高碳水化合物饮食与高血压发病的前瞻性队列研究  

The relationship between high carbohydrate diet and hypertension based on a prospective cohort study

作　　者：潘昀熙 王艺颖 周婕[1] 吴延莉 余丽莎[1] 张骥 赵否曦 任豫晋 刘涛[1] PAN Yun-xi;WANG Yi-ying;ZHOU Jie;WU Yan-li;YU Li-sha;ZHANG Ji;ZHAO Fou-xi;REN Yu-jin;LIU Tao(Guizhou Center for Disease Control and Prevention,Guiyang,Guizhou 550004,China)

机构地区：[1]贵州省疾病预防控制中心,贵州贵阳550004

出　　处：《现代预防医学》2023年第16期2937-2943,共7页Modern Preventive Medicine

基　　金：贵州省科技厅科技支撑项目(黔科合支撑[2018]2819);贵州省卫生健康委省级重点建设学科项目。

摘　　要：目的探讨碳水化合物摄入与高血压发病的关系。方法本研究使用贵州省自然人群队列研究数据库,队列于2010年采用分层随机整群抽样的方法,对贵州省12个区(县)的48个乡镇共9280人进行调查。2016至2020年,完成了随访调查。最终纳入5546例进入本次研究分析。在基线和随访时收集血压、食物摄入及高血压发生情况等资料,获得各类食物的能量、宏量营养素摄入量及其供能比,分别计算总碳水、素食类碳水、动物类碳水化合物的供能比,根据供能比进行三分位分组。采用多因素Cox生存回归分析碳水化合物摄入与高血压发病的相关性。结果以5546名成年人为分析对象,在随访期间,新发高血压1200人,其中男性占48.58%,平均年龄为(40.60±13.86)岁。与总碳水供能比在第一分位组的人群比较,总碳水供能比在第二分位组、第三分位组、第四分位组的人群高血压发病风险分别为HR=1.30,95%CI:1.09~1.54、HR=1.21,95%CI:1.02~1.44、HR=1.32,95%CI:1.11~1.57,高碳水饮食可增加高血压的发病风险。与素食类碳水供能比在第一分位组的人群比较,素食类碳水供能比在第二分位组、第三分位组、第四分位组的人群,高血压发病风险分别为HR=1.26,95%CI:1.06~1.50、HR=1.21,95%CI:1.01~1.44、HR=1.35,95%CI:1.13~1.61。与动物类碳水供能比在第一分位组的人群比较,动物类碳水供能比在第四分位组的人群,高血压发病风险降低了29%。高碳水饮食与高血压发病的相关性在城市人群中更为显著。结论高碳水化合物饮食是高血压的危险因素,在城市人群中更加显著,高动物类碳水化合物饮食是高血压的保护性因素。Objective To explore the relationship between carbohydrate intake and risk of hypertension.Methods In this study,a total of 9280 people from 48 towns and townships in 12 districts(counties)of Guizhou province were surveyed by stratified random cluster sampling in 2010.A follow-up survey was completed from 2016 to 2020.Finally,5546 respondents were included in this study.Data such as blood pressure,food intake and incidence of hypertension were collected at baseline and follow-up to obtain the energy,macronutrient intake and energy ratio of each food.The energy ratio of total carbohydrate,vegetarian carbohydrate and animal carbohydrate was calculated respectively.Multivariate Cox survival regression was used to analyze the correlation between carbohydrate intake and hypertension,and the related factors were adjusted.Results In this study,5546 adults were analyzed.During the follow-up,1200 of them developed hypertension,48.58%were male,with an average age of(40.60±13.86)years.Compared with the first quartile of total Carbon-water functional ratio,the risk of hypertension in the second,third and fourth quintile groups was 1.30(1.09-1.54),1.21(1.02-1.44),1.32(1.11-1.57).High carbohydrate diets increased the risk of high blood pressure.Compared with the first quartile of carbon-water functional ratio of vegetarians,the risk of hypertension in the second,third and fourth quintile groups was 1.26(1.06-1.50),1.21(1.01-1.44),1.35(1.13-1.61).Compared with the first quartile of carbon-water functional ratio of meats,the risk of hypertension was reduced by 29%.The correlation between high-carbohydrate diet and the incidence of hypertension was more significant in urban population.Conclusion High carbohydrate diet is a risk factor for hypertension,which is more significant in urban population.High animal-based carbohydrate diet is a protective factor for hypertension.

关 键 词：高血压 碳水化合物 发病 

分 类 号：R544.1[医药卫生—心血管疾病]