Mediterranean Diet, Retinopathy, Nephropathy, and Microvascular Diabetes Complications: A Post Hoc Analysis of a Randomized Trial
Mediterranean Diet, Retinopathy, Nephropathy, and Microvascular Diabetes Complications: A Post Hoc Analysis of a Randomized Trial
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地中海饮食、视网膜病变、肾病与糖尿病微血管并发症：一项随机试验的事后分析
DOI：
10.2337/dc15-1117
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发表时间：
2015-11-01
期刊：
影响因子：
16.2
通讯作者：
Salas-Salvado, Jordi
中科院分区：
文献类型：
--
作者：
Diaz-Lopez, Andres;Babio, Nancy;Salas-Salvado, Jordi
迄今为止，还没有临床试验评估饮食模式对糖尿病微血管并发症发生率的作用。研究设计和方法这是一项对参与地中海饮食预防的2型糖尿病患者队列的事后分析，（PREDIMED）研究，一项在心血管高危人群中进行的多中心随机营养干预试验。入组时没有微血管并发症的2型糖尿病患者（n = 3，614，年龄55-80岁）被随机分配到三种饮食干预措施之一：补充特级初榨橄榄油的MedDiet（MedDiet+EVOO）、补充混合坚果的Med Diet（MedDiet+Nuts）或低脂对照饮食。考虑两个独立的结局：新发糖尿病视网膜病变和肾病。采用多变量校正的考克斯回归计算风险比（HR）。在中位随访6.0年期间，我们发现了74例视网膜病变和168例肾病。与对照饮食相比，MedDiet+EVOO和MedDiet+Nuts的糖尿病视网膜病变的多变量校正HR分别为0.56（95% CI 0.32-0.97）和0.63（0.35-1.11）。未发现肾病的组间差异。当考虑每年更新的关于坚持中等饮食的信息时，最高与最低五分位数中视网膜病变的HR为0.34（0.13-0.89;趋势P = 0.001）。没有显着的协会被发现nephropathy.CONCLUSIONSA Med饮食富含EVOO可以防止糖尿病视网膜病变，但没有糖尿病肾病。
OBJECTIVETo date no clinical trials have evaluated the role of dietary patterns on the incidence of microvascular diabetes complications. We hypothesized that a nutritional intervention based on the Mediterranean diet (MedDiet) would have greater protective effect on diabetic retinopathy and nephropathy than a low-fat control diet.RESEARCH DESIGN AND METHODSThis was a post hoc analysis of a cohort of patients with type 2 diabetes participating in the PREvencion con Dleta MEDiterranea (PREDIMED) study, a multicenter randomized nutritional intervention trial conducted in a population at high cardiovascular risk. Individuals with type 2 diabetes who were free of microvascular complications at enrollment (n = 3,614, aged 55-80 years) were randomly assigned to one of three dietary interventions: MedDiet supplemented with extravirgin olive oil (MedDiet+EVOO), Med Diet supplemented with mixed nuts (MedDiet+Nuts), or a low-fat control diet. Two independent outcomes were considered: new onset of diabetic retinopathy and nephropathy. Hazard ratios (HRs) were calculated using multivariable-adjusted Cox regression.RESULTSDuring a median follow-up of 6.0 years, we identified 74 new cases of retinopathy and 168 of nephropathy. Compared with the control diet, multivariable-adjusted HRs for diabetic retinopathy were 0.56 (95% CI 0.32-0.97) for the MedDiet+EVOO and 0.63 (0.35-1.11) for the MedDiet+Nuts. No between-group differences were found for nephropathy. When the yearly updated information on adherence to the Med Diet was considered, the HR for retinopathy in the highest versus the lowest quintile was 0.34 (0.13-0.89; P = 0.001 for trend). No significant associations were found for nephropathy.CONCLUSIONSA Med Diet enriched with EVOO may protect against diabetic retinopathy but not diabetic nephropathy.