背景:尽管已经建立了氧化应激与胰岛素抵抗(IR)之间的关系,复合膳食抗氧化指数(CDAI)及其组分与胰岛素抵抗(IR)替代指数的关系,甘油三酯-葡萄糖指数(TyG),仍然不清楚。
方法:本研究分析了2003年至2018年国家健康与营养检查调查(NHANES)的横截面数据。多元线性回归,加权分位数和(WQS)回归,和贝叶斯核机回归(BKMR)用于分析CDAI及其组件与TyG的关联。此外,我们进行了亚组分析和一些敏感性分析.
结果:共纳入14,673名具有完整数据的参与者,平均年龄为50岁,女性为7,257名(49%)。多元线性回归表明,经过充分调整后,CDAI与TyG呈显著负相关[β:-0.005,95%CI:(-0.008,-0.002),p=0.002]。6种营养素相互校正的模型显示,维生素E(每SD增加)与TyG[β:-0.062,95%CI:(-0.074,-0.050),p<0.0001]。在WQS模型中,抗氧化剂饮食的WQS指数与TyG呈负相关(β:-0.060;P<0.0001)。在BKMR分析中观察到类似的效果。值得注意的是,在WQS和BKMR模型中,维生素E成为最具影响力的成分。此外,在亚组分析中,在超重或肥胖和糖尿病人群中,CDAI与TyG之间的关联显著减弱.
结论:抗氧化饮食,尤其是维生素E,与TyG呈显著负相关。本研究强调补充维生素E对改善IR的重要价值。然而,体重管理不良和糖尿病患者似乎从抗氧化饮食中获益较少.
BACKGROUND: Although the relationship between oxidative stress and insulin resistance (IR) has been established, the associations of the composite dietary antioxidant index (CDAI) and its components with the surrogate index of insulin resistance (IR), triglyceride-glucose index (TyG), is still not clear.
METHODS: This study analyzed the cross-sectional data of the National Health and Nutrition Examination Survey (NHANES) from 2003 to 2018. Multivariate linear regression, weighted quantile sum (WQS) regression, and Bayesian kernel machine regression (BKMR) were used to analyze the associations of the CDAI and its components with the TyG. In addition, subgroup analysis and several sensitivity analyses were conducted.
RESULTS: A total of 14,673 participants with complete data were included, with a median age of 50 years and 7,257 women (49%). Multivariate linear regression showed that after full adjustment, the CDAI was significantly negatively associated with the TyG [β: -0.005, 95% CI: (-0.008, -0.002), p = 0.002]. The model in which six nutrients were mutually corrected showed that vitamin E (per-SD increase) was most strongly associated with the TyG [β: -0.062, 95% CI: (-0.074, -0.050), p < 0.0001]. In the WQS model, the WQS index of the antioxidant diet was negatively associated with the TyG (β: -0.060; P < 0.0001). Similar effects were observed in the BKMR analysis. Notably, in the WQS and BKMR models, vitamin E became the most influential component. In addition, in the subgroup analysis, the association between the CDAI and the TyG in overweight or obese and diabetic populations was significantly weaker.
CONCLUSIONS: Antioxidant diets, especially vitamin E, are significantly negatively correlated with TyG. This study emphasizes the important value of supplementing vitamin E to improve IR. However, patients with poor weight management and diabetes seem to benefit less from antioxidant diets.