膳食总抗氧化能力与糖尿病前期和糖尿病风险：对170,919名参与者的系统评价和剂量反应荟萃分析
Dietary total antioxidant capacity and risk of prediabetes and diabetes mellitus: a systematic review and dose-response meta-analysis of 170,919 participants.
作者信息
Li Ruomeng, Shu Long, Zhu Qin, Lu Dan
机构信息
Department of Digestion, Zhejiang Hospital, Hangzhou, China.
Department of Nutrition, Zhejiang Hospital, Hangzhou, China.
出版信息
Front Nutr. 2025 Feb 25;12:1541734. doi: 10.3389/fnut.2025.1541734. eCollection 2025.
BACKGROUND
Observational studies have assessed the association between total antioxidant capacity of the diet and risk of diabetes mellitus. However, results from these studies were not entirely consistent. In the current systematic review and dose-response meta-analysis, we aimed to determine the association between dietary total antioxidant capacity (TAC) and the risk of prediabetes and diabetes mellitus.
METHODS
A systematic literature search of authentic electronic resources including PubMed/Medline, Embase, Scopus, ISI Web of Science and China National Knowledge Infrastructure (CNKI) was carried out to find the relevant articles published up to November 2024. Random-effects or fixed-effects models were used to aggregate the relative risks (RRs) and their 95% confidence intervals (CIs) where appropriate. Heterogeneity across the studies were determined using the Cochran's test and -square ( ) statistics.
RESULTS
A total of 10 observational studies (five cohort, three case-control and two cross-sectional studies) were included in our meta-analysis. The pooled results indicated that higher dietary TAC was significantly associated with lower risk of prediabetes (RR = 0.58; 95% CI: 0.34-0.97; = 0.039) and diabetes mellitus (RR = 0.71; 95% CI: 0.58-0.87, = 0.001). In addition, dose-response analysis showed a linear trend association between dietary TAC and risk of diabetes mellitus (RR = 0.928; 95% CI: 0.842-1.023, = 0.131, = 0.078). Subgroup analyses showed the significant inverse association between dietary TAC and diabetes mellitus in mean age <50 and sample size <5,000 (RR = 0.26, 95% CI: 0.16-0.41, < 0.001), and there was no evidence of heterogeneity ( = 0.939; = 0.0%). Meanwhile, there was also an inverse association between dietary TAC and diabetes mellitus in Western countries (RR = 0.79; 95% CI: 0.68-0.92, = 0.003), with less evidence of heterogeneity ( = 0.226; = 36.7%).
CONCLUSION
Overall, higher dietary TAC was inversely associated with the risk of prediabetes and diabetes mellitus. Further well-designed prospective studies or randomized controlled trials are needed to validate the present findings.
SYSTEMATIC REVIEW REGISTER
(PROSPERO), CRD42024611235.
背景
观察性研究评估了饮食总抗氧化能力与糖尿病风险之间的关联。然而，这些研究的结果并不完全一致。在当前的系统评价和剂量反应荟萃分析中，我们旨在确定饮食总抗氧化能力（TAC）与糖尿病前期和糖尿病风险之间的关联。
方法
对包括PubMed/Medline、Embase、Scopus、ISI Web of Science和中国知网（CNKI）在内的权威电子资源进行系统文献检索，以查找截至2024年11月发表的相关文章。在适当情况下，使用随机效应或固定效应模型汇总相对风险（RRs）及其95%置信区间（CIs）。使用Cochran检验和卡方（χ²）统计量确定研究间的异质性。
结果
我们的荟萃分析共纳入10项观察性研究（5项队列研究、3项病例对照研究和2项横断面研究）。汇总结果表明，较高的饮食TAC与较低的糖尿病前期风险（RR = 0.58；95% CI：0.34 - 0.97；P = 0.039）和糖尿病风险（RR = 0.71；95% CI：0.58 - 0.87，P = 0.001）显著相关。此外，剂量反应分析显示饮食TAC与糖尿病风险之间存在线性趋势关联（RR = 0.928；95% CI：0.842 - 1.023，P = 0.131，I² = 0.078）。亚组分析显示，在平均年龄<50岁且样本量<5000的人群中，饮食TAC与糖尿病之间存在显著的负相关（RR = 0.26，95% CI：0.16 - 0.41，P < 0.001），且没有异质性证据（I² = 0.939；P = 0.0%）。同时，在西方国家，饮食TAC与糖尿病之间也存在负相关（RR = 0.79；95% CI：0.68 - 0.92，P = 0.003），异质性证据较少（I² = 0.226；P = 36.7%）。
结论
总体而言，较高的饮食TAC与糖尿病前期和糖尿病风险呈负相关。需要进一步设计良好的前瞻性研究或随机对照试验来验证本研究结果。
系统评价注册
（PROSPERO），CRD42024611235。
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