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乳制品消费与荷兰中年成年人的糖尿病前期发病:霍恩研究前瞻性队列研究。

Dairy product consumption and incident prediabetes in Dutch middle-aged adults: the Hoorn Studies prospective cohort.

机构信息

Center of Research on Psychological and Somatic Disorders (CORPS), Department of Medical and Clinical Psychology, Tilburg University, PO Box 90153, 5000 LE, Tilburg, The Netherlands.

Department of Epidemiology and Biostatistics, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.

出版信息

Eur J Nutr. 2022 Feb;61(1):183-196. doi: 10.1007/s00394-021-02626-9. Epub 2021 Jul 10.

Abstract

PURPOSE

Our aim was to investigate prospective associations of consumption of total dairy and dairy types with incident prediabetes in a Dutch population-based study.

METHODS

Two enrolment waves of the Hoorn Studies were harmonized, resulting in an analytic sample of 2262 participants without (pre-) diabetes at enrolment (mean age 56 ± 7.3 years; 50% male). Baseline dietary intake was assessed by validated food frequency questionnaires. Relative risks (RRs) were calculated between dairy, fermented dairy, milk, yogurt (all total/high/low fat), cream and ice cream and prediabetes. Additionally, substituting one serving/day of dairy types associated with prediabetes with alternative dairy types was analysed.

RESULTS

During a mean 6.4 ± 0.7 years of follow-up, 810 participants (35.9%) developed prediabetes. High fat fermented dairy, cheese and high fat cheese were associated with a 17% (RR 0.83, 95% CI 0.69-0.99, p = 0.04), 14% (RR 0.86, 95% CI 0.73-1.02, p = 0.04) and 21% (RR 0.79, 95% CI 0.66-0.94, p = 0.01) lower risk of incident prediabetes, respectively, in top compared to bottom quartiles, after adjustment for confounders. High fat cheese consumption was continuously associated with lower prediabetes risk (RR 0.94, 95% CI 0.88-1.00, p = 0.04). Total dairy and other dairy types were not associated with prediabetes risk in adjusted models, irrespective of fat content (RR ~ 1). Replacing high fat cheese with alternative dairy types was not associated with prediabetes risk.

CONCLUSION

The highest intake of high fat fermented dairy, cheese and high fat cheese were associated with a lower risk of prediabetes, whereas other dairy types were not associated. Cheese seems to be inversely associated with type 2 diabetes risk, despite high levels of saturated fatty acids and sodium.

摘要

目的

本研究旨在通过一项荷兰人群为基础的研究,调查总乳制品和乳制品类型的摄入与前驱糖尿病发病之间的前瞻性关联。

方法

对霍恩研究的两个入组阶段进行了协调,由此产生了一个无(前)糖尿病的分析样本,共 2262 名参与者(平均年龄 56±7.3 岁;50%为男性)。通过验证后的食物频率问卷评估基线饮食摄入。计算乳制品、发酵乳制品、牛奶、酸奶(所有总/高脂/低脂)、奶油和冰淇淋与前驱糖尿病之间的相对风险(RR)。此外,还分析了用与前驱糖尿病相关的乳制品类型代替一份每日乳制品摄入量对疾病的影响。

结果

在平均 6.4±0.7 年的随访期间,810 名参与者(35.9%)发生了前驱糖尿病。高脂肪发酵乳制品、奶酪和高脂肪奶酪分别与低风险相关 17%(RR 0.83,95%CI 0.69-0.99,p=0.04)、14%(RR 0.86,95%CI 0.73-1.02,p=0.04)和 21%(RR 0.79,95%CI 0.66-0.94,p=0.01),分别位于最高四分位组和最低四分位组。调整混杂因素后,高脂肪奶酪的摄入量与较低的前驱糖尿病风险呈连续相关(RR 0.94,95%CI 0.88-1.00,p=0.04)。总乳制品和其他乳制品类型与调整后的模型中的前驱糖尿病风险无关,与脂肪含量无关(RR~1)。用替代乳制品代替高脂肪奶酪与前驱糖尿病风险无关。

结论

摄入最高量的高脂肪发酵乳制品、奶酪和高脂肪奶酪与较低的前驱糖尿病风险相关,而其他乳制品类型则与该风险无关。尽管奶酪含有高水平的饱和脂肪酸和钠,但它与 2 型糖尿病风险呈负相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9966/8783852/c555e074c9c7/394_2021_2626_Fig1_HTML.jpg

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