Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences International Campus (TUMS-IC), Tehran, Iran.
Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences International Campus (TUMS-IC), Tehran, Iran.
Eur J Nutr. 2019 Jun;58(4):1341-1350. doi: 10.1007/s00394-018-1705-2. Epub 2018 May 2.
The link between household food insecurity and risk of type 2 diabetes mellitus still remains controversial. Therefore, we performed a systematic review and meta-analysis to clarify the association between household food insecurity and type 2 diabetes mellitus.
EMBASE, PubMed, ISI Web of Science and Scopus databases were searched up to March 2017. The selection of studies, data extraction and assessing the risk of bias in the included studies were carried out by two reviewers independently. Study-specific odds ratios (ORs) were pooled using a random effects model.
A total of 18 articles including a total of 55,353,915 adult participants were included in the meta-analysis. The pooled ORs of the cross-sectional studies revealed that household food insecurity was significantly associated with the odds of T2DM (OR 1.27, 95% CI 1.11-1.42) with no evidence of publication bias (p = 0.63) but heterogeneity between studies (I = 61.1%). Similarly, subgroup analyses showed that the country where the study conducted and household food insecurity assessment tool used to influence the effect of household food insecurity on the odds of T2DM. However, the pooled ORs for two case-control and one cohort studies were not significantly associated between household food insecurity and T2DM in adults.
This study strengthens the hypothesis of the household food insecurity effect on the odds of T2DM among adults. Further longitudinal studies based on larger, and more representative samples are needed to identify the underlying relationships between food insecurity and type 2 diabetes mellitus.
家庭食物不安全与 2 型糖尿病风险之间的联系仍然存在争议。因此，我们进行了系统评价和荟萃分析，以阐明家庭食物不安全与 2 型糖尿病之间的关系。
截至 2017 年 3 月，我们检索了 EMBASE、PubMed、ISI Web of Science 和 Scopus 数据库。两位评审员独立进行了研究选择、数据提取和纳入研究的偏倚风险评估。使用随机效应模型汇总研究特异性比值比（OR）。
共有 18 篇文章（共包括 55353915 名成年参与者）纳入荟萃分析。横断面研究的汇总 OR 表明，家庭食物不安全与 T2DM 的发病风险显著相关（OR 1.27，95%CI 1.11-1.42），且无发表偏倚证据（p=0.63），但存在研究间异质性（I=61.1%）。同样，亚组分析表明，研究所在国家和用于评估家庭食物不安全的工具影响家庭食物不安全对 T2DM 发病风险的影响。然而，两项病例对照研究和一项队列研究的汇总 OR 表明，家庭食物不安全与成年人 T2DM 之间没有显著关联。
本研究加强了家庭食物不安全对成年人 T2DM 发病风险的假设。需要进一步开展基于更大、更具代表性样本的前瞻性研究，以确定食物不安全与 2 型糖尿病之间的潜在关系。
