Department of Nutrition and Food Hygiene, Suzhou Medical College of Soochow University, Suzhou 215127, China.
Yancheng Center for Disease Control and Prevention, Yancheng 224002, China.
Nutrients. 2023 Sep 8;15(18):3910. doi: 10.3390/nu15183910.
The relationship between coffee consumption and diabetes-related vascular complications remains unclear. To eliminate confounding by smoking, this study assessed the relationships of coffee consumption with major cardiovascular disease (CVD) and microvascular disease (MVD) in never-smokers with type 2 diabetes mellitus (T2DM). Included were 9964 never-smokers with T2DM from the UK Biobank without known CVD or cancer at baseline (7781 were free of MVD). Participants were categorized into four groups according to daily coffee consumption (0, 0.5-1, 2-4, ≥5 cups/day). CVD included coronary heart disease (CHD), myocardial infarction (MI), stroke, and heart failure (HF). MVD included retinopathy, peripheral neuropathy, and chronic kidney disease (CKD). Cox regression models were used to estimate hazard ratios (HRs) and 95% confidential intervals (CIs) of total CVD and MVD and the component outcomes associated with coffee consumption. During a median of 12.7 years of follow-up, 1860 cases of CVD and 1403 cases of MVD were identified. Coffee intake was nonlinearly and inversely associated with CVD (P-nonlinearity = 0.023) and the component outcomes. Compared with no coffee intake, HRs (95% CIs) associated with a coffee intake of 2 to 4 cups/day were 0.82 (0.73, 0.93) for CVD, 0.84 (0.73, 0.97) for CHD, 0.73 (0.57, 0.92) for MI, 0.76 (0.57, 1.02) for stroke, and 0.68 (0.55, 0.85) for HF. Higher coffee intake (≥5 cups/day) was not significantly associated with CVD outcomes. Coffee intake was linearly and inversely associated with risk of CKD (HR for ≥5 vs. 0 cups/day = 0.64; 95% CI: 0.45, 0.91; P-trend = 0.0029) but was not associated with retinopathy or peripheral neuropathy. Among never-smoking individuals with T2DM, moderate coffee consumption (2-4 cups/day) was associated with a lower risk of various CVD outcomes and CKD, with no adverse associations for higher consumption.
咖啡摄入与糖尿病相关血管并发症之间的关系尚不清楚。为了消除吸烟的混杂因素，本研究评估了在无已知心血管疾病（CVD）或癌症的 2 型糖尿病（T2DM）从不吸烟者中，咖啡摄入量与主要心血管疾病（CVD）和微血管疾病（MVD）的关系。英国生物库中纳入了 9964 名无吸烟史的 T2DM 患者，这些患者在基线时没有 CVD 或癌症（7781 名患者没有 MVD）。参与者根据每日咖啡摄入量（0、0.5-1、2-4、≥5 杯/天）分为四组。CVD 包括冠心病（CHD）、心肌梗死（MI）、中风和心力衰竭（HF）。MVD 包括视网膜病变、周围神经病和慢性肾脏病（CKD）。使用 Cox 回归模型估计总 CVD 和 MVD 以及与咖啡摄入相关的各成分结局的风险比（HR）和 95%置信区间（CI）。在中位 12.7 年的随访期间，共确定了 1860 例 CVD 和 1403 例 MVD。咖啡摄入量与 CVD（P-非线性=0.023）和各成分结局呈非线性负相关。与不摄入咖啡相比，每天摄入 2-4 杯咖啡与 CVD 的 HR（95%CI）为 0.82（0.73，0.93），与 CHD 的 HR（95%CI）为 0.84（0.73，0.97），与 MI 的 HR（95%CI）为 0.73（0.57，0.92），与中风的 HR（95%CI）为 0.76（0.57，1.02），与 HF 的 HR（95%CI）为 0.68（0.55，0.85）。更高的咖啡摄入量（≥5 杯/天）与 CVD 结局无显著相关性。咖啡摄入量与 CKD 风险呈线性负相关（≥5 与 0 杯/天的 HR=0.64；95%CI：0.45，0.91；P 趋势=0.0029），但与视网膜病变或周围神经病无关。在无吸烟史的 T2DM 个体中，中度咖啡摄入（2-4 杯/天）与各种 CVD 结局和 CKD 风险降低相关，而更高的摄入量没有不良关联。
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