Clinical Epidemiology, Steno Diabetes Center Copenhagen, Gentofte, Denmark.
Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark.
Diabet Med. 2019 Oct;36(10):1256-1260. doi: 10.1111/dme.13951. Epub 2019 Apr 11.
We examined whether late evening food consumption was prospectively associated with the risk of developing prediabetes or diabetes in a large observational study of individuals with normoglycaemia.
Participants were 2642 men and women with normoglycaemia (HbA < 39 mmol/mol; < 5.7%) from the Whitehall II study. Time of last eating episode (TLEE) before the examination day was assessed at baseline. We studied the associations of TLEE with 5-year changes in HbA and risk of developing prediabetes or diabetes (HbA ≥ 39 mmol/mol; ≥ 5.7%). Potential heterogeneity in the association between TLEE and prediabetes or diabetes was examined using recursive partitioning modelling for time-to-event outcomes.
There was a tendency of an overall association of TLEE with change in HbA but with little effect size [β per 1-h increase in TLEE = 0.2 mmol/mol, 95% CI -0.0 to 0.3 (0.01%, -0.00 to 0.03); P = 0.055] and no association with the risk of developing prediabetes/diabetes (risk ratio per 1-h increase in TLEE = 1.03, 95% CI 0.94 to 1.13; P = 0.511). According to the recursive partitioning modelling, women with HbA ≤ 36 mmol/mol and TLEE after 21:00 had a 1.51 times (95% CI 1.16 to 1.93) higher 5-year risk of developing prediabetes or diabetes than those having their TLEE between 16:00 and 21:00 (35.4% vs. 23.5%; P = 0.003).
There was no overall association of TLEE with the development of prediabetes or diabetes in the Whitehall II population. However, explorative analyses suggested that eating late in the evening was associated with increased risk of developing prediabetes/diabetes among women with good glycaemic control. Whether restricting late evening food consumption is effective and feasible for the prevention of Type 2 diabetes needs testing in randomized controlled trials.
我们在一项针对血糖正常人群的大型观察性研究中,考察了深夜进食与发生糖尿病前期或糖尿病的风险是否存在前瞻性关联。
研究对象为来自 Whitehall II 研究的 2642 名血糖正常(HbA<39mmol/mol;<5.7%)的男性和女性。在基线时评估检查日之前的最后进食时间(TLEE)。我们研究了 TLEE 与 HbA 5 年变化以及发生糖尿病前期或糖尿病(HbA≥39mmol/mol;≥5.7%)的风险之间的关联。使用递归分区模型对 TLEE 与糖尿病前期或糖尿病之间的关联进行潜在异质性检验,用于时间事件结局。
总体上,TLEE 与 HbA 的变化存在关联,但效应大小较小[每增加 1 小时 TLEE,HbA 增加 0.2mmol/mol,95%CI-0.0 至 0.3(0.01%,-0.00 至 0.03);P=0.055],与发生糖尿病前期/糖尿病的风险无关联(每增加 1 小时 TLEE,风险比为 1.03,95%CI 0.94 至 1.13;P=0.511)。根据递归分区模型,HbA≤36mmol/mol 的女性和 TLEE 时间在 21:00 之后的人群,发生糖尿病前期或糖尿病的 5 年风险比 TLEE 时间在 16:00 至 21:00 之间的人群高 1.51 倍(95%CI 1.16 至 1.93)(35.4%比 23.5%;P=0.003)。
在 Whitehall II 人群中,TLEE 与糖尿病前期或糖尿病的发生无总体关联。然而,探索性分析表明,在血糖控制良好的女性中,深夜进食与发生糖尿病前期/糖尿病的风险增加有关。限制深夜进食是否能有效且可行地预防 2 型糖尿病,需要在随机对照试验中进行检验。