Esposito Katherine, Chiodini Paolo, Maiorino Maria Ida, Bellastella Giuseppe, Panagiotakos Demosthenes, Giugliano Dario
Department of Clinical and Experimental Medicine, Second University of Naples, Naples, Italy.
Endocrine. 2014 Sep;47(1):107-16. doi: 10.1007/s12020-014-0264-4. Epub 2014 Apr 18.
No specific diet is recommended to prevent type 2 diabetes. We did a meta-analysis of prospective cohort studies to assess the association between different diets and prevention of type 2 diabetes. We did a comprehensive search of multiple electronic databases (Medline, Scopus, EMBASE, and ISI web of knowledge) until August 2013 using predefined criteria. We included prospective cohort studies that evaluated the role of different diets in type 2 diabetes prevention. Studies were selected by 2 independent reviewers. We did random-effects meta-analyses to determine the relative risk (RR) of incident diabetes associated with healthful dietary patterns. A total of 21,372 cases of incident diabetes, from 18 prospective studies, with 20 cohorts, in 4 world regions were identified. In the random-effect meta-analysis of the 20 cohorts, RR was 0.80 (95 % confidence interval (CI) = 0.74-0.86, P < 0.001), with high heterogeneity (I (2) = 57 %, P = 0.001) and no evidence of publication bias (Egger's test, P = 0.653). Exclusion of two cohorts produced identical RR (0.80, 95 % CI 0.76-0.84), with nonsignificant heterogeneity (I (2) = 9 %). The risk of incident diabetes did not appreciably change considering the geography (USA, Europe, and Asia), the duration of follow-up (≤10 and >10 years), and type of diets (Mediterranean and DASH, Dietary Approaches to Stop Hypertension, diets). There was a difference between at risk and general population (P = 0.0487), but the evidence was limited to two studies only. The results of our study demonstrate that several healthy diets are equally and consistently associated with a 20 % reduced risk of future type 2 diabetes.
目前尚无推荐用于预防2型糖尿病的特定饮食方案。我们对前瞻性队列研究进行了一项荟萃分析，以评估不同饮食与2型糖尿病预防之间的关联。我们使用预定义标准，对多个电子数据库（Medline、Scopus、EMBASE和ISI知识网络）进行了全面检索，直至2013年8月。我们纳入了评估不同饮食在2型糖尿病预防中作用的前瞻性队列研究。研究由两名独立评审员进行筛选。我们进行了随机效应荟萃分析，以确定与健康饮食模式相关的新发糖尿病的相对风险（RR）。共识别出来自4个世界区域的18项前瞻性研究、20个队列中的21372例新发糖尿病病例。在对这20个队列的随机效应荟萃分析中，RR为0.80（95%置信区间（CI）=0.74 - 0.86，P < 0.001），异质性较高（I(2)=57%，P = 0.001），且无发表偏倚证据（Egger检验，P = 0.653）。排除两个队列后得到相同RR（0.80，95% CI 0.76 - 0.84），异质性不显著（I(2)=9%）。考虑到地理区域（美国、欧洲和亚洲）、随访时间（≤10年和>10年）以及饮食类型（地中海饮食和DASH饮食，即终止高血压饮食方案），新发糖尿病的风险没有明显变化。高危人群与一般人群之间存在差异（P = 0.0487），但证据仅来自两项研究。我们的研究结果表明，几种健康饮食均与未来患2型糖尿病的风险降低20%具有同等且一致的关联。
