Department of Community Medicine, School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Kurdistan Province, Iran.
Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Isfahan University of Medical Sciences, Isfahan, Iran.
Sci Rep. 2024 Sep 17;14(1):21688. doi: 10.1038/s41598-024-72602-w.
Phytochemicals are compounds found in fruits, vegetables, whole grains, nuts and legumes that are non-nutritive but have bioactive properties. A high intake of these compounds is essential for optimal health and disease prevention. No study has investigated the association between Dietary Phytochemical Index (DPI) and polyneuropathy in patients with diabetes. This study aimed to examine the association between DPI and Diabetic Sensory-motor Polyneuropathy (DSPN) in a case-control study. In this case-control study, a total of 185 diabetic patients with DSPN (case group) and 185 sex- and age-matched diabetic patients without neuropathy (control group) were enrolled in this study. Participants were 30-60 years old. A validated food frequency questionnaire was used to measure the dietary intake of all participants. Daily energy derived from phytochemical-rich foods was used to calculate the DPI score. Toronto clinical neuropathy score was applied to define DSPN. Anthropometric data and fasting blood glucose levels were measured using standard methods. The Binary logistic regression was used to estimate Crude and multivariable-adjusted OR (95% CI) for DSPN across tertiles of DPI for the whole population. In the crude model, there was a significant trend across the tertile of DPI (OR = 0.33; 95%CI 0.18, 0.52; P-trend < 0.001). After controlling for age, sex, and energy, a significant reverse association was observed between DPI and DSPN (OR = 0.27; 95%CI 0.15, 0·48; P-trend < 0.001). Moreover, after adjusting for a wide range of confounding variables such as energy intake, physical activity, education, smoking status, and HbA1c, participants in the third tertile of DPI had 75% reduced odds for DSPN (95%CI 0.14, 0.45; P-trend < 0.001). Finally in the full adjusted model, after further adjustment for BMI, observed significant association was remained (OR : 0.24; 95% CI 0.13, 0.14; P-trend < 0.001). Higher intakes of phytochemical-rich foods are associated with lower odds of DSPN.
植物化学物质是存在于水果、蔬菜、全谷物、坚果和豆类中的非营养物质，但具有生物活性。大量摄入这些化合物对保持最佳健康和预防疾病至关重要。目前还没有研究调查膳食植物化学物质指数（DPI）与糖尿病患者多发性神经病之间的关系。本研究旨在通过病例对照研究检验 DPI 与糖尿病感觉运动性多发性神经病（DSPN）之间的关系。在这项病例对照研究中，共纳入 185 例 DSPN 糖尿病患者（病例组）和 185 例性别和年龄匹配无神经病变的糖尿病患者（对照组）。参与者年龄在 30-60 岁之间。采用经过验证的食物频率问卷测量所有参与者的饮食摄入量。每天从富含植物化学物质的食物中获得的能量用于计算 DPI 评分。多伦多临床神经病变评分用于定义 DSPN。采用标准方法测量人体测量数据和空腹血糖水平。采用二项逻辑回归估计 DPI 三分位组 DSPN 的粗比值比（OR）和多变量校正比值比（95%CI）。在未经校正的模型中，DPI 三分位组之间存在显著趋势（OR=0.33；95%CI 0.18，0.52；P-trend<0.001）。在校正年龄、性别和能量后，DPI 与 DSPN 之间存在显著的反向关联（OR=0.27；95%CI 0.15，0.48；P-trend<0.001）。此外，在校正了广泛的混杂变量（如能量摄入、体力活动、教育、吸烟状况和 HbA1c）后，DPI 三分位组的参与者发生 DSPN 的几率降低了 75%（95%CI 0.14，0.45；P-trend<0.001）。最后，在完全调整的模型中，进一步调整 BMI 后，观察到的关联仍然显著（OR：0.24；95%CI 0.13，0.14；P-trend<0.001）。摄入富含植物化学物质的食物较多与 DSPN 发生几率降低相关。
