Dietary Polyphenols, Urinary Biomarkers & Risk of Type 2 Diabetes

描述（由申请人提供）：本申请的目的是利用饮食摄入和尿液生物标志物的数据，前瞻性地评估饮食多酚与2型糖尿病风险的关系。关于饮食和2型糖尿病风险的研究主要集中在常量营养素、维生素和矿物质上。然而，近年来，越来越多的证据支持富含多酚的食物对葡萄糖代谢的有益作用，包括全谷物、咖啡、茶和黑巧克力。机制和动物研究表明，各种多酚具有抗氧化和植物雌激素特性，延迟肠道葡萄糖摄取，并影响胰岛素信号通路。然而，很少有研究调查多酚摄入量与2型糖尿病风险之间的关系。最近新的食品成分数据和准确的尿液生物标志物的可用性允许在大规模前瞻性研究中对多酚进行全面评估。护士健康研究（NHS） I和II是正在进行的前瞻性队列研究，有超过20万名参与者，他们收集了关于饮食、生活方式因素和疾病的极其详细的信息。在这些队列中，已经确定了6000多例2型糖尿病病例。从1997年到2001年，在48345名NHS参与者中收集了晨尿样本。在这些参与者中，我们将进行一项巢式病例对照研究，包括1060例2型糖尿病病例和1060例匹配的对照。我们建议研究：1)。尿中饮食多酚类生物标志物与2型糖尿病风险的关系我们将测量12种多酚类物质，包括肠木脂素、酚酸和类黄酮。2）. 多酚摄入与疾病生物标志物（性激素、炎症标志物、内皮功能障碍和胰岛素抵抗）的关系，可能介导2型糖尿病的发展。3）. 在全NHS队列中，摄入各类多酚与2型糖尿病风险的关系。使用生物标志物和膳食摄入量的方法是互补的，因为它们结合了生物利用度的变化或反映了摄入量本身的影响。这些定义明确的大型前瞻性队列，结合尿液样本和生物标志物的高通量测量，可获得饮食摄入的详细信息，为识别影响2型糖尿病风险的新型饮食因素提供了独特且极具成本效益的机会。公共卫生相关性：由于2型糖尿病是一种发病率迅速上升的严重慢性疾病，采取预防措施的重要性已得到广泛认可。拟议应用的结果可用于制定更有效的饮食建议，并改变食物成分，以有助于预防2型糖尿病。

DESCRIPTION (provided by applicant): The aim of this application is to prospectively evaluate dietary polyphenols in relation to risk of type 2 diabetes using data on dietary intakes as well as urinary biomarkers. Studies of diet and risk of type 2 diabetes have focused on macronutrients, vitamins and minerals. In recent years, however, there has been mounting evidence in support of beneficial effects of polyphenols-rich foods including whole grains, coffee, tea, and dark chocolate on glucose metabolism. Mechanistic and animal studies have shown that various polyphenols have antioxidant and phytoestrogen properties, delay intestinal glucose uptake, and affect signaling insulin signaling pathways. However, few studies have examined polyphenol intakes in relation to risk of type 2 diabetes. The recent availability of new food composition data and accurate urinary biomarkers allows the comprehensive evaluation of polyphenols in large-scale prospective studies. The Nurses' Health Studies (NHS) I and II are ongoing prospective cohort studies with over 200,000 participants on whom extremely detailed information on diet, lifestyle factors, and diseases has been collected. In these cohorts, more than 6,000 incident cases of type 2 diabetes have been ascertained. Morning spot urine samples have been collected in 48,345 NHS participants between 1997 and 2001. Among these participants, we will conduct a nested case-control study including 1,060 incident type 2 diabetes cases and 1,060 matched controls. We propose to study: 1). Urinary biomarkers of dietary polyphenols in relation to risk of type 2 diabetes. We will measure twelve polyphenols including enterolignans, phenolic acids, and flavonoids. 2). Polyphenol intakes in relation to disease biomarkers (sex hormones, and markers of inflammation, endothelial dysfunction and insulin resistance) that may mediate effects on the development of type 2 diabetes. 3). Intakes of the various classes of polyphenols in relation to risk of type 2 diabetes in the full NHS cohorts. The approaches using biomarkers and dietary intakes are complementary as they incorporate variation in bioavailability or reflect the effects of intakes per se. These large well-defined prospective cohorts with availability of detailed information on dietary intake in combination with urine samples and high-throughput measurement of biomarkers provide a unique and extremely cost- effective opportunity to identify novel dietary factors affecting risk of type 2 diabetes. PUBLIC HEALTH RELEVANCE: Because type 2 diabetes is a serious and chronic disease with a rapidly increasing prevalence, the importance of preventative action is widely acknowledged. Findings of the proposed application can be used to develop more effective dietary advice and to make changes in food composition to contribute to the prevention of type 2 diabetes.