这项工作的主要目的是研究地中海饮食(MD)与代谢综合征(MetS)之间的关系及其在35至74岁之间的高加索受试者中的成分。次要目标是分析性别差异。
方法:横断面试验。这项研究利用了EVA的数据,马克,和证据研究,共纳入3417名受试者,平均年龄±SD为60.14±9.14岁(57%为男性)。我们遵循国家胆固醇教育计划III中建立的五个标准来定义MetS。使用PREDIMED研究中使用的14项地中海饮食依从性筛选器(MEDAS)评估MD。当MD值高于中值时,认为具有良好的粘附性。
结果:MEDAS问卷的平均值±SD值为5.83±2.04(男性为5.66±2.06,女性为6.04±1.99;p<0.001)。对MD的坚持率为38.6%(男性34.3%,女性40.3%;p<0.001)。在41.6%中观察到MetS(39.0%男性和45.2%女性;p<0.001)。在多元回归分析中,在调整了可能的混杂因素后,平均MD值与每位受试者的MetS成分数量呈负相关(β=-0.336),以及MetS的不同成分:收缩压(β=-0.011),舒张压(β=-0.029),血糖(β=-0.009),甘油三酯(β=-0.004),和腰围(β=-0.026),除了HDL-胆固醇值显示出正相关(β=0.021);所有情况下p<0.001。在进行的逻辑回归分析中,我们发现,MD依从性的增加与MetS(OR=0.56)及其组成部分的概率降低有关:血压水平≥130/85mmHg(OR=0.63),空腹血糖≥100mg/dL(OR=0.62),甘油三酯水平≥150mg/dL(OR=0.65),女性腰围≥88厘米,男性腰围≥102厘米(OR=0.74),男性高密度脂蛋白胆固醇<40mg/dL,女性<50mg/dL(OR=1.70);所有情况下p<0.001。按性别划分的结果相似,多元回归和逻辑回归。
结论:在我们的工作中发现的结果表明,对MD的依从性越高,呈现MetS的概率越低。该结果在研究中按性别重复。需要更多的研究来澄清这些结果可以扩展到其他地中海国家,以及地中海盆地以外的其他国家。
The main objective of this work is to investigate the relationship between the Mediterranean diet (MD) and metabolic syndrome (MetS) and its components in Caucasian subjects between 35 and 74 years. The secondary objective is to analyze sex differences.
METHODS: A cross-sectional trial. This study utilized data from the EVA, MARK, and EVIDENT studies, and a total of 3417 subjects with a mean age ± SD of 60.14 ± 9.14 years (57% men) were included. We followed the five criteria established in the National Cholesterol Education Program III to define MetS. The MD was assessed with the 14-item Mediterranean diet adherence screener (MEDAS) used in the PREDIMED study. Good adherence was considered when the MD value was higher than the median value.
RESULTS: The mean ± SD value of the MEDAS questionnaire was 5.83 ± 2.04 (men 5.66 ± 2.06 and women 6.04 ± 1.99; p < 0.001). Adherence to the MD was observed by 38.6% (34.3% men and 40.3% women; p < 0.001). MetS was observed in 41.6% (39.0% men and 45.2% women; p < 0.001). In the multiple regression analysis, after adjusting for possible confounders, the mean MD value showed a negative association with the number of MetS components per subject (β = -0.336), and with the different components of MetS: systolic blood pressure (β = -0.011), diastolic blood pressure (β = -0.029), glycemia (β = -0.009), triglycerides (β = -0.004), and waist circumference (β = -0.026), except with the HDL-cholesterol value which showed a positive association (β = 0.021); p < 0.001 in all cases. In the logistic regression analysis performed, we found that an increase in MD adherence was associated with a decrease in the probability of MetS (OR = 0.56) and its components: blood pressure levels ≥ 130/85 mmHg (OR = 0.63), fasting plasma glucose ≥ 100 mg/dL (OR = 0.62), triglyceride levels ≥ 150 mg/dL (OR = 0.65), waist circumference levels ≥ 88 cm in women and ≥102 cm in men (OR = 0.74), and increased high-density lipoprotein cholesterol < 40 mg/dL in men and <50 mg/dL in women (OR = 1.70); p < 0.001 in all cases. The results by sex were similar, both in multiple regression and logistic regression.
CONCLUSIONS: The results found in our work indicate that the greater the adherence to the MD, the lower the probability of presenting MetS. This result is repeated in the study by sex. More studies are needed to clarify that these results can be extended to the rest of the Mediterranean countries, and to other countries outside the Mediterranean basin.