Woo Hye Won, Kim Mi Kyung, Ji-Sook Kong, Lee Jiseon, Shin Min-Ho, Koh Sang Baek, Kim Hyeon Chang, Kim Yu-Mi
Department of Preventive Medicine, College of Medicine, Hanyang University, 222 Wangsimni-ro, Medical School Building A-Room 517-2, Sungdong-gu, 04763, Seoul, South Korea.
Institute for Health and Society, Hanyang University, 222 Wangsimni-ro, Sungdong-gu, 04763, Seoul, South Korea.
Eur J Nutr. 2024 Jun;63(4):1339-1356. doi: 10.1007/s00394-024-03341-x. Epub 2024 Feb 28.
Data from mechanistic studies suggest flavonoids may benefit glucose metabolism, but their associations with type 2 diabetes (T2D) remain unclear. This study examined the prospective associations of dietary intake of total, classes, and individual flavonoids, as well as their source foods, with T2D in the CArdioVascular disease Association Study (CAVAS).
A total of 16,666 Korean men and women were enrolled at baseline, and 953 were newly diagnosed with T2D over a median follow-up of 5.96 years. Intake of flavonoids was cumulatively averaged using all food frequency questionnaires before the censoring events. A Poisson regression model was used to estimate incidence rate ratios (IRRs) and 95% confidence intervals (CIs).
Women with higher total flavonoid, flavonol, isoflavone, and proanthocyanidin intake had a lower risk of T2D (fourth vs. first quartile, IRR 0.62; 95% CI 0.44-0.89; P for linearity and non-linearity < 0.05 for total flavonoids), while in men, flavanones, anthocyanins, and proanthocyanidins, but not total flavonoids, were inversely associated with T2D risk (all P interaction for sex > 0.05). The key source foods contributing to flavonoid intake were also different between men and women, except for apples: tangerines and strawberries in men and green leafy vegetables and soy products in women.
A higher intake of total flavonoids, particularly from vegetables, soybeans, and apples, may be associated with lower risk of T2D in women. However, flavonoids from fruits, rather than total flavonoids, may be inversely associated in men. The association between flavonoid intake and the risk of T2D may be contingent upon the dietary sources of flavonoids consumed.
机制研究数据表明黄酮类化合物可能有益于葡萄糖代谢，但其与2型糖尿病（T2D）的关联仍不明确。本研究在心血管疾病关联研究（CAVAS）中，考察了总黄酮、各类黄酮、单个黄酮及其来源食物的膳食摄入量与T2D的前瞻性关联。
共有16666名韩国男性和女性在基线时入组，在中位随访5.96年期间，有953人新诊断为T2D。在审查事件发生前，使用所有食物频率问卷对黄酮类化合物的摄入量进行累积平均。采用泊松回归模型估计发病率比（IRR）和95%置信区间（CI）。
总黄酮、黄酮醇、异黄酮和原花青素摄入量较高的女性患T2D的风险较低（第四分位数与第一分位数相比，IRR 0.62；95%CI 0.44 - 0.89；总黄酮的线性和非线性P值<0.05），而在男性中，黄烷酮、花青素和原花青素与T2D风险呈负相关，但总黄酮与T2D风险无关（所有性别交互作用P值>0.05）。除苹果外，男性和女性黄酮类化合物摄入的主要来源食物也不同：男性为橘子和草莓，女性为绿叶蔬菜和豆制品。
较高的总黄酮摄入量，特别是来自蔬菜、大豆和苹果的摄入量，可能与女性患T2D的风险较低有关。然而，在男性中，水果中的黄酮类化合物而非总黄酮可能与T2D风险呈负相关。黄酮类化合物摄入量与T2D风险之间的关联可能取决于所摄入黄酮类化合物的膳食来源。
