Bhavadharini Balaji, Mohan Viswanathan, Dehghan Mahshid, Rangarajan Sumathy, Swaminathan Sumathi, Rosengren Annika, Wielgosz Andreas, Avezum Alvaro, Lopez-Jaramillo Patricio, Lanas Fernando, Dans Antonio L, Yeates Karen, Poirier Paul, Chifamba Jephat, Alhabib Khalid F, Mohammadifard Noushin, Zatońska Katarzyna, Khatib Rasha, Vural Keskinler Mirac, Wei Li, Wang Chuangshi, Liu Xiaoyun, Iqbal Romaina, Yusuf Rita, Wentzel-Viljoen Edelweiss, Yusufali Afzalhussein, Diaz Rafael, Keat Ng Kien, Lakshmi P V M, Ismail Noorhassim, Gupta Rajeev, Palileo-Villanueva Lia M, Sheridan Patrick, Mente Andrew, Yusuf Salim
Population Health Research Institute, Hamilton Health Sciences and McMaster University, Hamilton, Canada.
Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, Chennai, India
Diabetes Care. 2020 Nov;43(11):2643-2650. doi: 10.2337/dc19-2335. Epub 2020 Sep 1.
Previous prospective studies on the association of white rice intake with incident diabetes have shown contradictory results but were conducted in single countries and predominantly in Asia. We report on the association of white rice with risk of diabetes in the multinational Prospective Urban Rural Epidemiology (PURE) study.
Data on 132,373 individuals aged 35-70 years from 21 countries were analyzed. White rice consumption (cooked) was categorized as <150, ≥150 to <300, ≥300 to <450, and ≥450 g/day, based on one cup of cooked rice = 150 g. The primary outcome was incident diabetes. Hazard ratios (HRs) were calculated using a multivariable Cox frailty model.
During a mean follow-up period of 9.5 years, 6,129 individuals without baseline diabetes developed incident diabetes. In the overall cohort, higher intake of white rice (≥450 g/day compared with <150 g/day) was associated with increased risk of diabetes (HR 1.20; 95% CI 1.02-1.40; for trend = 0.003). However, the highest risk was seen in South Asia (HR 1.61; 95% CI 1.13-2.30; for trend = 0.02), followed by other regions of the world (which included South East Asia, Middle East, South America, North America, Europe, and Africa) (HR 1.41; 95% CI 1.08-1.86; for trend = 0.01), while in China there was no significant association (HR 1.04; 95% CI 0.77-1.40; for trend = 0.38).
Higher consumption of white rice is associated with an increased risk of incident diabetes with the strongest association being observed in South Asia, while in other regions, a modest, nonsignificant association was seen.
既往关于白米饭摄入量与糖尿病发病关系的前瞻性研究结果相互矛盾，且这些研究均在单一国家开展，主要是在亚洲。我们在多国开展的前瞻性城乡流行病学（PURE）研究中报告白米饭与糖尿病风险的关系。
分析了来自21个国家的132373名35至70岁个体的数据。根据一杯煮熟的米饭 = 150克，将白米饭摄入量（煮熟的）分为<150克/天、≥150至<300克/天、≥300至<450克/天和≥450克/天。主要结局是糖尿病发病。使用多变量Cox脆弱模型计算风险比（HRs）。
在平均9.5年的随访期内，6129名无基线糖尿病的个体发生了糖尿病。在整个队列中，白米饭摄入量较高（≥450克/天与<150克/天相比）与糖尿病风险增加相关（HR 1.20；95%CI 1.02 - 1.40；趋势P = 0.003）。然而，风险最高的是南亚（HR 1.61；95%CI 1.13 - 2.30；趋势P = 0.02），其次是世界其他地区（包括东南亚、中东、南美、北美、欧洲和非洲）（HR 1.41；95%CI 1.08 - 1.86；趋势P = 0.01），而在中国则无显著关联（HR 1.04；95%CI 0.77 - 1.40；趋势P = 0.38）。
白米饭摄入量较高与糖尿病发病风险增加相关，在南亚观察到的关联最强，而在其他地区，观察到的是适度的、无显著意义的关联。
