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2型糖尿病患者饮食摄入量与颈动脉内膜中层厚度之间的横断面关联:一项随机试验的基线数据

Cross-sectional associations between dietary intake and carotid intima media thickness in type 2 diabetes: baseline data from a randomised trial.

作者信息

Chiavaroli Laura, Mirrahimi Arash, Ireland Christopher, Mitchell Sandra, Sahye-Pudaruth Sandhya, Coveney Judy, Olowoyeye Omodele, Patel Darshna, de Souza Russell J, Augustin Livia S A, Bashyam Balachandran, Pichika Sathish Chandra, Blanco Mejia Sonia, Nishi Stephanie K, Leiter Lawrence A, Josse Robert G, McKeown-Eyssen Gail E, Moody Alan R, Kendall Cyril W C, Sievenpiper John L, Jenkins David J A

机构信息

Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.

Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Ontario, Canada.

出版信息

BMJ Open. 2017 Mar 22;7(3):e015026. doi: 10.1136/bmjopen-2016-015026.

Abstract

OBJECTIVE

To assess associations between dietary intake and carotid intima media thickness (CIMT) by carotid ultrasound (CUS), a surrogate marker of cardiovascular disease (CVD) risk, in those with type 2 diabetes.

DESIGN

Cross-sectional analysis of baseline data from 325 participants from three randomised controlled trials collected in the same way.

SETTING

Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Canada.

PARTICIPANTS

325 participants with type 2 diabetes, taking oral antidiabetic agents, with an HbA1c between 6.5% and 8.0% at screening, without a recent cardiovascular event.

MAIN OUTCOME MEASURES

CIMT by CUS and associations with dietary intake from 7-day food records, as well as anthropometric measures and fasting serum samples.

RESULTS

CIMT was significantly inversely associated with dietary pulse intake (β=-0.019, p=0.009), available carbohydrate (β=-0.004, p=0.008), glycaemic load (β=-0.001, p=0.007) and starch (β=-0.126, p=0.010), and directly associated with total (β=0.004, p=0.028) and saturated (β=0.012, p=0.006) fat intake in multivariate regression models adjusted for age, smoking, previous CVD event, blood pressure medication, antidiabetic medication and ultrasonographer.

CONCLUSIONS

Lower CIMT was significantly associated with greater consumption of dietary pulses and carbohydrates and lower total and saturated fat intake, suggesting a potential role for diet in CVD risk management in type 2 diabetes. Randomised controlled trials are anticipated to explore these associations further.

TRIAL REGISTRATION NUMBER

NCT01063374.

摘要

目的

通过颈动脉超声(CUS)评估2型糖尿病患者的饮食摄入量与颈动脉内膜中层厚度(CIMT)之间的关联,CIMT是心血管疾病(CVD)风险的替代标志物。

设计

对来自三项随机对照试验的325名参与者的基线数据进行横断面分析,这些数据以相同方式收集。

地点

加拿大多伦多圣迈克尔医院危险因素修正中心。

参与者

325名2型糖尿病患者,服用口服降糖药,筛查时糖化血红蛋白(HbA1c)在6.5%至8.0%之间,近期无心血管事件。

主要观察指标

通过CUS测量的CIMT以及与7天饮食记录中的饮食摄入量、人体测量指标和空腹血清样本的关联。

结果

在针对年龄、吸烟、既往CVD事件、血压药物治疗、抗糖尿病药物治疗和超声检查人员进行调整的多变量回归模型中,CIMT与豆类摄入量(β=-0.019,p=0.009)、可利用碳水化合物(β=-0.004,p=0.008)、血糖负荷(β=-0.001,p=0.007)和淀粉(β=-0.126,p=0.010)呈显著负相关,与总脂肪(β=0.004,p=0.028)和饱和脂肪摄入量(β=0.012,p=0.006)呈正相关。

结论

较低的CIMT与更多地食用豆类和碳水化合物以及更低的总脂肪和饱和脂肪摄入量显著相关,这表明饮食在2型糖尿病患者的CVD风险管理中可能发挥作用。预计将进行随机对照试验以进一步探索这些关联。

试验注册号

NCT01063374。

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