Grigorian Ani, Moradmand Zahra, Mirzaei Saeideh, Asadi Ali, Akhlaghi Masoumeh, Saneei Parvane
Students' Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran.
Department of Clinical Nutrition, School of Nutrition and Food Science, Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
Nutr J. 2025 Mar 14;24(1):41. doi: 10.1186/s12937-025-01111-x.
Insufficient evidence exists regarding the relationship between diabetes risk reduction diet (DRRD) and metabolic health status in adolescents. The current study aimed to investigate the relationship between DRRD and metabolic health status in Iranian adolescents with overweight/obesity.
In this cross-sectional study, a multistage cluster random sampling method was used to select 203 overweight/obese adolescents. Dietary intakes were evaluated using a validated 147-item food frequency questionnaire. The following parameters were measured: blood pressure, anthropometric indices, fasting glucose, insulin, and lipid profiles. Participants were classified to metabolically healthy overweight/obese (MHO) or metabolically unhealthy overweight/obese (MUO), based on 2 methods: International Diabetes Federation (IDF) criteria and a combination of IDF and Homeostasis Model Assessment Insulin Resistance (HOMA-IR).
Based on IDF criteria, highest vs. lowest adherence to DRRD was associated with a lower odds of having an MUO phenotype in both crude (OR = 0.05; 95%CI: 0.02-0.12) and fully adjusted model (OR = 0.06; 95%CI: 0.02-0.20). Based on IDF/HOMA-IR criteria, similar findings were obtained. This relationship was significant in both genders and was especially significant among adolescents with obesity. In both crude and fully adjusted model, adherence to DRRD was significantly lower the likelihood of having high fasting blood glucose, triglycerides, and HOMA-IR.
Adolescents who adhered more strictly to DRRD were less likely to be MUO, and have high fasting blood glucose, triglycerides, and HOMA-IR. Additional large-scale prospective studies are necessary to affirm these results.
关于糖尿病风险降低饮食（DRRD）与青少年代谢健康状况之间的关系，现有证据不足。本研究旨在调查伊朗超重/肥胖青少年中DRRD与代谢健康状况之间的关系。
在这项横断面研究中，采用多阶段整群随机抽样方法选取了203名超重/肥胖青少年。使用经过验证的147项食物频率问卷评估饮食摄入量。测量以下参数：血压、人体测量指标、空腹血糖、胰岛素和血脂谱。根据两种方法将参与者分为代谢健康超重/肥胖（MHO）或代谢不健康超重/肥胖（MUO）：国际糖尿病联盟（IDF）标准以及IDF与稳态模型评估胰岛素抵抗（HOMA-IR）的组合。
根据IDF标准，在粗模型（OR = 0.05；95%CI：0.02 - 0.12）和完全调整模型（OR = 0.06；95%CI：0.02 - 0.20）中，DRRD依从性最高与最低者相比，MUO表型的几率较低。根据IDF/HOMA-IR标准，获得了类似的结果。这种关系在男女中均显著，在肥胖青少年中尤为显著。在粗模型和完全调整模型中，DRRD依从性均显著降低了空腹血糖、甘油三酯和HOMA-IR升高的可能性。
更严格遵守DRRD的青少年患MUO以及空腹血糖、甘油三酯和HOMA-IR升高的可能性较小。需要更多大规模前瞻性研究来证实这些结果。
