J Am Coll Cardiol：研究证实膳食血糖负荷对男女两性影响存在差异

苏州大学的一项荟萃分析表明，在女性中高膳食血糖负荷（GL）和血糖指数（GI）可显著升高冠心病风险，但在男性中并非如此，不良影响在超重和肥胖患者中可能更为显著。论文于2012年3月22日在线发表于《The American Journal of Cardiology》。
 
高血糖膳食可能升高心血管风险，但该风险是否存在性别或肥胖差异尚无定论。研究者对Pubmed和Embase数据库中适宜文献进行了检索。利用随机效应模型计算最高与最低暴露分类相比合并相对危险度（RR）。利用性别和体质指数进行预定的亚组分析。
 
结果显示，共有8项前瞻性研究符合纳入标准，共纳入220050例受试者和4826例偶发冠心病。男性的膳食GL相关性冠心病综合RR为1.08，女性为1.69，男、女性综合为1.36。对于膳食GI，相应的综合RR分别为0.99、1.26和1.13。有限的证据提示上述相关性在超重和肥胖中更为显著。未提示发表偏倚。（生物谷 bioon.com）

doi:10.1016/j.amjcard.2012.01.385
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Meta-Analysis of Dietary Glycemic Load and Glycemic Index in Relation to Risk of Coronary Heart Disease

Jia-Yi Dong,Yong-Hong Zhang,Peiyu Wang,Li-Qiang Qin

A high glycemic diet may increase cardiovascular risk, yet whether the risk differs by gender or adiposity is inconclusive. Our goal was to determine the associations between dietary glycemic load (GL) and glycemic index (GI), and coronary heart disease (CHD) risk by conducting a meta-analysis of prospective studies. We searched the PubMed and Embase databases in July 2011 to identify eligible studies. The random-effects model was used to calculate pooled relative risks (RRs) comparing the highest categories of exposure to the lowest. Prespecified subgroup analyses were performed by gender and body mass index. We identified 8 prospective studies for meta-analysis, consisting of 220,050 participants and 4,826 incident CHD cases. Pooled RRs of CHD in relation to dietary GL were 1.08 (95% confidence interval [CI] 0.92 to 1.27) for men, 1.69 (95% CI 1.32 to 2.16) for women, and 1.36 (95% CI 1.13 to 1.63) for men and women combined. For dietary GI, corresponding pooled RRs were 0.99 (95% CI 0.84 to 1.16), 1.26 (95% CI 1.12 to 1.43), and 1.13 (95% CI 1.00 to 1.28), respectively. Limited evidence suggested the associations appeared more evident in the overweight and obese. There was no indication of publication bias. In conclusion, high dietary GL and GI significantly increased the risk of CHD in women but not in men, and the unfavorable effects may be more pronounced in overweight and obese patients. Further studies are needed to verify these findings and elucidate the underlying mechanisms.