无糖汽水和非热量人工甜味剂的使用与葡萄糖和胰岛素稳态标志物及糖尿病发病的关联：强心脏家族研究
Associations of diet soda and non-caloric artificial sweetener use with markers of glucose and insulin homeostasis and incident diabetes: the Strong Heart Family Study.
作者信息
Jensen Paul N, Howard Barbara V, Best Lyle G, O'Leary Marcia, Devereux Richard B, Cole Shelley A, MacCluer Jean W, Ali Tauqeer, Lee Elisa T, Yeh Fawn L, Yeh Jeunliang, Umans Jason G, Fretts Amanda M
机构信息
Department of Medicine, University of Washington, Seattle, WA, USA.
Georgetown and Howard Universities Center for Translational Sciences, Washington, DC, USA.
出版信息
Eur J Clin Nutr. 2020 Feb;74(2):322-327. doi: 10.1038/s41430-019-0461-6. Epub 2019 Jun 28.
BACKGROUND/OBJECTIVES: Non-caloric artificial sweeteners (NAS) are marketed as healthier alternatives to sugar, but the relationship between consumption of NAS and development of diabetes is unclear. This study assessed the associations of diet soda and NAS consumption with (1) early markers of insulin and glucose homeostasis (cross-sectionally) and (2) incident diabetes (over an average of 8 years of follow-up) among American Indians, a population with high rates of obesity.
SUBJECTS/METHODS: The study population included Strong Heart Family Study participants without cardiovascular disease or diabetes who participated in the 2007-2009 study exam (n = 1359). Diet soda and NAS consumption were assessed using a Block food frequency questionnaire and supplemental NAS questionnaire at the study exam. Fasting plasma glucose and insulin were measured during the study exam after a 12-h overnight fast. Participants were followed for incident diabetes through December 2017 using a single phone interview and medical record review; diabetes was identified by self-report and confirmed by documentation in medical records. Associations of diet soda and NAS consumption with fasting insulin, glucose, and incident diabetes were assessed using generalized estimating equations (fasting insulin and glucose analyses) and parametric survival models with Weibull distributions (incident diabetes analyses).
RESULTS
Just under half of participants reported regularly consuming diet soda (40%) or using NAS to sweeten their beverages (41%). During an average 8 years of follow-up, we identified 98 cases of incident diabetes. After correction for multiple comparisons, there were no statistically significant associations of reported diet soda and NAS consumption with fasting insulin, fasting glucose, or incident diabetes.
CONCLUSIONS
Although reported consumption of diet soda and NAS were high, neither were associated with diabetes risk.
背景/目的：无热量人工甜味剂（NAS）作为比糖更健康的替代品进行销售，但NAS的消费与糖尿病发展之间的关系尚不清楚。本研究评估了饮用无糖汽水和食用NAS与（1）胰岛素和葡萄糖稳态的早期标志物（横断面研究）以及（2）肥胖率较高的美国印第安人群体中的糖尿病发病（平均8年随访期）之间的关联。
受试者/方法：研究人群包括参加2007 - 2009年研究检查且无心血管疾病或糖尿病的强心脏家庭研究参与者（n = 1359）。在研究检查时，使用Block食物频率问卷和补充的NAS问卷评估无糖汽水和NAS的消费情况。在经过12小时过夜禁食后的研究检查期间测量空腹血糖和胰岛素。通过单次电话访谈和病历审查对参与者进行糖尿病发病随访至2017年12月；糖尿病通过自我报告确定，并经病历记录证实。使用广义估计方程（空腹胰岛素和葡萄糖分析）和具有Weibull分布的参数生存模型（糖尿病发病分析）评估无糖汽水和NAS消费与空腹胰岛素、葡萄糖和糖尿病发病之间的关联。
结果
略低于一半的参与者报告经常饮用无糖汽水（40%）或使用NAS来为饮料增甜（41%）。在平均8年的随访期间，我们确定了98例糖尿病发病病例。在进行多重比较校正后，报告的无糖汽水和NAS消费与空腹胰岛素、空腹血糖或糖尿病发病之间没有统计学上的显著关联。
结论
尽管报告的无糖汽水和NAS消费量很高，但两者均与糖尿病风险无关。
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