Ding Li, Yang Qinglin, Sun Zhongming, Liu Lu, Meng Zeyu, Zhao Xun, Tao Na, Liu Jun
Department of Preventive Medicine, School of Public Health, Zunyi Medical University, Zunyi, China.
Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, Suzhou, China.
Front Nutr. 2022 Oct 10;9:1002044. doi: 10.3389/fnut.2022.1002044. eCollection 2022.
There are limited studies describing the association between dietary intake of one-carbon metabolism nutrients and hyperglycemia. The present study aimed to investigate the association of habitual dietary intake of one-carbon metabolism nutrients with hyperglycemia in a fluorosis area in China, and explored the interaction between these nutrients and fluorosis related to hyperglycemia.
In a cross-sectional study, we recruited 901 villagers, ages ranging from 18-75, in Guizhou Province. Dietary data and other covariate data were obtained through an interviewer-administered questionnaire. We collected venous blood samples from participants who had fasted for one night to obtain fasting blood glucose levels and we categorized dietary intake of betaine, total choline, methionine, folate, vitamins B and B, and choline subclasses into quartiles (Q1-Q4). The lowest quartile (Q1) served as the reference group. An unconditional logistic regression model was used to evaluate the protective effects of a dietary intake of one-carbon nutrients against hyperglycemia. We calculated Odds Ratios (ORs) with 95% confidence intervals (CIs). A presence or absence of fluorosis subgroup analysis was performed to determine the potential effect of fluorosis on hyperglycemia.
After adjusting for potential confounding factors, we found that a greater intake of dietary vitamin B, total choline and methyl-donor index was inversely associated with the occurrence of hyperglycemia (-trend <0.05). However, there were no significant associations between hyperglycemia and the dietary intake of folate, vitamin B, methionine, and betaine. As for the choline subgroups, it showed that the dietary intake of free choline, phosphatidylcholine, and glycerol phosphatidylcholine was negatively correlated with the occurrence of hyperglycemia ( < 0.05). In contrast, there was no statistical association between dietary phosphatidylcholine and sphingomyelin and hyperglycemia (all > 0.05). The results of subgroup analysis showed that dietary intake of folate, vitamin B, total choline, free choline, glycerol phosphorylcholine, and phosphocholine had a protective effect against the occurrence of hyperglycemia in the non-fluorosis subgroup, although no effects were observed in the fluorosis subgroup. There were significant interactions between these nutrients and fluorosis ( = 0.010-0.048).
The study demonstrated that higher dietary intake of vitamin B, total choline, methyl-donor index, free choline, glycerol phosphorylcholine, and phosphocholine in choline compounds were associated with a lower incidence of hyperglycemia. Moreover, the associations were modified by the presence or absence of fluorosis. Further investigation is needed to test the association in large-scale follow-up studies.
关于一碳代谢营养素的饮食摄入与高血糖之间关联的研究有限。本研究旨在调查中国一个氟中毒地区一碳代谢营养素的习惯性饮食摄入与高血糖之间的关联，并探讨这些营养素与氟中毒在高血糖方面的相互作用。
在一项横断面研究中，我们招募了贵州省901名年龄在18至75岁之间的村民。通过访谈式问卷获取饮食数据和其他协变量数据。我们从禁食一晚的参与者中采集静脉血样以获取空腹血糖水平，并将甜菜碱、总胆碱、蛋氨酸、叶酸、维生素B6和B12以及胆碱亚类的饮食摄入量分为四分位数（Q1 - Q4）。最低四分位数（Q1）作为参考组。使用无条件逻辑回归模型评估一碳营养素饮食摄入对高血糖的保护作用。我们计算了具有95%置信区间（CI）的比值比（OR）。进行有无氟中毒亚组分析以确定氟中毒对高血糖的潜在影响。
在调整潜在混杂因素后，我们发现饮食中维生素B6、总胆碱和甲基供体指数的摄入量增加与高血糖的发生呈负相关（P趋势<0.05）。然而，高血糖与叶酸、维生素B12、蛋氨酸和甜菜碱的饮食摄入量之间无显著关联。至于胆碱亚类，结果显示游离胆碱、磷脂酰胆碱和甘油磷脂酰胆碱的饮食摄入量与高血糖的发生呈负相关（P<0.05）。相比之下，饮食中磷脂酰胆碱和鞘磷脂与高血糖之间无统计学关联（均P>0.05）。亚组分析结果表明，在无氟中毒亚组中，叶酸、维生素B12、总胆碱、游离胆碱、甘油磷酸胆碱和磷酸胆碱的饮食摄入对高血糖的发生有保护作用，而在氟中毒亚组中未观察到这种作用。这些营养素与氟中毒之间存在显著的相互作用（P = 0.010 - 0.048）。
该研究表明，饮食中较高的维生素B6、总胆碱、甲基供体指数、游离胆碱、甘油磷酸胆碱以及胆碱化合物中的磷酸胆碱摄入量与较低的高血糖发病率相关。此外，这种关联因是否存在氟中毒而有所改变。需要进一步研究以在大规模随访研究中验证这种关联。
