Bahadoran Zahra, Mirmiran Parvin, Ghasemi Asghar, Azizi Fereidoun
Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Micronutrient Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
J Diabetes Metab Disord. 2024 Dec 16;24(1):8. doi: 10.1007/s40200-024-01517-0. eCollection 2025 Jun.
This cohort study investigated the possible association of dietary nitrate (NO)/nitrite (NO) intake and risk of progression to type 2 diabetes (T2D) across different phenotypes of prediabetes (Pre-DM).
A total of 1586 adults diagnosed with Pre-DM [i.e., 60.2% isolated impaired fasting glucose (iIFG), 21% isolated impaired glucose tolerance (iIGT), and 18.8% combined IFG-IGT] in the third (2006-2008) and fourth (2009-2011) examinations of the Tehran Lipid and Glucose Study, were assessed for dietary intake of NO and NO and were followed up to 2015-2017. Cox proportional hazard models, stratified by Pre-DM phenotypes, were used to plot cumulative hazard curve and calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for developing T2D across tertile categories and per every 100 mg/d NO and 2 mg/d NO intake exceeded the acceptable daily intake (ADI).
The mean age of the participants was 47.2 ± 12.9 years at baseline, and 52.2% were men. Highest intake of NO (≥ 645 vs. < 451 mg/d) and NO (≥ 11.5 vs. <9.0 mg/d) increased risk of T2D among subjects with iIFG (HR = 1.69, 95% CI = 1.04-2.74 and HR = 2.07, 95% CI = 1.29-3.32). The cumulative hazards were higher in the highest compared to the lowest NO and NO intake in subjects with iIFG phenotype. Every 100 mg/d of NO and 2 mg/d NO intake exceeded ADI was associated with an increased risk of progression from iIFG to T2D by 13 and 25%, respectively.
High exposure to dietary NO and NO may be a risk factor for developing T2D in subjects with iIFG.
本队列研究调查了不同表型的糖尿病前期（Pre-DM）患者膳食硝酸盐（NO）/亚硝酸盐（NO₂）摄入量与进展为2型糖尿病（T2D）风险之间的可能关联。
在德黑兰脂质与血糖研究的第三次（2006 - 2008年）和第四次（2009 - 2011年）检查中，共有1586名被诊断为Pre-DM的成年人[即60.2%单纯空腹血糖受损（iIFG）、21%单纯糖耐量受损（iIGT）和18.8%空腹血糖受损合并糖耐量受损（IFG-IGT）]接受了NO和NO₂膳食摄入量评估，并随访至2015 - 2017年。采用按Pre-DM表型分层的Cox比例风险模型绘制累积风险曲线，并计算不同三分位数类别以及每摄入超过可接受每日摄入量（ADI）100 mg/d NO和2 mg/d NO₂时发生T2D的风险比（HR）和95%置信区间（CI）。
参与者基线时的平均年龄为47.2±12.9岁，男性占52.2%。在iIFG受试者中，最高NO摄入量（≥645 vs. <451 mg/d）和NO₂摄入量（≥11.5 vs. <9.0 mg/d）会增加T2D风险（HR = 1.69，95% CI = 1.04 - 2.74和HR = 2.07，95% CI = 1.29 - 3.32）。iIFG表型受试者中，与最低NO和NO₂摄入量相比，最高摄入量时的累积风险更高。每摄入超过ADI 100 mg/d NO和2 mg/d NO₂分别使iIFG进展为T2D的风险增加13%和25%。
高膳食NO和NO₂暴露可能是iIFG受试者发生T2D的一个风险因素。
