Saw Swee Hock School of Public Health, National University of Singapore, Singapore.
Department of Epidemiology and Biostatistics, MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Clin Nutr. 2018 Apr;37(2):712-718. doi: 10.1016/j.clnu.2017.02.022. Epub 2017 Mar 8.
BACKGROUND & AIMS: The effect of total dairy products, milk, and calcium intake on risk of type 2 diabetes (T2D) is uncertain, particularly in the Chinese population.
The present study was based on a prospective cohort of 63,257 Chinese men and women aged 45-74 years during enrollment (1993-1998) in Singapore. Dietary information was obtained using a validated 165-item semi-quantitative food-frequency questionnaire. Information about newly diagnosed T2D was collected by self-report during two follow-up interviews in 1999-2004 and 2006-2010. Cox proportional hazard regression method was used to estimate hazard ratios (HRs) and their 95% confidence intervals (CIs) in 45,411 eligible participants.
Incidence rate (95% CI) of T2D was 10.5 (10.2-10.8) per 1000 person-years. Intake of dairy food was significantly associated with reduced T2D risk; compared with the lowest quartile, HRs (95% CI) for the second, third and fourth quartiles of dairy intake were 0.98 (0.91-1.06), 0.96 (0.89-1.03) and 0.90 (0.83-0.98), respectively, after adjustment for potential confounders at baseline (P-trend = 0.01). Daily drinkers of milk had a significant 12% reduction in T2D risk compared with non-drinkers. While dairy calcium was associated with a decreased risk of T2D (HR comparing extreme quartiles 0.84; 95% CI 0.76-0.93; P-trend = 0.001), no association was found for non-dairy calcium (HR 1.02; 95% CI 0.92-1.14; P-trend = 0.61).
In this large cohort study of Chinese adults, dairy product intake and daily milk consumption was associated with a statistically significant, although modest, decrease in risk of developing T2D, which may be independent of its calcium content.
乳制品、牛奶和钙的总摄入量对 2 型糖尿病(T2D)风险的影响尚不确定,尤其是在中国人群中。
本研究基于新加坡一项前瞻性队列研究,纳入了 63257 名年龄在 45-74 岁的中国男性和女性(1993-1998 年入组)。使用经过验证的 165 项半定量食物频率问卷获得饮食信息。在 1999-2004 年和 2006-2010 年的两次随访中,通过自我报告收集新诊断的 T2D 信息。采用 Cox 比例风险回归法估计 45411 名合格参与者中 T2D 的风险比(HR)及其 95%置信区间(CI)。
T2D 的发病率(95%CI)为 10.5(10.2-10.8)/1000 人年。乳制品的摄入量与 T2D 风险降低显著相关;与最低四分位数相比,乳制品摄入量第二、第三和第四四分位数的 HR(95%CI)分别为 0.98(0.91-1.06)、0.96(0.89-1.03)和 0.90(0.83-0.98),在基线时调整了潜在混杂因素后(P 趋势=0.01)。与不饮酒者相比,每日饮用牛奶的人患 T2D 的风险降低了 12%。虽然乳制品钙与 T2D 风险降低相关(比较极端四分位数的 HR 0.84;95%CI 0.76-0.93;P 趋势=0.001),但非乳制品钙无此关联(HR 1.02;95%CI 0.92-1.14;P 趋势=0.61)。
在这项对中国成年人的大型队列研究中,乳制品摄入和每日牛奶消费与 T2D 发病风险呈统计学显著相关,尽管幅度较小,但可能与钙含量无关。