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葡萄糖不耐受高危人群的饮食模式。日本裔巴西糖尿病研究小组。

Dietary patterns in a high-risk population for glucose intolerance. Japanese-Brazilian Diabetes Study Group.

作者信息

Costa M B, Ferreira S R, Franco L J, Gimeno S G, Iunes M

机构信息

Department of Medicine, Federal University of Juiz de Fora, Brazil.

出版信息

J Epidemiol. 2000 Mar;10(2):111-7. doi: 10.2188/jea.10.111.

Abstract

We evaluated dietary habits as risk factor for glucose intolerance in a high risk population of Japanese-Brazilians enrolled in a study on the prevalence of diabetes (DM). Based on oral glucose tolerance test and WHO criteria, 331 had normal tolerance (NGT), 88 impaired tolerance (IGT) and 83 had type 2 DM (51 self-reported, 32 newly diagnosed diabetics). Clinical, laboratory and dietary data, assessed by food frequency questionnaire (FFQ), were compared between the NGT group and another composed of IGT and newly diagnosed DM (disturbed glucose tolerance or DGT group). Associations of total energy intake and nutrient intakes with glucose intolerance were analyzed by logistic regression. Also, subjects with NGT and DGT entered into separate models of multiple linear regression including BMI as the dependent variable, and total energy intake or each nutrient as independent variables. DGT group showed higher waist-to-hip ratio, blood pressure, plasma glucose and insulin levels and worse lipid profile. Total energy intake, macronutrients, fibers, alcohol and saturated fat intakes did not differ between groups; DGT was not associated with any nutrient intake in multivariate analyses. BMI of the subjects with DGT but not with NGT was associated with protein and cholesterol intakes in linear regression analysis. Our findings did not support an association between nutritional factors and glucose intolerance even in subjects who are unaware of their DGT, using FFQ to reflect current habits. However, we suggest that protein and cholesterol intakes may be markers of increased BMI. Despite assuming that obesity and insulin resistance precedes DM, FFQ may not be useful in the assessment of unfavorable dietary patterns among subjects at risk for glucose intolerance, such as Japanese-Brazilians with elevated BMI.

摘要

我们在一项针对日本裔巴西人的糖尿病(DM)患病率研究中,评估了饮食习惯作为葡萄糖耐量异常的风险因素。根据口服葡萄糖耐量试验和世界卫生组织标准,331人葡萄糖耐量正常(NGT),88人糖耐量受损(IGT),83人患有2型糖尿病(51人自我报告,32人新诊断糖尿病)。通过食物频率问卷(FFQ)评估的临床、实验室和饮食数据,在NGT组与由IGT和新诊断糖尿病患者组成的另一组(血糖耐量异常或DGT组)之间进行了比较。通过逻辑回归分析了总能量摄入和营养素摄入与葡萄糖耐量异常的关联。此外,NGT和DGT受试者分别进入多元线性回归模型,以BMI作为因变量,总能量摄入或每种营养素作为自变量。DGT组显示出更高的腰臀比、血压、血糖和胰岛素水平以及更差的血脂谱。两组之间的总能量摄入、宏量营养素、纤维、酒精和饱和脂肪摄入量没有差异;在多变量分析中,DGT与任何营养素摄入均无关联。在线性回归分析中,DGT受试者而非NGT受试者的BMI与蛋白质和胆固醇摄入量相关。我们的研究结果不支持营养因素与葡萄糖耐量异常之间存在关联,即使在未意识到自己有DGT的受试者中,使用FFQ反映当前习惯也是如此。然而,我们建议蛋白质和胆固醇摄入量可能是BMI升高的标志。尽管假设肥胖和胰岛素抵抗先于糖尿病出现,但FFQ可能无助于评估葡萄糖耐量异常风险人群(如BMI升高的日本裔巴西人)的不良饮食模式。

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