膳食和血清镁与葡萄糖代谢标志物的关联：古川营养与健康研究

Association of dietary and serum magnesium with glucose metabolism markers: The Furukawa Nutrition and Health Study.

作者信息

Akter Shamima, Eguchi Masafumi, Nanri Akiko, Kochi Takeshi, Kashino Ikuko, Kuwahara Keisuke, Hu Huanhuan, Miki Takako, Kabe Isamu, Mizoue Tetsuya

机构信息

Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan.

Department of Health Administration, Furukawa Electric Corporation, Tokyo, Japan.

出版信息

Clin Nutr ESPEN. 2018 Apr;24:71-77. doi: 10.1016/j.clnesp.2018.01.011. Epub 2018 Feb 9.

DOI:10.1016/j.clnesp.2018.01.011

PMID:29576367

Abstract

BACKGROUND & AIMS: Magnesium may play an important role in cardio-metabolic abnormalities, including type 2 diabetes, but epidemiological evidence linking magnesium status to glucose metabolism is limited among Asians. We cross-sectionally examined the association of dietary and serum magnesium with markers of glucose metabolism among Japanese subjects.

METHODS

Subjects were 1796 workers, aged 18-78 years, who participated in a health survey. Dietary magnesium intake was assessed with a validated brief diet history questionnaire. Serum magnesium concentrations were measured using an enzymatic method. Multivariable linear regression models were used to estimate means of fasting insulin, fasting plasma glucose, homeostatic model assessment of insulin resistance (HOMA-IR), homeostatic model assessment of β-cell function (HOMA-β), and glycated hemoglobin (HbA1c), with adjustments made for potential confounding variables.

RESULTS

Dietary magnesium was inversely associated with HOMA-IR (P = 0.01). Multivariable-adjusted means (95% confidence intervals) of HOMA-IR for the lowest to highest quartiles of dietary magnesium were 0.94 (0.89-0.99), 0.92 (0.88-0.97), 0.88 (0.83-0.92), and 0.86 (0.81-0.90). Serum magnesium concentrations were also inversely associated with HOMA-IR (P = 0.04) and HbA1c (P <0.01). Multivariable-adjusted means (95% confidence intervals) for the lowest to highest quartiles of serum magnesium were 0.94 (0.90-0.98), 0.87 (0.83-0.91), 0.90 (0.85-0.95), and 0.86 (0.81-0.92) for HOMA-IR and 5.41 (5.36-5.45), 5.33 (5.28-5.37), 5.30 (5.25-5.36), and 5.28 (5.22-5.35) for HbA1c. Excluding subjects with diabetes did not materially change the association between dietary magnesium and HOMA-IR (P <0.01), while it attenuated the association of serum magnesium with HOMA-IR (P = 0.27) and HbA1c (P = 0.15).

CONCLUSIONS

The present findings suggest that lower dietary magnesium, but not serum magnesium, is associated with IR in apparently healthy adults.

摘要

背景与目的

镁可能在包括2型糖尿病在内的心脏代谢异常中发挥重要作用，但在亚洲人群中，将镁状态与葡萄糖代谢联系起来的流行病学证据有限。我们对日本受试者进行了横断面研究，以检验膳食镁和血清镁与葡萄糖代谢指标之间的关联。

方法

研究对象为1796名年龄在18 - 78岁之间参与健康调查的工人。膳食镁摄入量通过一份经过验证的简短饮食史问卷进行评估。血清镁浓度采用酶法测量。使用多变量线性回归模型来估计空腹胰岛素、空腹血糖、胰岛素抵抗稳态模型评估（HOMA - IR）、β细胞功能稳态模型评估（HOMA - β）和糖化血红蛋白（HbA1c）的均值，并对潜在的混杂变量进行调整。

结果

膳食镁与HOMA - IR呈负相关（P = 0.01）。膳食镁从最低四分位数到最高四分位数的多变量调整均值（95%置信区间）对应的HOMA - IR分别为0.94（0.89 - 0.99）、0.92（0.88 - 0.97）、0.88（0.83 - 0.92）和0.86（0.81 - 0.90）。血清镁浓度也与HOMA - IR呈负相关（P = 0.04）以及与HbA1c呈负相关（P <0.01）。血清镁从最低四分位数到最高四分位数的多变量调整均值（95%置信区间）对应的HOMA - IR分别为0.94（0.90 - 0.98）、0.87（0.83 - 0.91）、0.90（0.85 - 0.95）和0.86（0.81 - 0.92），对应的HbA1c分别为5.41（5.36 - 5.45）、5.33（5.28 - 5.37）、5.30（5.25 - 5.36）和5.28（5.22 - 5.35）。排除糖尿病患者后，膳食镁与HOMA - IR之间的关联没有实质性变化（P <0.01），而血清镁与HOMA - IR（P = 0.27）和HbA1c（P = 0.15）之间的关联有所减弱。