膳食脂肪摄入量与冠心病发生危险度（转自麦知音）
膳食脂肪摄入量与冠心病发生危险度：强心计划
摘要：
背景--在过去的研究结果中，关于膳食脂肪摄入量与冠心病发病率之间的联系仍不确定。目的--研究强心计划中美洲印第安人膳食脂肪摄入量与冠心病发病率的联系。
方法--2938名参与者，年龄47-79岁，在该计划第二阶段（1993-1995）的检查中确定为非冠心病。研究这些参与者到研究结束时（2002.12.31）冠心病、非致命冠心病以及致命冠心病的发病情况及膳食状况。通过24小时膳食回顾法来评估饮食脂肪摄入，并以其占总能量的百分比来计算。
结果--对参与者进行了7.2±2.3（mean±SD）年的跟踪调查。在随访中有436人被确认为冠心病，其中298名为非致命性，138名为致命性。年龄在47-59岁的参与者中，总脂肪、饱和脂肪酸和单不饱和脂肪酸摄入量最高的四分之一与最低的四分之一相比，冠心病发病率更高。排除混杂因素，这三个指标的危险比率（95%可信区间）分别为3.57 (1.21, 10.49), 5.17 (1.64, 16.36) 和3.43 (1.17, 10.04)。这种联系在60-79岁的参与者中并未发现。
结论--总脂肪酸、饱和脂肪酸和单不饱和脂肪酸摄入量可以作为独立的冠心病发病的预测指标，用于47-59岁的美洲印第人。这一结果或许可以警示他们，早期减少脂肪摄入以降低死于冠心病的风险。
原文：
Dietary fat intake and risk of coronary heart disease: the Strong Heart Study
ABSTRACT
Background: The results of previous studies on the association between dietary fat intake and coronary heart disease (CHD) incidence are inconsistent.
Objective: The aim of this study was to examine the association between dietary fat intake and CHD incidence in American Indians in the Strong Heart Study.
Design: A total of 2938 participants aged 47–79 y and free of CHD at the second examination (1993–1995) were examined and followed for CHD, nonfatal CHD, and fatal CHD events to 31 December 2002. Dietary intake was assessed by using a 24-h diet recall and was calculated as percentages of energy.
Results: Participants were followed for a mean (_SD) of 7.2 _2.3 y. During follow-up, 436 incident CHD cases (298 nonfatal CHD and 138 fatal CHD events) were ascertained. Participants aged 47–59 y in the highest quartile of intake of total fat, saturated fatty acids, or monounsaturated fatty acids had higher CHD mortality than did those in the lowest quartile [hazard ratio (95% CI): 3.57 (1.21, 10.49), 5.17 (1.64, 16.36), and 3.43 (1.17, 10.04), respectively] after confounders were controlled for. These associations were not observed for those aged 60–79 y.
Conclusions: Total fat, saturated fatty acid, and monounsaturated fatty acid intake were strong predictors of CHD mortality in American Indians aged 47–59 y, independent of other established CHD risk factors. It may be prudent for American Indians to reduce their fat intake early in life to reduce the risk of dying from CHD.
