饮食硝酸盐、亚硝酸盐和亚硝胺与糖尿病的关系：系统评价和荟萃分析。

Dietary nitrate, nitrite, and nitrosamine in association with diabetes: a systematic review and meta-analysis.

机构信息

International Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.

School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei, Taiwan.

出版信息

Nutr Rev. 2024 Nov 1;82(11):1473-1481. doi: 10.1093/nutrit/nuad148.

DOI:10.1093/nutrit/nuad148

PMID:38007611

Abstract

CONTEXT

Diabetes is a global health concern, and diet is a contributing factor to diabetes. Findings regarding the connection between nitrate, nitrite, and nitrosamine and diabetes risk are inconsistent.

OBJECTIVE

The aim was to examine the effects of these dietary compounds on diabetes risk.

DATA SOURCES

The data were sourced from PubMed, EMBASE, Scopus, and Web of Science until February 28, 2023. Studies that reported individual-level consumption of these compounds were included. Review articles or ecological studies were excluded.

DATA EXTRACTION

The number of events and total observations were recorded.

DATA ANALYSIS

The pooled odds ratio (OR) was calculated and displayed in a forest plot. Subgroup and sensitivity analyses were predefined. A dose-response meta-analysis was conducted to determine the exposure intervals that may increase the risk of disease. Six observational reports that met the inclusion criteria were included, involving 108 615 individuals. Participants in the highest quantile of nitrite intake had a greater risk of diabetes compared with those in the lowest quantile (OR, 1.61; 95% confidence interval [CI], 1.08-2.39; I2 = 74%, P = 0.02). Higher nitrosamine consumption tended to increase diabetes risk (OR, 1.52; 95% CI, 0.76-3.04; I2 = 76%; P = 0.24). The relationship was stronger for type 1 (OR, 1.79; 95% CI, 1.20-2.67; I2 = 58%; P < 0.01) than for type 2 diabetes (OR, 1.42; 95% CI, 0.86-2.37; I2 = 71%; P = 0.17). Additionally, nitrite consumption had a dose-dependent association with both phenotypes. No association was found between diabetes risk and high nitrate intake (OR, 1.01; 95% CI, 0.87-1.18; I2 = 28%; P = 0.87).

CONCLUSION

Attention should be paid to the consumption of nitrite-containing foods.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO registration no. CRD42023394462 (https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=394462).

摘要

背景

糖尿病是全球关注的健康问题，饮食是导致糖尿病的一个因素。硝酸盐、亚硝酸盐和亚硝胺与糖尿病风险之间的关系的研究结果并不一致。

目的

本研究旨在探讨这些饮食化合物对糖尿病风险的影响。

数据来源

数据来源于 PubMed、EMBASE、Scopus 和 Web of Science，检索时间截至 2023 年 2 月 28 日。纳入了报告这些化合物个体水平摄入情况的研究。排除了综述文章或生态学研究。

数据提取

记录了事件数量和总观察数。

数据分析

计算并以森林图展示汇总比值比（OR）。预设了亚组和敏感性分析。进行了剂量-反应荟萃分析，以确定可能增加疾病风险的暴露间隔。纳入了符合纳入标准的 6 项观察性报告，涉及 108615 人。与最低四分位数相比，摄入亚硝酸盐最高四分位数的参与者患糖尿病的风险更高（OR，1.61；95%置信区间[CI]，1.08-2.39；I2 = 74%，P = 0.02）。更高的亚硝胺摄入倾向于增加糖尿病风险（OR，1.52；95%CI，0.76-3.04；I2 = 76%；P = 0.24）。1 型糖尿病（OR，1.79；95%CI，1.20-2.67；I2 = 58%；P < 0.01）的相关性强于 2 型糖尿病（OR，1.42；95%CI，0.86-2.37；I2 = 71%；P = 0.17）。此外，亚硝酸盐的摄入量与两种表型均呈剂量依赖性相关。高硝酸盐摄入量与糖尿病风险无关联（OR，1.01；95%CI，0.87-1.18；I2 = 28%；P = 0.87）。