Plant versus animal based diets and insulin resistance, prediabetes and type 2 diabetes: the Rotterdam Study.
Plant versus animal based diets and insulin resistance, prediabetes and type 2 diabetes: the Rotterdam Study.
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DOI：
10.1007/s10654-018-0414-8
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发表时间：
2018-09
影响因子：
13.6
通讯作者：
Voortman T
中科院分区：
文献类型：
--
作者：
Chen Z;Zuurmond MG;van der Schaft N;Nano J;Wijnhoven HAH;Ikram MA;Franco OH;Voortman T
素食或素食饮食被认为可以降低2型糖尿病（T2 D）的风险。然而，关于植物性饮食与动物性饮食的程度差异是否有利于预防T2 D，目前还知之甚少。我们的目的是调查坚持高植物性食物和低动物性食物的饮食水平是否与胰岛素抵抗，前驱糖尿病和T2 D相关。我们的分析包括来自鹿特丹研究（RS）的6798名参与者（62.7 ± 7.8岁），这是一项荷兰前瞻性人群队列研究。在RS的三个子队列（RS-I-1：1989-1993，RS-II-1：2000-2001，RS-III-1：2006-2008）的基线时，通过食物频率问卷收集饮食摄入数据。我们构建了一个连续的植物性饮食指数（范围0-92），评估对植物性饮食和动物性饮食的依从性。使用胰岛素抵抗稳态模型评估（HOMA-IR）评估基线和随访时的胰岛素抵抗。前驱糖尿病和T2 D是从全科医生的记录、药房数据库和我们研究中心的随访检查中收集的，直到2012年。我们使用多变量线性混合模型来检验该指数与纵向HOMA-IR的相关性，并使用多变量考克斯比例风险回归模型来检验该指数与糖尿病前期和T2 D风险的相关性。在平均5.7年和7.3年的随访期间，我们记录了928例前驱糖尿病病例和642例T2 D病例。在调整了社会人口统计学和生活方式因素后，植物性饮食指数得分越高，胰岛素抵抗越低（每高10个单位评分：β = −0.09; 95% CI：− 0.10; − 0.08），糖尿病前期风险较低（HR = 0.89; 95% CI：0.81; 0.98），T2 D风险较低[HR = 0.82（0.73; 0.92）]。在对BMI进行额外校正后，纵向胰岛素抵抗[β =-0.05（-0.06;-0.04）]和T2 D风险[HR = 0.87（0.79; 0.99）]的相关性减弱并保持统计学显著性，但糖尿病前期风险不再存在[HR = 0.93（0.85; 1.03）]。总之，更多的植物性饮食和更少的动物性饮食可能会降低胰岛素抵抗，前驱糖尿病和T2 D的风险。这些发现加强了最近的饮食建议，以采用更多的植物性饮食。临床试验注册号和网站NTR 6831，http://www.trialregister.nl/trialreg/admin/rctview.asp? TC=6831。本文的在线版本（10.1007/s10654-018-0414-8）包含补充材料，可供授权用户使用。
Vegan or vegetarian diets have been suggested to reduce type 2 diabetes (T2D) risk. However, not much is known on whether variation in the degree of having a plant-based versus animal-based diet may be beneficial for prevention of T2D. We aimed to investigate whether level of adherence to a diet high in plant-based foods and low in animal-based foods is associated with insulin resistance, prediabetes, and T2D. Our analysis included 6798 participants (62.7 ± 7.8 years) from the Rotterdam Study (RS), a prospective population-based cohort in the Netherlands. Dietary intake data were collected with food-frequency questionnaires at baseline of three sub-cohorts of RS (RS-I-1: 1989–1993, RS-II-1: 2000–2001, RS-III-1: 2006–2008). We constructed a continuous plant-based dietary index (range 0–92) assessing adherence to a plant-based versus animal-based diet. Insulin resistance at baseline and follow-up was assessed using homeostasis model assessment of insulin resistance (HOMA-IR). Prediabetes and T2D were collected from general practitioners’ records, pharmacies’ databases, and follow-up examinations in our research center until 2012. We used multivariable linear mixed models to examine association of the index with longitudinal HOMA-IR, and multivariable Cox proportional-hazards regression models to examine associations of the index with risk of prediabetes and T2D. During median 5.7, and 7.3 years of follow-up, we documented 928 prediabetes cases and 642 T2D cases. After adjusting for sociodemographic and lifestyle factors, a higher score on the plant-based dietary index was associated with lower insulin resistance (per 10 units higher score: β = −0.09; 95% CI: − 0.10; − 0.08), lower prediabetes risk (HR = 0.89; 95% CI: 0.81; 0.98), and lower T2D risk [HR = 0.82 (0.73; 0.92)]. After additional adjustment for BMI, associations attenuated and remained statistically significant for longitudinal insulin resistance [β = −0.05 (− 0.06; − 0.04)] and T2D risk [HR = 0.87 (0.79; 0.99)], but no longer for prediabetes risk [HR = 0.93 (0.85; 1.03)]. In conclusion, a more plant-based and less animal-based diet may lower risk of insulin resistance, prediabetes and T2D. These findings strengthen recent dietary recommendations to adopt a more plant-based diet. Clinical Trial Registry number and website NTR6831, http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=6831. The online version of this article (10.1007/s10654-018-0414-8) contains supplementary material, which is available to authorized users.