Slurink Isabel A L, Voortman Trudy, Ochoa-Rosales Carolina, Ahmadizar Fariba, Kavousi Maryam, Kupper Nina, Smeets Tom, Soedamah-Muthu Sabita S
Center of Research on Psychological Disorders and Somatic Diseases (CORPS), Department of Medical and Clinical Psychology, Tilburg University, 5000 LE Tilburg, The Netherlands.
Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The Netherlands.
Nutrients. 2022 Jan 18;14(3):415. doi: 10.3390/nu14030415.
Evidence suggests neutral or moderately beneficial effects of dairy intake on type 2 diabetes mellitus risk. Nevertheless, evidence on associations with early phases of type 2 diabetes remains inconsistent. We aimed to examine associations between dairy-type intake with prediabetes risk and longitudinal insulin resistance. The analytic sample consisted of 6770 participants (aged 62 ± 4 years, 59% female) free of (pre-)diabetes at baseline from the prospective population-based Rotterdam Study. Dairy intake was measured at baseline using food frequency questionnaires. Data on prediabetes (fasting blood glucose 6.1-6.9 mmol/L or non-fasting 7.7-11.1 mmol/L) and the longitudinal homeostatic model assessment of insulin resistance (HOMA-IR) were available from 1993-2015. Associations with these outcomes were analyzed with dairy intake in quartiles (Q4 vs. Q1) and continuous using multivariable Cox proportional hazard models and linear mixed models. During a mean follow-up of 11.3 ± 4.8 years, 1139 incident prediabetes cases were documented (18.8%). In models adjusting for sociodemographic, lifestyle and dietary factors, a higher intake of high-fat yogurt was associated with lower prediabetes risk (HR 0.70, 95% CI 0.54-0.91 and HR 0.67, 0.51-0.89). In addition, a higher intake of high-fat milk was associated with lower prediabetes risk (HR 0.81, 0.67-0.97, HR 0.88, 0.79-0.99). Associations were found for low-fat dairy, low-fat milk and total cheese with a higher prediabetes risk (HR ranging from 1.05-1.07, not significant in quartiles). Associations with longitudinal HOMA-IR were similar to prediabetes for high-fat yogurt, low-fat dairy and low-fat milk. Fermented dairy, low-fat yogurt, high-fat cheese, cream and ice cream were not associated with the outcomes. In conclusion, a higher intake of high-fat yogurt was associated with a lower prediabetes risk and lower longitudinal insulin resistance. Additionally, high-fat milk was associated with a lower prediabetes risk. Some low-fat dairy types were inconsistently associated with these outcomes. Studies are needed to confirm associations and to examine the influence of confounding by population characteristics.
有证据表明，摄入乳制品对2型糖尿病风险具有中性或适度有益的影响。然而，关于与2型糖尿病早期阶段关联的证据仍然不一致。我们旨在研究不同类型乳制品的摄入量与糖尿病前期风险及纵向胰岛素抵抗之间的关联。分析样本包括来自基于人群的前瞻性鹿特丹研究的6770名参与者（年龄62±4岁，59%为女性），他们在基线时无（糖尿病）前期症状。在基线时使用食物频率问卷测量乳制品摄入量。有关糖尿病前期（空腹血糖6.1 - 6.9 mmol/L或非空腹血糖7.7 - 11.1 mmol/L）以及胰岛素抵抗的纵向稳态模型评估（HOMA-IR）的数据可追溯至1993 - 2015年。使用四分位数（Q4与Q1）的乳制品摄入量以及连续变量，通过多变量Cox比例风险模型和线性混合模型分析与这些结果的关联。在平均11.3±4.8年的随访期间，记录了1139例新发糖尿病前期病例（18.8%）。在对社会人口统计学、生活方式和饮食因素进行调整的模型中，高脂肪酸奶摄入量较高与糖尿病前期风险较低相关（风险比0.70，95%置信区间0.54 - 0.91以及风险比0.67，0.51 - 0.89）。此外，高脂肪牛奶摄入量较高与糖尿病前期风险较低相关（风险比0.81，0.67 - 0.97，风险比0.88，0.79 - 0.99）。发现低脂乳制品、低脂牛奶和全脂奶酪与较高的糖尿病前期风险相关（风险比范围为1.05 - 1.07，在四分位数分析中不显著）。与纵向HOMA-IR的关联与糖尿病前期类似，涉及高脂肪酸奶、低脂乳制品和低脂牛奶。发酵乳制品、低脂酸奶、高脂肪奶酪、奶油和冰淇淋与这些结果无关。总之，高脂肪酸奶摄入量较高与较低的糖尿病前期风险和较低的纵向胰岛素抵抗相关。此外，高脂肪牛奶与较低的糖尿病前期风险相关。一些低脂乳制品类型与这些结果的关联不一致。需要开展研究以确认这些关联，并研究人群特征造成的混杂影响。
