Yang Guangrui, Du Xihao, Wang Jingxuan, Jiang Xuanwei, Shi Shuxiao, Shen Jie, Zhong Victor W
Department of Epidemiology and Biostatistics, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Medical Records and Statistics Office, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
J Am Nutr Assoc. 2025 Jan;44(1):59-67. doi: 10.1080/27697061.2024.2401053. Epub 2024 Sep 10.
To investigate the associations between data-driven dietary patterns, immune function, and incident type 2 diabetes (T2D) and the mediating effects of immune function.
This study included 375,665 participants without diabetes at baseline in the UK Biobank study. Dietary patterns were derived through principal component analysis of food frequency questionnaire data. Immune function was assessed using 14 individual inflammatory markers and an integrated low-grade inflammation score (INFLA-score). Cox proportional hazard models were used to estimate the associations of dietary patterns or immune function with incident T2D. Linear regressions were used to estimate the associations of dietary patterns with immune function. Mediating effects of immune function were quantified.
During a median 14.6-year follow-up, 13,932 participants developed T2D. Four dietary patterns were identified: prudent diet (high in whole grains, vegetables, fruits, fish), wheat/dairy/eggs restrictive diet (limiting these foods), meat-based diet (high in red/processed meat, salt), and full-cream dairy diet (preference for full cream milk or dairy products). The prudent diet was negatively (HR, 0.69 [95% CI, 0.65-0.72]), while the wheat/dairy/eggs restrictive diet (HR, 1.08 [95% CI, 1.03-1.13]), meat-based diet (HR, 1.12 [95% CI, 1.06-1.17]), and full-cream dairy diet (HR, 1.08 [95% CI, 1.03-1.12]) were positively associated with incident T2D (all for trend ≤0.04). The prudent diet was negatively and the full-cream dairy diet was positively associated with most inflammatory markers. Most inflammatory markers, especially INFLA-score (HR, 1.18 [95% CI, 1.16-1.20]), were positively associated with incident T2D. INFLA-score mediated 13% of the association with incident T2D for the prudent diet and 34% for the full-cream dairy diet.
This study identified four distinct dietary patterns and a range of inflammatory markers associated with incident T2D. A notable proportion of the associations between dietary patterns and T2D was mediated by immune function.
研究数据驱动的饮食模式、免疫功能与2型糖尿病（T2D）发病之间的关联以及免疫功能的中介作用。
本研究纳入了英国生物银行研究中375,665名基线时无糖尿病的参与者。通过对食物频率问卷数据进行主成分分析得出饮食模式。使用14种个体炎症标志物和综合低度炎症评分（INFLA评分）评估免疫功能。采用Cox比例风险模型估计饮食模式或免疫功能与T2D发病之间的关联。使用线性回归估计饮食模式与免疫功能之间的关联。对免疫功能的中介作用进行量化。
在中位14.6年的随访期间，13,932名参与者患上了T2D。确定了四种饮食模式：谨慎饮食（富含全谷物、蔬菜、水果、鱼类）、限制小麦/乳制品/蛋类饮食（限制这些食物）、以肉类为主的饮食（富含红肉/加工肉类、盐分）和全脂乳制品饮食（偏好全脂牛奶或乳制品）。谨慎饮食与T2D发病呈负相关（HR，0.69 [95% CI，0.65 - 0.72]），而限制小麦/乳制品/蛋类饮食（HR，1.08 [95% CI，1.03 - 1.13]）、以肉类为主的饮食（HR，1.12 [95% CI，1.06 - 1.17]）和全脂乳制品饮食（HR，1.08 [95% CI，1.03 - 1.12]）与T2D发病呈正相关（所有趋势P≤0.04）。谨慎饮食与大多数炎症标志物呈负相关，全脂乳制品饮食与大多数炎症标志物呈正相关。大多数炎症标志物，尤其是INFLA评分（HR，1.18 [95% CI，1.16 - 1.20]）与T2D发病呈正相关。INFLA评分介导了谨慎饮食与T2D发病关联的13%以及全脂乳制品饮食与T2D发病关联的34%。
本研究确定了四种不同的饮食模式以及一系列与T2D发病相关的炎症标志物。饮食模式与T2D之间相当一部分关联是由免疫功能介导的。
