Khoshnoudi-Rad Bayyeneh, Hosseinpour-Niazi Somayeh, Javadi Maryam, Mirmiran Parvin, Azizi Fereidoun
Children Growth Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Bahonar Blvd, P.O. Box: 34185-754, Qazvin, Iran.
Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, No. 24, A'rabi St., Yeman Av., Velenjak, P.O. Box: 19395-4763, Tehran, Iran.
Diabetol Metab Syndr. 2022 Dec 30;14(1):198. doi: 10.1186/s13098-022-00968-w.
The hypothesis of the effect of the insulinogenic effects of diet on the development of cardiovascular diseases has been proposed, but the findings of previous studies are very contradictory. We investigated the association between dietary insulin index (DII) and dietary insulin load (DIL), and metabolic syndrome (MetS) risk. Another objective was to examine the extent to which lifestyle (physical activity, smoking status, and weight change) and sex influence the relationship between DII, DIL, and MetS risk.
We followed 1915 participants in the Tehran Lipid and Glucose Study. DIL and DII were calculated based on a validated food frequency questionnaire. Weight change was measured, and participants were categorized into > 3% weight loss, weight stable (± 3%), and > 3% weight gain. By joint classification, the association between DII and DIL (< median and ≥ median) and risk of MetS was assessed according to weight change, sex, physical activity levels, and smoking status. Cox proportional hazards models were used to estimate the HRs (95% CI), adjusting for potential confounders.
During 8.9 years of follow-up, among 1915 participants, we documented 591 new cases of MetS. DII and DIL were not associated with MetS risk in the crude and adjusted models. However, DIL and DII were associated with weight gain (≥ 3%). In the crude model, DIL and DII were associated with a higher risk of weight gain [HR: 1.74: 95% CI 1.50-2.03, and 1.70 (1.46-1.98), respectively]. These associations remained significant after further adjustment for confounders. The HRs were 1.61 (1.35-1.92) for DIL and 1.64 (1.39-1.93) for DII. Among men, women, participants with low physical activity levels, and smokers, the risk of MetS, independent of DIL and DII, only increased in a participant with weight gain. In women with weight stability, DIL and DII, higher than the median, were positively associated with MetS risk.
Our findings suggest that the association between MetS risk and a hyperinsulinemic diet depended on weight change.
饮食的胰岛素生成作用对心血管疾病发展影响的假说已被提出，但先前研究的结果非常矛盾。我们调查了饮食胰岛素指数（DII）和饮食胰岛素负荷（DIL）与代谢综合征（MetS）风险之间的关联。另一个目标是研究生活方式（身体活动、吸烟状况和体重变化）和性别在多大程度上影响DII、DIL与MetS风险之间的关系。
我们对德黑兰脂质与葡萄糖研究中的1915名参与者进行了随访。基于经过验证的食物频率问卷计算DIL和DII。测量体重变化，参与者被分为体重减轻>3%、体重稳定（±3%）和体重增加>3%。通过联合分类，根据体重变化、性别、身体活动水平和吸烟状况评估DII和DIL（<中位数和≥中位数）与MetS风险之间的关联。使用Cox比例风险模型估计风险比（HRs，95%置信区间），并对潜在混杂因素进行调整。
在8.9年的随访期间，1915名参与者中，我们记录了591例新的MetS病例。在未调整和调整后的模型中，DII和DIL与MetS风险均无关联。然而，DIL和DII与体重增加（≥3%）有关。在未调整模型中，DIL和DII与体重增加风险较高相关[HR分别为：1.74，95%置信区间1.50 - 2.03；1.70（1.46 - 1.98）]。在进一步调整混杂因素后，这些关联仍然显著。DIL的HR为1.61（1.35 - 1.92），DII的HR为1.64（1.39 - 1.93）。在男性、女性、身体活动水平低的参与者和吸烟者中，独立于DIL和DII的MetS风险仅在体重增加的参与者中增加。在体重稳定的女性中，高于中位数的DIL和DII与MetS风险呈正相关。
我们的研究结果表明，MetS风险与高胰岛素血症饮食之间的关联取决于体重变化。
