英国剑桥大学临床医学院Nita G Forouhi团队分析了水果蔬菜摄入的血浆生物标志物与2型糖尿病的相关性。该研究于2020年7月8日发表在《英国医学杂志》上。
为了探讨血浆维生素C和类胡萝卜素作为水果和蔬菜摄入量的指标，与2型糖尿病风险的关系，研究组进行了一项前瞻性病例队列研究。研究组在8个欧洲国家招募了9754名2型糖尿病参与者，以及13662名亚队列参与者。主要结局是2型糖尿病事件。
在多变量校正模型中，较高的血浆维生素C与较低的2型糖尿病风险相关。总类胡萝卜素显示出相似的负相关性。复合生物标志物评分（分为5个相等的组，由维生素C和单独类胡萝卜素组成）与2型糖尿病风险呈负相关，与第1组（最低组）相比，第2-5组的风险比分别为0.77、0.66、0.59和0.50。
复合生物标志物评分第1、3、5组参与者自我报告的水果蔬菜摄入量中值分别为274 g/天、396 g/天和508 g/天。复合生物标志物评分的一个标准偏差，相当于水果蔬菜摄入总量差66 g/天，风险比为0.75。若在整个人口中实现该分析所包含的8个欧洲国家的特征，相当于每1000人年随访的绝对风险降低0.95。
研究结果表明，在不同的欧洲国家，血浆维生素C、类胡萝卜素及其复合生物标志物评分与2型糖尿病的发生呈负相关，适当地多吃水果蔬菜可帮助预防2型糖尿病的发展。
附：英文原文
Title: Association of plasma biomarkers of fruit and vegetable intake with incident type 2 diabetes: EPIC-InterAct case-cohort study in eight European countries
Author: Ju-Sheng Zheng, Stephen J Sharp, Fumiaki Imamura, Rajiv Chowdhury, Thomas E Gundersen, Marinka Steur, Ivonne Sluijs, Yvonne T van der Schouw, Antonio Agudo, Dagfinn Aune, Aurelio Barricarte, Heiner Boeing, María-Dolores Chirlaque, Miren Dorronsoro, Heinz Freisling, Douae El-Fatouhi, Paul W Franks, Guy Fagherazzi, Sara Grioni, Marc J Gunter, Cecilie Kyr, Verena Katzke, Tilman Kühn, Kay-Tee Khaw, Nasser Laouali, Giovanna Masala, Peter M Nilsson, Kim Overvad, Salvatore Panico, Keren Papier, J Ramón Quirós, Olov Rolandsson, Daniel Redondo-Sánchez, Fulvio Ricceri, Matthias B Schulze, Annemieke M W Spijkerman, Anne Tjnneland, Tammy Y N Tong, Rosario Tumino, Elisabete Weiderpass, John Danesh, Adam S Butterworth, Elio Riboli, Nita G Forouhi, Nicholas J Wareham
Issue&Volume: 2020/07/08
Abstract: Objective To investigate the association of plasma vitamin C and carotenoids, as indicators of fruit and vegetable intake, with the risk of type 2 diabetes.
Design Prospective case-cohort study.
Setting Populations from eight European countries.
Participants 9754 participants with incident type 2 diabetes, and a subcohort of 13662 individuals from the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort of 340 234 participants: EPIC-InterAct case-cohort study.
Main outcome measure Incident type 2 diabetes.
Results In a multivariable adjusted model, higher plasma vitamin C was associated with a lower risk of developing type 2 diabetes (hazard ratio per standard deviation 0.82, 95% confidence interval 0.76 to 0.89). A similar inverse association was shown for total carotenoids (hazard ratio per standard deviation 0.75, 0.68 to 0.82). A composite biomarker score (split into five equal groups), comprising vitamin C and individual carotenoids, was inversely associated with type 2 diabetes with hazard ratios 0.77, 0.66, 0.59, and 0.50 for groups 2-5 compared with group 1 (the lowest group). Self-reported median fruit and vegetable intake was 274 g/day, 396 g/day, and 508 g/day for participants in categories defined by groups 1, 3, and 5 of the composite biomarker score, respectively. One standard deviation difference in the composite biomarker score, equivalent to a 66 (95% confidence interval 61 to 71) g/day difference in total fruit and vegetable intake, was associated with a hazard ratio of 0.75 (0.67 to 0.83). This would be equivalent to an absolute risk reduction of 0.95 per 1000 person years of follow up if achieved across an entire population with the characteristics of the eight European countries included in this analysis.
Conclusions These findings indicate an inverse association between plasma vitamin C, carotenoids, and their composite biomarker score, and incident type 2 diabetes in different European countries. These biomarkers are objective indicators of fruit and vegetable consumption, and suggest that diets rich in even modestly higher fruit and vegetable consumption could help to prevent development of type 2 diabetes.
DOI: 10.1136/bmj.m2194
Source: https://www.bmj.com/content/370/bmj.m2194
BMJ-British Medical Journal:《英国医学杂志》，创刊于1840年。隶属于BMJ出版集团，最新IF：93.333
官方网址：http://www.bmj.com/
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本期文章：《英国医学杂志》：Online/在线发表
