Øyen Jannike, Brantsæter Anne Lise, Nøstbakken Ole Jakob, Birkeland Kåre I, Haugen Margareta, Madsen Lise, Egeland Grace M
Seafood and Nutrition, Institute of Marine Research, Bergen, Norway
Department of Environmental Health, Norwegian Institute of Public Health, Oslo, Norway.
Diabetes Care. 2021 Aug 18;44(10):2337-45. doi: 10.2337/dc21-0447.
To investigate associations between intakes of total fish, lean fish, fatty fish, and long-chain n-3 polyunsaturated fatty acid (LC-3PUFA) supplements and risk of type 2 diabetes in women after pregnancy. Furthermore, we sought to compare the estimated intakes of methylmercury (MeHg) and sum of dioxins and dioxin-like polychlorinated biphenyls (-PCBs) with tolerable weekly intakes (TWI).
Women free of diabetes at baseline ( = 60,831) who participated in the population-based Norwegian Mother, Father and Child Cohort Study (MoBa) were prospectively evaluated for incident type 2 diabetes, identified on the basis of medication usage >90 days after delivery, ascertained through the Norwegian Prescription Database. Dietary intake data were obtained with a validated 255-item food-frequency questionnaire (FFQ), which assessed habitual diet during the first 4-5 months of pregnancy. Intakes of MeHg and sum of dioxins and -PCBs were derived with use of a contaminant database and the FFQ.
Median age was 31 years (interquartile range 27, 34) at time of delivery, and follow-up time was 7.5 years (6.5, 8.5). Type 2 diabetes occurred in 683 (1.1%) participants. Multivariable Cox regression analyses identified lower risk of type 2 diabetes with increasing energy-adjusted lean fish intake, 25 g/1,000 kcal (25 g/1,000 kcal: hazard ratio 0.71, 95% CI 0.53-0.95, P = 0.022). However, in stratified analyses, a lower risk was found only in women with prepregnancy BMI ≥25 kg/m. There were no associations between intake of total fish, fatty fish, or LC-3PUFA supplements and type 2 diabetes. MeHg intake was low, but the intake of the sum of dioxins and -PCBs (picograms of toxic equivalents/kilograms of body weight/week) exceeded the TWI set by the European Food Safety Authority (EFSA) for the majority of participants.
Intake of lean fish, but not fatty fish or LC-3PUFA supplements, was associated with lower risk of pharmacologically treated type 2 diabetes in Norwegian women who were overweight or obese. Fatty fish, which contain dioxins and -PCBs, did not increase the risk of type 2 diabetes, but the exceedance of the EFSA TWI for dioxins and -PCBs is a health concern.
研究孕期后女性摄入总鱼类、瘦鱼、肥鱼和长链n-3多不饱和脂肪酸（LC-3PUFA）补充剂与2型糖尿病风险之间的关联。此外，我们试图将甲基汞（MeHg）以及二噁英和类二噁英多氯联苯（-PCBs）的估计摄入量与可耐受每周摄入量（TWI）进行比较。
对参加基于人群的挪威母亲、父亲和儿童队列研究（MoBa）且基线时无糖尿病的女性（n = 60,831）进行前瞻性评估，以确定2型糖尿病的发病情况，根据分娩后>90天的用药情况进行识别，通过挪威处方数据库确定。饮食摄入数据通过经过验证的255项食物频率问卷（FFQ）获得，该问卷评估了妊娠前4 - 5个月的习惯性饮食。MeHg以及二噁英和-PCBs的摄入量通过污染物数据库和FFQ得出。
分娩时的中位年龄为31岁（四分位间距27, 34），随访时间为7.5年（6.5, 8.5）。683名（1.1%）参与者发生了2型糖尿病。多变量Cox回归分析发现，随着能量调整后的瘦鱼摄入量增加，2型糖尿病风险降低，25 g/1,000 kcal（25 g/1,000 kcal：风险比0.71，95%CI 0.53 - 0.95, P = 0.022）。然而，在分层分析中，仅在孕前BMI≥25 kg/m²的女性中发现风险较低。总鱼类、肥鱼或LC-3PUFA补充剂的摄入量与2型糖尿病之间无关联。MeHg摄入量较低，但对于大多数参与者，二噁英和-PCBs的摄入量（皮克毒性当量/千克体重/周）超过了欧洲食品安全局（EFSA）设定的TWI。
在超重或肥胖的挪威女性中，瘦鱼的摄入与药物治疗的2型糖尿病风险较低相关，而肥鱼则不然。含有二噁英和-PCBs的肥鱼并未增加2型糖尿病的风险，但二噁英和-PCBs的摄入量超过EFSA的TWI是一个健康问题。
