宏量营养素的质量和数量，及其与九年内 2 型糖尿病发病风险的联合关联。
Quality and quantity of macronutrients, and their joint associations with the incidence of type 2 diabetes over a nine-year follow-up.
机构信息
Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, No. 7, Shahid Hafezi St., Farahzadi Blvd., Shahrak-e-qods, Tehran, 1981619573, Iran.
出版信息
Nutr J. 2024 Aug 30;23(1):101. doi: 10.1186/s12937-024-01003-6.
BACKGROUND
The association between macronutrient consumption and the risk of type 2 diabetes (T2D) remains equivocal. Here, we investigated whether the quantity and quality of macronutrient intake are associated with T2D incidence in a West Asian population.
METHODS
T2D-free adults (n = 2457, mean age 38.5 ± 13.6 years, 54.2% women) who participated in the third examination cycle (2005-2008) of the Tehran Lipid and Glucose Study were followed for a median of 8.6 years. We estimated the macronutrient quality index (MQI), its individual sub-indices (carbohydrate quality index (CQI), fat quality index (FQI), and healthy plate protein quality index (HPPQI)), as well as the macronutrient quantity. The risk of T2D in relation to macronutrient quantity, quality, and their combined effects was examined using Cox proportional hazard models adjusted for known risk factors for T2D.
RESULTS
During the study follow-up, 257 incident cases of T2D were documented. Individuals in the highest tertiles of MQI and CQI had a 27% (HR = 0.73, 95% CI = 0.54, 0.98) and 29% (HR = 0.71, 95% CI = 0.51-0.99) lower T2D risk than those in the lowest tertiles. The T2D incidence was 35% lower in the middle HPPQI tertile than in the lowest (HR = 0.65, 95% CI = 0.47, 0.89). The multivariable adjusted model showed that individuals in the middle and highest tertiles of carbohydrate intake had 32% (HR = 0.68, 95% CI = 0.49-0.95) and 26% (HR = 0.74, 95% CI = 0.55-1.00) lower risks of T2D than individuals in the lowest tertile. A high-quantity, high-quality carbohydrate diet (≥ 58.5% of energy from carbohydrate with a CQI ≥ 13) and a low-glycemic index (GI), high-fiber diet (GI < 55 and fiber ≥ 25 g/d) were related to a reduced risk of T2D by 34% (HR = 0.66, 95% CI = 0.47, 0.93) and 42% (HR = 0.58, 95% CI = 0.38, 0.90), respectively.
CONCLUSION
A diet with a higher carbohydrate quality may be associated with a lower T2D incidence, particularly when the carbohydrate quantity is also high.
背景
宏量营养素的摄入与 2 型糖尿病（T2D）风险之间的关联仍然存在争议。在这里，我们研究了在西亚人群中，宏量营养素的摄入量和质量是否与 T2D 的发病率有关。
方法
无 T2D 的成年人（n=2457，平均年龄 38.5±13.6 岁，54.2%为女性）参加了德黑兰血脂和血糖研究的第三次检查周期（2005-2008 年），随访中位数为 8.6 年。我们估计了宏量营养素质量指数（MQI）及其各个子指数（碳水化合物质量指数（CQI）、脂肪质量指数（FQI）和健康餐盘蛋白质质量指数（HPPQI）），以及宏量营养素的数量。使用 Cox 比例风险模型，调整了 T2D 的已知危险因素，对 T2D 与宏量营养素数量、质量及其综合效应的关系进行了检验。
结果
在研究随访期间，共记录了 257 例 T2D 事件。与最低三分位数相比，MQI 和 CQI 最高三分位数的个体 T2D 风险分别降低了 27%（HR=0.73，95%CI=0.54，0.98）和 29%（HR=0.71，95%CI=0.51，0.99）。中间 HPPQI 三分位数的 T2D 发病率比最低三分位数低 35%（HR=0.65，95%CI=0.47，0.89）。多变量调整模型显示，碳水化合物摄入量处于中间和最高三分位数的个体 T2D 风险分别降低了 32%（HR=0.68，95%CI=0.49，0.95）和 26%（HR=0.74，95%CI=0.55，1.00），与最低三分位数相比。高数量、高质量的碳水化合物饮食（碳水化合物提供的能量≥58.5%，CQI≥13）和低血糖指数（GI）、高纤维饮食（GI<55，纤维≥25 g/d）与 T2D 风险降低 34%（HR=0.66，95%CI=0.47，0.93）和 42%（HR=0.58，95%CI=0.38，0.90）有关。
结论
更高的碳水化合物质量的饮食可能与较低的 T2D 发病率有关，特别是当碳水化合物的摄入量也很高时。
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