Chen Boyang, Wu Qi, Liu Sibo, Di Hongkun, Hu Wen, Qin Tianzhu, Wang Yushuang, Chen Rong, Wang Han, Chen Ying, Cheng Xiang, Yin Jiawei, Liu Liegang, Shan Zhilei
Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
J Diabetes. 2025 Jun;17(6):e70110. doi: 10.1111/1753-0407.70110.
Dietary alpha-linolenic acid (ALA) regulates lipid metabolism and insulin sensitivity, but few studies have investigated the association between ALA and the risk of mortality among adults with type 2 diabetes (T2D). This study examines whether increasing dietary ALA intake contributes to the long-term survival of adults with T2D.
This cohort study included 9603 participants with T2D, including 7953 adults from the National Health and Nutrition Examination Survey (NHANES; 1999-2018) and 1650 adults from the China Health and Nutrition Survey (CHNS; 1997-2011). Dietary information was collected through 24-h dietary recalls. Cox proportional hazards regression was employed to estimate hazard ratios (HRs) and 95% CIs for mortality from all-cause and cardiovascular disease (CVD).
During 75 535 person-years of follow-up, a total of 2468 deaths were documented. After multivariate adjustment, the pooled HRs (95% CIs) of all-cause mortality were 1.00, 0.87 (0.76-0.99), and 0.79 (0.67-0.94) across tertiles of ALA (p = 0.01). There was a linear inverse relationship between ALA intake and all-cause mortality, demonstrating a 9% (HR: 0.91;95% CI: 0.85_0.97) lower risk of all-cause mortality with each 1 g/day increase of dietary ALA intake in the pooled analysis (p > 0.05). In addition, ALA intake was inversely associated with CVD mortality, and HR comparing the highest with the lowest tertile was 0.68 (0.50-0.91; p = 0.01). Consistent results were observed in both the stratified and sensitivity analyses.
Higher dietary ALA intake was associated with a lower risk of all-cause and CVD mortality among adults with T2D.
膳食α-亚麻酸（ALA）可调节脂质代谢和胰岛素敏感性，但很少有研究调查ALA与2型糖尿病（T2D）成人死亡率之间的关联。本研究探讨增加膳食ALA摄入量是否有助于T2D成人的长期生存。
这项队列研究纳入了9603名T2D参与者，其中包括来自国家健康与营养检查调查（NHANES；1999 - 2018年）的7953名成年人以及来自中国健康与营养调查（CHNS；1997 - 2011年）的1650名成年人。通过24小时膳食回顾收集膳食信息。采用Cox比例风险回归来估计全因死亡率和心血管疾病（CVD）死亡率的风险比（HR）及95%置信区间（CI）。
在75535人年的随访期间，共记录了2468例死亡。多变量调整后，ALA三分位数组的全因死亡率合并HR（95%CI）分别为1.00、0.87（0.76 - 0.99）和0.79（0.67 - 0.94）（p = 0.01）。ALA摄入量与全因死亡率之间存在线性负相关关系，在汇总分析中，膳食ALA摄入量每增加1克/天，全因死亡率风险降低9%（HR：0.91；95%CI：0.85 - 0.97）（p > 0.05）。此外，ALA摄入量与CVD死亡率呈负相关，最高三分位数与最低三分位数相比的HR为(0.68(0.50 - 0.91;p = 0.01))。在分层分析和敏感性分析中均观察到一致的结果。
T2D成人中较高的膳食ALA摄入量与较低的全因死亡率和CVD死亡率风险相关。
