Center for Research in Policies, Population and Health, Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico.
Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico.
Am J Clin Nutr. 2020 Sep 1;112(3):661-668. doi: 10.1093/ajcn/nqaa169.
Insulin resistance (IR) is an important risk factor for type 2 diabetes (T2D) and other cardiometabolic diseases. Recent studies suggest that soft drink consumption could increase IR. However, inconsistent findings have been observed.
The aim was to estimate the association between the cumulative consumption of soft drinks and IR by means of the HOMA-IR in Mexican adults.
We analyzed the association between cumulative consumption of soft drinks and HOMA-IR change after 7 y of follow-up in participants (n = 1073) of the Health Workers Cohort Study. Soft drink consumption was estimated by food-frequency questionnaires. Insulin was measured by chemiluminescence, and fasting glucose was measured with the enzymatic colorimetric method. HOMA-IR was computed as fasting insulin (mIU/L) × fasting glucose (mmol/L)/22.5. To assess the relation between cumulative soft drink consumption and HOMA-IR change, we performed robust linear regression models. Additionally, we used fixed-effects models to estimate the association between changes in soft drink consumption and change in HOMA-IR.
At baseline, the average age was 44 y. Mean cumulative soft drink consumption was 0.42 servings/d. Median HOMA-IR increased from 1.5 at baseline to 2.0 at follow-up. Soft drink consumption was positively associated with HOMA-IR change. In the multiple linear regression analysis, for each increase in the consumption of 2 (355 mL) soft drinks/d, the average change between baseline and follow-up HOMA-IR showed an increase of 1.11 units (95% CI: 0.74, 1.48).
Our data support the hypothesis that, in Mexican adults, a higher soft drink consumption is associated with an increase in HOMA-IR, despite known risk factors. These findings support the need for reinforcing policies to reduce soft drink consumption in our population.
胰岛素抵抗（IR）是 2 型糖尿病（T2D）和其他心血管代谢疾病的重要危险因素。最近的研究表明，饮用软饮料可能会增加 IR。然而，观察到的结果并不一致。
本研究旨在通过 HOMA-IR 估计墨西哥成年人中软饮料累积摄入量与 IR 之间的关系。
我们分析了健康工作者队列研究中 1073 名参与者（n=1073）的软饮料累积摄入量与 7 年随访期间 HOMA-IR 变化之间的关联。软饮料的摄入量通过食物频率问卷进行评估。胰岛素采用化学发光法测定，空腹血糖采用酶比色法测定。HOMA-IR 通过空腹胰岛素（mIU/L）×空腹血糖（mmol/L）/22.5 计算得出。为了评估软饮料累积摄入量与 HOMA-IR 变化之间的关系，我们进行了稳健的线性回归模型。此外，我们使用固定效应模型来估计软饮料消费变化与 HOMA-IR 变化之间的关系。
在基线时，平均年龄为 44 岁。平均累积软饮料摄入量为 0.42 份/天。中位数 HOMA-IR 从基线时的 1.5 增加到随访时的 2.0。软饮料的摄入量与 HOMA-IR 的变化呈正相关。在多元线性回归分析中，每天增加 2 份（355 毫升）软饮料时，基线和随访期间 HOMA-IR 的平均变化增加 1.11 个单位（95%CI：0.74，1.48）。
我们的数据支持这样一种假设，即在墨西哥成年人中，尽管存在已知的危险因素，但较高的软饮料摄入量与 HOMA-IR 的增加有关。这些发现支持需要加强政策以减少我们人群中软饮料的消费。
