背景:尽管食用红肉与动脉粥样硬化性冠状动脉疾病和中风的风险有关,没有前瞻性研究对慢性威胁肢体缺血(CLTI)的风险进行了检测.
方法:在一项针对63,257名新加坡华人的前瞻性研究中,招募时年龄在45-74岁之间,通过经过验证的半定量食物频率问卷评估饮食.通过与全国医院下肢截肢或周围动脉疾病血管成形术的记录联系,确定了CLTI事件。多变量Cox模型用于检查肉类摄入量的四分位数与CLTI风险之间的关联。
结果:经过18.8年的平均随访,有1069例CLTI。较高的红肉摄入量与逐步增加CLTI风险相关。比较红肉摄入量的极端四分位数,与CLTI风险相关的风险比(HR)为1.24[95%置信区间(CI)=1.03~1.49;P趋势=0.02].在分层分析中,在没有糖尿病的人群中,红肉摄入与CLTI风险的相关性更强[HR(95%CI)比较极端四分位数=1.41(1.10-1.80);P-趋势=0.03]比基线糖尿病患者[HR(95%CI)比较极端四分位数=1.04(0.79-1.38);P-趋势=0.05](P-交互作用=0.03).否则,这些协会并没有因性别而异,BMI,吸烟状况,高血压,酒精消费,或心血管疾病史。在替代分析中使用理论模型,用家禽或鱼/贝类代替每周三份红肉,CLTI的相对风险降低了13-14%.
结论:在该亚洲队列中,食用红肉与较高的CLTI风险相关。用家禽或鱼/贝类代替红肉可能会降低这种风险。
BACKGROUND: Although red meat consumption has been associated with risk of atherosclerotic coronary artery disease and stroke, no prospective study has examined this with the risk of chronic limb-threatening ischemia (CLTI).
METHODS: In a prospective study of 63,257 Chinese in Singapore, who were aged 45-74 years old at recruitment, diet was assessed via a validated semi-quantitative food frequency questionnaire. Incident CLTI cases were ascertained via linkage with nationwide hospital records for lower extremity amputation or angioplasty for peripheral arterial disease. Multivariable Cox models were used to examine associations between quartiles of meat intake and CLTI risk.
RESULTS: After a mean follow-up of 18.8 years, there were 1069 cases of CLTI. Higher intake of red meat intake was associated with increased risk of CLTI in a stepwise manner. Comparing extreme quartiles of red meat intake, the hazard ratio (HR) for the association with CLTI risk was 1.24 [95% confidence interval (CI) = 1.03-1.49; P-trend = 0.02]. In stratified analysis, red meat intake had a stronger association with CLTI risk among those without diabetes [HR (95% CI) comparing extreme quartiles = 1.41 (1.10-1.80); P-trend = 0.03] than among those with diabetes at baseline [HR (95% CI) comparing extreme quartiles = 1.04 (0.79-1.38); P-trend = 0.05] (P-interaction = 0.03). Otherwise, the associations were not different by sex, BMI, smoking status, hypertension, alcohol consumption, or history of cardiovascular diseases. Using a theoretical model in substitution analysis that substituted three servings per week of red meat with poultry or fish/shellfish, the relative risk of CLTI was reduced by 13-14%.
CONCLUSIONS: Consumption of red meat was associated with higher CLTI risk in this Asian cohort. Substituting red meat with poultry or fish/shellfish may reduce this risk.