Wood Alexis C, Senn Mackenzie K, Rotter Jerome I
USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, 1100 Bates Avenue, Houston, TX 77030. USA.
The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA 90502. USA.
J Diabetes Mellitus. 2023 May;13(2):116-129. doi: 10.4236/jdm.2023.132010. Epub 2023 Apr 25.
BACKGROUND/PURPOSE: Hispanic/Latinos in the US are at increased risk for type 2 diabetes (T2D). Data suggest that avocado intake is associated with better glycemic control, but whether this translates to protection from T2D has not been studied. The goal of the current analyses was to examine whether consuming avocados at baseline is associated with lower incident T2D over a six-year period, compared to not consuming avocados at baseline.
SUBJECTS/METHODS: Using data from a large population of US adults with Hispanic ancestry, without known or unknown T2D at baseline (N=6,159), participants were classified as avocado consumers (N=983) or non-consumers (N=5,176) based on the mean of two 24-hour dietary recalls. Cox proportional hazard models estimated the association of avocado consumption with incident T2D (N=656 cases) over a six-year follow-up period, in the population as a whole, and separately in those with normoglycemia vs. prediabetes at baseline. A set of three sequential models were run: the first controlling only for sociodemographic factors ("minimally adjusted" models), the second for these and health behaviors ("fully adjusted" models), and a third for both sets of covariates and also body mass index (BMI; "fully adjusted + BMI" models).
In the population as a whole, avocado intake at baseline was associated with reduced incident T2D in both the minimally adjusted (hazard ratio [HR] (+/- 95% confidence intervals [CIs]): 0.70 (0.52 - 0.94), P=.04) and the fully adjusted models (HR: 0.72 (0.54-0.97), P=.03). This association was observed in both those with prediabetes and with normoglycemia at baseline, but only reached significance in those with prediabetes (minimally adjusted model: HR: 0.68 (0.48-0.97), P=.03; fully adjusted model: HR: 0.69 (0.48-0.98), P=.04), not in those with normoglycemia (minimally adjusted model: HR: 0.86 (0.45-1.65), P=.65; fully adjusted model: HR: 0.80 (0.41-1.55), P=.50). In models which additionally controlled for BMI ("fully adjusted + BMI model"), the associations were slightly attenuated (overall population: HR: 0.79 (0.59-1.06), P=.60; normoglycemia: HR: 0.83 (0.42-1.64), P=.60; prediabetes: HR= 0.75 (0.54 - 1.05), P=0.09).
In our longitudinal analyses, adults with Hispanic / Latino ancestry who consumed avocado were less likely to develop T2D than those who did not consume avocado at baseline, especially if they had prediabetes at baseline.
背景/目的：美国的西班牙裔/拉丁裔患2型糖尿病（T2D）的风险增加。数据表明，食用鳄梨与更好的血糖控制有关，但这是否能转化为对T2D的预防作用尚未得到研究。当前分析的目的是研究与基线时不食用鳄梨相比，基线时食用鳄梨是否与六年内较低的T2D发病率相关。
受试者/方法：利用来自大量有西班牙裔血统的美国成年人的数据，这些人在基线时无已知或未知的T2D（N = 6159），根据两次24小时饮食回忆的平均值，将参与者分为鳄梨消费者（N = 983）或非消费者（N = 5176）。Cox比例风险模型估计了在六年随访期内，食用鳄梨与T2D发病率（N = 656例）之间的关联，在总体人群中，以及分别在基线时血糖正常与糖尿病前期的人群中。运行了一组三个连续模型：第一个仅控制社会人口学因素（“最小调整”模型），第二个控制这些因素和健康行为（“完全调整”模型），第三个控制两组协变量以及体重指数（BMI；“完全调整+BMI”模型）。
在总体人群中，基线时食用鳄梨与最低调整模型（风险比[HR]（±95%置信区间[CI]）：0.70（0.52 - 0.94），P = 0.04）和完全调整模型（HR：0.72（0.54 - 0.97），P = 0.03）中T2D发病率降低相关。在基线时患有糖尿病前期和血糖正常的人群中均观察到这种关联，但仅在糖尿病前期人群中达到显著水平（最小调整模型：HR：0.68（0.48 - 0.97），P = 0.03；完全调整模型：HR：
