Shanghai Minhang Center for Disease Control and Prevention, 965 Zhongyi Road, Shanghai, 201101, China.
Eur J Epidemiol. 2014 Feb;29(2):79-88. doi: 10.1007/s10654-013-9876-x. Epub 2014 Jan 5.
Observational studies suggest an association between dietary fiber intake and risk of type 2 diabetes, but the results are inconclusive. We conducted a meta-analysis of prospective studies evaluating the associations of dietary fiber intake and risk of type 2 diabetes. Relevant studies were identified by searching EMBASE (from 1974 to April 2013) and PubMed (from 1966 to April 2013). The fixed or random-effect model was selected based on the homogeneity test among studies. In addition, a 2-stage random-effects dose-response meta-analysis was performed. We identified 17 prospective cohort studies of dietary fiber intake and risk of type 2 diabetes involving 19,033 cases and 488,293 participants. The combined RR (95 % CI) of type 2 diabetes for intake of total dietary fiber, cereal fiber, fruit fiber and insoluble fiber was 0.81 (0.73-0.90), 0.77 (0.69-0.85), 0.94 (0.88-0.99) and 0.75 (0.63-0.89), respectively. A nonlinear relationship was found of total dietary fiber intake with risk of type 2 diabetes (P for nonlinearity < 0.01), and the RRs (95 % CI) of type 2 diabetes were 0.98 (0.90-1.06), 0.97 (0.87-1.07), 0.89 (0.80-0.99), 0.76 (0.65-0.88), and 0.66 (0.53-0.82) for 15, 20, 25, 30, and 35 g/day. The departure from nonlinear relationship was not significant (P for nonlinearity = 0.72), and the risk of type 2 diabetes decreased by 6 % (RR 0.94, 95 % CI 0.93-0.96) for 2 g/day increment in cereal fiber intake. Findings from this meta-analysis indicate that the intakes of dietary fiber may be inversely associated with risk of type 2 diabetes.
观察性研究表明膳食纤维摄入量与 2 型糖尿病风险之间存在关联，但结果尚无定论。我们对评估膳食纤维摄入量与 2 型糖尿病风险之间关联的前瞻性研究进行了荟萃分析。通过检索 EMBASE（1974 年至 2013 年 4 月）和 PubMed（1966 年至 2013 年 4 月）来确定相关研究。根据研究间的同质性检验，选择固定或随机效应模型。此外，还进行了两阶段随机效应剂量反应荟萃分析。我们确定了 17 项膳食纤维摄入量与 2 型糖尿病风险的前瞻性队列研究，涉及 19033 例病例和 488293 名参与者。总膳食纤维、谷物纤维、水果纤维和不溶性纤维摄入量与 2 型糖尿病的合并 RR（95%CI）分别为 0.81（0.73-0.90）、0.77（0.69-0.85）、0.94（0.88-0.99）和 0.75（0.63-0.89）。膳食纤维摄入量与 2 型糖尿病风险之间存在非线性关系（P<0.01），2 型糖尿病的 RR（95%CI）分别为 0.98（0.90-1.06）、0.97（0.87-1.07）、0.89（0.80-0.99）、0.76（0.65-0.88）和 0.66（0.53-0.82），摄入量分别为 15、20、25、30 和 35 g/天。非线性关系的偏离不显著（P=0.72），谷物纤维摄入量每增加 2 g/天，2 型糖尿病的风险降低 6%（RR 0.94，95%CI 0.93-0.96）。本荟萃分析的结果表明，膳食纤维的摄入量可能与 2 型糖尿病的风险呈负相关。
