Glycemic index, glycemic load, carbohydrates, and type 2 diabetes: systematic review and dose-response meta-analysis of prospective studies.
Glycemic index, glycemic load, carbohydrates, and type 2 diabetes: systematic review and dose-response meta-analysis of prospective studies.
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DOI：
10.2337/dc13-0325
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发表时间：
2013-12
期刊：
影响因子：
16.2
通讯作者：
Burley VJ
中科院分区：
文献类型：
--
作者：
Greenwood DC;Threapleton DE;Evans CE;Cleghorn CL;Nykjaer C;Woodhead C;Burley VJ
高血糖指数（GI）、高血糖负荷（GL）或所有碳水化合物含量高的饮食可能易导致血糖和胰岛素浓度升高、葡萄糖耐受不良和2型糖尿病风险。我们的目的是进行系统的文献综述和剂量反应荟萃分析的证据，从前瞻性队列。我们检索了科克伦图书馆、MEDLINE、MEDLINE进程中、Embase、CAB摘要、ISI Web of Science和BIOSIS，以获得截至2012年7月17日关于GI、GL和总碳水化合物与2型糖尿病风险相关的前瞻性研究。数据提取自21项队列研究的24篇出版物。采用线性和非线性剂量-反应趋势，将使用不同暴露类别的研究合并在同一尺度上。使用随机效应荟萃分析估计汇总相对风险（RR）。总体RR为1.08/5 GI单位（95% CI 1.02 - 1.15; P = 0.01）、1.03/20 GL单位（95% CI 1.00 - 1.05; P = 0.02）和0.97/50 g/天碳水化合物（95% CI 0.90 - 1.06; P = 0.5）。GI和GL的剂量反应趋势呈线性，但总碳水化合物摄入量的剂量反应趋势更为复杂。所有暴露（I2> 50%）的异方差均较高，部分原因是不同的协变量调整和随访时间。纳入的研究是观察性的，应谨慎解释。然而，我们的研究结果与低饮食GI和GL的保护作用一致，量化了与低风险相关的摄入量范围。未来的研究可能会集中在与最大风险相关的糖和其他碳水化合物的类型上。
Diets with high glycemic index (GI), with high glycemic load (GL), or high in all carbohydrates may predispose to higher blood glucose and insulin concentrations, glucose intolerance, and risk of type 2 diabetes. We aimed to conduct a systematic literature review and dose–response meta-analysis of evidence from prospective cohorts. We searched the Cochrane Library, MEDLINE, MEDLINE in-process, Embase, CAB Abstracts, ISI Web of Science, and BIOSIS for prospective studies of GI, GL, and total carbohydrates in relation to risk of type 2 diabetes up to 17 July 2012. Data were extracted from 24 publications on 21 cohort studies. Studies using different exposure categories were combined on the same scale using linear and nonlinear dose–response trends. Summary relative risks (RRs) were estimated using random-effects meta-analysis. The summary RR was 1.08 per 5 GI units (95% CI 1.02–1.15; P = 0.01), 1.03 per 20 GL units (95% CI 1.00–1.05; P = 0.02), and 0.97 per 50 g/day of carbohydrate (95% CI 0.90–1.06; P = 0.5). Dose–response trends were linear for GI and GL but more complex for total carbohydrate intake. Heterogeneity was high for all exposures (I2 >50%), partly accounted for by different covariate adjustment and length of follow-up. Included studies were observational and should be interpreted cautiously. However, our findings are consistent with protective effects of low dietary GI and GL, quantifying the range of intakes associated with lower risk. Future research could focus on the type of sugars and other carbohydrates associated with greatest risk.
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影响因子：
5
作者：
GREENLAND, S;LONGNECKER, MP
通讯作者：
LONGNECKER, MP
影响因子：
7.1
作者：
Barclay, Alan W.;Petocz, Peter;Brand-Miller, Jennie C.
通讯作者：
Brand-Miller, Jennie C.
影响因子：
3.6
作者：
Dong, Jia-Yi;Zhang, Lijun;Qin, Li-Qiang
通讯作者：
Qin, Li-Qiang
影响因子：
3.6
作者：
Flint, A;Moller, BK;Astrup, A
通讯作者：
Astrup, A
影响因子：
4.2
作者：
Montonen, Jukka;Jarvinen, Ritva;Reunanen, Antti
通讯作者：
Reunanen, Antti