Inan-Eroglu Elif, Kuxhaus Olga, Jannasch Franziska, Nickel Daniela V, Schulze Matthias B
Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, 14558 Nuthetal, Germany.
German Center for Diabetes Research (DZD), 85764 Neuherberg, Germany.
Metabolites. 2024 Mar 19;14(3):172. doi: 10.3390/metabo14030172.
Our knowledge about the connection between protein intake and diabetes-related complications comes largely from studies among those already diagnosed with type 2 diabetes (T2D). However, there is a lack of information on whether changing protein intake after diabetes diagnosis affects complications risk. We aimed to explore the association between protein intake (total, animal, and plant) and vascular complications in incident T2D patients considering pre-diagnosis intake and changes in intake after diagnosis. This prospective cohort study included 1064 participants from the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam cohort who developed T2D during follow-up (physician-verified). Dietary protein intake was measured with a food frequency questionnaire at baseline and follow-up. We included physician-reported incident diabetes complications (myocardial infarction, stroke, nephropathy, and neuropathy). A total of 388 participants developed complications, 82 macrovascular complications, and 343 microvascular complications. Substituting carbohydrates with protein showed a trend towards lower complications risk, although this association was not statistically significant (hazard ratio (HR) for 5% energy (E) substitution: 0.83; 95% confidence intervals (CI): 0.60-1.14). Increasing protein intake at the expense of carbohydrates after diabetes diagnosis was not associated with total and microvascular complications (HR for 5% E change substitution: 0.98; 95% CI: 0.89-1.08 and HR for 5% E change substitution: 1.02; 95% CI: 0.92-1.14, respectively). Replacing carbohydrates with protein did not elevate the risk of diabetes complications in incident T2D cases.
我们关于蛋白质摄入量与糖尿病相关并发症之间联系的知识，很大程度上来自于对那些已被诊断为2型糖尿病（T2D）患者的研究。然而，对于糖尿病诊断后改变蛋白质摄入量是否会影响并发症风险，目前缺乏相关信息。我们旨在探讨初发T2D患者中蛋白质摄入量（总蛋白质、动物蛋白和植物蛋白）与血管并发症之间的关联，同时考虑诊断前的摄入量以及诊断后摄入量的变化。这项前瞻性队列研究纳入了欧洲癌症与营养前瞻性调查（EPIC）-波茨坦队列中的1064名参与者，这些参与者在随访期间患上了T2D（经医生核实）。在基线和随访时，通过食物频率问卷来测量膳食蛋白质摄入量。我们纳入了医生报告的新发糖尿病并发症（心肌梗死、中风、肾病和神经病变）。共有388名参与者出现了并发症，其中82例为大血管并发症，343例为微血管并发症。用蛋白质替代碳水化合物显示出并发症风险降低的趋势，尽管这种关联在统计学上并不显著（5%能量（E）替代的风险比（HR）：0.83；95%置信区间（CI）：0.60 - 1.14）。糖尿病诊断后以碳水化合物为代价增加蛋白质摄入量与总体并发症和微血管并发症均无关联（5% E变化替代的HR：0.98；95% CI：0.89 - 1.08以及5% E变化替代的HR：1.02；95% CI：0.92 - 1.14）。在初发T2D病例中，用蛋白质替代碳水化合物不会增加糖尿病并发症的风险。
