Which diet for prevention of type 2 diabetes? A meta-analysis of prospective studies
Which diet for prevention of type 2 diabetes? A meta-analysis of prospective studies
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DOI：
10.1007/s12020-014-0264-4
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发表时间：
2014-09-01
期刊：
影响因子：
3.7
通讯作者：
Giugliano, Dario
中科院分区：
文献类型：
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作者：
Esposito, Katherine;Chiodini, Paolo;Giugliano, Dario
没有特定的饮食可以预防2型糖尿病。我们对前瞻性队列研究进行了荟萃分析，以评估不同饮食与2型糖尿病预防之间的关系。在2013年8月之前，我们使用预定义的标准对多个电子数据库（Medline、Scopus、EMBASE和ISI web of knowledge）进行了全面的搜索。我们纳入了评估不同饮食在2型糖尿病预防中的作用的前瞻性队列研究。研究由2位独立审稿人选择。我们进行了随机效应荟萃分析，以确定与健康饮食模式相关的糖尿病发病相对风险（RR）。来自世界4个地区的18项前瞻性研究、20个队列共确定了21372例糖尿病发病病例。在20个队列的随机效应荟萃分析中，RR为0.80(95%置信区间(CI) = 0.74 ~ 0.86, P < 0.001)，异质性高（i2 = 57%, P = 0.001），无发表偏倚证据（Egger检验，P = 0.653）。排除两个队列产生相同的RR (0.80, 95% CI 0.76-0.84)，异质性不显著（i2 = 9%）。考虑到地理位置（美国、欧洲和亚洲）、随访时间（10年）和饮食类型（地中海和DASH，停止高血压的饮食方法，饮食），发生糖尿病的风险没有明显变化。高危人群与普通人群之间存在差异（P = 0.0487），但证据仅限于两项研究。我们的研究结果表明，几种健康饮食与未来2型糖尿病风险降低20%有着同等且一致的联系。
No specific diet is recommended to prevent type 2 diabetes. We did a meta-analysis of prospective cohort studies to assess the association between different diets and prevention of type 2 diabetes. We did a comprehensive search of multiple electronic databases (Medline, Scopus, EMBASE, and ISI web of knowledge) until August 2013 using predefined criteria. We included prospective cohort studies that evaluated the role of different diets in type 2 diabetes prevention. Studies were selected by 2 independent reviewers. We did random-effects meta-analyses to determine the relative risk (RR) of incident diabetes associated with healthful dietary patterns. A total of 21,372 cases of incident diabetes, from 18 prospective studies, with 20 cohorts, in 4 world regions were identified. In the random-effect meta-analysis of the 20 cohorts, RR was 0.80 (95 % confidence interval (CI) = 0.74-0.86, P < 0.001), with high heterogeneity (I 2 = 57 %, P = 0.001) and no evidence of publication bias (Egger's test, P = 0.653). Exclusion of two cohorts produced identical RR (0.80, 95 % CI 0.76-0.84), with nonsignificant heterogeneity (I 2 = 9 %). The risk of incident diabetes did not appreciably change considering the geography (USA, Europe, and Asia), the duration of follow-up (10 years), and type of diets (Mediterranean and DASH, Dietary Approaches to Stop Hypertension, diets). There was a difference between at risk and general population (P = 0.0487), but the evidence was limited to two studies only. The results of our study demonstrate that several healthy diets are equally and consistently associated with a 20 % reduced risk of future type 2 diabetes.