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新鲜水果摄入与中国主要心血管疾病的关系
Fresh Fruit Consumption and Major Cardiovascular Disease in China


Huaidong Du ... 心脑血管疾病 • 2016.04.07
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摘要


背景

在西方人群中,较高的水果摄入水平与较低的心血管疾病危险相关,但在水果摄入水平低且卒中发病率高的中国,我们对于上述关联的了解极少。

 

方法

在2004—2008年间,我们在中国的10个不同地方招募了512,891名30~79岁的成人。在320万人年的随访期间,在基线时无心血管疾病病史且未接受抗高血压治疗的451,665名参与者中,我们记录到了5,173例心血管疾病导致的死亡,2,551例新发严重冠状动脉事件(致死性或非致死性),14,579例缺血性卒中和3,523例脑内出血。Cox回归产生了在新鲜水果摄入与发病率之间建立关联的校正风险比。

 

结果

共有18.0%的参与者报告每日摄入新鲜水果。与从不或很少摄入新鲜水果的参与者(“不摄入水果”分类)相比,每日摄入新鲜水果的参与者的收缩压(比前者低4.0 mm Hg)和血糖水平(比前者低0.5 mmol/L [9.0 mg/dL])较低(对于两项比较而言,趋势的P值均<0.001)。对于心血管性死亡而言,每日摄入水果与不摄入水果之间比较的校正风险比为0.60(95%可信区间[CI]为0.54~0.67),对于新发严重冠状动脉事件、缺血性卒中和出血性卒中而言,校正风险比分别为0.66(95% CI为0.58~0.75)、0.75(95% CI为0.72~0.79)和0.64(95% CI为0.56~0.74)。每项结局的发生率与新鲜水果摄入量之间有强的对数-线性剂量-反应关系。这些关联在10个研究地区之间以及在依照基线特征定义的参与者亚组中均相似。

 

结论

在中国成人中,较高的水果摄入水平与较低的血压和血糖水平相关,并且在大体上不依赖于这些因素及其他膳食和非膳食因素的情况下,较高的水果摄入水平与显著较低的主要心血管疾病的患病危险相关(惠康基金会[Wellcome Trust]等提供资助)。





作者信息

Huaidong Du, Ph.D., Liming Li, M.D., M.P.H., Derrick Bennett, Ph.D., Yu Guo, M.Sc., Timothy J. Key, D.Phil., Zheng Bian, M.Sc., Paul Sherliker, B.A., Haiyan Gao, Ph.D., Yiping Chen, D.Phil., Ling Yang, Ph.D., Junshi Chen, M.D., Shanqing Wang, Ph.D., Ranran Du, B.A., Hua Su, M.D., M.P.H., Rory Collins, F.Med.Sci., F.R.C.P.(E.), Richard Peto, F.R.S., and Zhengming Chen, D.Phil., for the China Kadoorie Biobank Study*
From the Clinical Trial Service Unit and the Epidemiological Studies Unit (H.D., D.B., P.S., H.G., Y.C., L.Y., R.C., R.P., Z.C.) and the Cancer Epidemiology Unit (T.J.K.), Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom; and the Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center (L.L.), the Chinese Academy of Medical Sciences (L.L., Y.G., Z.B.), and the China National Center for Food Safety Risk Assessment ( J.C.), Beijing, Hainan Center for Disease Control (CDC), Haikou (S.W.), Qingdao CDC, Qingdao (R.D.), and Heilongjiang CDC, Harbin (H.S.) — all in China. Address reprint requests to Dr. Du at the Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Old Rd. Campus, Oxford OX3 7LF, United Kingdom, or at huaidong.du@ctsu.ox.ac.uk; or to Prof. Li at the Department of Epidemiology and Biostatistics, Peking University, Beijing 100191, China, or at lmlee@vip.163.com. *A complete list of the members of the steering committee and collaborative group of the China Kadoorie Biobank is provided in the Supplementary Appendix, available at NEJM.org.

 

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