Papier K, D'Este C, Bain C, Banwell C, Seubsman S, Sleigh A, Jordan S
National Centre for Epidemiology and Population Health (NCEPH) and Department of Global Health, Research School of Population Health, College of Medicine, Biology and Environment, The Australian National University, Canberra, Australia.
Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia.
Nutr Diabetes. 2017 Jun 19;7(6):e283. doi: 10.1038/nutd.2017.27.
The global prevalence of type 2 diabetes mellitus (T2DM) is high and is increasing in countries undergoing rapid socio-economic development, including Thailand. Sugar-sweetened beverage (SSB) intake may contribute to the risk of developing T2DM. However, few studies have assessed this association in Asian populations, and the results have been inconsistent. We aimed to assess that association in a prospective study of Thai adults.
Data were from Thai Cohort Study participants surveyed in 2005, 2009 and 2013. The nation-wide sample included adult cohort members who were free of diabetes in 2005 and who were followed-up in 2013 (n=39 175). We used multivariable logistic regression to assess associations between SSB intake and eight-year T2DM incidence. We used a counterfactual mediation analysis to explore potential mediation of the SSB intake and T2DM-risk relationship.
In women (but not men) consuming SSBs once or more per day (versus rarely) was associated with increased T2DM incidence at the 8-year follow-up (odds ratio (OR)=2.4, 95% confidence interval (CI) 1.5-3.9). Obesity in 2009 was found to mediate ~23% of the total association between SSB intake in 2005 and T2DM risk in 2013 (natural indirect effect 1.15, 95% CI (1.02, 1.31).
Frequent SSB consumption associated with higher T2DM incidence in women but not men. We found that a moderate proportion of the SSB-T2DM relationship was mediated through body mass index (BMI). Our findings suggest that targeting SSB consumption can help prevent a national rise in the incidence of T2DM.
2型糖尿病（T2DM）在全球的患病率很高，并且在包括泰国在内的社会经济快速发展的国家中呈上升趋势。摄入含糖饮料（SSB）可能会增加患T2DM的风险。然而，很少有研究评估亚洲人群中的这种关联，且结果并不一致。我们旨在通过一项针对泰国成年人的前瞻性研究来评估这种关联。
数据来自于2005年、2009年和2013年接受调查的泰国队列研究参与者。全国范围内的样本包括2005年无糖尿病且在2013年接受随访的成年队列成员（n = 39175）。我们使用多变量逻辑回归来评估SSB摄入量与八年T2DM发病率之间的关联。我们使用反事实中介分析来探讨SSB摄入量与T2DM风险关系的潜在中介作用。
在女性中（男性则不然），每天饮用一次或多次SSB（相对于很少饮用）与8年随访时T2DM发病率增加相关（优势比（OR）= 2.4，95%置信区间（CI）1.5 - 3.9）。2009年的肥胖被发现介导了2005年SSB摄入量与2013年T2DM风险之间总关联的约23%（自然间接效应1.15，95% CI（1.02，1.31））。
频繁饮用SSB与女性而非男性较高的T2DM发病率相关。我们发现SSB与T2DM关系的适度比例是通过体重指数（BMI）介导的。我们的研究结果表明，针对SSB消费可以帮助预防该国T2DM发病率的上升。
