Eguaras Sonia, Bes-Rastrollo Maira, Ruiz-Canela Miguel, Carlos Silvia, de la Rosa Pedro, Martínez-González Miguel A
1Department of Preventive Medicine and Public Health,Institute of Investigation of Navarra (IdiSNA),University of Navarra,Irunlarrea 1,31008 Pamplona,Spain.
Br J Nutr. 2017 May;117(10):1478-1485. doi: 10.1017/S0007114517001404. Epub 2017 Jun 19.
It is likely that the Mediterranean diet (MedDiet) may mitigate the adverse effects of obesity on the incidence of type 2 diabetes mellitus (T2DM). We assessed this hypothesis in a cohort of 18 225 participants initially free of diabetes (mean age: 38 years, 61 % women). A validated semi-quantitative 136-item FFQ was used to assess dietary intake and to build a 0-9 score of adherence to MedDiet. After a median of 9·5-year follow-up, 136 incident cases of T2DM were confirmed during 173 591 person-years follow-up. When MedDiet adherence was low (≤4 points), the multivariable-adjusted hazard ratios (HR) were 4·07 (95 % CI 1·58, 10·50) for participants with BMI 25-29·99 kg/m2 and 17·70 (95 % CI 6·29, 49·78) kg/m2 for participants with BMI≥30 kg/m2, (v.4 points), these multivariable-adjusted HR were 3·13 (95 % CI 1·63, 6·01) and 10·70 (95 % CI 4·98, 22·99) for BMI 25-30 and ≥30 kg/m2, respectively. The P value for the interaction was statistically significant (P=0·002). When we assessed both variables (BMI and MedDiet) as continuous, the P value for their interaction product-term was marginally significant (P=0·051) in fully adjusted models. This effect modification was not explained by weight changes during follow-up. Our results suggest that the MedDiet may attenuate the adverse effects of obesity on the risk of T2DM.
地中海饮食（MedDiet）可能会减轻肥胖对2型糖尿病（T2DM）发病率的不利影响。我们在一个由18225名最初无糖尿病的参与者组成的队列中评估了这一假设（平均年龄：38岁，61%为女性）。使用经过验证的136项半定量食物频率问卷（FFQ）来评估饮食摄入量，并构建一个0至9分的地中海饮食依从性评分。经过中位数为9.5年的随访，在173591人年的随访期间确诊了136例T2DM新发病例。当地中海饮食依从性较低（≤4分）时，体重指数（BMI）为25至29.99kg/m²的参与者多变量调整后的风险比（HR）为4.07（95%置信区间1.58，10.50），BMI≥30kg/m²的参与者为17.70（95%置信区间6.29，49.78）；而当地中海饮食依从性较高（>4分）时，BMI为25至30kg/m²和≥30kg/m²的参与者多变量调整后的HR分别为3.13（95%置信区间1.63，6.01）和10.70（95%置信区间4.98，22.99）。交互作用的P值具有统计学意义（P = 0.002）。当我们将两个变量（BMI和MedDiet）作为连续变量进行评估时，在完全调整模型中它们的交互作用乘积项的P值边缘显著（P = 0.051）。这种效应修正不能用随访期间的体重变化来解释。我们的结果表明，地中海饮食可能会减弱肥胖对T2DM风险的不利影响。
