糖尿病前期患者中健康饮食模式与死亡率的关联。
Associations of healthy dietary patterns with mortality among people with prediabetes.
作者信息
Li Lin, Wan Zhenzhen, Geng Tingting, Lu Qi, Zhu Kai, Qiu Zixin, Zhang Xuena, Liu Yujie, Tian Qingying, Liu Liegang, Pan An, Shan Zhilei, Liu Gang
机构信息
Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety (Huazhong University of Science and Technology), Ministry of Education Key Lab of Environment and Health, and State Key Laboratory of Environment Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, China.
Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
出版信息
Eur J Nutr. 2023 Apr;62(3):1377-1387. doi: 10.1007/s00394-022-03078-5. Epub 2022 Dec 27.
PURPOSE
To examine the associations of healthy dietary patterns with cardiometabolic biomarkers and all-cause mortality among individuals with prediabetes.
METHODS
This cohort study included 8363 adults with prediabetes from the National Health and Nutrition Examination Survey 1999-2014. Healthy dietary patterns including Alternate Healthy Eating Index-2010 (AHEI-2010), Alternate Mediterranean Diet score (AMED), Dietary Approaches to Stop Hypertension score (DASH), and Healthy Eating Index-2015 (HEI-2015) were calculated based on 24-h dietary recall data. Mortality status was obtained by linkage to National Death Index records. Cardiometabolic biomarkers, including blood glucose, insulin, HbA1c, C-reactive protein (CRP), and lipids, were measured at recruitment.
RESULTS
During 61,991 person-years of follow-up, 991 deaths occurred. Comparing the extreme quartiles, the multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause mortality were 0.65 (0.49, 0.85) for AHEI-2010 (P-trend = 0.002), 0.68 (0.50, 0.92) for AMED (P-trend = 0.004), 0.72 (0.53, 0.98) for DASH (P-trend = 0.03), and 0.78 (0.58, 1.05) for HEI-2015 (P-trend = 0.08). Besides, the HRs (95% CIs) for all-cause mortality per 20-percentile increment in scores were 0.78 (0.67, 0.90) for AHEI-2010 (P = 0.001), 0.73 (0.62, 0.86) for AMED (P < 0.001), 0.84 (0.69, 1.02) for DASH (P = 0.08), and 0.86 (0.74, 1.00) for HEI-2015 (P = 0.04). In addition, higher dietary scores were associated with favorable blood glucose, insulin, HOMA-IR, blood lipids, and CRP (all P-trend < 0.05). The high-density lipoprotein cholesterol and CRP explained 1.53-9.21% of the associations between dietary patterns and all-cause mortality (P < 0.05).
CONCLUSIONS
Diets with higher AHEI-2010, AMED, DASH, and HEI-2015 were associated with improved cardiometabolic factors and lower all-cause mortality among individuals with prediabetes. These findings suggest that multiple healthy dietary patterns instead of a one-size-fits-all diet plan might be beneficial and acceptable for individuals with prediabetes.
目的
研究健康饮食模式与糖尿病前期个体的心脏代谢生物标志物及全因死亡率之间的关联。
方法
这项队列研究纳入了1999 - 2014年美国国家健康与营养检查调查中的8363名糖尿病前期成年人。基于24小时饮食回忆数据计算出健康饮食模式，包括2010年替代健康饮食指数（AHEI - 2010）、替代地中海饮食评分（AMED）、终止高血压饮食方法评分（DASH）和2015年健康饮食指数（HEI - 2015）。通过与国家死亡指数记录进行关联来获取死亡状态。在招募时测量心脏代谢生物标志物，包括血糖、胰岛素、糖化血红蛋白（HbA1c）、C反应蛋白（CRP）和血脂。
结果
在61991人年的随访期间，发生了991例死亡。比较极端四分位数，AHEI - 2010全因死亡率的多变量调整风险比（HRs）及95%置信区间（CIs）为0.65（0.49，0.85）（P趋势 = 0.002），AMED为0.68（0.50，0.92）（P趋势 = 0.004），DASH为0.72（0.53，0.98）（P趋势 = 0.03），HEI - 2015为0.78（0.58，1.05）（P趋势 = 0.08）。此外，各评分每增加20%时全因死亡率的HRs（95% CIs），AHEI - 2010为0.78（0.67，0.90）（P = 0.001），AMED为0.73（0.62，0.86）（P < 0.001），DASH为0.84（0.69，1.02）（P = 0.08），HEI - 2015为0.86（0.74，1.00）（P = 0.04）。此外，较高的饮食评分与良好的血糖、胰岛素、胰岛素抵抗指数（HOMA - IR）、血脂和CRP相关（所有P趋势 < 0.05）。高密度脂蛋白胆固醇和CRP解释了饮食模式与全因死亡率之间1.53 - 9.21%的关联（P < 0.
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