Whole-grain consumption and the metabolic syndrome: a favorable association in Tehranian adults
Whole-grain consumption and the metabolic syndrome: a favorable association in Tehranian adults
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DOI：
10.1038/sj.ejcn.1602080
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发表时间：
2005-03-01
影响因子：
4.7
通讯作者：
Azizi, F
中科院分区：
文献类型：
--
作者：
Esmaillzadeh, A;Mirmiran, P;Azizi, F
背景资料：虽然饮食指南建议增加谷物制品的摄入量以预防慢性疾病，但关于全谷物摄入量与代谢综合征相关的流行病学数据很少。目的：评估德黑兰成年人全谷物摄入量、代谢综合征和代谢危险因素之间的关系。设计：基于人群的横断面研究。地点：伊朗首都德黑兰。受试者：一个代表性的样本827名受试者（357名男性和470名女性），年龄在18 - 74岁。方法：使用食物频率问卷调查的膳食摄入量进行了评估。Jacobs等人开发的程序用于将谷物产品分为全谷物和精制谷物。根据标准方案测量体重和身高，并计算体重指数。采集空腹血液样本进行生化测量，并根据标准方法评估血压。根据ATP III指南定义高脂血症、高胆固醇血症、高LDL、低HDL和代谢综合征，根据JNC VI定义高血压。糖尿病定义为空腹血糖水平大于或等于126 mg/dl或激发后2小时血糖水平大于或等于200 mg/dl。根据全谷物和精制谷物摄入量的四分位数划分受试者。全谷物和精制谷物的消耗量分别为93 +/- 29和201 +/- 57克/天。男性和女性都报告说精制谷物的摄入量高于全谷物。与处于下四分位数类别的受试者相比，那些处于全谷物摄入量较高类别的受试者的代谢危险因素患病率较低。相反，那些高类别的精制谷物摄入量有较高的代谢危险因素的患病率，除了糖尿病。在控制混杂因素后，观察到高甘油三酯血症（四分位数之间的比值比分别为：1.00、0.89、0.74、0.61）、高血压（1.00、0.99、0.93、0.84）和代谢综合征（1.00、0.84、0.76、0.68）的风险呈显著下降趋势。食用更多的精制谷物与高胆固醇血症的几率有关（1.00，1.07，1.19，1.23），高甘油三酯血症（1.00，1.17，1.49，2.01），高血压（1.00，1.22，1.48，1.69）和代谢综合征结论：全谷物摄入量与代谢综合征发病风险呈负相关，而精谷物摄入量与代谢综合征发病风险呈正相关。建议增加全谷物的摄入量可以降低这种风险。赞助：内分泌研究中心，沙希德贝赫什蒂医科大学。
Background: Although dietary guidelines recommend increased intake of grain products to prevent chronic diseases, epidemiologic data regarding whole-grain intake association with metabolic syndrome are sparse.Objective: To evaluate the relationship between whole-grain intakes, metabolic syndrome and metabolic risk factors in Tehranian adults.Design: Population-based cross-sectional study.Setting: Tehran, the capital of Iran.Subjects: A representative sample of 827 subjects ( 357 men and 470 women) aged 18 - 74 y.Methods: Usual dietary intake was assessed using a food frequency questionnaire. The procedure developed by Jacobs et al was used to classify grain products into whole and refined grains. Weight and height were measured according to standard protocols and body mass index was calculated. Fasting blood samples were taken for biochemical measurements and blood pressure was assessed according to standard methods. Hypertriglyceridemia, hypercholestrolemia, high LDL, low HDL and metabolic syndrome were defined according to ATP III guidelines and hypertension based on JNC VI. Diabetes was defined as fasting plasma glucose level of greater than or equal to126 mg/dl or 2-h postchallenge blood glucose level of greater than or equal to200 mg/dl. Subjects were categorized based on quartile cut-points of whole-and refined-grain intake.Results: Mean ( +/- s.d.) consumptions of whole and refined grains were 93 +/- 29 and 201 +/- 57 g/day, respectively. Both men and women reported higher intakes of refined grain than of whole grains. Compared with subjects in the lower quartile category, those in the upper category of whole-grain intake had lower prevalence of metabolic risk factors. Conversely, those in the higher category of refined-grain intake had higher prevalence of metabolic risk factors, except for diabetes. After controlling for confounders, a significantly decreasing trend was observed for the risk of having hypertriglyceridemia ( odds ratios among quartiles: 1.00, 0.89, 0.74, 0.61, respectively), hypertension ( 1.00, 0.99, 0.93, 0.84) and metabolic syndrome ( 1.00, 0.84, 0.76, 0.68). Higher consumption of refined grains was associated with higher odds of having hypercholestrolemia ( 1.00, 1.07, 1.19, 1.23), hypertriglyceridemia ( 1.00, 1.17, 1.49, 2.01), hypertension ( 1.00, 1.22, 1.48, 1.69) and metabolic syndrome ( 1.00, 1.68, 1.92, 2.25).Conclusion: Whole-grain intake is inversely and refined-grain intake is positively associated with the risk of having metabolic syndrome. Recommendations to increase whole-grain intake may reduce this risk.Sponsorship: Endocrine Research Center, Shaheed Beheshti University of Medical Sciences.