习惯性喝咖啡与既往妊娠糖尿病个体 2 型糖尿病风险的关系：一项前瞻性研究。
Habitual coffee consumption and subsequent risk of type 2 diabetes in individuals with a history of gestational diabetes - a prospective study.
机构信息
Global Center for Asian Women's Health, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
出版信息
Am J Clin Nutr. 2022 Dec 19;116(6):1693-1703. doi: 10.1093/ajcn/nqac241.
BACKGROUND
Females with a history of gestational diabetes mellitus (GDM) are at higher risk of developing type 2 diabetes mellitus (T2D) later in life.
OBJECTIVE
This study prospectively examined whether greater habitual coffee consumption was related to a lower risk of T2D among females with a history of GDM.
METHODS
We followed 4522 participants with a history of GDM in the NHS II for incident T2D between 1991 and 2017. Demographic, lifestyle factors including diet, and disease outcomes were updated every 2-4 y. Participants reported consumption of caffeinated and decaffeinated coffee on validated FFQs. Fasting blood samples were collected in 2012-2014 from a subset of participants free of diabetes to measure glucose metabolism biomarkers (HbA1c, insulin, C-peptide; n = 518). We used multivariable Cox regression models to calculate adjusted HRs and 95% CIs for the risk of T2D. We estimated the least squares mean of glucose metabolic biomarkers according to coffee consumption.
RESULTS
A total of 979 participants developed T2D. Caffeinated coffee consumption was inversely associated with the risk of T2D. Adjusted HR (95% CI) for ≤1 (nonzero), 2-3, and 4+ cups/d compared with 0 cup/d (reference) was 0.91 (0.78, 1.06), 0.83 (0.69, 1.01), and 0.46 (0.28, 0.76), respectively (P-trend = 0.004). Replacement of 1 serving/d of sugar-sweetened beverage and artificially sweetened beverage with 1 cup/d of caffeinated coffee was associated with a 17% (risk ratio [RR] = 0.83, 95% CI: 0.75, 0.93) and 9% (RR = 0.91, 95% CI: 0.84, 0.99) lower risk of T2D, respectively. Greater caffeinated coffee consumption was associated with lower fasting insulin and C-peptide concentrations (all P-trend <0.05). Decaffeinated coffee intake was not significantly related to T2D but was inversely associated with C-peptide concentrations (P-trend = 0.003).
CONCLUSIONS
Among predominantly Caucasian females with a history of GDM, greater consumption of caffeinated coffee was associated with a lower risk of T2D and a more favorable metabolic profile.
背景
有妊娠糖尿病史的女性日后患 2 型糖尿病的风险更高。
目的
本研究前瞻性地研究了习惯性饮用更多咖啡是否与有妊娠糖尿病史的女性患 2 型糖尿病的风险降低有关。
方法
我们对 NHS II 中的 4522 名有妊娠糖尿病史的参与者进行了随访，以观察他们在 1991 年至 2017 年间是否发生 2 型糖尿病。每隔 2-4 年更新一次人口统计学、生活方式因素（包括饮食）和疾病结局的数据。参与者在经过验证的 FFQ 上报告了含咖啡因和脱咖啡因咖啡的摄入量。在 2012-2014 年，从无糖尿病的一部分参与者中采集空腹血样，以测量葡萄糖代谢生物标志物（HbA1c、胰岛素、C 肽；n=518）。我们使用多变量 Cox 回归模型计算了 T2D 风险的调整后 HR 和 95%CI。我们根据咖啡摄入量估计了葡萄糖代谢生物标志物的最小二乘平均值。
结果
共有 979 名参与者发生了 T2D。含咖啡因咖啡的摄入与 T2D 的发病风险呈负相关。与 0 杯/天（参考）相比，≤1（非零）、2-3 和 4+杯/天的调整后 HR（95%CI）分别为 0.91（0.78，1.06）、0.83（0.69，1.01）和 0.46（0.28，0.76）（P 趋势=0.004）。用 1 杯/天的含咖啡因咖啡替代 1 份/天的含糖饮料和人工甜味饮料，T2D 的风险分别降低 17%（风险比 [RR]为 0.83，95%CI：0.75，0.93）和 9%（RR 为 0.91，95%CI：0.84，0.99）。饮用更多含咖啡因的咖啡与空腹胰岛素和 C 肽浓度降低相关（所有 P 趋势<0.05）。脱咖啡因咖啡的摄入量与 T2D 无显著相关性，但与 C 肽浓度呈负相关（P 趋势=0.003）。
结论
在以白种人为主、有妊娠糖尿病史的女性中，更多地饮用含咖啡因的咖啡与 T2D 风险降低和更有利的代谢特征有关。
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