心血管-肾脏代谢综合征饮食模式的叙述性综述

摘要(中文译文)

在全球肥胖率上升和生活方式转变的推动下，心血管-肾脏-代谢（CKM）综合征已成为一种以代谢紊乱为特征、涉及多器官相互作用的病理生理连续体。在CKM综合征的综合管理中，饮食模式因其高度可改变性和成本效益而成为干预的基石。本叙述性综述从CKM综合征病理生理连续体的视角出发，对地中海饮食、DASH饮食、植物性饮食和生酮饮食与代谢综合征、2型糖尿病、慢性肾脏病和心血管疾病相关的现有文献进行了主题性概述。证据表明，地中海饮食和DASH饮食通过已确立的抗炎、抗氧化和内皮保护机制，是CKM风险缓解方面支持证据最为一致的饮食模式。植物性饮食的功效严格依赖于其质量：富含全谷物和蔬菜的健康模式与心肾结局改善相关，而以精制碳水化合物为主的不健康模式可能加剧代谢紊乱。尽管生酮饮食可能在短期内改善葡萄糖代谢，但关于低密度脂蛋白胆固醇升高、潜在肝毒性以及长期依从性有限的担忧表明，其作用可能更适合于特定的短期情境，而非作为长期持续采用的饮食模式。此外，结构化的饮食质量指数可为表征与CKM相关的饮食暴露以及生成机制性假设提供有用的工具。通过整合临床和机制证据，本综述勾勒了一个以分期为导向的概念框架，以讨论不同饮食模式如何与CKM综合征的不同阶段相关联。

Abstract

Driven by the global rise in obesity and lifestyle transitions, cardiovascular-kidney-metabolic (CKM) syndrome has emerged as a pathophysiological continuum characterized by metabolic dysregulation and involving multi-organ interactions. Within the comprehensive management of CKM syndrome, dietary patterns represent a cornerstone of intervention due to their high modifiability and cost-effectiveness. Adopting the perspective of the CKM syndrome pathophysiological continuum, this narrative review provides a thematic overview of the current literature on the Mediterranean, DASH, plant-based, and ketogenic diets in relation to metabolic syndrome, type 2 diabetes mellitus, chronic kidney disease, and cardiovascular disease. Evidence indicates that the Mediterranean and DASH diets, through established anti-inflammatory, antioxidant, and endothelial protective mechanisms, are the most consistently supported dietary patterns for CKM risk mitigation. The efficacy of plant-based diets is strictly quality-dependent: while healthful patterns rich in whole grains and vegetables are associated with improved cardiorenal outcomes, unhealthful patterns dominated by refined carbohydrates may exacerbate metabolic derangements. Although the ketogenic diet may improve glucose metabolism in the short term, concerns regarding elevated low-density lipoprotein cholesterol, potential hepatotoxicity, and limited long-term adherence suggest that its role may be more relevant in selected short-term settings than as a sustained long-term dietary pattern. Furthermore, structured dietary quality indices may provide useful tools for characterizing dietary exposure in relation to CKM and for generating mechanistic hypotheses. By integrating clinical and mechanistic evidence, this review outlines a stage-oriented conceptual framework to discuss how different dietary patterns may relate to distinct phases of the CKM syndrome.

如何引用

Frontiers in nutrition 的其他文献

• 从饮食到疾病调节：药用食物同源植物在肝纤维化中的多靶点作用
• 短期生酮饮食诱导与人类代谢适应相关的全身性脂质组重塑
• 无麸质藜麦蒸粗麦粉的工艺优化和营养分析：氨基酸和多酚特征
• 急性有氧运动调节尼古丁依赖者与甜味相关的食物偏好：前额叶皮层活动的中介作用
• 白及寡糖通过调节肠道菌群和宿主代谢缓解高脂饮食诱导的小鼠代谢相关脂肪性肝病
• 中国新生儿重症监护病房中极低出生体重婴儿的肠内喂养实践与指南依从性：一项多中心横断面调查
• 老年营养风险指数预测老年尿脓毒症患者的短期死亡率：一项具有外部验证的回顾性队列研究
• 估计的葡萄糖处理率与患有肌少症的老年人代谢综合征之间的关联
• 妊娠期糖尿病女性饮食炎症指数与妊娠结局之间的相关性：一项前瞻性队列研究
• 乒乓球运动员的膳食和营养补充策略：一个小综述