Department of Clinical Vision Sciences, Latrobe University, Melbourne, Vic., Australia.
Department of Dietetics and Human Nutrition, Latrobe University, Melbourne, Vic., Australia.
Acta Ophthalmol. 2016 Aug;94(5):e345-52. doi: 10.1111/aos.12941. Epub 2016 Jan 8.
To examine the association between dietary patterns and retinal vascular calibre in children and adolescents with type 1 diabetes.
A hospital-based cross-sectional study of 83 children and adolescents with type 1 diabetes was conducted over an 8-month period. Dietary patterns were extracted using principal components analysis from completed food frequency questionnaires. Retinal vascular calibre was measured by a trained grader using a standardized protocol and later summarized as central retinal artery equivalent (CRAE) and central retinal vein equivalent (CRVE) using a semi-automated computer program.
Three major dietary patterns were identified as follows: (1) processed foods, (2) plant-based foods and (3) vegetable/fish avoidance pattern. The processed pattern had high component loadings for processed meats and high fat takeaway foods. The plant-based pattern had high component loadings for a number of fruits including, but not limited to, pineapple, grapes oranges and mangos as well as a smaller number of vegetables, including beans and leeks. The vegetable and fish avoidance pattern had high inverse component loadings for canned and fresh fish as well as a number of vegetables including, but not limited to, pumpkin, green beans, broccoli, sweet potato and cabbage. Adjusted regression analysis revealed the 'vegetable/fish avoidance' dietary pattern was associated with a wider CRVE (ExpB = 3.67, 95% CI = 0.11/7.24, p = 0.039). After multivariable adjustments, a vascular risk profile that included: older age, higher BMI, higher systolic blood pressure, greater gestational age, longer screen viewing time, lower maternal education level, lower physical activity levels and lower high-density lipoproteins concentrations were more likely to display narrower CRAE (ExpB = -2.43, 95% CI = -4.92/0.06, p = 0.041).
This study provides the first evidence for a diet-calibre relationship in children and adolescents with type 1 diabetes. This outcome has potential public health implications, as promotion of healthy eating patterns in children and adolescents might attenuate changes in microvasculature that have been related to an increased risk of microvascular disease, such as retinopathy, in adulthood. Additional studies are warranted to explore and validate this novel finding.
研究 1 型糖尿病儿童和青少年的饮食模式与视网膜血管口径之间的关系。
在 8 个月的时间里，对 83 名 1 型糖尿病儿童和青少年进行了基于医院的横断面研究。使用完成的食物频率问卷，通过主成分分析提取饮食模式。由经过培训的分级员使用标准化方案测量视网膜血管口径，并使用半自动计算机程序将其总结为中央视网膜动脉当量（CRAE）和中央视网膜静脉当量（CRVE）。
确定了三种主要的饮食模式：（1）加工食品，（2）植物性食品和（3）蔬菜/鱼类回避模式。加工模式的加工肉类和高脂肪外卖食品成分负荷较高。植物性模式的水果成分负荷较高，包括但不限于菠萝、葡萄、橙子和芒果，以及较少的蔬菜，包括豆类和韭菜。蔬菜和鱼类回避模式的新鲜和罐装鱼类以及许多蔬菜的成分负荷较高，包括但不限于南瓜、绿豆、西兰花、红薯和白菜。调整后的回归分析显示，“蔬菜/鱼类回避”饮食模式与更宽的 CRVE 相关（ExpB=3.67，95%CI=0.11/7.24，p=0.039）。经过多变量调整后，具有以下特征的血管风险特征更有可能显示出更窄的 CRAE：年龄较大、BMI 较高、收缩压较高、胎龄较大、屏幕观看时间较长、母亲教育水平较低、体力活动水平较低和高密度脂蛋白浓度较低（ExpB=-2.43，95%CI=-4.92/0.06，p=0.041）。
本研究首次提供了 1 型糖尿病儿童和青少年饮食与血管口径之间关系的证据。这一结果具有潜在的公共卫生意义，因为在儿童和青少年中促进健康的饮食模式可能会减缓与微血管疾病风险增加相关的微血管变化，例如成年后患糖尿病视网膜病变。需要进一步研究来探索和验证这一新发现。
