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Am J Clin Nutr:经常摄入黄酮类与缺血性卒中风险降低有关

2021-05-10 Dr.Sun Nutrition & Health MedSci原创

从全球范围来看,卒中是造成残疾和死亡的主要原因,其社会经济负担随着人口老龄化的增加而持续增加。总体而言,卒中包括缺血性卒中和出血性卒中,是全世界第二大死因。包括致命性和非致命性在内的全部卒中病例中大约

从全球范围来看,卒中是造成残疾和死亡的主要原因,其社会经济负担随着人口老龄化的增加而持续增加。总体而言,卒中包括缺血性卒中和出血性卒中,是全世界第二大死因。包括致命性和非致命性在内的全部卒中病例中大约80%为缺血性卒中,尽管这一点因人口而异。缺血性卒中发生的血管闭塞,主要是动脉粥样硬化和心源性脑栓塞的结果,而由于血管破裂所致的出血性卒中,是由不同的潜在致病机制引起的,通常涉及高血压和脑淀粉样沉积。茶、可可、坚果、水果和蔬菜等食品中存在的黄酮类化合物具有抗炎、抗动脉粥样硬化和抗血栓特性,研究表明在预防缺血性卒中方面发挥作用。先前的研究表明,总黄酮类化合物的摄入量较高与动脉粥样硬化心血管疾病住院率降低有关,包括缺血性卒中住院率降低。然而,除此之外,只有少数其他研究调查了类黄酮类化合物摄入量与缺血性卒中风险之间的关联。

近日,发表在American Journal of Clinical Nutrition杂志上的一项研究,来自澳大利亚西澳大学等机构的研究人员调查了总黄酮、黄酮亚类和主要的黄酮类化合物与缺血性卒中发病率之间的关联,并调查了可能从高黄酮摄入量中获益最大的人群。

在这项前瞻性队列研究中,55,169名先前没患缺血性卒中的丹麦居民 [入组年龄中位数(IQR)为56岁(52–60岁)],随访21年(20-22年)。研究人员使用Phenol-Explorer评估在研究开始时获得的食物频率问卷中的黄酮类摄入量。从丹麦全国登记处确定缺血性卒中新发病例,并利用Cox比例风险回归模型中的限制性立方样条来调查与黄酮类化合物摄入量的关系。

研究结果发现,在21年(20–22年)的中位(IQR)随访期间,发生了4237例缺血性卒中新发病例(包括致命性和非致命性)。在对人口统计学和生活方式因素进行多变量调整后,总黄酮摄入量与缺血性卒中发病率降低相关。限制性立方样条显示呈非线性负相关;这种相关性稳定在∼500mg/d的摄入量。经过多变量调整后,与总黄酮摄入量最低的参与者相比,摄入量最高的参与者缺血性卒中的风险降低12%[HR: 0.88 (95% CI: 0.81, 0.96)]。

立方样条曲线描述总黄酮摄入量与总(首次)缺血性卒中事件之间的关联(n = 4237

黄酮醇和黄烷醇寡聚体+多聚体的摄入量与缺血性卒中的发病率呈负相关,在Q5中观察到最低的相对风险。在对饮食混杂因素进行额外调整后,黄烷醇寡聚体+多聚体的摄入量的关联在统计学上仍然具有显著性,但黄酮醇不显著。花青苷类和黄酮类的关联为U形;观察到中等摄入量者缺血性卒中的相对风险最低。在对饮食混杂因素进行额外调整后,花青苷类的摄入量的关联在统计学上仍然具有显著性,但黄酮类不显著。黄烷酮类和黄烷醇单体的摄入与缺血性卒中无关。

基于立方样条曲线的危险比描述黄酮类亚类摄入量(mg/d)与总 (首次)缺血性卒中事件  之间的关联(n = 4237)

在所调查的黄酮醇化合物中,槲皮素而非崁非醇,与缺血性卒中风险降低呈非线性相关;这种负相关稳定在中等摄入量。在对饮食混杂因素进行额外调整后,无论是槲皮素还是崁非醇与缺血性卒中风险的相关性均不显著。检查的两种黄烷醇寡聚体,即原花色素二聚体和原花色素三聚体,与缺血性卒中风险降低均呈非线性相关,黄烷醇单体表儿茶素同样如此:所有显著负相关稳定在中等摄入量,在模型3中保持不变。关于花青素化合物,所有模型中较高的锦葵色素摄入量与缺血性卒中风险较低相关;然而,花青定和翠雀定的相关性为U形:观察到中等摄入量的缺血性卒中风险降低。在对饮食摄入量进行调整后,花青定的显著性减弱,但翠雀定不减弱。黄酮芹菜素也与缺血性卒中呈U形相关,虽然这在对饮食进行调整后减弱。

基于立方样条曲线的危险比描述主要黄酮类化合物摄入量与总(首次)缺血性卒中事件之间的关联(n = 4237)

总黄酮类摄入量与缺血性卒中之间的相关性在所有调查的亚组人群中都存在;这些相关性的形状似乎与在整个人群中看到的相似,除了BMI >30 kg/m2的人群,其相关性看起来更多呈U形。在绝对尺度上,吸烟者缺血性卒中的风险评估差异往往高于非吸烟者,肥胖参与者高于非肥胖参与者,高酒精摄入量者高于低酒精摄入量者。这可能表明,易于出现动脉粥样硬化的亚群可能从较高的黄酮类化合物摄入量中获益最大,尽管需要进一步调查以支持这些初步调查。

研究人员解释说,缺血性卒中的病理学是复杂的。对黄酮类化合物和富含黄酮类化合物的食物进行的随机对照试验(RCTs)表明,它们具有多种抗动脉粥样硬化作用,包括有益调节血压、内皮功能和动脉硬化的能力。同时,黄酮类化合物已显示出抗血栓和抗炎特性。总的来说,这些作用可能有助于降低缺血性卒中的风险。

总之,经常适量摄入某些黄酮亚类和化合物似乎与缺血性卒中的风险降低有关。这些发现为食用富含黄酮类化合物的健康食品提供了支持,并凸显了其在未来针对营养的健康促进政策、实践或方案中改善人群健康的潜力。

原始出处:

Benjamin H Parmenter, Frederik Dalgaard et al. Habitual flavonoid intake and ischemic stroke incidence in the Danish Diet, Cancer, and Health Cohort. Am J Clin Nutr. 2021 May 8;nqab138.  doi: 10.1093/ajcn/nqab138.

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  4. 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replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Tue May 11 02:52:17 CST 2021, time=2021-05-11, status=1, ipAttribution=)]
    2022-04-18 fengyi821
  5. 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  6. 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replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Tue May 11 02:52:17 CST 2021, time=2021-05-11, status=1, ipAttribution=)]
    2021-05-12 汉水人家

    学习学习

    0

  7. 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createdName=guihongzh, createdTime=Thu Aug 12 20:52:17 CST 2021, time=2021-08-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1806435, encodeId=e70e1806435fb, content=<a href='/topic/show?id=b649e9358fa' target=_blank style='color:#2F92EE;'>#缺血性卒#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79358, encryptionId=b649e9358fa, topicName=缺血性卒)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=636e2500187, createdName=12498da4m32(暂无昵称), createdTime=Sat Feb 19 18:52:17 CST 2022, time=2022-02-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1683591, encodeId=01861683591ac, content=<a href='/topic/show?id=3f17103210ed' target=_blank style='color:#2F92EE;'>#黄酮#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=103210, encryptionId=3f17103210ed, topicName=黄酮)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=443c27982006, createdName=fengyi821, createdTime=Mon Apr 18 05:52:17 CST 2022, time=2022-04-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1281369, encodeId=0398128136950, content=<a href='/topic/show?id=455f36085f0' target=_blank style='color:#2F92EE;'>#卒中风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36085, encryptionId=455f36085f0, topicName=卒中风险)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a8f1167, createdName=wmr111, createdTime=Wed May 12 14:52:17 CST 2021, time=2021-05-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=964800, encodeId=af00964800a6, content=学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=115, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=65d55484096, createdName=汉水人家, createdTime=Wed May 12 08:04:27 CST 2021, time=2021-05-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=964475, encodeId=1a069644e510, content=谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTLEOiakaK8sYGCv76kLFzxPhdQgDEGEMYESvlybZeTpwIypq7MnxAhZvG6DGtFE4RhyOecg4Heajeg/132, createdBy=3f195230122, createdName=排位, createdTime=Tue May 11 08:35:48 CST 2021, time=2021-05-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=964467, encodeId=d6e196446e2e, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210416/63ad7921535a46e793fc2b5377a539a7/1def2b169ab84693982a3100c8eba665.jpg, createdBy=59f35474720, createdName=ms8000000973263526, createdTime=Tue May 11 08:25:11 CST 2021, time=2021-05-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=964456, encodeId=d35e964456ad, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=116, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210511/dccd6a45c3b140ec99972fd01118c709/8ad2e0adb86c43f6881478af5c7f32d5.jpg, createdBy=28c55256344, createdName=老大208, createdTime=Tue May 11 07:24:13 CST 2021, time=2021-05-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1026849, encodeId=166a10268499c, content=卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Tue May 11 02:52:17 CST 2021, time=2021-05-11, status=1, ipAttribution=)]
    2021-05-11 排位

    谢谢分享

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=1820719, encodeId=84e51820e1991, content=<a href='/topic/show?id=0c6a1009105e' target=_blank style='color:#2F92EE;'>#风险降低#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100910, encryptionId=0c6a1009105e, topicName=风险降低)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fd18451, createdName=xre2008, createdTime=Tue Aug 10 07:52:17 CST 2021, time=2021-08-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1893378, encodeId=957418933e853, content=<a href='/topic/show?id=c738e93521f' target=_blank style='color:#2F92EE;'>#缺血性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79352, encryptionId=c738e93521f, topicName=缺血性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=66ec123, 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topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=65d55484096, createdName=汉水人家, createdTime=Wed May 12 08:04:27 CST 2021, time=2021-05-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=964475, encodeId=1a069644e510, content=谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTLEOiakaK8sYGCv76kLFzxPhdQgDEGEMYESvlybZeTpwIypq7MnxAhZvG6DGtFE4RhyOecg4Heajeg/132, createdBy=3f195230122, createdName=排位, createdTime=Tue May 11 08:35:48 CST 2021, time=2021-05-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=964467, encodeId=d6e196446e2e, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, 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replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Tue May 11 02:52:17 CST 2021, time=2021-05-11, status=1, ipAttribution=)]
    2021-05-11 ms8000000973263526

    学习了

    0

  9. 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replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Tue May 11 02:52:17 CST 2021, time=2021-05-11, status=1, ipAttribution=)]
    2021-05-11 老大208

    学习了

    0

  10. 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replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Tue May 11 02:52:17 CST 2021, time=2021-05-11, status=1, ipAttribution=)]
    2021-05-11 健健

    卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!

    0

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