Division of Epidemiology and Health Index, Center for Genome Science, Korea National Institute of Health, Korea Centers for Disease Control and Prevention, Chungcheongbuk-do, South Korea.
Division of Epidemiology and Health Index, Center for Genome Science, Korea National Institute of Health, Korea Centers for Disease Control and Prevention, Chungcheongbuk-do, South Korea.
Nutrition. 2019 Jan;57:245-251. doi: 10.1016/j.nut.2018.04.011. Epub 2018 May 24.
This study aimed to investigate whether dietary glycemic load (GL), glycemic index (GI), and carbohydrate intake were prospectively associated with incident type 2 diabetes mellitus (T2DM) in a middle-aged and older Korean populations.
Data from the Korean Genome and Epidemiology Study were used. A total of 7294 Korean adults ages 40 y to 69 y and with no previous diagnosis of T2DM or cancer at baseline were followed for 10 y. Dietary GL, GI, and carbohydrate intake were estimated on the basis of participants' responses to a validated, semiquantitative, food-frequency questionnaire at baseline. T2DM was defined according to the World Health Organization and International Diabetes Federation criteria.
During 7.7 y (56 377 person-years) of follow-up time, 1259 participants (17.3%) developed T2DM. Grain and its products (particularly refined and whole grains) were the greatest contributors to dietary GL. In the multivariable Cox models, dietary GL was differentially associated with T2DM risk by sex. Men in the highest quintile demonstrated a higher risk of T2DM incidence than did those with the lowest, energy-adjusted, dietary GL (hazard ratio for fifth vs. first quarter = 1.26; 95% confidence interval, 1.05-1.52; P for trend < 0.05) but no association between dietary GL and the risk of T2DM was observed in women. Similar to the findings from the main models, the effect of dietary GL on T2DM incidence according to body mass index, abdominal obesity, and physical activity levels differed substantially by sex.
High GL diets may increase the risk of the development of T2DM in middle-aged and older Korean men but not in women. Nutrition education and emphasis on self-monitoring of dietary carbohydrate quality and quantity of overall diets is necessary in the middle-aged and older Korean populations.
本研究旨在探讨饮食血糖负荷（GL）、血糖指数（GI）和碳水化合物摄入量是否与中年和老年韩国人群中 2 型糖尿病（T2DM）的发生具有前瞻性相关性。
本研究使用了韩国基因组与流行病学研究的数据。共有 7294 名年龄在 40 至 69 岁之间、基线时无 T2DM 或癌症诊断的韩国成年人参与了本研究，随访时间为 10 年。根据参与者在基线时对经过验证的半定量食物频率问卷的回答，估计了饮食 GL、GI 和碳水化合物的摄入量。T2DM 根据世界卫生组织和国际糖尿病联合会的标准进行定义。
在 7.7 年（56377 人年）的随访期间，1259 名参与者（17.3%）发生了 T2DM。谷物及其制品（特别是精制谷物和全谷物）是饮食 GL 的最大贡献者。在多变量 Cox 模型中，饮食 GL 与 T2DM 风险的相关性因性别而异。与最低五分位相比，最高五分位的男性发生 T2DM 的风险更高（第五五分位与第一四分位相比的风险比为 1.26；95%置信区间为 1.05-1.52；趋势 P<0.05），但女性中饮食 GL 与 T2DM 风险之间无关联。与主要模型的结果相似，饮食 GL 对 T2DM 发病率的影响根据体重指数、腹部肥胖和身体活动水平在性别之间存在显著差异。
高 GL 饮食可能会增加中年和老年韩国男性发生 T2DM 的风险，但对女性没有影响。在中年和老年韩国人群中，有必要进行营养教育，并强调自我监测饮食中碳水化合物的质量和数量。
