Zhang Zenghui, Huang Zegui, Xi Yangbo, Han Shaojie, Ye Xunda, Zhu Huimin, Guo Chuxian, Liu Zhaoyu, Guo Jun
Department of Cardiology, The First Affiliated Hospital of Jinan University, Guangzhou, China.
The First Clinical Medical College, Jinan University, Guangzhou, China.
Diabetes Obes Metab. 2025 Jul;27(7):3858-3868. doi: 10.1111/dom.16414. Epub 2025 Apr 23.
This study aimed to investigate the association between adherence to the EAT-Lancet diet and the incidence of microvascular complications in type 2 diabetes (T2D).
This prospective study included 7525 individuals with T2D who were free of diabetic microvascular complications (including diabetic retinopathy, neuropathy and nephropathy) at baseline from the UK Biobank cohort. Dietary data were collected via a web-based 24-hour dietary recall questionnaire. The EAT-Lancet diet index, ranging from 0 to 14 points, was constructed based on the EAT-Lancet reference diet. Cox proportional hazard models were used to examine the relationship between the EAT-Lancet diet index and the incidence of microvascular complications among individuals with T2D.
During a mean follow-up of 12.58 years, 1217 participants developed diabetic microvascular complications. After adjusting for potential confounders, participants in the highest adherence group of the EAT-Lancet diet index had a significantly lower risk of developing microvascular complications (hazard ratio: 0.76, 95% CI: 0.64-0.88) compared to those in the lowest adherence group. Subtype analyses for incident diabetic retinopathy, neuropathy and nephropathy yielded consistent results. Additionally, each 1-point increase in the EAT-Lancet diet index was associated with an 8% lower risk of microvascular complications. These findings remained robust across several sensitivity analyses and nearly all subgroups.
Our findings demonstrate a significant inverse association between adherence to the EAT-Lancet diet and the risk of microvascular complications in individuals with T2D.
本研究旨在调查坚持遵循《柳叶刀》饮食与2型糖尿病（T2D）微血管并发症发生率之间的关联。
这项前瞻性研究纳入了7525例T2D患者，这些患者来自英国生物银行队列，基线时无糖尿病微血管并发症（包括糖尿病视网膜病变、神经病变和肾病）。通过基于网络的24小时饮食回顾问卷收集饮食数据。根据《柳叶刀》参考饮食构建了范围从0到14分的《柳叶刀》饮食指数。采用Cox比例风险模型来检验《柳叶刀》饮食指数与T2D患者微血管并发症发生率之间的关系。
在平均12.58年的随访期间，1217名参与者发生了糖尿病微血管并发症。在对潜在混杂因素进行调整后，与最低依从性组相比，《柳叶刀》饮食指数最高依从性组的参与者发生微血管并发症的风险显著更低（风险比：0.76，95%置信区间：0.64 - 0.88）。对新发糖尿病视网膜病变、神经病变和肾病的亚组分析得出了一致的结果。此外，《柳叶刀》饮食指数每增加1分，微血管并发症风险降低8%。这些发现在多项敏感性分析以及几乎所有亚组中都保持稳健。
我们的研究结果表明，坚持遵循《柳叶刀》饮食与T2D患者微血管并发症风险之间存在显著的负相关。
