Department of Endocrinology, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China.
Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xian, China.
Lipids Health Dis. 2024 Aug 19;23(1):254. doi: 10.1186/s12944-024-02233-7.
Although the relationship between oxidative stress and insulin resistance (IR) has been established, the associations of the composite dietary antioxidant index (CDAI) and its components with the surrogate index of insulin resistance (IR), triglyceride-glucose index (TyG), is still not clear.
This study analyzed the cross-sectional data of the National Health and Nutrition Examination Survey (NHANES) from 2003 to 2018. Multivariate linear regression, weighted quantile sum (WQS) regression, and Bayesian kernel machine regression (BKMR) were used to analyze the associations of the CDAI and its components with the TyG. In addition, subgroup analysis and several sensitivity analyses were conducted.
A total of 14,673 participants with complete data were included, with a median age of 50 years and 7,257 women (49%). Multivariate linear regression showed that after full adjustment, the CDAI was significantly negatively associated with the TyG [β: -0.005, 95% CI: (-0.008, -0.002), p = 0.002]. The model in which six nutrients were mutually corrected showed that vitamin E (per-SD increase) was most strongly associated with the TyG [β: -0.062, 95% CI: (-0.074, -0.050), p < 0.0001]. In the WQS model, the WQS index of the antioxidant diet was negatively associated with the TyG (β: -0.060; P < 0.0001). Similar effects were observed in the BKMR analysis. Notably, in the WQS and BKMR models, vitamin E became the most influential component. In addition, in the subgroup analysis, the association between the CDAI and the TyG in overweight or obese and diabetic populations was significantly weaker.
Antioxidant diets, especially vitamin E, are significantly negatively correlated with TyG. This study emphasizes the important value of supplementing vitamin E to improve IR. However, patients with poor weight management and diabetes seem to benefit less from antioxidant diets.
尽管氧化应激与胰岛素抵抗（IR）之间的关系已得到确立，但复合饮食抗氧化指数（CDAI）及其成分与替代胰岛素抵抗（IR）指数——甘油三酯-葡萄糖指数（TyG）之间的关联仍不清楚。
本研究分析了 2003 年至 2018 年全国健康和营养检查调查（NHANES）的横断面数据。采用多元线性回归、加权总量和（WQS）回归和贝叶斯核机器回归（BKMR）分析 CDAI 及其成分与 TyG 的关系。此外，还进行了亚组分析和几种敏感性分析。
共纳入 14673 名数据完整的参与者，中位年龄为 50 岁，女性 7257 名（49%）。多元线性回归显示，经充分调整后，CDAI 与 TyG 呈显著负相关[β：-0.005，95%置信区间：（-0.008，-0.002），p=0.002]。在相互校正六种营养素的模型中，维生素 E（每标准差增加）与 TyG 相关性最强[β：-0.062，95%置信区间：（-0.074，-0.050），p<0.0001]。在 WQS 模型中，抗氧化饮食的 WQS 指数与 TyG 呈负相关（β：-0.060；P<0.0001）。在 BKMR 分析中也观察到了类似的效果。值得注意的是，在 WQS 和 BKMR 模型中，维生素 E 成为最具影响力的成分。此外，在亚组分析中，超重或肥胖和糖尿病患者的 CDAI 与 TyG 的相关性明显较弱。
抗氧化饮食，尤其是维生素 E，与 TyG 呈显著负相关。本研究强调了补充维生素 E 改善 IR 的重要价值。然而，体重管理和糖尿病状况不佳的患者似乎从抗氧化饮食中获益较少。
