Lilja Erika, Bergwall Sara, Sonestedt Emily, Gottsäter Anders, Acosta Stefan
Department of Clinical Sciences, Malmö, Lund University, Ruth Lundskogs gata 10, 205 02 Malmö, Sweden.
Department of Clinical Sciences, Malmö, Lund University, Malmö, Sweden.
Ther Adv Endocrinol Metab. 2019 Dec 4;10:2042018819890532. doi: 10.1177/2042018819890532. eCollection 2019.
With the rising prevalence of both diabetes mellitus (DM) and peripheral arterial disease (PAD), the aim of this project was to examine the association between dietary intake and lifestyle on the risk of developing PAD among individuals with DM. The Malmö Diet and Cancer study was a prospective cohort study with baseline examinations carried out between 1991 and 1996 in Malmö, Sweden ( = 30,446). Individuals with prevalent PAD and cardiovascular disease (prior stroke or myocardial infarction) were excluded from the study, resulting in a total study population of 1112 patients with prevalent DM. The diagnosis of incident PAD was validated and confirmed in 98% of patients. Of the 1112 individuals, 136 (12.2%) were diagnosed with PAD during a median follow up of 19.7 years (interquartile range 12.9-22.4). Kaplan-Meier analysis showed that men with DM more often developed incident PAD compared with women (cumulative incidences 15.5% and 8.9%, respectively, = 0.012). In Cox multivariable regression analysis, smoking (hazard ratio of 1.96, 95% confidence interval of 1.28-3.00) was associated with increased risk of PAD, and there was a trend that a higher intake of fish and shellfish (hazard ratio per additional gram per week of 0.99, 95% confidence interval of 0.99-1.00; = 0.051) was associated with a decreased risk of PAD. In conclusion, the present study demonstrated a trend towards a protective effect of higher intake of fish and shellfish upon incident symptomatic PAD among individuals with DM.
随着糖尿病（DM）和外周动脉疾病（PAD）患病率的不断上升，本项目旨在研究饮食摄入和生活方式与DM患者发生PAD风险之间的关联。马尔默饮食与癌症研究是一项前瞻性队列研究，于1991年至1996年在瑞典马尔默进行基线检查（n = 30446）。患有PAD和心血管疾病（既往中风或心肌梗死）的个体被排除在研究之外，最终研究人群为1112例患有DM的患者。98%的患者对新发PAD的诊断得到了验证和确认。在1112名个体中，136名（12.2%）在中位随访19.7年（四分位间距12.9 - 22.4）期间被诊断为PAD。Kaplan - Meier分析显示，DM男性比女性更常发生新发PAD（累积发病率分别为15.5%和8.9%，P = 0.012）。在Cox多变量回归分析中，吸烟（风险比为1.96，95%置信区间为1.28 - 3.00）与PAD风险增加相关，并且有一个趋势是，每周鱼类和贝类摄入量每增加一克（风险比为0.99，95%置信区间为0.99 - 1.00；P = 0.051）与PAD风险降低相关。总之，本研究表明，DM患者中较高的鱼类和贝类摄入量对新发有症状PAD具有保护作用的趋势。
