Fruit Intake and Incident Diabetic Retinopathy with Type 2 Diabetes
Fruit Intake and Incident Diabetic Retinopathy with Type 2 Diabetes
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DOI：
10.1097/ede.0b013e318281725e
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发表时间：
2013-03-01
期刊：
影响因子：
5.4
通讯作者：
Sone, Hirohito
中科院分区：
文献类型：
--
作者：
Tanaka, Shiro;Yoshimura, Yukio;Sone, Hirohito
背景：抗氧化剂和膳食纤维被认为对糖尿病视网膜病变有预防作用，但缺乏证据。我们在一个年龄在40-70岁、血红蛋白（Hb）A（1C）6.5%的2型糖尿病患者队列中调查了这种关联，该队列最初是日本糖尿病并发症研究的一部分。方法：在排除了对饮食调查没有反应的人和基线时患有糖尿病视网膜病变或主要眼部疾病的患者后，我们分析了978例患者。通过基于食物组和24小时饮食记录的食物频率问卷评估基线饮食摄入。主要结果是事件糖尿病视网膜病变确定使用国际严重scales.Results：平均水果摄入量的四分位数范围从23至253克/天，随着水果摄入量的四分位数的维生素C，维生素E，胡萝卜素，视黄醇当量，膳食纤维，钾，钠的增加趋势。平均能量摄入范围为1644至1863千卡/天，脂肪摄入量约为25%。HbA（1C）、体重指数、甘油三酯和收缩压控制良好。在8年的随访中，从水果摄入量的第一至第四四个四分位数的糖尿病视网膜病变的发病病例数分别为83，74，69和59。水果摄入量的第二、第三和第四四个四分位数与第一个四分位数相比的多变量调整风险比分别为0.66（95%置信区间= 0.46-0.92）、0.59（0.41-0.85）和0.48（0.32-0.71）（趋势检验，P < 0.01）。年龄、性别、糖化血红蛋白（1C）、糖尿病病程、超重、吸烟和高血压没有显著影响。糖尿病视网膜病变的风险下降，水果和蔬菜，维生素C，和carotene.Conclusion的摄入量增加的水果摄入量的范围内，通常消费与坚持低脂能量限制饮食的患者中减少糖尿病视网膜病变的发病率。（流行病学2013;24：204-211）
Background: Antioxidants and dietary fiber are postulated to have preventive effects on diabetic retinopathy, but evidence is lacking. We investigated this association in a cohort with type 2 diabetes 40-70 years of age with hemoglobin (Hb)A(1C) 6.5%, originally part of the Japan Diabetes Complications Study.Methods: After excluding people who did not respond to a dietary survey and patients with diabetic retinopathy or a major ocular disease at baseline, we analyzed 978 patients. Baseline dietary intake was assessed by a food frequency questionnaire based on food groups and 24-hour dietary records. Primary outcome was incident diabetic retinopathy determined using international severity scales.Results: Mean fruit intake in quartiles ranged from 23 to 253 g/day, with increasing trends across quartiles of fruit intake for vitamin C, vitamin E, carotene, retinol equivalent, dietary fiber, potassium, and sodium. Mean energy intake ranged from 1644 to 1863 kcal/day, and fat intake was approximately 25%. HbA(1C), body mass index, triglycerides, and systolic blood pressure were well controlled. During the 8-year follow-up, the numbers of incident cases of diabetic retinopathy from the first through the fourth quartiles of fruit intake were 83, 74, 69, and 59. Multivariate-adjusted hazard ratios for the second, third, and fourth quartiles of fruit intake compared with the first quartile were 0.66 (95% confidence interval = 0.46-0.92), 0.59 (0.41-0.85), and 0.48 (0.32-0.71) (test for trend, P < 0.01). There was no substantial effect modification by age, sex, HbA(1C), diabetes duration, overweight, smoking, and hypertension. Risk for diabetic retinopathy declined with increased intake of fruits and vegetables, vitamin C, and carotene.Conclusion: Increased fruit intake in ranges commonly consumed was associated with reduced incident diabetic retinopathy among patients adhering to a low-fat energy-restricted diet. (Epidemiology 2013;24: 204-211)