Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China.
J Diabetes. 2024 May;16(5):e13555. doi: 10.1111/1753-0407.13555.
The association between macronutrient intake and diabetes is unclear. We used data from the China Health and Nutrition Survey to explore the association between macronutrient intake trajectories and diabetes risk in this study.
We included 6755 participants who did not have diabetes at baseline and participated in at least three surveys. The energy supply ratio of carbohydrate, protein, and fat was further calculated from dietary data; different macronutrient trajectories were determined using multitrajectory models; and multiple Cox regression models were used to evaluate the association between these trajectories and diabetes.
We found three multitrajectories: decreased low carbohydrate-increased moderate protein-increased high fat (DLC-IMP-IHF), decreased high carbohydrate-moderate protein-increased low fat (DHC-MP-ILF), and balanced-macronutrients (BM). Compared to the BM trajectory, DHC-MP-ILF trajectories were significantly associated with increased risk of diabetes (hazard ratio [HR]: 3.228, 95% confidence interval [CI]: 1.571-6.632), whereas no association between DLC-IMP-IHF trajectories and diabetes was found in our study (HR: 0.699, 95% CI: 0.351-1.392).
The downward trend of high carbohydrate and the increasing trend of low fat increased the risk of diabetes in Chinese adults.
宏量营养素摄入与糖尿病之间的关系尚不清楚。本研究利用中国健康与营养调查的数据，探讨了宏量营养素摄入轨迹与糖尿病风险之间的关系。
我们纳入了 6755 名基线时无糖尿病且至少参加过三次调查的参与者。从膳食数据中进一步计算了碳水化合物、蛋白质和脂肪的能量供应比例；使用多轨迹模型确定了不同的宏量营养素轨迹；并使用多变量 Cox 回归模型评估了这些轨迹与糖尿病之间的关系。
我们发现了三种多轨迹：低碳水化合物-中蛋白质-高脂肪减少（DLC-IMP-IHF）、高碳水化合物-中蛋白质-低脂肪增加（DHC-MP-ILF）和均衡宏量营养素（BM）。与 BM 轨迹相比，DHC-MP-ILF 轨迹与糖尿病风险增加显著相关（风险比[HR]：3.228，95%置信区间[CI]：1.571-6.632），而 DLC-IMP-IHF 轨迹与糖尿病之间无关联（HR：0.699，95%CI：0.351-1.392）。
中国成年人中碳水化合物呈下降趋势，而脂肪呈上升趋势，这增加了糖尿病的风险。
