Whole-grain, cereal fiber, bran, and germ intake and the risks of all-cause and cardiovascular disease-specific mortality among women with type 2 diabetes mellitus.
Whole-grain, cereal fiber, bran, and germ intake and the risks of all-cause and cardiovascular disease-specific mortality among women with type 2 diabetes mellitus.
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DOI：
10.1161/circulationaha.109.907360
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发表时间：
2010-05-25
期刊：
影响因子：
37.8
通讯作者：
Qi L
中科院分区：
文献类型：
--
作者：
He M;van Dam RM;Rimm E;Hu FB;Qi L
虽然全谷物消费与一般人群中较低的心血管疾病（CVD）和死亡率风险相关，但全谷物与糖尿病患者死亡率的相关性仍有待确定。本研究调查了全谷物及其成分谷物纤维、麸皮和胚芽与2型糖尿病患者全因死亡率和心血管疾病特异性死亡率的关系。我们在护士健康研究（NHS）中跟踪了7，822名患有2型糖尿病的美国女性。通过定期问卷调查评估饮食摄入量和潜在混杂因素。在长达26年的随访中，我们记录了852例全因死亡和295例心血管疾病死亡。调整年龄后，全谷物、谷物纤维、麸皮和胚芽摄入量最高与最低的五分之一与全因死亡率降低16-31%相关。在进一步调整生活方式和饮食风险因素后，只有麸皮摄入量的相关性仍然显着（趋势P = 0.01）。五分之一麸皮摄入量的多变量相对风险（RR）分别为1.0（参考）、0.94（0.75-1.18）、0.80（0.64-1.01）、0.82（0.65-1.04）和0.72（0.56-0.92）。同样，麸皮摄入量与CVD特异性死亡率呈负相关（趋势P = 0.04）。五分之一麸皮摄入量的RR分别为1.0（参考）、0.95（0.66-1.38）、0.80（0.55-1.16）、0.76（0.51-1.14）和0.65（0.43-0.99）。对于单独添加的麸皮观察到类似的结果。全谷物和麸皮摄入量与糖尿病女性的全因死亡率和心血管疾病特异性死亡率降低相关。这些发现表明，全谷物摄入量在降低糖尿病患者死亡率和心血管风险方面具有潜在的益处。
Although whole grain consumption has been associated with a lower risk of cardiovascular diseases (CVD) and mortality in the general population, the association of whole grain with mortality in diabetic patients remain to be determined. This study investigated whole grain and its components cereal fiber, bran and germ in relation to all-cause and CVD-specific mortality in patients with type 2 diabetes. We followed 7,822 US women with type 2 diabetes in the Nurses’ Health Study (NHS). Dietary intakes and potential confounders were assessed with regularly administered questionnaires. We documented 852 all-cause deaths and 295 CVD-deaths during up to 26 years of follow-up. After adjustment for age, the highest versus the lowest fifth of intakes of whole grain, cereal fiber, bran, and germ were associated with 16–31% lower all-cause mortality. After further adjustment for lifestyle and dietary risk factors, only the association for bran intake remained significant (P for trend = 0.01). The multivariate relative risks (RRs) across the fifths of bran intake were 1.0 (reference), 0.94 (0.75–1.18), 0.80 (0.64–1.01), 0.82 (0.65–1.04), and 0.72 (0.56–0.92). Similarly, bran intake was inversely associated with CVD-specific mortality (P for trend = 0.04). The RRs across the fifths of bran intake were 1.0 (reference), 0.95 (0.66–1.38), 0.80 (0.55–1.16), 0.76 (0.51–1.14), and 0.65 (0.43–0.99). Similar results were observed for added bran alone. Whole grain and bran intakes were associated with reduced all-cause and CVD-specific mortality in women with diabetes. These findings suggest a potential benefit of whole grain intake in reducing mortality and cardiovascular risk in diabetic patients.