目的 探讨膳食营养素对冠心病患者血浆致动脉硬化指数(atherogenic index of plasma,AIP)的影响.方法 采用横断面研究,选择在某三甲医院首次经冠状动脉造影确诊为冠心病的患者309例,通过实验室检查检测总胆固醇、甘油三酯、高密度脂蛋白胆固醇及低密度脂蛋白胆固醇,并计算AIP值,将患者分为低AIP组(AIP＜0.06)和高AIP组(AIP≥0.06).采用半定量食物频率问卷进行问卷调查,通过多因素logistic回归分析探讨膳食营养素与AIP的相关性.结果 低AIP组患者159例,高AIP组患者150例.冠心病患者的膳食脂肪、膳食纤维、维生素A及维生素C摄入量分别为(97.48±34.75)g/d、(17.21±6.62)g/d、(759.83±446.53)μgRE/d 及(142.84±62.49)mg/d.logistic 回归分析显示,膳食纤维、维生素A及维生素C是高AIP的独立保护因素(OR=0.920,95％CI:0.864～0.980;OR=0.999,95％CI:0.998～0.999;OR=0.998,95％CI:0.997～0.999,P均＜0.05),而膳食脂肪是高 AIP的独立危险因素(OR=1.014,95％CI:1.006～1.022,P=0.001).结论 将AIP值列入冠心病筛查与预后常规指标具有积极现实意义,膳食纤维、维生素A、维生素C及脂肪摄入量是AIP的重要影响因素,对冠心病患者进行膳食指导可有效改善机体血脂代谢,减轻疾病负担.
Association between dietary nutrients and the atherogenic index of plasma in patients with coronary artery disease
Objective To explore the impact of dietary nutrients on the atherogenic index of plasma(AIP)in patients with coronary artery disease(CAD).Methods A cross-sectional study was performed.We selected 309 patients diagnosed with CAD by coronary angiography for the first time in a grade-A tertiary hospital.Total cholesterol,triglyceride,high density lipoprotein-cholesterol and low density lipoprotein-cholesterol were detected by laboratory testing,and the AIP value was calculated.According to the AIP value,309 CAD patients were divided into the low AIP group(AIP＜0.06)and the high AIP group(AIP ≥ 0.06).A questionnaire survey was conducted by using Semi-Quantitative Food Frequency Questionnaire.Multivariate logistic regression analysis was performed to explore the association between dietary nutrients and AIP.Results There were 159 CAD patients in the low AIP group and 150 CAD patients in the high AIP group.The intake of dietary fat,dietary fiber,vitamin A and vitamin C in the CAD patients was(97.48±34.75)g/d,(17.21±6.62)g/d,(759.83±446.53)μgRE/d and(142.84±62.49)mg/d respectively.Multivariate logistic analysis indicated that dietary fiber,vitamin A and vitamin C were independent protective factors for AIP(OR=0.920,95％CI:0.864-0.980;OR=0.999,95％CI:0.998-0.999;OR=0.998,95％CI:0.997-0.999;all P＜0.05),while dietary fat was an independent risk factor for AIP(OR=1.014,95％CI:1.006-1.022,P=0.001).Conclusion It has positive and practical significance to include AIP in the routine indicator of CAD screening and prognosis.Dietary fiber,vitamin A,vitamin C and fat intake are important factors influencing AIP.Therefore,dietary guidance for the CAD patients can effectively improve body lipid metabolism and reduce the disease burden.
coronary artery diseaseatherogenic index of plasmadietary nutrientdietary guidance
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