Section of Nutrition, Department of Pediatrics, School of Medicine, University of Colorado, Aurora, CO 80045, USA.
Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA.
Nutrients. 2023 Jun 12;15(12):2718. doi: 10.3390/nu15122718.
The impact that dietary carbohydrates have on children developing type 2 diabetes remains controversial. Furthermore, there are limited pediatric longitudinal studies on changes in body mass index (BMI) and diet related to the development of acanthosis nigricans (AN), a risk factor associated with type 2 diabetes.
Two 24 h dietary records were collected for 558 children, 2-8 years of age, at baseline and at a 2-year follow-up. Data on age, sex, BMI, and the presence of AN were also collected at each time point from the Children's Healthy Living Program. Logistic regression was used to determine factors associated with the presence of AN at follow-up. Multinominal regression was used to determine factors associated with changes in AN status. Linear regression was used to measure the associations between changes in dietary intake and in the Burke Score for AN.
AN was present in 28 children at baseline and 34 children at follow-up. Adjusting for the presence of AN at baseline, age, sex, study group, baseline BMI, change in BMI z-score, time between assessments, and baseline intake, an increase from baseline for each teaspoon of sugar and serving of carbohydrate-rich food increased the risk for having AN at follow-up by 9% and 8%, respectively ( ≤ 0.05). An increased intake of added sugar (teaspoons) increased the risk of developing AN by 13% ( ≤ 0.01) and an increase in servings of foods rich in starch increased the risk of developing AN by 12% ( ≤ 0.01) compared to children who never had AN. Increasing the intake of fruit was also associated with decreased Burke Scores using multiple regression. However, the intake of energy and macronutrients were not associated with AN.
Added sugar and foods rich in starch were independently associated with the occurrence of AN, suggesting the type of carbohydrates consumed is a factor in AN occurrence.
饮食碳水化合物对儿童 2 型糖尿病发展的影响仍存在争议。此外，关于儿童体重指数 (BMI) 和与黑棘皮病 (AN) 发展相关的饮食变化的儿科纵向研究有限，AN 是 2 型糖尿病的一个相关风险因素。
在基线和 2 年随访时，共收集了 558 名 2-8 岁儿童的 2 份 24 小时膳食记录。在每个时间点还从儿童健康生活计划中收集了年龄、性别、BMI 和 AN 的存在数据。使用逻辑回归确定与随访时 AN 存在相关的因素。使用多项回归确定与 AN 状态变化相关的因素。使用线性回归测量饮食摄入变化与 AN 的 Burke 评分之间的相关性。
基线时有 28 名儿童存在 AN，随访时有 34 名儿童存在 AN。在调整基线时 AN 的存在、年龄、性别、研究组、基线 BMI、BMI z 分数变化、评估之间的时间和基线摄入量后，每增加一茶匙糖和一份富含碳水化合物的食物，分别使随访时发生 AN 的风险增加 9%和 8%（≤0.05）。与从未发生过 AN 的儿童相比，添加糖（茶匙）的摄入量增加会使 AN 的发病风险增加 13%（≤0.01），富含淀粉的食物摄入量增加会使 AN 的发病风险增加 12%（≤0.01）。使用多元回归，增加水果的摄入量也与 Burke 评分降低有关。然而，能量和宏量营养素的摄入量与 AN 无关。
添加糖和富含淀粉的食物与 AN 的发生独立相关，这表明所消耗的碳水化合物类型是 AN 发生的一个因素。
