背景:大量营养素消费与2型糖尿病(T2D)风险之间的关系仍然模棱两可。这里,我们调查了西亚人群中大量营养素摄入的数量和质量是否与T2D发病率相关.
方法:无T2D的成年人(n=2457,平均年龄38.5±13.6岁,54.2%的妇女)参加了德黑兰脂质和葡萄糖研究的第三个检查周期(2005-2008年),平均随访8.6年。我们估计了常量营养素质量指数(MQI),其各个子指数(碳水化合物质量指数(CQI),脂肪质量指数(FQI),和健康平板蛋白质质量指数(HPPQI)),以及大量营养素的数量。与大量营养素数量相关的T2D风险,质量,并使用Cox比例风险模型对其联合效应进行检验,校正了已知的T2D危险因素.
结果:在研究随访期间,记录了257例T2D事件。MQI和CQI最高三分位数的个体的T2D风险比最低三分位数的个体低27%(HR=0.73,95%CI=0.54,0.98)和29%(HR=0.71,95%CI=0.51-0.99)。中间HPPQI三元组的T2D发生率比最低三元组低35%(HR=0.65,95%CI=0.47,0.89)。多变量调整模型显示,碳水化合物摄入量中和最高三元的个体比最低三元的个体低32%(HR=0.68,95%CI=0.49-0.95)和26%(HR=0.74,95%CI=0.55-1.00)T2D风险。大量的,高质量的碳水化合物饮食(CQI≥13的碳水化合物能量≥58.5%)和低血糖指数(GI),高纤维饮食(GI<55和纤维≥25g/d)与T2D风险降低34%(HR=0.66,95%CI=0.47,0.93)和42%(HR=0.58,95%CI=0.38,0.90)相关,分别。
结论:具有较高碳水化合物质量的饮食可能与较低的T2D发病率相关,特别是当碳水化合物的数量也很高时。
BACKGROUND: The association between macronutrient consumption and the risk of type 2 diabetes (T2D) remains equivocal. Here, we investigated whether the quantity and quality of macronutrient intake are associated with T2D incidence in a West Asian population.
METHODS: T2D-free adults (n = 2457, mean age 38.5 ± 13.6 years, 54.2% women) who participated in the third examination cycle (2005-2008) of the Tehran Lipid and Glucose Study were followed for a median of 8.6 years. We estimated the macronutrient quality index (MQI), its individual sub-indices (carbohydrate quality index (CQI), fat quality index (FQI), and healthy plate protein quality index (HPPQI)), as well as the macronutrient quantity. The risk of T2D in relation to macronutrient quantity, quality, and their combined effects was examined using Cox proportional hazard models adjusted for known risk factors for T2D.
RESULTS: During the study follow-up, 257 incident cases of T2D were documented. Individuals in the highest tertiles of MQI and CQI had a 27% (HR = 0.73, 95% CI = 0.54, 0.98) and 29% (HR = 0.71, 95% CI = 0.51-0.99) lower T2D risk than those in the lowest tertiles. The T2D incidence was 35% lower in the middle HPPQI tertile than in the lowest (HR = 0.65, 95% CI = 0.47, 0.89). The multivariable adjusted model showed that individuals in the middle and highest tertiles of carbohydrate intake had 32% (HR = 0.68, 95% CI = 0.49-0.95) and 26% (HR = 0.74, 95% CI = 0.55-1.00) lower risks of T2D than individuals in the lowest tertile. A high-quantity, high-quality carbohydrate diet (≥ 58.5% of energy from carbohydrate with a CQI ≥ 13) and a low-glycemic index (GI), high-
fiber diet (GI < 55 and
fiber ≥ 25 g/d) were related to a reduced risk of T2D by 34% (HR = 0.66, 95% CI = 0.47, 0.93) and 42% (HR = 0.58, 95% CI = 0.38, 0.90), respectively.
CONCLUSIONS: A diet with a higher carbohydrate quality may be associated with a lower T2D incidence, particularly when the carbohydrate quantity is also high.