Wong Mark Y Z, Man Ryan E K, Fenwick Eva K, Gupta Preeti, Li Ling-Jun, van Dam Rob M, Chong Mary F, Lamoureux Ecosse L
Singapore Eye Research Institute, Singapore National Eye Center, Singapore.
Duke-NUS Medical School, Office of Clinical Sciences, Singapore.
PLoS One. 2018 Jan 11;13(1):e0186582. doi: 10.1371/journal.pone.0186582. eCollection 2018.
The evidence linking dietary intake with diabetic retinopathy (DR) is growing but unclear. We conducted a systematic review of the association between dietary intake and DR.
We systematically searched PubMed, Embase, Medline, and the Cochrane Central register of controlled trials, for publications between January 1967 and January 2017 using standardized criteria for diet and DR. Interventional and observational studies investigating micro- and macro-nutrient intakes; food and beverage consumptions; and dietary patterns were included. Study quality was evaluated using a modified Newcastle-Ottawa scale for observational studies, and the Cochrane collaboration tool for interventional studies.
Of 4265 titles initially identified, 31 studies (3 interventional, 28 Observational) were retained. Higher intakes of dietary fibre, oily fish, and greater adherence to a Mediterranean diet were protective of DR. Conversely, high total caloric intake was associated with higher risk of DR. No significant associations of carbohydrate, vitamin D, and sodium intake with DR were found. Associations of antioxidants, fatty acids, proteins and alcohol with DR remain equivocal.
Dietary fibre, oily fish, a Mediterranean diet and a reduced caloric intake are associated with lower risk of DR. Longitudinal data and interventional models are warranted to confirm our findings and better inform clinical guidelines.
饮食摄入与糖尿病视网膜病变（DR）之间的关联证据不断增加，但仍不明确。我们对饮食摄入与DR之间的关联进行了系统评价。
我们使用饮食和DR的标准化标准，系统检索了PubMed、Embase、Medline以及Cochrane对照试验中央注册库，以查找1967年1月至2017年1月期间的出版物。纳入了调查微量和宏量营养素摄入、食物和饮料消费以及饮食模式的干预性和观察性研究。使用改良的纽卡斯尔-渥太华量表评估观察性研究的质量，使用Cochrane协作工具评估干预性研究的质量。
在最初确定的4265篇标题中，保留了31项研究（3项干预性研究，28项观察性研究）。膳食纤维、油性鱼类的摄入量较高以及对地中海饮食的更高依从性对DR具有保护作用。相反，高热量总摄入量与DR的较高风险相关。未发现碳水化合物、维生素D和钠摄入量与DR有显著关联。抗氧化剂、脂肪酸、蛋白质和酒精与DR的关联仍不明确。
膳食纤维、油性鱼类、地中海饮食和热量摄入减少与DR风险降低相关。需要纵向数据和干预模型来证实我们的发现，并更好地为临床指南提供信息。
