Department of Epidemiology, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.
Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands.
Eur J Nutr. 2020 Jun;59(4):1717-1727. doi: 10.1007/s00394-019-02026-0. Epub 2019 Sep 5.
Artificially sweetened and sugar-sweetened beverage consumptions have both been reported to be associated with type 2 diabetes mellitus (T2D) risk. The aim of the current study was to investigate the potential underlying associations with dynamic pancreatic β-cell function (BCF) and insulin sensitivity.
We evaluated cross-sectional associations in 2240 individuals (mean ± SD age 59.6 ± 8.18, 49.4% male, 21.9% T2D) participating in a diabetes-enriched population-based cohort. Artificially sweetened and sugar-sweetened soft drinks and juice consumption were assessed by a food-frequency questionnaire. Glucose metabolism status, insulin sensitivity, and BCF were measured by a seven-point oral glucose tolerance test. Regression analyses were performed to assess associations of artificially and sugar-sweetened beverage consumption with measures of glucose homeostasis. Associations were adjusted for potential confounders, and additionally with and without total energy intake and BMI, as these variables could be mediators.
Moderate consumption of artificially sweetened soft drink was associated with lower β-cell glucose sensitivity [standardized beta (95% CI), - 0.06 (- 0.11, - 0.02)], total insulin secretion [β - 0.06 (- 0.10, - 0.02)], and with lower β-cell rate sensitivity [odds ratio (95% CI), 1.29 (1.03, 1.62)] compared to abstainers. Daily artificially sweetened soft drink consumption was associated with lower β-cell glucose sensitivity [β - 0.05 (- 0.09, 0.00)], and total insulin secretion [β - 0.05 - 0.09, - 0.01)] compared to abstainers.
Moderate and daily consumption of artificially sweetened soft drinks was associated with lower BCF, but not with insulin sensitivity. No evidence was found for associations of sugar-sweetened soft drink and juice consumption with BCF or insulin sensitivity in this middle-aged population. Prospective studies are warranted to further investigate the associations of artificially and sugar-sweetened beverage consumption with non-fasting insulin sensitivity and multiple BCF aspects.
人工甜味剂和含糖饮料的摄入均与 2 型糖尿病（T2D）风险相关。本研究旨在探讨与动态胰岛β细胞功能（BCF）和胰岛素敏感性相关的潜在关联。
我们评估了 2240 名个体（平均年龄 59.6±8.18 岁，49.4%为男性，21.9%为 T2D）的横断面关联，这些个体参与了一个糖尿病丰富的基于人群的队列。人工甜味剂和含糖软饮料及果汁的摄入量通过食物频率问卷进行评估。葡萄糖代谢状态、胰岛素敏感性和 BCF 通过七点口服葡萄糖耐量试验进行测量。回归分析用于评估人工和含糖饮料摄入与葡萄糖稳态测量值之间的关联。调整了潜在混杂因素，并在考虑和不考虑总能量摄入和 BMI 的情况下进行了调整，因为这些变量可能是中介因素。
与不饮用人工甜味软饮料者相比，适量饮用人工甜味软饮料与β细胞葡萄糖敏感性降低（标准化β[95%置信区间]，-0.06[-0.11，-0.02]）、总胰岛素分泌减少[β-0.06[-0.10，-0.02]]以及β细胞速率敏感性降低[比值比（95%置信区间），1.29（1.03，1.62）]相关。与不饮用人工甜味软饮料者相比，每天饮用人工甜味软饮料与β细胞葡萄糖敏感性降低（β-0.05[-0.09，0.00]）和总胰岛素分泌减少（β-0.05[-0.09，-0.01]）相关。
适量和每天饮用人工甜味软饮料与 BCF 降低相关，但与胰岛素敏感性无关。在该中年人群中，没有证据表明含糖软饮料和果汁的摄入与 BCF 或胰岛素敏感性相关。需要前瞻性研究来进一步探讨人工和含糖饮料摄入与非空腹胰岛素敏感性和多个 BCF 方面的关联。
