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乳制品与 2 型糖尿病风险:队列研究的系统评价和剂量反应荟萃分析。

Dairy products and the risk of type 2 diabetes: a systematic review and dose-response meta-analysis of cohort studies.

机构信息

Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway, and the Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom.

出版信息

Am J Clin Nutr. 2013 Oct;98(4):1066-83. doi: 10.3945/ajcn.113.059030. Epub 2013 Aug 14.

Abstract

BACKGROUND

The association between intake of dairy products and the risk of type 2 diabetes has been investigated in several studies, but the evidence is not conclusive.

OBJECTIVE

We conducted an updated systematic review and dose-response meta-analysis of dairy product intake and the risk of type 2 diabetes.

DESIGN

We searched the PubMed database for prospective cohort and nested case-control studies of dairy product intake and risk of type 2 diabetes up to 5 June 2013. Summary RRs were estimated by use of a random-effects model.

RESULTS

Seventeen cohort studies were included in the meta-analysis. In the dose-response analysis, the summary RRs (95% CIs) were 0.93 (0.87, 0.99; I(2) = 33%) per 400 g total dairy products/d (n = 12), 0.98 (0.94, 1.03; I(2) = 8%) per 200 g high-fat dairy products/d (n = 9), 0.91 (0.86, 0.96; I(2) = 40%) per 200 g low-fat dairy products/d (n = 9), 0.87 (0.72, 1.04; I(2) = 94%) per 200 g milk/d (n = 7), 0.92 (0.86, 0.99; I(2) = 0%) per 50 g cheese/d (n = 8), and 0.78 (0.60, 1.02; I(2) = 70%) per 200 g yogurt/d (n = 7). Nonlinear inverse associations were observed for total dairy products (P-nonlinearity < 0.0001), low-fat dairy products (P-nonlinearity = 0.06), cheese (P-nonlinearity = 0.05), and yogurt (P-nonlinearity = 0.004), and there was a flattening of the curve at higher intakes.

CONCLUSIONS

This meta-analysis suggests that there is a significant inverse association between intakes of dairy products, low-fat dairy products, and cheese and risk of type 2 diabetes. Any additional studies should assess the association between other specific types of dairy products and the risk of type 2 diabetes and adjust for more confounding factors.

摘要

背景

已有多项研究调查了摄入乳制品与 2 型糖尿病风险之间的关系,但证据尚无定论。

目的

我们对乳制品摄入与 2 型糖尿病风险的相关研究进行了更新的系统评价和剂量-反应荟萃分析。

设计

我们在 PubMed 数据库中检索了截至 2013 年 5 月 5 日关于乳制品摄入与 2 型糖尿病风险的前瞻性队列研究和巢式病例对照研究。采用随机效应模型估计汇总相对危险度(RR)。

结果

荟萃分析纳入了 17 项队列研究。在剂量-反应分析中,400 g/d 总乳制品(n = 12)、200 g/d 高脂乳制品(n = 9)、200 g/d 低脂乳制品(n = 9)、200 g/d 牛奶(n = 7)、50 g/d 奶酪(n = 8)和 200 g/d 酸奶(n = 7)的 RR(95%CI)分别为 0.93(0.87,0.99;I2 = 33%)、0.98(0.94,1.03;I2 = 8%)、0.91(0.86,0.96;I2 = 40%)、0.87(0.72,1.04;I2 = 94%)、0.92(0.86,0.99;I2 = 0%)和 0.78(0.60,1.02;I2 = 70%)。总乳制品(P 非线性 < 0.0001)、低脂乳制品(P 非线性 = 0.06)、奶酪(P 非线性 = 0.05)和酸奶(P 非线性 = 0.004)摄入量与风险之间呈显著负相关,且摄入量较高时曲线趋于平缓。

结论

本荟萃分析提示,乳制品、低脂乳制品和奶酪的摄入量与 2 型糖尿病风险之间存在显著的负相关。任何进一步的研究都应评估其他特定类型的乳制品与 2 型糖尿病风险之间的关系,并调整更多的混杂因素。

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