Jacobs Simone, Harmon Brook E, Boushey Carol J, Morimoto Yukiko, Wilkens Lynne R, Le Marchand Loic, Kröger Janine, Schulze Matthias B, Kolonel Laurence N, Maskarinec Gertraud
Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany.
Diabetologia. 2015 Jan;58(1):98-112. doi: 10.1007/s00125-014-3404-8. Epub 2014 Oct 16.
AIMS/HYPOTHESIS: Dietary patterns have been associated with the incidence of type 2 diabetes, but little is known about the impact of ethnicity on this relationship. This study evaluated the association between four a priori dietary quality indexes and risk of type 2 diabetes among white individuals, Japanese-Americans and Native Hawaiians in the Hawaii component of the Multiethnic Cohort.
After excluding participants with prevalent diabetes and missing values, the analysis included 89,185 participants (11,217 cases of type 2 diabetes). Dietary intake was assessed at baseline with a quantitative food frequency questionnaire designed for use in the relevant ethnic populations. Sex- and ethnicity-specific HRs were calculated for the Healthy Eating Index-2010 (HEI-2010), the Alternative HEI-2010 (AHEI-2010), the Alternate Mediterranean Diet Score (aMED) and the Dietary Approaches to Stop Hypertension (DASH).
We observed significant inverse associations between higher DASH index scores and risk of type 2 diabetes in white men and women, as well as in Japanese-American women and Native Hawaiian men, with respective risk reductions of 37%, 31%, 19% and 21% (in the highest compared with the lowest index category). A higher adherence to the AHEI-2010 and aMED diet was related to a 13-28% lower risk of type 2 diabetes in white participants but not in other ethnic groups. No significant associations with risk of type 2 diabetes were observed for the HEI-2010 index.
CONCLUSIONS/INTERPRETATION: The small ethnic differences in risk of type 2 diabetes associated with scores of a priori-defined dietary patterns may be due to a different consumption pattern of food components and the fact that the original indexes were not based on diets typical for Asians and Pacific Islanders.
目的/假设：饮食模式与2型糖尿病的发病率相关，但关于种族对这种关系的影响知之甚少。本研究评估了多民族队列研究夏威夷部分中白种人、日裔美国人和夏威夷原住民中，四种预先设定的饮食质量指数与2型糖尿病风险之间的关联。
在排除患有糖尿病和有缺失值的参与者后，分析纳入了89185名参与者（11217例2型糖尿病患者）。在基线时使用为相关种族人群设计的定量食物频率问卷评估饮食摄入量。针对健康饮食指数-2010（HEI-2010）、替代HEI-2010（AHEI-2010）、替代地中海饮食评分（aMED）和终止高血压饮食方法（DASH）计算了性别和种族特异性风险比（HR）。
我们观察到，较高的DASH指数得分与白种男性和女性、日裔美国女性和夏威夷原住民男性的2型糖尿病风险之间存在显著的负相关关系。与最低指数类别相比，最高指数类别中2型糖尿病风险分别降低了37%、31%、19%和21%。较高的AHEI-2010和aMED饮食依从性与白种参与者中2型糖尿病风险降低13%-28%相关，但在其他种族群体中并非如此。未观察到HEI-2010指数与2型糖尿病风险之间存在显著关联。
结论/解读：与预先定义的饮食模式得分相关的2型糖尿病风险的微小种族差异，可能是由于食物成分的消费模式不同，以及原始指数并非基于亚洲人和太平洋岛民的典型饮食这一事实。
