Institute of Nutrition and Health, Qingdao University , Qingdao , China.
Department of Food Science and Nutrition, Zhejiang University , Hangzhou , China.
Crit Rev Food Sci Nutr. 2019;59(17):2850-2862. doi: 10.1080/10408398.2018.1476964. Epub 2019 Jan 21.
Epidemiological studies have suggested controversial associations between flavonoid subclasses and type 2 diabetes mellitus (T2DM) risk. The aim of the present meta-analysis was to quantitatively estimate these associations with prospective cohort study. A systematic literature search in PubMed and Scopus databases was performed up to May 2018. Multivariate-adjust relative risks (RRs) with corresponding 95% confidence intervals (CIs) for the highest versus the lowest category were pooled by using a random-effects model. Using restricted cubic spline regression model, non-linear dose-response analysis was estimated. Nine independent prospective cohort studies with 172,058 participants and 16910 events were included. Dietary intakes of flavanols, flavonols, flavan-3-ols and isoflavones were inversely associated with T2DM risk, and the summary RRs were 0.86 (95%CI: 0.77, 0.97), 0.91 (95%CI: 0.85, 0.98), 0.90 (95%: 0.82, 0.99) and 0.91 (95%CI: 0.84, 0.98), respectively. Dose-response analysis showed that 135 mg/day increment of flavanols (95%CI: 0.92, 0.96; P for trend <0.001), 50 mg/day increment of flavonols (95%CI: 0.88, 0.99, for trend = 0.021), 68 mg/day increment of flavan-3-ols (95%CI: 0.92, 0.96, for trend <0.001), or 1.8 mg/day increment of isoflavones (95%CI: 0.92, 0.97, for trend <0.001) were associated with 6% reduction in T2DM risk. Non-significant association was observed with respect to flavanones and flavones. The present meta-analysis provides substantial evidence that dietary intakes of flavanols, flavonols, flavan-3-ols and isoflavones were inversely associated with T2DM risk, respectively. Higher dietary intakes of flavanol-, flavonol-, flavan-3-ol- and isoflavone-foods would have beneficial effects for protection against T2DM.
流行病学研究表明，类黄酮亚类与 2 型糖尿病（T2DM）风险之间存在争议性关联。本荟萃分析的目的是通过前瞻性队列研究定量评估这些关联。在 2018 年 5 月之前，在 PubMed 和 Scopus 数据库中进行了系统的文献检索。使用随机效应模型，通过受限立方样条回归模型，对最高类别与最低类别进行了多变量校正的相对风险（RR）及其相应的 95%置信区间（CI）的汇总。共纳入了 9 项独立的前瞻性队列研究，涉及 172058 名参与者和 16910 例事件。饮食中类黄酮醇、黄酮醇、黄烷-3-醇和异黄酮的摄入量与 T2DM 风险呈负相关，汇总 RR 分别为 0.86（95%CI：0.77，0.97）、0.91（95%CI：0.85，0.98）、0.90（95%CI：0.82，0.99）和 0.91（95%CI：0.84，0.98）。剂量反应分析表明，类黄酮醇摄入量增加 135mg/天（95%CI：0.92，0.96；P 趋势<0.001）、黄酮醇摄入量增加 50mg/天（95%CI：0.88，0.99，P 趋势=0.021）、黄烷-3-醇摄入量增加 68mg/天（95%CI：0.92，0.96，P 趋势<0.001）或异黄酮摄入量增加 1.8mg/天（95%CI：0.92，0.97，P 趋势<0.001），T2DM 风险降低 6%。类黄酮酮和黄酮类与 T2DM 风险之间无显著关联。本荟萃分析提供了充分的证据表明，类黄酮醇、黄酮醇、黄烷-3-醇和异黄酮的饮食摄入与 T2DM 风险呈负相关。较高的类黄酮醇、黄酮醇、黄烷-3-醇和异黄酮食物的饮食摄入对预防 T2DM 具有有益作用。
