohorts.
Associations of glycemic index and load with coronary heart disease events: a systematic review and meta-analysis of prospective cohorts.
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DOI：
10.1161/jaha.112.000752
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发表时间：
2012-10
影响因子：
5.4
通讯作者：
Jenkins DJ
中科院分区：
文献类型：
--
作者：
Mirrahimi A;de Souza RJ;Chiavaroli L;Sievenpiper JL;Beyene J;Hanley AJ;Augustin LS;Kendall CW;Jenkins DJ
在一些但不是所有队列研究中，血糖指数(GI)和血糖负荷(GL)与冠心病(CHD)风险相关。因此，我们在前瞻性队列中评估了GI和GL与CHD风险的相关性。我们检索了MEDLINE、EMBASE和CINAHL(截至2012年4月5日)，确定了所有评估GI和GL与CHD发病率相关性的前瞻性队列。流行病学观察研究的荟萃分析(MOOSE)方法被使用。用随机效应模型将暴露最高的组(队列的平均GI=84.4GI单位，范围79.9至91；队列的平均GL=224.8，范围166至270)与参照组(平均GI=72.3GI单位，范围68.1至77；平均GL=135.4，范围83至176)进行风险的相对测量，用随机效应模型表示为具有χ2评估的异质性的相对风险(RR)，并由I2量化。亚组包括性别和随访时间。10篇研究(n=240,936)符合条件。合并分析显示，与最低分位数相比，最高GI分位数的冠心病风险增加，RR=1.11(95%可信区间[CI]0.99至1.24)，GL的RR=1.27(95%可信区间1.09至1.49)，两者均有异质性(I2>；42%，P<；0.07)。亚组分析仅显示性别的显著改变，女性队列显示GI RR=1.26(95%CI 1.12至1.41)和GL RR=1.55(95%CI 1.18至2.03)。在女性中，高GI和高血糖饮食与CHD事件显著相关，而在男性中则不显著。需要进一步的研究来确定GI和GL与男性CHD的关系。
Glycemic index (GI) and glycemic load (GL) have been associated with coronary heart disease (CHD) risk in some but not all cohort studies. We therefore assessed the association of GI and GL with CHD risk in prospective cohorts. We searched MEDLINE, EMBASE, and CINAHL (through April 5, 2012) and identified all prospective cohorts assessing associations of GI and GL with incidence of CHD. Meta-analysis of observational studies in epidemiology (MOOSE) methodologies were used. Relative measures of risk, comparing the group with the highest exposure (mean GI of cohorts=84.4 GI units, range 79.9 to 91; mean GL of cohorts=224.8, range 166 to 270) to the reference group (mean GI=72.3 GI units, range 68.1 to 77; mean GL=135.4, range 83 to 176), were pooled using random-effects models, expressed as relative risk (RR) with heterogeneity assessed by χ2 and quantified by I2. Subgroups included sex and duration of follow-up. Ten studies (n=240 936) were eligible. Pooled analyses showed an increase in CHD risk for the highest GI quantile compared with the lowest, with RR=1.11 (95% confidence interval [CI] 0.99 to 1.24) and for GL, RR=1.27 (95% CI 1.09 to 1.49), both with evidence of heterogeneity (I2>42%, P<0.07). Subgroup analyses revealed only a significant modification by sex, with the female cohorts showing significance for GI RR=1.26 (95% CI 1.12 to 1.41) and for GL RR=1.55 (95% CI 1.18 to 2.03). High GI and GL diets were significantly associated with CHD events in women but not in men. Further studies are required to determine the relationship between GI and GL with CHD in men.