Association of Dietary Glycemic Index and Glycemic Load With Proatherogenic Factors and Carotid Intima-Media Thickness in Patients With Metabolic Syndrome.

Abstract

Metabolic syndrome (MetS) is associated with an increased risk of cardiovascular disease (CVD); however, its etiology-particularly its relationship with dietary factors-remains poorly understood. The study aimed to investigate the relationship between dietary glycemic index (GI) and glycemic load (GL) with carotid intima-media thickness (cIMT) and proatherogenic inflammatory markers in patients with MetS. This cross-sectional study was conducted among 185 subjects (80 males and 105 females) aged 20-50 years. Dietary intake was assessed using a validated food frequency questionnaire, and dietary GI and GL were calculated. Main outcomes were cIMT as well as serum levels of malondialdehyde (MDA), high-sensitivity C-reactive protein (hs-CRP), tumor necrosis factor-alpha (TNF-α), intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), and E-selectin. There was a significant trend indicating that higher GI and GL were associated with elevated serum levels of MDA, TNF-α, and VCAM-1. In addition, a significant trend was observed indicating an increase in cIMT across higher tertile categories of both GI and GL. However, dietary GI and GL were not associated with serum levels of hs-CRP, ICAM-1, and E-selectin. Higher dietary GI and GL are associated with increased cIMT, elevated oxidative stress, and proatherogenic inflammatory markers in patients with MetS. These findings suggest that diets high in GI and GL may contribute to the progression of atherosclerosis in this population. Therefore, low-GI and low-GL diets may help reduce the risk of CVD and should be considered in dietary recommendations for these patients.