1997年至2015年中国成年人饮食中支链氨基酸转变与2型糖尿病风险：基于七项横断面研究和一项前瞻性队列研究
The Dietary Branched-Chain Amino Acids Transition and Risk of Type 2 Diabetes Among Chinese Adults From 1997 to 2015: Based on Seven Cross-Sectional Studies and a Prospective Cohort Study.
作者信息
Yu Lianlong, Song Pengkun, Zhu Qianrang, Li Yuqian, Jia Shanshan, Zhang Shixiu, Wang Zhihong, Zhang Jian
机构信息
National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China.
NHC Key Laboratory of Trace Element Nutrition, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China.
出版信息
Front Nutr. 2022 May 23;9:881847. doi: 10.3389/fnut.2022.881847. eCollection 2022.
BACKGROUND
The situation is grim for the prevention and control of type 2 diabetes (T2D) and prediabetes in China. Serum and dietary branched-chain amino acids (BCAAs) were risk factors for T2D. However, there is a lack of information on trends in consumption of BCAAs and the risk of T2D associated with BCAAs intake, based on nationally representative data in China. Thus, we aimed to comprehensively describe the dietary BCAAs transition and risk of T2D, at a national level among Chinese adults from 1997 to 2015.
METHODS
The data sources were the China Health and Nutrition Survey (CHNS) and China Nutrition and Health Survey (CNHS). Cross-sectional data on intake were obtained from CHNS (1997, = 9,404), CHNS (2000, = 10,291), CHNS (2004, = 9,682), CHNS (2006, = 9,553), CHNS (2009, = 9,811), CHNS (2011, = 12,686) and CNHS (2015, = 71,695). Prospective cohort data were obtained CHNS (1997-2015, = 15,508).
RESULTS
From 1997 to 2015, there was a significant decreasing trend in the BCAAs intake of Chinese adults in all subgroups ( < 0.0001) except for Leu in 80 or older, and a decreasing trend in the consumption of BCAAs after 40 years old ( < 0.05). The mean intake of BCAAs in the population of cohort study was 11.83 ± 3.77g/day. The 95% CI was above the HR of 1.0, when the consumptions were higher than 14.01, 3.75, 6.07, 4.21 g/day in BCAAs, Ile, Leu and Val, based on RCS curves. According to the Cox proportional hazards models, Compared with individuals with BCAAs consumption of 10.65-12.37 g/day, the multivariable-adjusted HR for diabetes was 2.26 (95% CI 1.45 to 3.51) for individuals with consumption of BCAAs more than 18.52 g/day. A statistically significant positive association between BCAAs intake and risk of T2D was observed in males or participants aged 45 years and older, but not in females or participants younger than 45 years.
CONCLUSION
Our results reveal a trend toward decreased BCAAs intake in Chinese from 1997 to 2015. After 40 years of age, consumption of BCAAs declined with increasing age. Higher BCAAs intake was associated with higher risk of T2D. This relationship is more stable among men and middle-aged and elderly people.
背景
中国2型糖尿病（T2D）和糖尿病前期的防控形势严峻。血清和膳食中的支链氨基酸（BCAAs）是T2D的危险因素。然而，基于中国具有全国代表性的数据，关于BCAAs的消费趋势以及与BCAAs摄入量相关的T2D风险的信息尚缺。因此，我们旨在全面描述1997年至2015年中国成年人在全国范围内膳食BCAAs的变化情况以及T2D风险。
方法
数据来源为中国健康与营养调查（CHNS）和中国营养与健康调查（CNHS）。摄入量的横断面数据来自CHNS（1997年，n = 9404）、CHNS（2000年，n = 10291）、CHNS（2004年，n = 9682）、CHNS（2006年，n = 9553）、CHNS（2009年，n = 9811）、CHNS（2011年，n = 12686）以及CNHS（2015年，n = 71695）。前瞻性队列数据来自CHNS（1997 - 2015年，n = 15508）。
结果
1997年至2015年，除80岁及以上人群的亮氨酸（Leu）外，所有亚组中国成年人的BCAAs摄入量均呈显著下降趋势（P < 0.0001），且40岁以后BCAAs的消费量呈下降趋势（P < 0.05）。队列研究人群中BCAAs的平均摄入量为11.83±3.77克/天。根据限制立方样条（RCS）曲线，当BCAAs、异亮氨酸（Ile）、亮氨酸、缬氨酸（Val）的摄入量分别高于14.01、3.75、6.07、4.21克/天时，95%置信区间高于风险比（HR）1.0。根据Cox比例风险模型，与BCAAs摄入量为10.65 - 12.37克/天的个体相比，BCAAs摄入量超过18.52克/天的个体患糖尿病的多变量调整HR为2.26（95%置信区间1.45至3.51）。在男性或45岁及以上的参与者中观察到BCAAs摄入量与T2D风险之间存在统计学显著的正相关，但在女性或45岁以下的参与者中未观察到。
结论
我们的结果显示，1997年至2015年中国人的BCAAs摄入量呈下降趋势。40岁以后，BCAAs的消费量随年龄增长而下降。较高的BCAAs摄入量与较高的T2D风险相关。这种关系在男性以及中老年人群中更为稳定。
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