Abstract MP55: Protein Intake is Associated With Lower Risk of Type 2 Diabetes in the Framingham Offspring Study
Abstract MP55: Protein Intake is Associated With Lower Risk of Type 2 Diabetes in the Framingham Offspring Study
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摘要 MP55：弗雷明汉后代研究中蛋白质摄入量与降低 2 型糖尿病风险相关
DOI：
10.1161/circ.141.suppl_1.mp55
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发表时间：
2020
期刊：
影响因子：
37.8
通讯作者：
L. Moore
中科院分区：
文献类型：
--
作者：
R. T. Pickering;Mengjie Yuan;M. Singer;L. L. Castor;L. Moore
简介：
饮食和运动是2型糖尿病（T2 DM）的关键预防策略。很少有纵向研究考察动物和植物蛋白对T2 DM风险的单独影响，结果相互矛盾。本研究的目的是评估日常膳食蛋白质（总蛋白、动物蛋白和植物蛋白）摄入量与2型糖尿病风险之间的关系。
研究方法：
使用了来自纵向Frachial Offspring研究（FOS）中中年男性和女性的数据，随访时间约为20年。使用三天饮食记录（检查3和5）评估饮食;使用线性回归模型的残差根据体重调整蛋白质摄入量。空腹血糖（IFG）被定义为FG >100;糖尿病是使用标准化和有效的FOS方案诊断的。为了估计IFG或T2 DM的风险比（HR），使用考克斯比例风险模型调整年龄、性别、教育水平、体力活动、吸烟、身高、能量摄入和体重调整的碳水化合物摄入的混杂因素。
结果如下：
总蛋白摄入量最高的受试者（≥100 g，男性，≥90 g，女性）IFG/T2 DM风险降低34%（HR：0.66; 95% CI：0.51，0.85）。在这个队列中，动物蛋白的摄入量是植物蛋白的两倍多。最高动物蛋白摄入量（≥65 g，男性; ≥55 g，女性）与较低摄入量（<55 g，男性; <40 g，女性）相比，IFG/T2 DM风险降低33%（95% CI：0.55，0.82），而中等水平的摄入量与风险降低29%相关。相比之下，中等和更高的植物蛋白摄入量（20-25 g和≥25 g与<20 g）导致风险降低6-12%，但无统计学意义。总蛋白对女性的有益作用（HR：0.53; 95% CI：0.36，0.80）强于男性（HR：0.80; 95% CI：0.57，1.13）。在二次分析中，我们评估了其他饮食和生活方式因素的影响。特别是，与蛋白质摄入量较低的久坐成年人相比，蛋白质摄入量较高和体力活动水平较高的男性和女性IFG/T2 DM的长期风险在统计学上显著降低（总蛋白、动物蛋白和植物蛋白摄入量较高的活跃成年人的风险分别降低31%、39%和22%）。相比之下，单独较高的体力活动水平（在蛋白质摄入量较低的人群中）与IFG/T2 DM风险降低13-14%的非统计学显著性相关。
结论：
这项针对中年男性和女性的前瞻性研究提供了重要的证据，表明膳食蛋白质与积极的生活方式相结合，可能是降低糖尿病长期风险的一种策略。在这项研究中，动物蛋白具有更强的有益效果，但未来的研究需要在植物蛋白摄入量较高的人群中进行，以确定这些效果是否具有可比性。
Introduction:
Diet and exercise are key prevention strategies for type 2 diabetes (T2DM). Few longitudinal studies have examined separate effects of animal and plant proteins on T2DM risk and results are conflicting. The goal of this study was to evaluate the association between usual intake of dietary protein (total, animal, and plant) and T2DM risk.
Methods:
Data from middle-aged men and women in the longitudinal Framingham Offspring Study (FOS) with approximately 20 years of follow-up were used. Diet was assessed using three-day diet records (exams 3 and 5); protein intake was adjusted for body weight using the residuals from a linear regression model. Glucose was measured after an overnight fast; impaired fasting glucose (IFG) was defined as a FG >100; diabetes was diagnosed using a standardized and validated FOS protocol. To estimate the hazards ratios) (HR) for IFG or T2DM, Cox proportional hazards models were used to adjust for confounding by age, sex, education level, physical activity, cigarette smoking, height, energy intake, and weight-adjusted carbohydrate intake.
Results:
Subjects with the highest total protein intakes (≥100 g, men, ≥90 g women) had 34% reduced risks of IFG/T2DM (HR: 0.66; 95% CI: 0.51, 0.85). In this cohort, intakes of animal protein were more than double those of plant protein. The highest intakes of animal protein (≥65 g, men; ≥55 g, women) vs. lower intakes (<55 g, men; <40 g, women) were linked with 33% reduced risks of IFG/T2DM (95% CI: 0.55, 0.82) while intermediate levels of intake were linked with 29% lower risks. In contrast, moderate and higher intakes of plant protein (20-25 g and ≥25 g vs. <20 g) led to non-statistically significant 6-12% risk reductions. Beneficial effects of total protein were stronger for women (HR: 0.53; 95% CI: 0.36, 0.80) than for men (HR: 0.80; 95% CI 0.57, 1.13). In secondary analyses, we evaluated effect modification by other dietary and lifestyle factors. In particular, both men and women with higher intakes of protein and higher levels of physical activity had statistically significant reductions in long-term risk of IFG/T2DM (31%, 39%, and 22% risk reductions among active adults with higher intakes of total, animal, and plant protein, respectively) compared with more sedentary adults who had lower intakes of protein. In contrast, higher physical activity levels alone (among those with lower protein intakes) were associated with non-statistically significant 13-14% lower risks of IFG/T2DM.
Conclusions:
This prospective study of middle-aged men and women provides important evidence to suggest that dietary protein when combined with an active lifestyle, may be a strategy for lowering long-term risk of diabetes. In this study, animal protein had stronger beneficial effects, but future studies are needed in population groups with higher intakes of plant protein to determine whether these effects would be comparable.