Department of Epidemiology, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.
School for Cardiovascular Diseases (CARIM), Maastricht University, Maastricht, The Netherlands.
Eur J Nutr. 2019 Mar;58(2):597-608. doi: 10.1007/s00394-018-1644-y. Epub 2018 Mar 10.
Type 2 diabetes mellitus (T2DM) is characterized by both impaired pancreatic β-cell function (BCF) and insulin resistance. In the etiology of T2DM, BCF basically determines whether a person with a certain degree of insulin resistance develops T2DM, as β-cells are able to compensatorily increase insulin secretion. The effects of dietary intake on BCF are largely unknown. Our study aim was to investigate whether dietary macronutrient intake predicts BCF.
Prospective data (median follow-up 7 years) of 303 individuals recruited from the CODAM study population (aged 40-70 years, 39% women) were analyzed. BCF was measured by C-peptide deconvolution and physiological modeling of data from a 5-point, 75-g, 2-h oral glucose tolerance test. Macronutrient intake was estimated by a 178-item Food Frequency Questionnaire.
Associations adjusted for relevant covariates of baseline macronutrient intake with model-derived parameters describing BCF (glucose sensitivity, rate sensitivity or potentiation) or C-peptidogenic index were detected for trans fat [standardized regression coefficient (95%-CI) glucose sensitivity - 0.14 (- 0.26, - 0.01)] per g, cholesterol [potentiation 0.20 (0.02, 0.37)] per 100 mg, dietary fiber [glucose sensitivity 0.21 (0.08, 0.33)] per 10 g, MUFA glucose sensitivity 0.16 (0.02, 0.31) per 10 g, and polysaccharide [potentiation - 0.24 (- 0.43, - 0.05), C-peptidogenic index - 0.16 (- 0.29 - 0.03); odds ratio lowest versus highest tertile (95%-CI) rate sensitivity 1.51 (1.06, 2.15)) per 50 g.
In this population at high risk for developing T2DM, polysaccharide and trans fat intake were associated with worse BCF, whereas increased intake of MUFA, dietary cholesterol, and fiber were associated with better BCF.
2 型糖尿病（T2DM）的特征是胰岛β细胞功能（BCF）受损和胰岛素抵抗。在 T2DM 的病因学中，BCF 基本上决定了一个具有一定程度胰岛素抵抗的人是否会发展为 T2DM，因为β细胞能够代偿性地增加胰岛素分泌。饮食摄入对 BCF 的影响在很大程度上尚不清楚。我们的研究目的是探讨膳食宏量营养素摄入是否可以预测 BCF。
对来自 CODAM 研究人群的 303 名参与者（年龄 40-70 岁，39%为女性）前瞻性数据（中位随访 7 年）进行了分析。通过 C 肽解卷积和对 5 点、75g、2 小时口服葡萄糖耐量试验数据进行生理建模来测量 BCF。宏量营养素摄入量通过 178 项食物频率问卷进行估计。
在调整了相关协变量后，发现基线宏量营养素摄入与描述 BCF 的模型衍生参数（葡萄糖敏感性、速率敏感性或增强作用）或 C 肽生成指数之间存在关联：每克反式脂肪[标准化回归系数（95%-CI）葡萄糖敏感性-0.14（-0.26，-0.01）]、每 100mg 胆固醇[增强作用 0.20（0.02，0.37）]、每 10g 膳食纤维[葡萄糖敏感性 0.21（0.08，0.33）]、每 10gMUFA 葡萄糖敏感性[0.16（0.02，0.31）]和多糖[增强作用-0.24（-0.43，-0.05），C 肽生成指数-0.16（-0.29-0.03）]。最低与最高三分位（95%-CI）之间的比值比（OR）速率敏感性为 1.51（1.06，2.15）。
在这群有发生 T2DM 高风险的人群中，多糖和反式脂肪的摄入与较差的 BCF 相关，而 MUFA、膳食胆固醇和纤维的摄入增加与较好的 BCF 相关。
