Virtanen Heli E K, Koskinen Timo T, Voutilainen Sari, Mursu Jaakko, Tuomainen Tomi-Pekka, Kokko Petra, Virtanen Jyrki K
Institute of Public Health and Clinical Nutrition,University of Eastern Finland,PO Box 1627,70211 Kuopio,Finland.
Br J Nutr. 2017 Mar;117(6):882-893. doi: 10.1017/S0007114517000745. Epub 2017 Apr 11.
The roles of different dietary proteins in the aetiology of type 2 diabetes (T2D) remain unclear. We investigated the associations of dietary proteins with the risk of incident T2D in Finnish men from the prospective Kuopio Ischaemic Heart Disease Risk Factor Study. The study included 2332 men aged 42-60 years at the baseline examinations in 1984-1989. Protein intakes were calculated from 4-d dietary records. Incident T2D was determined by self-administered questionnaires, fasting blood glucose measurements, 2-h oral glucose tolerance tests, and with national registers. The multivariable-adjusted risk of T2D on the basis of protein intakes was compared by the Cox proportional hazard ratios (HR). During the mean follow-up of 19·3 years, 432 incident T2D cases were identified. Total, animal, meat or dairy product protein intakes were not associated with risk of T2D when the potential confounders were accounted for. Plant (multivariable-adjusted extreme-quartile HR 0·65; 95 % CI 0·42, 1·00; P trend 0·04) and egg (HR 0·67; 95 % CI 0·44, 1·00; P trend 0·03) protein intakes were associated with a decreased risk of T2D. Adjustments for BMI, plasma glucose and serum insulin slightly attenuated associations. Replacing 1 % energy from carbohydrates with energy from protein was associated with a 5 % (95 % CI 0, 11) increased risk of T2D, but adjustment for fibre intake attenuated the association. Replacing 1 % of energy from animal protein with energy from plant protein was associated with 18 % (95 % CI 0, 32) decreased risk of T2D. This association remained after adjusting for BMI. In conclusion, favouring plant and egg proteins appeared to be beneficial in preventing T2D.
不同膳食蛋白质在2型糖尿病（T2D）病因学中的作用仍不明确。我们在前瞻性的库奥皮奥缺血性心脏病危险因素研究中，调查了芬兰男性膳食蛋白质与新发T2D风险之间的关联。该研究纳入了1984 - 1989年基线检查时年龄在42 - 60岁的2332名男性。蛋白质摄入量通过4天的饮食记录计算得出。新发T2D通过自行填写的问卷、空腹血糖测量、2小时口服葡萄糖耐量试验以及国家登记册来确定。基于蛋白质摄入量的T2D多变量调整风险通过Cox比例风险比（HR）进行比较。在平均19.3年的随访期间，共识别出432例新发T2D病例。在考虑潜在混杂因素后，总蛋白质、动物蛋白、肉类或奶制品蛋白摄入量与T2D风险无关。植物蛋白（多变量调整后极端四分位数HR 0.65；95%CI 0.42, 1.00；P趋势0.04）和蛋类蛋白（HR 0.67；95%CI 0.44, 1.00；P趋势0.03）摄入量与T2D风险降低相关。对体重指数（BMI）、血浆葡萄糖和血清胰岛素进行调整后，关联略有减弱。用蛋白质能量替代1%碳水化合物能量与T2D风险增加5%（95%CI 0, 11）相关，但对纤维摄入量进行调整后减弱了该关联。用植物蛋白能量替代1%动物蛋白能量与T2D风险降低18%（95%CI 0, 32）相关。在调整BMI后，这种关联仍然存在。总之，偏好植物蛋白和蛋类蛋白似乎对预防T2D有益。
