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日常饮食摄入会影响糖尿病视网膜病变的进展吗?来自 45 岁及以上研究的 10 年结果。

Does daily dietary intake affect diabetic retinopathy progression? 10-year results from the 45 and Up Study.

机构信息

Eye Center, Renmin Hospital of Wuhan University, Eye Institute of Wuhan University, Wuhan, China.

Centre for Eye Research Australia; Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Victoria, Australia.

出版信息

Br J Ophthalmol. 2020 Dec;104(12):1774-1780. doi: 10.1136/bjophthalmol-2018-312990. Epub 2019 Feb 22.

Abstract

BACKGROUND/AIMS: To evaluate the associations of dietary consumption with the 10-year incidence of diabetic retinopathy (DR) progression in working-aged Australians with diabetes.

METHODS

We obtained longitudinal data of all diabetic subjects aged 45-65 years from the baseline of the 45 and Up Study and linked this data with Medicare Benefits Schedule (MBS) and Pharmaceutical Benefits Scheme claims until 2016. Retinal photocoagulation (RPC), as determined based on the MBS data, was used as a proxy measure of DR progression. Dietary measurements were assessed via self-reported consumption of meat, dairy products, whole-meal bread, breakfast cereal, vegetables, fruit and fruit juice using a self-administered questionnaire at baseline. Cox regression was used to assess the association between dietary consumption and incident RPC during the follow-up period.

RESULTS

A total of 8122 participants were included in the current analysis with a mean age of 57.2±5.2 years. During a mean follow-up of 8.6 years, 314 participants (3.8% of baseline) received RPC. Higher consumption of cheese and whole-meal bread was associated with a lower risk of incident RPC, with the HRs of the highest quartiles versus the lowest being 0.58 (95% CI 0.41 to 0.83; test for trend, p=0.007) and 0.64 (0.46 to 0.89; p=0.04), respectively. Body mass index, insulin treatment and gender were significant modifiers for the association between cheese/whole-meal bread and RPC.

CONCLUSION

Consumption of cheese and whole-meal bread could reduce the risk of DR progression among the working-aged Australian population with diabetes.

摘要

背景/目的:评估饮食摄入与澳大利亚工作年龄段糖尿病患者糖尿病视网膜病变(DR)进展的 10 年发生率之间的相关性。

方法

我们从 45 岁以上研究的基线处获得了所有年龄在 45-65 岁之间的糖尿病患者的纵向数据,并将这些数据与医疗保险福利计划(MBS)和药品福利计划(PBS)的索赔数据进行了关联,直到 2016 年。视网膜光凝术(RPC)作为 MBS 数据的替代指标,用于评估 DR 进展。饮食测量是通过基线时使用自我报告的肉、奶制品、全麦面包、早餐麦片、蔬菜、水果和果汁的消耗量来评估的,使用自我管理的问卷进行评估。Cox 回归用于评估随访期间饮食摄入与新发性 RPC 之间的关联。

结果

共有 8122 名参与者纳入了本次分析,平均年龄为 57.2±5.2 岁。在平均 8.6 年的随访期间,有 314 名参与者(占基线的 3.8%)接受了 RPC。较高的奶酪和全麦面包的摄入量与较低的新发性 RPC 风险相关,最高四分位数与最低四分位数的 HR 分别为 0.58(95%CI 0.41 至 0.83;趋势检验,p=0.007)和 0.64(0.46 至 0.89;p=0.04)。体重指数、胰岛素治疗和性别是奶酪/全麦面包与 RPC 之间关联的显著调节剂。

结论

食用奶酪和全麦面包可能会降低澳大利亚工作年龄段糖尿病患者 DR 进展的风险。

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