Nutritional factors and preservation of C-peptide in youth with recently diagnosed type 1 diabetes: SEARCH Nutrition Ancillary Study.
Nutritional factors and preservation of C-peptide in youth with recently diagnosed type 1 diabetes: SEARCH Nutrition Ancillary Study.
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DOI：
10.2337/dc12-2084
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发表时间：
2013-07
期刊：
影响因子：
16.2
通讯作者：
The N
中科院分区：
文献类型：
--
作者：
Mayer-Davis EJ;Dabelea D;Crandell JL;Crume T;D'Agostino RB Jr;Dolan L;King IB;Lawrence JM;Norris JM;Pihoker C;The N
测试新的假设，即先前与 1 型糖尿病病因或胰岛素分泌相关的营养因素与最近诊断为 1 型糖尿病的青少年中的空腹 C 肽 (FCP) 浓度前瞻性相关。其中包括 1,316 名患有自身抗体阳性 1 型糖尿病的青少年，他们参加了 SEARCH for Diabetes in Youth 研究（基线病程为 9.9 个月；标准差为 6.3）。营养暴露包括母乳喂养和引入补充食品时的年龄、基线血浆长链 omega-3 脂肪酸（包括二十碳五烯酸 (EPA) 和二十二碳六烯酸 (DHA)）、维生素 D、维生素 E，以及根据基线食物频率调查问卷估计的支链氨基酸亮氨酸和总碳水化合物的摄入量。建立多重线性回归模型，将每个营养因素与基线 FCP 联系起来，并根据人口统计、疾病相关因素和其他混杂因素进行调整。前瞻性分析包括基线时保留 β 细胞功能的参与者子集（基线 FCP ≥0.23 ng/mL），并对基线 FCP 和时间进行额外调整（平均随访时间，24.3 个月；SD，8.2；n = 656）。 FCP浓度分析为log(FCP)。在调整后的前瞻性分析中，基线 EPA (P = 0.02)、EPA 加 DHA (P = 0.03) 和亮氨酸 (P = 0.03) 均与随访时的 FCP 呈显着正相关。维生素 D 与 FCP 出乎意料地呈负相关 (P = 0.002)。增加支链氨基酸和长链 omega-3 脂肪酸的摄入量可能有助于保存 β 细胞功能。这代表了改善 1 型糖尿病预后的研究新方向。
To test the novel hypothesis that nutritional factors previously associated with type 1 diabetes etiology or with insulin secretion are prospectively associated with fasting C-peptide (FCP) concentration among youth recently diagnosed with type 1 diabetes. Included were 1,316 youth with autoantibody-positive type 1 diabetes who participated in the SEARCH for Diabetes in Youth study (baseline disease duration, 9.9 months; SD, 6.3). Nutritional exposures included breastfeeding and age at introduction of complementary foods, baseline plasma long-chain omega-3 fatty acids including eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), vitamin D, vitamin E, and, from a baseline food frequency questionnaire, estimated intake of the branched-chain amino acid leucine and total carbohydrate. Multiple linear regression models were conducted to relate each nutritional factor to baseline FCP adjusted for demographics, disease-related factors, and other confounders. Prospective analyses included the subset of participants with preserved β-cell function at baseline (baseline FCP ≥0.23 ng/mL) with additional adjustment for baseline FCP and time (mean follow-up, 24.3 months; SD, 8.2; n = 656). FCP concentration was analyzed as log(FCP). In adjusted prospective analyses, baseline EPA (P = 0.02), EPA plus DHA (P = 0.03), and leucine (P = 0.03) were each associated positively and significantly with FCP at follow-up. Vitamin D was unexpectedly inversely associated with FCP (P = 0.002). Increased intake of branched-chain amino acids and long-chain omega-3 fatty acids may support preservation of β-cell function. This represents a new direction for research to improve prognosis for type 1 diabetes.
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