Dietary patterns and risk factors for type 2 diabetes mellitus in Fijian, Japanese and Vietnamese populations

Diabetes mellitus is now a serious and increasing problem in Asian countries, where dietary patterns have shifted toward Westernized foods and people are becoming more sedentary. In order to elucidate the relationship of dietary habits to the development of diabetic risk factors, the dietary patterns of 200 Fijian, 171 Japanese and 181 Vietnamese women of 30-39 years of age were investigated using 3 day-24 h recall or dietary records. Anthropometric measurements and glycosuria tests were also conducted. The dietary trends of Fijians and Japanese have changed drastically in the past 50 years, while Vietnamese have been minimally influenced by Western dietary habits. The mean 24 h dietary intake showed that Fijians had the highest energy intake. Energy intake from fat was only 13% for Vietnamese, but over 30% for Japanese and Fijians. Percentage of body fat was higher in Vietnamese than in Japanese, though there were no significant differences in body mass index (BMI). In the overweight and obese women, Vietnamese had higher abdominal obesity than Japanese. The prevalence of obesity (BMI > or = 30 kg/m2) was 63.0% for Fijians, 1.8% for Japanese and 1.1% for Vietnamese. Glycosuria testing yielded the most positive cases among Fijians. Dietary transition and dietary excess appear to be potential risk factors for diabetes in Fijian women.     

2型糖尿病合并肥胖患者膳食结构及肠道菌群结构的差异性

目的 观察2型糖尿病（type 2 diabetes mellitus,T2DM）合并肥胖患者膳食结构及肠道菌群结构与健康人群的差异,为T2DM合并肥胖患者通过营养治疗重建肠道菌群提供依据。 方法 选取32例新诊断为T2DM合并肥胖的患者及32例健康人员分别作为观察组和对照组。收集两组研究对象1年内的食物摄入情况并运用主成分分析法比较2组人群膳食结构差异,同时采集粪便提取DNA后使用Illumina MiSeq高通量测序平台分析两组研究对象肠道菌群的结构和丰度差异。 结果 膳食结构方面,观察组的主要膳食结构特点是油脂摄入较多蔬菜摄入较少,而健康对照组则是一种主食、蔬菜、优质蛋白比例较均衡的膳食模式。肠道菌群分析结果：观察组粪便样本中菌群多样性降低,菌属Welch's t检验发现与膳食纤维消化相关的瘤胃球菌属（P < 0.001,FDR=0.037）、豆类消化相关的梭菌属（P < 0.001,FDR=0.014）及短链脂肪酸产生相关的布劳特菌属（P=0.042,FDR=0.049）丰度较健康人群降低。 结论 膳食结构不均衡及膳食纤维摄入不足可能通过影响肠道菌群的结构和丰度从而与T2DM合并肥胖的发生相关,提示T2DM合并肥胖组人群的营养治疗应重视膳食结构平衡和膳食纤维的补充。     

2型糖尿病危险因素分析

目的 探讨重庆市城市社区人群2型糖尿病的主要危险因素，为城市社区人群制定适宜的预防和干预措施提供科学依据。方法 在重庆市城市社区人群2型糖尿病流行病学调查的基础上，采用频数匹配的病例对照研究方法，对研究因素进行单因素和多因素非条件Logistic回归分析。结果 糖尿病家族史、收缩压升高、腰臀比值大、高甘油三酯是2型糖尿病的主要危险因素。结论 在社区人群中，倡导健康合理的膳食习惯，控制血压、体重是预防2型糖尿病发生的重要措施。     

上海市松江地区40岁及以上居民膳食模式对2型糖尿病患病影响的研究

目的 探索上海市松江地区 ≥ 40岁居民的膳食模式与2型糖尿病的关联及作用模式。方法 使用上海市"高峰计划"松江人群队列基线调查得到的资料进行分析,选择符合纳入排除标准的2型糖尿病患者作为病例组,并根据性别、年龄和饮酒情况匹配非糖尿病患者作为对照组;采用因子分析确立研究人群的膳食模式;采用条件logistic回归模型探索不同膳食模式以及膳食模式之间的相乘交互作用与2型糖尿病之间的联系。结果 经因子分析,本研究得到6种膳食模式,分别为肉类模式、甜品杂粮模式、调味品蛋类模式、饮料模式、谷薯类模式和水果蔬菜模式。经单因素和多因素条件logistic回归分析,肉类模式和甜品杂粮模式与2型糖尿病的相关性无统计学意义,而调味品蛋类模式(OR=0.543,95%CI:0.377~0.781)、饮料模式(OR=0.590,95%CI:0.409~0.852)、谷薯类模式(OR=0.592,95%CI:0.414~0.848)和水果蔬菜模式(OR=0.604,95%CI:0.417~0.876)与2型糖尿病的发病风险降低有关。分析膳食模式两两之间的相乘交互作用之后,有3个交互项与2型糖尿病的联系有统计学意义:肉类模式与调味品蛋类模式的相乘交互项与2型糖尿病的发病风险升高有关;谷薯类模式与肉类模式、谷薯类模式与水果蔬菜模式的相乘交互项与2型糖尿病发病风险降低有关。结论 6种膳食模式中谷薯类模式和水果蔬菜模式可能具有预防2型糖尿病的意义。此外,以谷类、薯类为主,搭配适量肉类,减少调味品摄入的膳食模式对降低2型糖尿病的患病风险可能也有积极作用。     

Nutritional risk and metabolic syndrome in Korean type 2 diabetes mellitus

The prevalence of diabetes mellitus (DM) and the metabolic syndrome (MetS) are rapidly increasing in Asia including Korea. In 2005, the Third Korea National Health and Nutrition examination survey (KNHANES III) reported that the prevalence of DM and MetS in adults was estimated to be 8.7% and 32.6%, respectively. In our study of 688 type 2 DM patients, MetS prevalence was 46.9% for males, and 65.1% for females. Patients with T2DM and MetS showed significantly higher insulin resistance than T2DM without MetS, confirming that insulin resistance is an important feature of MetS in T2DM patients. Patients with T2DM and MetS showed higher BMI, waist circumference, blood triglycerides, atherogenic index, C-reactive protein and lower HDL-cholesterol. In recent years, concerns with regard to the association of diet with MetS have grown. In our study with non-DM elderly people, higher % energy from carbohydrate, and lower intakes of antioxidant vitamins were considered to be associated with the risk of MetS. Patients with T2DM and MetS showed significant positive correlations between intakes of energy, carbohydrate, protein and lipids with BMI, weight, as well as waist circumference. These associations were not found in patients with T2DM without MetS. Nutritional risk factors for MetS among middle-aged T2DM subjects would be excessive carbohydrate intake with low intakes of fat, protein, vitamins, and minerals.     

Menstrual patterns and risk of adult-onset diabetes mellitus

We examined the association between menstrual patterns and risk of developing adult-onset diabetes in a prospective study of 668 white, college-educated women who completed menstrual diaries throughout their reproductive years. We calculated summary measures of cycle length and variability and bleeding duration for ages < or = 22, 23-27, 28-32, and 33-37 years. The analysis included 35,418 person-years of follow-up and 49 self-reported cases of diabetes (median age at diagnosis, 63 years). There was no association between diabetes risk and age at menarche, mean cycle length, cycle variability, or frequency of long cycles (> 42 days). Longer bleeding periods in the mid- and late reproductive years were somewhat associated with an increased risk of diabetes (adjusted rate ratio 1.4, 95% confidence interval 1.0-1.8 per day increase in bleeding duration for menses during ages 28-32). These results do not support the association of long or irregular menstrual cycles with post-menopausal diabetes incidence, but do suggest a possible association of longer bleeding duration with subsequent onset of diabetes.     

Coffee consumption and the decreased risk of diabetes mellitus type 2

Coffee is among the most commonly consumed beverages in The Netherlands. Caffeine can acutely lower insulin sensitivity, but it is not clear whether tolerance for this effect develops after long-term regular intake. Furthermore, it is plausible that the effects of coffee are different from those of caffeine. Coffee contains hundreds of substances and there are indications that certain components may partly counter-act the effect of caffeine or may have independent beneficial effects. Intake of the coffee components chlorogenic acid, quinides, lignans, and trigonelline improved glucose metabolism in animal studies. Habitual coffee consumption has been studied in relation to the risk of diabetes mellitus type 2 in 12 cohort studies in Europe, the USA, and Japan. Generally, high coffee consumption was associated with a substantially lower risk of type-2 diabetes. The findings were similar for caffeinated and decaffeinated coffee, suggesting that the non-caffeine components of coffee may be responsible. Identification of these coffee components may lead to the development or selection of coffee types with improved effects on health.     

Soy intake and risk of type 2 diabetes mellitus in Chinese Singaporeans

Purpose

To examine the association between soy products and their components, isoflavones and protein, and incident type 2 diabetes in a population with varied soy intake and high rates of diabetes.

Methods

We used data from the Singapore Chinese Health Study, including 43,176 Chinese men and women aged 45–74?years, free of chronic disease at baseline (1993–1998) and followed through 2004. Intake of individual soy items, total unsweetened soy, and soy components was assessed by food-frequency questionnaire and examined with type 2 diabetes risk using Cox regression.

Results

During an average follow-up of 5.7?years, 2,252 of the 43,176 participants included in the current analyses developed diabetes. After adjustment for potential confounders and BMI, consumption of unsweetened soy was inversely associated with diabetes risk. Hazard ratios (HRs) and 95% CI for diabetes across unsweetened soy intake categories (none, 1–4/month, 1–2/week, 3–4/week, ≥5/week) were: 1 (referent), 0.81 (0.67–0.97), 0.76 (0.63–0.91), 0.76 (0.63–0.92), and 0.72 (0.59–0.89), respectively (P _trend?=?0.015). Conversely, in multivariate models, consuming sweetened soybean drink was positively associated with diabetes risk. HRs for diabetes across soybean drink intake categories (none, 1–3/month, 1/week, ≥2/week) were: 1 (referent), 1.07 (0.95–1.20), 1.12 (1.00–1.26), and 1.13 (1.00–1.28), respectively (P _trend?=?0.03). Furthermore, after full adjustment, including adjustment for sweetened soy items, we observed a marginally significant inverse association between isoflavone intake and diabetes (HR for the fifth compared to the first quintile: 0.76; 95% CI: 0.58–1.00; P _trend?=?0.08).

Conclusions

The current findings support a protective role for unsweetened soy foods and isoflavones on risk of type 2 diabetes.     

2型糖尿病家系危险因素Logistic回归分析

目的研究家系人群中2型糖尿病(T2DM)的危险因素，为制定干预措施提供依据。方法利用葡萄糖耐量试验(OGTT)、PCR-RFLP和免疫法排除其他类型后确定了115个2型糖尿病家系，通过问卷调查和实验室检查收集危险因素的情况，并采用Logistic回归分析方法对新老2型糖尿病患者和糖耐量低减(IGT)患者危险因素进行分析。结果糖尿病患者的多因素分析显示，T2DM患者的年龄(OR=1．043，95％CI 1．024～1．062)、高血脂史(OR=4．471。95％CI 2．149～9．303)、高血压史(OR=2．075，95％CI 1．001～4．301)和腰臀比超标(OR=1．809，95％CI 1．00～4．301)是独立的危险因素，而新诊断患者仅高血压史(OR=6．068，95％ CI 1．697～21．689)是独立的危险因素，IGT患者的年龄(OR=1．398，95％CI～1．138～1．717)是危险因素。结论在本研究人群中，高血压、年龄、中心性肥胖可能是2型糖尿病的危险因素。     

老年2型糖尿病患者隐匿性肺部感染病原学及其危险因素

目的分析老年2型糖尿病患者隐匿性肺部感染现状及其危险因素。方法选取2017年1月-2019年12月杭州师范大学附属医院收治的2型糖尿病合并社区获得性肺部感染老年患者286例,根据肺部感染的隐匿性分为隐匿性肺炎组134例和非隐匿性肺炎组152例,回顾性分析患者临床病历资料,总结老年糖尿病患者合并隐匿性肺炎的感染特点,采用单因素及多因素Logistic回归分析其危险因素。结果 134例隐匿性肺炎组患者病原菌培养阳性110例,阳性率为82.09%,共检出病原菌157株;152例非隐匿性肺炎组病原菌培养阳性者有135例,阳性率为88.82%,共检出病原菌183株;两组患者病原菌培养阳性率比较差异无统计学意义(χ²=2.264,P>0.05);阳性患者检出病原菌分布比较差异无统计学意义(χ²=2.473,P>0.05);两组治疗情况大致相似,隐匿组肺炎组患者住院时间和病死率均高于非隐匿性肺炎组(P<0.05);两组年龄、合并老年痴呆、甲状腺功能减退、实验室指标[白细胞计数(WBC)、降钙素原(PCT)、血清白蛋白(ALB)水平]及长时间卧床情况比较,差异有统计学意义(P<0.05);多因素Logistic回归发现,高龄(OR=1.984)、合并症[甲状腺功能减退(OR=1.511)、老年痴呆(OR=1.470)]及长时间卧床(OR=1.267)是老年糖尿病患者出现隐匿性肺炎的独立危险因素(P<0.05)。结论老年糖尿病患者合并肺部感染常具有隐匿性,病原菌以革兰阴性菌为主,预后情况较差,其中高龄、合并症(老年痴呆、甲状腺功能减退)及长时间卧床是患者出现隐匿性肺炎的独立危险因素。     

孕早期膳食模式与妊娠期糖尿病的关联研究

目的 探讨孕早期不同膳食模式与妊娠期糖尿病(GDM)发生风险的关系以及在不同营养补充剂使用情况下二者的关联。方法 采用前瞻性出生队列研究设计。纳入2018年1月至2021年9月在西南地区15所妇幼保健院建卡的7 546名孕妇作为研究对象。收集研究对象社会人口学信息、膳食记录信息、营养补充剂使用情况以及口服葡萄糖耐量试验(OGTT)数据。采用主成分分析法提取膳食模式,并利用logistic回归模型探索孕早期膳食模式与GDM发生风险间的关系。结果 本研究提取了3种膳食模式,发现“综合型膳食模式”(OR=0.57,95%CI:0.41～0.78)和“高植物蛋白型膳食模式”(OR=0.65,95%CI:0.50～0.85)与GDM发生风险降低有关,而“高动物蛋白型膳食模式”(OR=2.90,95%CI:2.11～4.01)与GDM发生风险增加有关。在不同孕早期营养补充剂使用情况下,高动物蛋白型膳食模式与GDM的发病风险均显著相关。结论 孕早期的膳食模式对GDM的发生产生影响。无论在孕早期是否使用营养补充剂,高动物蛋白型膳食模式均提高GDM的发病风险。应加强对孕妇的营养教育,指导其选择健康的食物...     

Dietary patterns,dietary intakes and the risk of type 2 diabetes: results from the Hefei Nutrition and Health Study

A total of 1776 Chinese adults, aged 40–60 years, had been recruited to participate in the Hefei Nutrition and Health Study started in 2012. Three major dietary patterns were identified, “High-salt and high-fat”, “Traditional Chinese” and “Western” dietary patterns. After adjusting for potential confounders, there is no significant difference in the effect of different dietary pattern quintiles on the risk of type 2 diabetes (T2D). However, compared with lowest quintile intakes, the adjusted odds ratio of T2D for highest quintile intakes of bread and noodle, rice noodle and coarse grain were 2.45 (95% CI: 1.17, 5.12), 0.34 (95% CI: 0.17, 0.92), 0.27 (95% CI: 0.14, 0.51), with corresponding p trend being .002, .375, .003, respectively. Our study suggests that high intakes of bread and noodle are significantly associated with increased risk of T2D, while high intakes of rice noodle and coarse grain are remarkably correlated with decreased risk of T2D.     

Systematic review of type 1 and type 2 diabetes mellitus and risk of fracture

The authors conducted a systematic review of published data on the association between diabetes mellitus and fracture. The authors searched MEDLINE through June 2006 and examined the reference lists of pertinent articles (limited to studies in humans). Summary relative risks and 95% confidence intervals were calculated with a random-effects model. The 16 eligible studies (two case-control studies and 14 cohort studies) included 836,941 participants and 139,531 incident cases of fracture. Type 2 diabetes was associated with an increased risk of hip fracture in both men (summary relative risk (RR) = 2.8, 95% confidence interval (CI): 1.2, 6.6) and women (summary RR = 2.1, 95% CI: 1.6, 2.7). Results were consistent between studies of men and women and between studies conducted in the United States and Europe. The association between type of diabetes and hip fracture incidence was stronger for type 1 diabetes (summary RR = 6.3, 95% CI: 2.6, 15.1) than for type 2 diabetes (summary RR = 1.7, 95% CI: 1.3, 2.2). Type 2 diabetes was weakly associated with fractures at other sites, and most effect estimates were not statistically significant. These findings strongly support an association between both type 1 and type 2 diabetes and increased risk of hip fracture in men and women.     

糖尿病肾病易患因素分析

[目的 ]探讨 2型糖尿病肾病 (DN )的易患因素。 [方法 ]以尿白蛋白排泄率 (UAER)作为糖尿病肾病的早期检测指标 ,对 3 3 9例 2型糖尿病进行筛查及病例分析。 [结果 ]糖尿病病程、腰围 /臀围、血压、血糖、胰岛素及血清甘油三脂、低密度脂蛋白 -胆固醇、脂蛋白 (a) [Lp(a) ]升高与糖尿病肾病发生有关。[结论 ]糖尿病肾病是多因素作用结果。     

Trends in adherence to dietary recommendations among Korean type 2 diabetes mellitus patients

BACKGROUND/OBJECTIVESThe current study examined trends in adherence to dietary recommendations and compared the levels of adherence between diagnosed and undiagnosed subjects with type 2 diabetes mellitus (T2DM) in Korea over the past 14 years.SUBJECTS/METHODSData were collected from the 1998-2012 Korea National Health and Nutrition Examination Surveys (KNHANES). Diagnosed diabetes was defined as giving a positive response to questions about awareness of the disease, a physician''s diagnosis of diabetes, or medical treatment for diabetes, whereas undiagnosed diabetes was defined as having a fasting glucose level ≥ 126 mg/dl. Assessment of adherence level was based on 6 components of dietary guidelines, considering meal patterns and intake levels of calories, carbohydrates, vegetable/seaweed, sodium, and alcohol. The participants received 1 point if they met the criteria for each of the 6 components, and the total possible score ranged from 0 to 6 points. Multivariate generalized linear regression was performed, taking into account the complex survey design.RESULTSAmong all diabetic patients aged 30 years or older, the proportion of diagnosed diabetes increased dramatically, from 40.9% in 1998 to 75.9% in 2012 (P for trend < 0.001). The overall adherence levels to dietary recommendations were low and did not significantly differ between diagnosed and undiagnosed subjects with T2DM for all survey years. Several improvements were observed, including increased adherence to maintaining sufficient vegetable/seaweed consumption (increased from 0.12 to 0.16 points) and limiting sodium intake (increased from 0.12-0.13 points to 0.19-0.24 points; P for trend < 0.001), while adherence to maintaining moderate alcohol consumption decreased.CONCLUSIONSAnalysis of data collected by the KNHANES indicates that Korean T2DM patients have poor adherence to dietary recommendations and maintenance of a healthy lifestyle, regardless of disease awareness. This finding suggests that development of practical, evidence-based guidelines is necessary and that provision and expansion of educational programs for T2DM patients is critical after diagnosis.     

地特胰岛素与瑞格列奈治疗老年2型糖尿病的体会

目的:探讨地特胰岛素+瑞格列奈在老年2型糖尿病中的应用价值.方法:选择老年2型糖尿病病患74例,采用数字抽签的方式将之随机等分成A、B两组.其中,A组联合应用地特胰岛素与瑞格列奈,B组应用预混胰岛素.观察两组用药后相关血糖指标的变化情况,比较低血糖发生率等指标.结果:A组治疗后的2hBG、MACE、FBG与HbAlc指标水平均明显优于B组(P<0.05).A组的低血糖发生率(2.7％)比B组(21.62％)更低(P<0.05).结论:积极对老年2型糖尿病病患施以地特胰岛素+瑞格列奈治疗,有助于促进其血糖水平的降低,提高用药安全性.