Zhang Shunming, Janzi Suzanne, Du Yufeng, Smith J Gustav, Qi Lu, Borné Yan, Sonestedt Emily
School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China; Nutritional Epidemiology, Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden.
Nutritional Epidemiology, Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden.
Am J Clin Nutr. 2025 May;121(5):1137-1148. doi: 10.1016/j.ajcnut.2025.02.023. Epub 2025 Apr 3.
Whether dairy intake is related to type 2 diabetes (T2D) remains unclear, as does potential metabolic mechanisms for this association.
We aimed to examine the association between high dairy intake and risk of T2D and identify plasma metabolites reflecting dairy intake.
This prospective cohort study included 26,461 Swedish individuals recruited between 1991 and 1996 and followed up until 31 December, 2020, with available data on dairy intake at baseline and linked registers. Plasma metabolites were measured in a subsample (n = 893) using mass spectrometry. Associations of dairy intake with risk of T2D were assessed using Cox proportional hazards models, with results presented as hazard ratios (HRs) and 95% confidence intervals (CIs).
A total of 4552 new-onset incident T2D cases were documented during a median follow-up of 24.3 y. Increased risk of T2D was observed among participants consuming high nonfermented milk (>1000 g/d compared with <200 g/d; HR: 1.40; 95% CI: 1.12, 1.74) and cheese (>100 g/d compared with <20 g/d; HR: 1.23; 95% CI: 1.07, 1.41), although decreased risk of T2D was observed among those with high fermented milk (>300 g/d compared with 0 g/d; HR: 0.88; 95% CI: 0.74, 1.03), cream (>50 g/d compared with <10 g/d; HR: 0.77; 95% CI: 0.64, 0.92), and butter (>50 g/d compared with 0 g/d; HR: 0.82; 95% CI: 0.71, 0.94). Such associations were slightly attenuated after additional adjustment for BMI. In addition, we identified metabolite profiles for nonfermented milk (n = 45), fermented milk (n = 48), cheese (n = 12), cream (n = 27), and butter (n = 46); no overlap between metabolites was found.
In this cohort of Swedish adults, high intakes of nonfermented milk and cheese are positively associated with risk of T2D, although high intakes of fermented milk, cream, and butter are inversely associated. Metabolomics provides novel insights into understanding the metabolic pathways of these associations.
乳制品摄入量与2型糖尿病（T2D）之间是否存在关联尚不清楚，这种关联的潜在代谢机制也不明确。
我们旨在研究高乳制品摄入量与T2D风险之间的关联，并确定反映乳制品摄入量的血浆代谢物。
这项前瞻性队列研究纳入了1991年至1996年间招募的26461名瑞典人，随访至2020年12月31日，有基线时的乳制品摄入量数据及相关登记信息。对一个子样本（n = 893）使用质谱法测量血浆代谢物。使用Cox比例风险模型评估乳制品摄入量与T2D风险的关联，结果以风险比（HRs）和95%置信区间（CIs）表示。
在中位随访24.3年期间，共记录了4552例新发病例。在摄入高量非发酵乳（>1000克/天与<200克/天相比；HR：1.40；95%CI：1.12，1.74）和奶酪（>100克/天与<20克/天相比；HR：1.23；95%CI：1.07，1.41）的参与者中观察到T2D风险增加，尽管在摄入高量发酵乳（>300克/天与0克/天相比；HR：0.88；95%CI：0.74，1.03）、奶油（>50克/天与<10克/天相比；HR：0.77；95%CI：0.64，0.92）和黄油（>50克/天与0克/天相比；HR：0.82；95%CI：0.71，0.94）的参与者中观察到T2D风险降低。在进一步调整BMI后，这种关联略有减弱。此外，我们确定了非发酵乳（n = 45）、发酵乳（n = 48）、奶酪（n = 12）、奶油（n = 27）和黄油（n = 46）的代谢物谱；未发现代谢物之间有重叠。
在这个瑞典成年人队列中，高摄入量的非发酵乳和奶酪与T2D风险呈正相关，而高摄入量的发酵乳、奶油和黄油则呈负相关。代谢组学为理解这些关联的代谢途径提供了新的见解。
